IMR Press / CEOG / Volume 51 / Issue 2 / DOI: 10.31083/j.ceog5102033
Open Access Review
Low Fetal Resistance to Hypoxia as a Cause of Stillbirth and Neonatal Encephalopathy
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1 Department of Psychopharmacology, Institute of Experimental Medicine, 197376 Saint Petersburg, Russia
2 Department of Pharmacology with a Course of Сlinical Pharmacology, Bashkir State Medical University, 450008 Ufa, Bashkortostan, Russia
3 Department of Obstetrics and Gynecology, Izhevsk State Medical Academy, 426034 Izhevsk, Udmurt Republic, Russia
4 Department of Experimental and Clinical Research and Inventive, Institute of Thermology, 426054 Izhevsk, Udmurt Republic, Russia
*Correspondence: avsamorodov@gmail.com (Aleksandr Samorodov)
Clin. Exp. Obstet. Gynecol. 2024, 51(2), 33; https://doi.org/10.31083/j.ceog5102033
Submitted: 29 August 2023 | Revised: 23 November 2023 | Accepted: 6 December 2023 | Published: 4 February 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Objective: Low fetal resistance to hypoxia is a factor in stillbirth and neonatal encephalopathy. This review examines fetal movement patterns in response to hypoxia as a predictor of the likelihood of stillbirth. Monitoring the dynamics of fetal movements during maternal apnea could allow the assessment of fetal resistance to hypoxia. The goal of this study is to describe the practical application of this method by doctors and pregnant women. Mechanism: We searched relevant keywords in the international scientific literature databases Scopus and Web of Science, as well as databases for patents granted in China, India, USA, Japan, Germany, Russia and other countries. Devices, drugs and medical technologies that provide diagnosis, modeling, prevention and treatment of intrauterine fetal hypoxia, stillbirth and neonatal encephalopathy were considered. Findings in Brief: During apnea by a pregnant woman in the second half of normal pregnancy, if the maximum duration of fetal immobility exceeds 30 seconds from the onset of breath-holding, then the fetus is considered to show good resistance to hypoxia, thus preserving its health and life during vaginal delivery. On the other hand, excessive fetal movements <10 seconds after the onset of apnea in a pregnant woman indicates low fetal resistance to hypoxia. When fetal resistance to hypoxia is low, there is no alternative to immediate cesarean section for the preservation of fetal life and health. Conclusions: The monitoring of fetal movements during apnea in pregnant women allows real-time assessment of fetal resistance to intrauterine hypoxia. Obtaining timely information on fetal resistance to hypoxia is critical for determining the optimal timing and type of delivery in order to prevent encephalopathy and stillbirth.

Keywords
fetal movement
hypoxia
resistance
reserves
stillbirth
Funding
PRIORITY-2030/Bashkir State Medical University Strategic Academic Leadership Program
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