The perinatal period refers to the period from the 28th week of pregnancy to 7 days after the baby is born. Perinatal medicine is the study of diseases that can harm the fetus by pregnant women during the perinatal period, as well as the diseases of the fetus and the newborn. Early detection of diseases and early treatment can protect the health of pregnant women and reduce the mortality of fetuses and newborns in the perinatal period.
The mortality of fetuses and newborns in the perinatal period is about 11-25%. Hypoxia is the first cause of death, followed by congenital malformations and premature birth. Fetal hypoxia is clinically called fetal distress and is a common disease in obstetrics. Common neonatal diseases are neonatal appointments and neonatal sepsis. The occurrence of these diseases in newborns is closely related to hypoxia.
Fetal distress refers to the lack of oxygen in the mother's body. Fetal hypoxia can be chronic or acute. There are many reasons for fetal hypoxia, mainly as follows:
1. Some pregnant women suffer from chronic diseases such as the heart, lungs, and kidneys. Due to pregnancy, the burden on the heart, lungs, and kidneys is increased, and sometimes heart failure or anemia may occur. Due to the pregnant woman's own ischemia and hypoxia, the fetus is ischemia and hypoxia, which affects the development of the fetus.
⒉ Hemolysis of the fetus caused by the incompatibility of the blood types of mother and child. In severe cases (due to the large amount of fetal hemolysis), the fetus may die in utero.
3. Poor function of the placenta. Especially in the third trimester of pregnancy, the placenta does not function well, and nutrients and oxygen cannot penetrate into the fetus, causing malnutrition, ischemia, and hypoxia.
4. Acute fetal hypoxia is a phenomenon frequently encountered by pregnant women during childbirth. It is an acute intrauterine distress. The cause is mostly short, knotted, entangled, and prolapsed umbilical cord.
5. Maternal dystocia or prolonged labor, did not get timely treatment or improper treatment. Fetal distress is often overlooked, because pregnant women themselves do not have obvious subjective feelings, and only the prenatal examination will find that the fetal heart rate slows down or speeds up (ie slower than 120 beats/min, or faster than 160 beats/min) , Fetal movement is reduced (less than 10 times in 24 hours). Intrauterine distress can cause miscarriage, premature delivery, and intrauterine death. Even if the labor is short and the delivery goes smoothly, the hypoxia of the fetus will damage the brain of the fetus, which may cause the fetus to be mentally retarded, slow to respond, dumb, and even become disabled for life.
Since fetal distress is difficult to find and there is no medicine to treat it, we can only do more work on prevention and oxygen therapy. Prevention methods focus on the following points:
1. Women with chronic heart, lung, and kidney diseases should not rush into pregnancy. Because as the fetus continues to grow, the required nutrients are also increasing, which is bound to increase the burden on the heart, lungs, brain, kidneys and other organs of pregnant women. If some organs of pregnant women are not healthy enough to meet the needs of themselves and the fetus at the same time, the mild ones will cause malnutrition of the fetus, and the severe ones will lead to stillbirth and teratogenesis. There are also fetuses with hypoxia and mental retardation after birth, or other serious consequences.
2. Pregnant women who have had a history of miscarriage, stillbirth, or severe jaundice in the past, especially after checking the blood type of their parents and found that it may cause hemolysis of the newborn, they should go to the hospital for serum immune antibody titers on a regular basis. Once a month during the 6th month of pregnancy, once every half month for 7-8 months, and once a week after 8 months, in order to detect and prevent the harm of hemolysis to the fetus as soon as possible.
3. For various degrees of fetal distress in utero, pregnant women should be supplemented with oxygen. After a pregnant woman inhales oxygen, her blood oxygen concentration increases, and the increased oxygen can bring oxygen to the fetus through the placental blood flow. For pregnant women with heart, lung, kidney and other diseases, inhale oxygen for 1 to 2 hours a day at a flow rate of 1 to 2 The liter/min is appropriate to avoid organ failure, interrupt the process of hypoxia and fetal hypoxia, and prolong the growth time of the fetus in the mother to ensure the maturity of the fetus. For pregnant women with severe fetal distress, hyperbaric oxygen therapy can be performed if possible.