Базові аспекти оцінювання стану плода і прогнозування здоров’я новонародженого

Abstract

Negative processes in modern society - economic and environmental crisis, psycho-emotional tension due to military confrontation, migration, deformation of the family value system – cause changes in medical and social «portrait» of pregnant women, and therefore adversely affect the fetus. This should motivate the modern physician to improve the professional level of clinical informative instrumental methods of assessing the condition of the fetus when choosing a method of delivery, the correct use of modern methods of fetal monitoring, based on skills development, error assessment, updating knowledge of pathophysiology of fetal oxygen supply. Perinatal encephalopathy due to hypoxic-ischemic lesions of the nervous system plays a leading role in the development of disorders of neonatal adaptation, neurological morbidity and disability of newborns. The article schematically presents modern ideas about the triggers of fetal hypoxia in physiological childbirth, as well as in pathological conditions with impaired gas exchange between mother and fetus. The main vectors for assessing the condition of the fetus during full-term pregnancy are determined: registration of cardiac activity, identification of patterns of pathological condition of the nervous system, identification of the consequences of fetoplacental vascular disorders, determination of oxygen markers. The actual data and basic aspects of the use of modern technologies for assessing the condition of the fetus are given: cardiotocography (CTG), electrocardiography of the fetus, blood samples from the present head. Particular attention is paid to the CPC as the «gold standard» for assessing the condition of the fetus. The main points of the computer system of CTG Dawes–Redman are covered. Emphasis is placed on the need for a modern physician to have a visual assessment of CTG samples. Information on invasive technologies used to identify the state of gas exchange in the fetus is presented. The role of regular training of medical staff on technologies of intranatal assessment of fetal condition using the classification criteria of CTG and FIGO recommendations is emphasized, which is a necessary condition for achieving positive results in perinatal care of the fetus. Keywords: fetal condition, intranatal evaluation, hypoxemia, cardiotocography, lactate.