Cord blood circulation disorder

Introduction Umbilical cord blood circulation disorder is one of the clinical causes of fetal distress. Fetal distress refers to the combination of fetal health and life in the uterus due to acute or chronic hypoxia. Due to abnormal umbilical cord, placenta previa, placental abruption, excessive uterine contractions, prolonged labor, shock or severe preeclampsia, chronic nephritis. The clinical manifestation was the change of fetal heart rate, and the fetal heart rate was >160 beats/min in the early stage of hypoxia. In the absence of fetal movement and contractions, fetal heart rate > 180 beats / min. When the fetal movement is abnormal, the fetal movement is frequent at the initial stage of hypoxia, and then decreases and the number of times decreases, eventually disappearing. Fetal scalp blood pH 60mmHg (normal value 35 ~ 55mmHg) during acidosis.

Cause

1. Acute hypoxia in the fetus, blood oxygen transport and exchange disorders or cord blood circulation disorders:

1 placenta previa, placenta premature peeling. 2 abnormal umbilical cord, such as the umbilical cord around the neck, the umbilical cord is true. 3 pregnant women shocked. 4 improper use of oxytocin caused excessive and uncoordinated contractions. 5 pregnant women use anesthetics and sedatives to suppress breathing.

2. Fetal chronic hypoxia

1 maternal blood oxygen deficiency, such as heart failure, severe anemia.

2 uterine placental blood perfusion, such as severe pre-eclampsia expired pregnancy.

3 fetal severe cardiovascular disease, respiratory diseases, fetal transport and decreased oxygen utilization capacity.

an examination

Related inspection

Ratio of systolic blood pressure to diastolic blood pressure in fetal umbilical arteries

Clinical manifestation and diagnosis

Acute fetal distress occurs mainly during childbirth. Due to abnormal umbilical cord, placenta previa, placental abruption, excessive uterine contractions, prolonged labor and shock.

(1) Changes in fetal heart rate: an important sign of acute fetal distress. The fetal heart rate was >160 beats/min in the early stage of hypoxia.

(2) Amniotic fluid meconium contamination: amniotic fluid pollution is divided into 3 degrees: I degree light green, common fetal chronic hypoxia. II degree dark green or yellow-green, suggesting acute hypoxia in the fetus. Grade III is brownish yellow and thick, suggesting that the fetus is severely deprived of oxygen.

(3) Abnormal fetal movement: In the early stage of hypoxia, the fetal movement was frequent, then weakened and the number of times decreased, and eventually disappeared.

(4) Acidosis: Fetal scalp blood pH60mmHg (normal value 35 ~ 55mmHg), can diagnose fetal acidosis.

Differential diagnosis

Mainly based on fetal monitoring, amniotic fluid fecal pollution to determine the degree of fetal hypoxia. Take measures to determine the treatment method to ensure the safety of mother and child.

Chronic fetal distress mainly occurs in the end of pregnancy, often extending to labor and aggravation. Due to severe pre-eclampsia, chronic nephritis and so on.

(1) Fetal movement is reduced or disappeared.

(2) abnormal fetal heart rate: 1 in the absence of fetal movement and contractions, fetal heart rate > 180 beats / min.

(3) Fetal biophysical score: 3 points suggest fetal distress, 4 to 7 is divided into fetal suspected hypoxia.

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