No woman can be sure that her pregnancy will proceed without complications, especially if she suffers from any diseases. The state of the fetus can be affected by various factors that can harm it. Therefore, it is extremely important to monitor your he alth and try to protect yourself from the influence of harmful conditions. Especially these points concern those women who have various disorders in the body.
Women diagnosed with diabetes and dreaming of having a baby should know that in this case a great responsibility lies on their shoulders, since such a disease can lead to various complications in the baby. One of them is fetal fetopathy.
Features of the disease
Diabetic fetopathy is a serious fetal disease that occurs when a pregnant woman has prediabetes or diabetes mellitus when the glucose level is higher than normal. This pathology is characterized by a change in the state of the fetus and a violation of the functioning of its pancreas, kidneys, macro- and microvascularsystem.
If a pregnant woman has such a diagnosis as "fetal fetopathy" in the anamnesis, then most often the doctor decides to perform an operative delivery.
Favorable course of pregnancy in a woman with diabetes depends on numerous factors. These include: the type of disease, the existing complications, the drugs taken to treat the pathology. You can not be afraid of any harmful consequences if throughout the pregnancy the level of glycemia did not rise above a critical value.
If this disease is not compensated, then diabetes mellitus of pregnant women most negatively affects the development of the fetus and the gestation period. Doctors usually give birth to a woman in advance in order to save her life and the child. With such a disease, the ultrastructure of the placental barrier changes, as a result of which it ceases to function normally and deliver everything necessary to the fetus. Doctors in this case often diagnose "capillary hyperplasia". The baby gains a lot of weight in utero, but develops poorly.
Signs
Diabetes during pregnancy causes a newborn to be born with the following signs of the disease:
- large body weight (usually over 4 kg);
- spot subcutaneous hemorrhages on the skin;
- swelling of soft tissues and skin;
- big belly due to highly developed subcutaneous fat;
- short limbs;
- reddish-blue skin tone;
- too muchcheese skin lubricant;
- broad shoulders.
Symptoms
Fetopathy of the newborn is manifested as follows:
- breathing disorder, which is due to a lack of synthesis of a specific substance in the lungs (surfactant), which helps them deal with the first breath;
- probable shortness of breath and even respiratory arrest immediately after birth;
- jaundice, which is considered a sign of a pathological change in the liver, which requires the necessary treatment;
- neurological disorders: decreased muscle tone, inhibition of the sucking reflex, alternating decreased activity with hyperexcitability.
Reasons
Fetopathy diabetic fetus develops due to unfavorable course of pregnancy, during which uncompensated type 1 and type 2 diabetes mellitus arose. In addition, the mother's disease of gestational diabetes is the cause.
Excess maternal blood glucose causes the fetal pancreas to produce too much insulin. Entering through the blood of the mother to the child, glucose in large quantities begins to be actively consumed. However, for the full development of the fetus, a certain amount of it is required, so the excess is converted into fat, and this leads to a large weight of the child.
If you do not normalize glycemia, then this can contribute to a strong build-up of fetal fatty tissue and will not allow the entire internal organ system to develop normally andbaby fabrics.
Diagnosis
To detect abnormalities in the fetus, the doctor prescribes the following procedures:
- ultrasound;
- study of the biophysical state of the fetus;
- doppler;
- KTG;
- assessment of biochemical markers of the fetoplacental system.
Ultrasound
The main method for determining any abnormalities in the fetus is ultrasound. Ultrasound is recommended at the following times if diabetes mellitus is diagnosed during pregnancy:
- In the first trimester - once.
- In the second trimester - also once between 24 and 26 weeks. This is necessary in order to identify various malformations of the central nervous, osteoarticular, genitourinary and cardiovascular systems, as well as the digestive organs.
- In the third trimester, ultrasound can be performed two or even three times. With insulin-dependent diabetes mellitus, such a study is carried out at 30-32 weeks, after which it is done once a week.
Signs of diabetic fetopathy on ultrasound in the fetus:
- too much weight for a specific time frame;
- body imbalance;
- double head contour;
- increased amount of water;
- double contour of the fetus due to a large amount of subcutaneous fat or soft tissue swelling;
- an echo-negative zone is noted in the region of the skull bones, which indicates edema.
Study of the biophysical state of the fetus
Thisexamination can reveal a violation in the morphofunctional development of the brain, which is considered the most severe manifestation of embryopathy. To find out, the doctor records the breath, heart rate and motor activity of the fetus for one and a half hours.
If there is a suspicion of fetopathy, then in this case the baby's sleep will be short, and most of the time he makes active movements. The duration of short sleep is no more than 50 minutes, during which there is a slowdown in heart rate and a decrease in heart rate.
Doppler testing
With the help of such a study, the following indicators are monitored:
- speed of contraction of myocardial fibers;
- cardiac output;
- left ventricular ejection time;
- systolic-diastolic ratio of arterial blood flow.
Dopplerometry is carried out at 30 weeks to assess the state of the central nervous system.
Carrying out cardiotocography with evaluation of functional tests
This procedure allows you to evaluate the heart rate at rest, during movement, during uterine contractions. Doctors conduct tests and during this time they take several samples.
Implementation of the assessment of biochemical markers of the fetoplacental system
To diagnose placental insufficiency, urine and blood tests are taken. With such a disease in the third trimester, diabetic fetopathy is manifested by a significant increase in ACE.
Treatment during pregnancy
Throughout a woman's pregnancyshould conduct self-monitoring of blood pressure and glycemia. If this is required, then insulin therapy is additionally prescribed. As a preventive measure, sugar should be examined every 3-4 hours daily. Glycemic levels are adjusted with glucose or insulin.
Diabetic fetopathy involves taking vitamins, following a special diet and other doctor's recommendations. Food should be rich in easily digestible carbohydrates, and fatty foods should be reduced.
Treatment during childbirth
First, with the help of ultrasound, the optimal date of delivery is determined. If the pregnancy is uncomplicated, then it is best to give birth to a woman at 37 weeks. If there is a threat to the life of the mother and child, then they do it at 36 weeks. Earlier medical abortions are usually performed only if there is an imminent threat to the life of the mother, and there is no longer any talk of saving the child.
During childbirth, doctors are required to monitor glycemia. With a strong drop in blood sugar, a woman will not have enough strength during contractions, since a lot of glucose is spent on uterine contractions. During or immediately after childbirth, there is a risk that the patient will fall into a hypoglycemic coma.
Prenatal diabetes involves short delivery. If they last more than 10 hours, then in this case, a caesarean section is performed, after which antibiotic treatment is prescribed.
Postpartum treatment
To prevent the development of hypoglycemia and further complications, throughsome time after birth, a 5% glucose solution is administered to the child. Every 2 hours it is necessary to give the newborn mother's milk, as this nutrient fluid can stop this condition.
The early neonatal period should proceed under the supervision of doctors who are required to monitor the child's breathing. In its absence, a ventilator is connected. In the presence of neurological disorders, solutions of calcium and magnesium help. If the child has signs of liver disease, when the whites of the eyes and the skin of the child become icteric, then the doctor prescribes sessions of ultraviolet irradiation in a strictly defined dose.
A woman after childbirth is reduced by 2-3 times the introduction of insulin, because the level of glucose in the blood drops sharply. By the time of discharge, the norm of glycemia is restored to normal values.
Complications
Diabetic fetopathy of the newborn can have the following consequences:
- neonatal hypoxia;
- a sharp drop in blood glucose to a critical level;
- acute heart failure;
- newborn diabetes;
- lack of magnesium and calcium, which negatively affects the functioning of the central nervous system;
- obesity.
Conclusion
Diabetic fetopathy, which develops in a fetus when its mother has diabetes mellitus, is a very unpleasant and dangerous disease. A woman must follow all the recommendations of a doctor during pregnancy and keep her blood glucose levels under control. Only in this case the consequences for the child will not be too deplorable.
