intrauterine asphyxia
Introduction
Introduction Intrauterine asphyxia refers to the lack of oxygen in the uterus or excessive gas or respiratory disorders, and difficulty breathing or even stopping breathing. Intrauterine asphyxia can occur during the labor process and can also occur during pregnancy. Occurrence in the process of labor can be the continuation and aggravation of the pregnancy. Neonatal asphyxia is the result of the failure of the fetal intrauterine asphyxia to be corrected before delivery. It is the most common neonatal crisis in obstetrics and the main cause of perinatal death. Intrauterine distress is a common cause of fetal perinatal death and neonatal nervous system sequelae, accounting for the first cause of perinatal death.
Cause
Cause
Abnormal fetal heart rate Normal fetal heart rate is 110~160 beats/min. When fetal hypoxemia, it can stimulate fetal adrenal gland to produce catecholamine, which is characterized by increased heart rate, fetal heart rate >160 beats / min, lasting 180 beats / min or more , indicating that the fetus has intrauterine distress. If acidosis continues to worsen, myocardial contractility decreases and fetal heart rate slows down to less than 110 beats per minute. Fetal movement abnormal fetal movement is an indirect method for monitoring the integrity and functional status of the fetal central nervous system, but it is related to the cognitive ability of the pregnant woman. Under normal circumstances, the fetal movement count in the third trimester should be 3 to 5 times an hour. Because the standard of fetal movement is too small, there is no clear boundary between fetal movement and frequency. There is a certain difficulty in accurate counting of pregnant women. Single fetal movement abnormality can not be used as a diagnostic standard for fetal distress, but it should be paid attention to.
Examine
an examination
Related inspection
Fetal heart monitoring oxytocin challenge test obstetric B-hypergglutinin test for fetal umbilical artery systolic pressure and diastolic blood pressure ratio
Pregnant women can be judged by the following methods:
1. Feel the fetal movement: Under normal circumstances, the number of fetal movements should be 3--5 times / hour. If the pregnant woman feels that the fetal movement is reduced, especially below 20 times / every 24 hours, and no recovery, should pay attention, quickly find a doctor.
2. Observe the color of amniotic fluid: After breaking the water, the amniotic fluid is cloudy and dark green. This is the result of fetal suffocation and hypoxia, and defecation contaminating amniotic fluid. At this time, the doctor should immediately ask the doctor for emergency treatment or cesarean section to quickly end the pregnancy.
Diagnosis
Differential diagnosis
1. Pulmonary hyaline membrane disease: premature infants are generally poor in general, dyspnea and bruising are progressively worse, the disease has a poor prognosis, lung maturity check and chest) X-ray examination have special changes
2. Aspiration pneumonia: Many history of asphyxia and inhalation history often cause shortness of breath after resuscitation, clinical symptoms are heavy, X-ray shows bronchial pneumonia changes with little interlobular and / or pleural effusion, the lesion disappears for a longer time.
3. Amniocentesis inhalation syndrome: The disease has a history of asphyxia or respiratory distress. After the resuscitation, the neonatal wet lung is normal at birth, and the late X-ray examination of respiratory distress is also helpful.
4. Cerebral hyperventilation: This is caused by cerebral edema, which is common in term infants with asphyxia and shortness of breath, but the prognosis of no signs in the lungs is related to the etiology.
