Fertilized egg in the middle section. What does a fertilized egg look like. A fertilized egg without an embryo. Dead fertilized egg

03.09.2019

Of course, one of the most beautiful life segments of a woman is carrying a baby and waiting for his birth. However, things don't always go smoothly.

Recently, the representatives of the weaker sex are increasingly faced with various problems associated with the reproductive system. One of the worst situations that a woman can face during pregnancy is without an embryo. This pathology, like any other disease, has its own causes, symptoms and various diagnostic methods. Such a defect must be subjected to medical correction, since it will not lead to the birth of a child, and the decomposition of a non-developing fetal egg in the uterine cavity can lead to serious complications and long-term treatment later.

Where does it all start

When a woman is planning a pregnancy, she cannot even imagine a fertilized egg without an embryo. However, often the representatives of the weaker sex have to deal with this problem.

The numerical values of the heart rate in an embryo during an uncomplicated pregnancy gradually increase from 110-130 beats / min at 6-8 weeks of pregnancy to 180 beats / min at 9-10 weeks.

The length of the embryo is measured from the head to the tail end, and is designated under the term KTP (coccygeal-parietal size), in Eng. literature - CRL (Crown-Rump Length). It should be noted that the coccygeal-parietal size of the embryo is less subject to individual fluctuations than the average inner diameter of the fetal egg, and therefore, its use to determine the gestational age gives better results. The error in this case usually does not exceed ±3 days. With a clear visualization of the embryo, the gestational age is set depending on its length, and not on the size of the average internal diameter of the ovum (MID).

For the correct measurement of the coccyx-parietal size of the embryo, its clear visualization is necessary. In this case, one should strive to measure the maximum length of the embryo from its head end to the coccyx.

In the normal course of pregnancy, the diameter of the fetal egg increases by 1 mm per day. Lower growth rates are a poor prognostic sign. With a gestational age of 6-7 weeks, the diameter of the fetal egg should be about 30 mm.

Table 1. The dependence of the gestational age on the average internal diameter of the fetal egg (Dv), M.N. Skvortsova, M.V. Medvedev.

Table 2. Normal values of the coccygeal-parietal size (KTP) depending on the gestational age (full weeks + days), data in millimeters, the lower limit is the 5th percentile, the upper limit is the 95th percentile.

It should be emphasized that it is best to determine the gestational age by the length of the CTE before 12 weeks of gestation. At a later date, measurement of the biparietal diameter, head and abdomen circumference should be used.

Fig.3Pregnancy 12 weeks 3 days.

The motor activity of the embryo is determined after 7 weeks of pregnancy. At first, these movements are very weak and isolated, hardly distinguishable during the study. Then, when differentiation into the head and pelvic ends of the embryo becomes possible, the movements resemble flexion and extension of the body, then separate movements of the limbs appear. Since the episodes of the motor activity of the embryo are very short and are calculated in seconds, and the periods of motor rest can be significant in time, the registration of the cardiac activity of the embryo is undoubtedly a more important criterion for assessing its vital activity.

The diagnosis of anembryony (empty gestational sac) is assumed if no yolk sac is detected in a 20 mm gestational sac. Or if a fetal egg with a diameter of more than 25 mm with a yolk sac does not contain an embryo. And also with a yolk sac size of 10 mm or more. In any case, if anembryony is suspected, all data obtained should be interpreted in favor of pregnancy, and the study should be repeated after 7 days.

The diagnosis of a non-developing pregnancy should not be made if the fetal egg is less than 20 mm in size on ultrasound. With an embryo length of 5 mm or more, in most cases, the heartbeat should be clearly defined. If the embryo is less than 5 mm, the ultrasound should be repeated in a week. If, upon re-examination a week later, with KTP = 5-6 mm, cardiac activity is not determined, the pregnancy is not viable. The diagnosis of non-developing pregnancy can be confirmed by the discrepancy between the level of beta-hCG and echographic data.

It should be noted that the frequency of termination of pregnancy in the norm in the population is 15-20% of all clinically diagnosed pregnancies. However, in reality, if we count all "chemically" diagnosed pregnancies, determined by the level of beta-hCG before the expected next period, the miscarriage rate can reach up to 60%.

Sincerely, doctor of ultrasound diagnostics, Barto Ruslan Alexandrovich, 2012

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Ultrasound in the first trimester of pregnancy

Observation in the antenatal clinic for a pregnant woman is carried out according to a certain scheme. What does it include and why do we need all these numerous examinations, analyzes and examinations?

Ultrasound has been used in obstetrics not so long ago - since the mid-1960s. And, despite this, today it is no longer possible to imagine an examination of a pregnant woman without ultrasound. During this time, doctors have accumulated vast practical experience in the application of this research method, ultrasound scanners have been repeatedly improved, three- and four-dimensional ultrasound has appeared, and most importantly, more than one generation of healthy children has grown up.

How does ultrasound work?

Ultrasound is called sound waves propagating in space with a high frequency (above 20 kHz). Sensors of ultrasonic scanners are both a source and a receiver of ultrasonic waves. An ultrasonic wave, passing through various tissues in the body, changes its speed and is reflected, all these changes are recorded and converted into an image on the monitor of the ultrasound scanner. Currently, when examining pregnant women, two types of sensors are used: transabdominal - TA (with the help of which the study is carried out through the anterior abdominal wall) and transvaginal - TV (the study is carried out through the vagina). In the first trimester, both types of sensors can be used, but transvaginal ultrasound is more informative, because the TV sensor is brought closer to the uterus and has a higher frequency of ultrasound waves, which gives a clearer image on the monitor of the ultrasound scanner. From the second trimester, transabdominal ultrasound is mainly used.

Ultrasound of pregnant women is performed three times - at 10-14 weeks, 20-24 and 30-34 weeks. If necessary, the obstetrician-gynecologist can prescribe an additional ultrasound, and even more than one.

Ultrasound examination of the fetus (ultrasound, echography) is the only sufficiently informative and safe research method that allows you to assess the development of pregnancy from the very beginning to delivery. The first visit to the ultrasound room will be for the expectant mother already at the beginning of pregnancy.

It is necessary to prepare for a transabdominal ultrasound - fill the bladder. To do this, you need to drink approximately 300-500 ml of liquid without gas 30 minutes before the study. You should take a clean diaper or towel with you to the examination. During the study, a special transparent gel without color and odor is applied to the abdomen and to the sensor. Transvaginal ultrasound does not require special preparation. It is only necessary to empty the bladder before the study. During the study, a special protective cover or condom is put on the sensor and a gel is applied.

The study lasts an average of 10-30 minutes. After that, the doctor fills out a special protocol, in which he records in detail all the results of the ultrasound.

In the first trimester of pregnancy, ultrasound is performed to:

establishing the localization (location) of the fetal egg (in the uterine cavity or outside it);
diagnosis of single or multiple pregnancy;
assessment of the size and growth, structure of the ovum and embryo;
assessment of the vital activity of the embryo or fetus;
studies of the structure of the embryo or fetus;
studies of extraembryonic structures (yolk sac, chorion, amnion);
diagnosis of pregnancy complications (threatening or incipient abortion, etc.);
diagnosis of diseases and malformations of the internal genital organs (uterine fibroids - a benign tumor of the uterus, cysts and tumors of the ovaries, bicornuate uterus, intrauterine septum, etc.).

Establishment of uterine pregnancy by ultrasound

With early diagnosis of pregnancy, a fetal egg on ultrasound is defined as a round or oval formation of a dark gray (almost black) color, located, as a rule, in the upper half of the uterine cavity. With multiple pregnancies in the earliest stages, you can see separately located two or more fetal eggs. Diagnosis of uterine pregnancy with TA-scan is possible at an obstetric period of 5-6 weeks, i.e. when the delay in menstruation with a regular menstrual cycle is 1 week or more. The average diameter of the fetal egg in these terms is approximately 5-7 mm. With transvaginal ultrasound, visualization of the fetal egg in the uterus is possible a little earlier - with a delay in menstruation by 3-6 days, which corresponds to 4-5 weeks of pregnancy. In this case, the size of the ovum is 2-4 mm. mbrion is determined from 5 weeks of pregnancy with a TV study and from 6 weeks with a TA as a white linear formation in the cavity of the fetal egg. At the same time or a little later, heartbeats can be determined.

Normally, in the presence of a regular menstrual cycle, it is necessary to determine the presence of an embryo in the fetal egg at 6 weeks of pregnancy with a TV scan. At this time, it is not necessary to do an ultrasound scan, but if it is performed (at the request of the woman, with habitual miscarriage), then at 6 weeks the embryo should be determined. And if the cycle is irregular, then the period for menstruation cannot be accurately determined. Then the period is determined by ultrasound and, if there is no embryo, they look again.

If any deviation from the norm is detected, a follow-up ultrasound is recommended in a week.

With the localization of the fetal egg outside the uterine cavity, i.e. with an ectopic pregnancy, visualization of the fetal egg is difficult and not always possible. A reliable sign of an ectopic pregnancy is the determination of the heartbeat of the embryo outside the uterine cavity.

Assessment of the size and growth of the ovum and embryo

To assess the size and growth of the fetal egg and embryo / fetus, indicators such as the average internal diameter of the fetal egg (MID) and the coccyx-parietal size of the embryo / fetus (CTE) are used.

To determine the SVD of the ovum, the length, width and anterior-posterior dimensions of the fetal egg along the internal contour are measured, then the measurements are summed up, and the sum is divided by 3. For each gestational age in the first trimester, the dimensions of the SVD of the fetal egg are determined. These data are entered in special tables and in the program of ultrasound scanners, which makes it possible to approximately determine the gestational age by this indicator. The average error in determining the gestational age according to the SVD of the fetal egg is ± 6 days.

The first size that is measured when imaging the embryo is the coccygeal-parietal size (CTE). In fact, this is the length of the embryo from head to tailbone. It should be noted that the CTE of the embryo is less subject to individual fluctuations than the average internal diameter of the fetal egg, so using this size to determine the gestational age gives more accurate results. The error in this case is ± 3 days. The absence of an echographic image of the embryo with SVD of the ovum greater than 14 mm is a reliable sign of a non-developing pregnancy in which there is no embryo.

Assessment of the vital activity of the embryo and fetus

The vital activity of the embryo (fetus) in the first trimester is assessed by cardiac and motor activity.

Normally, with transvaginal ultrasound, cardiac activity in the embryo is recorded from 5-6 weeks of pregnancy. In this case, the correct rhythm of heart contractions is observed. The heart rate (HR) of the embryo during uncomplicated pregnancy gradually increases from 110-130 beats per minute at 6-8 weeks to 190 beats per minute at 9-10 weeks, after which it decreases to 140-160 and remains at this level until childbirth . The value of heart rate in the embryo in the first trimester is important for predicting the course of pregnancy. Thus, a decrease in heart rate to 85-100 beats per minute and an increase over 200 are unfavorable prognostic signs and indicate a high probability of abortion. The lack of visualization of heart contractions with an embryonic KTR of more than 8 mm is a sign of a non-developing pregnancy. For the final confirmation of a non-developing pregnancy, it is necessary to conduct a control ultrasound in a week, following which a final diagnosis is made.

The motor activity of the embryo is determined from 7-8 weeks of pregnancy. At the beginning, these are weak, single, barely distinguishable movements. Then - flexion and extension of the body. After that, as the embryo grows and develops, movements of the limbs appear. But it should be noted that episodes of motor activity can be replaced by long periods of rest, so the registration of heartbeats is a more important criterion for assessing the viability of the embryo.

Study of the structure of the embryo and fetus

During ultrasound, special attention is paid to the anatomy of the developing embryo, since at the end of the first trimester gross malformations can be detected, such as anencephaly (absence of the brain), spinal cord herniation, skeletal anomalies, etc. The head of the embryo is determined as a separate rounded formation from 8-9 weeks of pregnancy. Most of the organs of the chest and abdominal wall are determined after 10-11 weeks of pregnancy.

Special attention should be paid to the echographic marker of chromosomal disorders - collar space (Nuchal translucency - NT). The collar space is measured on the back of the neck at 10-14 weeks of gestation with a fetal CTE of 45-84 mm. Normally, the size of the collar space should not exceed 3 mm. An increase in this indicator makes it possible to diagnose up to 80% of chromosomal disorders at the end of the first trimester.

With the improvement of ultrasound machines, data are accumulating on the possibility of diagnosing malformations of the cardiovascular system, central nervous system (CNS), gastrointestinal tract (GIT), urinary system up to 12 weeks of pregnancy.

Study of extraembryonic structures

In addition to the embryo, ultrasound evaluates the yolk sac, chorion and amnion.

During physiological pregnancy, the yolk sac (an extraembryonic structure that performs nutritional and hematopoietic functions in the first weeks of pregnancy) is determined when the SVD of the fetal egg is more than 10 mm (gestational age is more than 5 weeks) in the form of a white ring with a diameter of 2 mm (5 weeks) to 7 mm (10 weeks). A sign of a non-developing pregnancy is also the absence of a yolk sac with a fetal egg larger than 10 mm. After 12 weeks of pregnancy, the yolk sac is normally not detected. There is a relationship between yolk sac size and pregnancy outcome. An increase of more than 7 mm and a decrease of less than 2 mm, an irregular shape and thickening of the walls of the yolk sac are prognostically significant only when combined with other disorders, such as a change in the thickness of the chorion (villous membrane), growth retardation of the embryo. An isolated discrepancy between the size of the yolk sac and the norm does not significantly affect the incidence of pregnancy complications.

Chorion is the outer villous membrane of the fetal egg. The fetal part of the placenta is formed from the chorion. With ultrasound, the chorion is visualized as a white ring with wavy contours, located along the outer edge of the fetal egg. The thickness of the chorion in the first trimester in millimeters is approximately equal to the gestational age in weeks. Underdevelopment of the chorion (hypoplasia) or a change in its structure often leads to spontaneous abortion. The chorionic villi are interconnected with the inner (decidual - falling away) membrane of the uterus. If this interaction is violated, detachment of the fetal egg occurs. As a result, a retrochorial (located behind the chorion) hematoma (limited accumulation of blood) is formed. Retrochorial hematoma is a formidable sign indicating a miscarriage that has begun.

Amnion - a water shell, which is a closed bag in which the embryo / fetus is located, surrounded by amniotic fluid. The amnion is adjacent to the chorion from the inside. Hypoplasia (underdevelopment) of the amniotic cavity leads to non-developing pregnancy. In such cases, the diameter of the amniotic cavity does not exceed 10-12 mm for more than 6 weeks of pregnancy. An increase in the size of the amnion, characteristic of early polyhydramnios, and its heterogeneous contents (suspension in the amniotic fluid) are often associated with the presence of infection. Early polyhydramnios is an unfavorable sign.

Diagnosis of pregnancy complications by ultrasound results

The most common pathology in the first trimester is the threat of abortion. The main echo sign of the threat of interruption is a local thickening of the muscles of the uterus (myometrial hypertonicity). Several areas of hypertonicity can be determined. At the same time, the shape of the fetal egg changes: from round or oval, it becomes irregular, sometimes severely deformed. The most unfavorable situation is when the site of increased tone is located at the placenta formation site: in this case, detachment of the fetal egg and termination of pregnancy is possible.

In most cases, hypertonicity of the myometrium is accompanied by pain in the lower abdomen. This requires treatment aimed at maintaining pregnancy. In the event that the fetal egg loses contact with the uterine wall and exfoliates from its bed, a retrochorial hematoma is formed (a limited accumulation of blood between the fetal egg and the uterine wall). That is typical for a miscarriage that has begun. With a significant detachment, deformation and a decrease in the size of the fetal egg occur, and the death of the embryo. Clinically, bleeding of varying intensity is usually observed. The shortening of the cervix to 2.5 cm (the norm is 3.5-4 cm) and the funnel-shaped expansion of the internal pharynx also indicate the threat of termination of pregnancy.

If, against the background of bloody discharge from the genital tract, an ultrasound scan reveals an expansion of the uterine cavity and the presence of heterogeneous contents in it, and the fetal egg is not visible, then an incomplete miscarriage is diagnosed. In this case, hospitalization in the gynecology department is necessary to carry out curettage of the remnants of the fetal egg and stop bleeding.

A non-developing pregnancy is characterized by a smaller size of the fetal egg for a given gestational age, its deformation, fuzzy contours, a decrease in the thickness of the chorion, and the absence of heart contractions of the embryo.

The localization of the fetal egg in the cervical canal (cervical canal) is typical for cervical pregnancy. In this case, the best visualization is achieved with transvaginal ultrasound. In this situation, urgent hospitalization is necessary, since the likelihood of heavy bleeding is very high.

Quite often during pregnancy, a corpus luteum cyst occurs in one of their ovaries, which is a formation with a diameter of 3 to 8 cm with thick walls and a heterogeneous internal structure. that's a variant of the norm. A characteristic feature of this cyst is a gradual decrease in its size and disappearance by the end of the first trimester.

Bubble skid is a rare complication observed in 1 case per 2000-3000 pregnancies associated with the pathology of the chorion, in which the chorion turns into vinelike formations that destroy all other structures of the fetal egg. In this case, the uterus is filled with many bubbles with fluid. With ultrasound, the uterus is visualized with dimensions larger than normal for a given gestational age, with an expanded cavity filled with inhomogeneous contents (the so-called "snowstorm" picture).

Diseases and defects of the internal genital organs on ultrasound

When conducting ultrasound of the pelvic organs, the size of the uterus and ovaries is evaluated, as well as the presence of pathological changes (uterine fibroids - a benign tumor of the uterus, cysts and tumor diseases of the ovaries) and congenital malformations (saddle uterus, bicornuate uterus, doubling of the uterus, septum in the uterine cavity and etc.). The most unfavorable situation is when the placenta is located above the myomatous node. In this case, there is a high risk of premature detachment of the placenta.

Currently, three-dimensional ultrasound is gaining more and more popularity, in which a "volumetric picture" is obtained. Three-dimensional ultrasound makes it possible to diagnose some malformations at an earlier stage (for example, facial defects: cleft lip, etc.). But 3D scanning is a longer study, and, unfortunately, it is not always possible to obtain the necessary image. Yes, and experience in three-dimensional ultrasound has not been accumulated yet. Therefore, most likely, this method is the future, and at present, three-dimensional ultrasound is just an additional research method.

So, ultrasound examination of the fetus and pelvic organs in the first trimester of pregnancy is one of the most important and indispensable diagnostic methods that allows you to assess the development of pregnancy from the earliest stages and choose the right tactics for its management.

Immediately after the joyful news of an interesting situation, a woman begins to worry and take care of the developing baby. Doctors come to her aid - at the end of the first month of bearing a child, an ultrasound can already see a fetal egg. Changing its size by weeks allows you to draw conclusions about whether the pregnancy is proceeding correctly.

Fertilized egg: what is it and why follow it?

A fertilized egg is a fertilized egg surrounded by membranes. It is constantly dividing - first into 2 parts, then into 4, etc. As a result of this process, the size of the embryo is constantly increasing. Before fixation in the uterus, which occurs 7 days after conception, the fetal egg receives the necessary substances from the yolk sac. The term "gestational sac" is replaced by "fetus" at the end of 12-14 weeks of pregnancy.

Tracking the size of the fetal egg by weeks is not a whim and not a reinsurance of scrupulous physicians and their patients. This information helps:

determine the duration of pregnancy;
name the expected date of birth;
make sure that the growth of the embryo is normal;
detect the appearance of pathologies;
prevent involuntary termination of pregnancy, that is, miscarriage.

Do not put off an ultrasound examination until later. After all, the woman herself, who is preparing for imminent motherhood, is interested in obtaining the above information, first of all.

What numbers create a "portrait" of a tiny embryo?

Medical science has long known the norms of various indicators of the development of the fetal egg in the first 3 months of expecting a child. Examining the embryo, visualized on the monitor, the doctor will first of all pay attention to its shape - at the minimum time it resembles a circle. Next, you need to measure the inner diameter of the fetal egg and tell the woman how long the long-awaited "resident" is inside her. But this diameter is not the same for everyone, as it depends on the individual characteristics of the organism. Therefore, if, when establishing the time elapsed after conception, rely only on this indicator, an error of 1.5 weeks is possible.

Thanks to modern transvaginal ultrasound devices, it is possible to detect a fetal egg measuring 2-4 mm. What period confirms this measurement? No more than 2-3 weeks after the onset of development and 5-6 weeks from the day of the last menstruation.

When conducting the very first ultrasound examination, which is done with a delay in menstruation and in order to accurately diagnose the presence of a uterine pregnancy, a fetal egg can be examined. It is when the doctor sees this miniature formation on the monitor that he already informs the woman that she will soon become a mother. On the monitor, you can see the fetal egg, which is a small oval-shaped formation. In the early stages, the embryo, which will continue to develop and grow in the fetal egg, is not yet visualized, but soon it will grow up, and then it will already be possible to see it well.

An empty ovum is an egg without an embryo when pregnancy does not develop. The embryo is often visible already from the fifth week of pregnancy, but sometimes there are cases when the doctor does not see the embryo on ultrasound at this time, in such a situation a second ultrasound is prescribed. Very often, repeated ultrasound shows both the embryo and its heartbeat. When, after six to seven weeks, the embryo is not visible, then, unfortunately, there is a high risk that pregnancy does not develop. In this article, we will look at the norms of the fetal egg by week.

What is a fertilized egg

The fertilized egg is the embryonic membranes and the embryo. This period of pregnancy is its first stage of development. And it all starts with the fusion of two cells - male and female.

Further, the fertilized egg actively begins to divide, first into two parts, then into four, and so on. The number of cells, like the size of the fetus, is constantly growing. And the entire group of cells that continue the process of division moves along the fallopian tube to the zone of their implantation. This group of cells is the fertilized egg.

Having reached its goal, the fetal egg is attached to one of the walls of the woman's uterus. This happens a week after fertilization. Until this time, the fertilized egg receives nutrients from the egg itself.

fertilized egg 2 weeks after insertion into the uterine cavity, it nourishes the swollen mucosa of this reproductive organ, which is already prepared for the process of development and nutrition of the fetus until the placenta is formed.
The baby's place, or placenta, is created from the outer shell fertilized egg at 3 weeks, which at this time is already densely covered with villi. These villi in the place of fixation of the fetal egg destroy a small area of the mucous membrane of the uterus, as well as the vascular walls. Then they fill it with blood and dive into the prepared place.
In general, a fertilized egg is the very first sign of a normal pregnancy. It can be seen on ultrasound after two weeks of delayed menstruation. Usually in this case it is seen fertilized egg 3-4 weeks. The embryo becomes visible only at the 5th week of pregnancy. However, if the doctor diagnoses the absence of an embryo in fertilized egg 5 weeks- in other words, an empty fetal egg, then the ultrasound is repeated again in a couple of weeks.
Usually in such a situation, at 6-7 weeks, the fetus and its heartbeat begin to be visualized. When fertilized egg at 7 weeks is still empty, this indicates a non-developing pregnancy. In addition to this complication, others may appear in early pregnancy - the wrong location of the fetal egg, its irregular shape, detachment, and others.
It is for this reason that it is important to undergo an ultrasound examination as early as possible so that the situation can be changed if it can be corrected. Since in the first trimester ( fertilized egg up to 10 weeks) there is a high probability of spontaneous miscarriage, detachment and other pathologies. But enough of the sad stuff.

fertilized egg at 6 weeks and before this period of pregnancy has an oval shape. And on ultrasound, its inner diameter is usually evaluated - SVD of the fetal egg. Because gestational sac size 7 weeks or at another gestational age is a variable value, that is, an error in determining the gestational age for this fetometric indicator.

On average, this error is 10 days. The gestational age is usually determined not only by this indicator, but also the values of the coccyx-parietal size of the fetus and other indicators that are also very important are used.

Diameter of the fetal egg by week

When a fetal egg has a diameter of 4 millimeters, this indicates a fairly short period - up to six weeks.

Often these size of the fetal egg 4 weeks. Already at five weeks, the SVD reaches 6 millimeters, and at five weeks and three days, the fetal egg has a diameter of 7 millimeters.
At the sixth week, the fetal egg usually grows to eleven to eighteen millimeters, and the average internal size of the fetal egg of sixteen millimeters corresponds to a period of six weeks and five days. At the seventh week of pregnancy, the diameter ranges from nineteen to twenty-six millimeters.
fertilized egg at 8 weeks increases to twenty-seven - thirty-four millimeters. At this time, the fetus can be clearly seen on ultrasound.
fertilized egg 9 weeks grows to thirty-five - forty-three millimeters.
And at the end of the tenth week, the fetal egg has a size of about fifty millimeters in diameter.

As you can see fertilized egg at 4 weeks very much different in size it is the tenth week.

The question of how quickly the fetal egg increases can be answered with confidence: until the fifteenth or sixteenth week, its size increases daily by one millimeter. Further, the diameter of the fetal egg becomes larger by two to three millimeters per day.

The average size of the ovum in the first trimester of pregnancy

Date of last menstrual period (weeks)	Conception period (weeks)	Inner diameter (mm)	Area (mm 2)	Volume (mm 3)
5	3	18	245	2187
6	4	22	363	3993
7	5	24	432	6912
8	6	30	675	13490
9	7	33	972	16380
10	8	39	1210	31870
11	9	47	1728	55290
12	10	56	2350	87808
13	11	65	3072	131070

When a long-awaited pregnancy occurs, a fertilized egg descends into the uterine cavity and attaches to its wall. Thus, the development of an embryo surrounded by a fetal egg occurs. The first month, from the date of fertilization, the embryo is so small that it is very difficult to visualize it. That is why the first ultrasound is done at 6-7 weeks so that you can examine the embryo and confirm the onset of pregnancy.

Why is the embryo not visible on ultrasound?

It happens that a woman who saw the long-awaited two stripes on the test comes to the doctor and hears: "The fetal egg is empty, the embryo is not visible on the ultrasound." This phenomenon is called an embryonic pregnancy.

If a pregnant woman is given anembryony, this means that with an increase in the level of hCG in the blood, there is no embryo in the fetal egg. It is difficult to say exactly which week specialists will be able to see the embryo on an ultrasound scan. This period ranges from 5 to 9 weeks, depending on certain factors:

Features of the body of each particular woman.
The correctness of the calculation of the period from the date of conception.
What kind of pregnancy is on the account. With each subsequent pregnancy, the probability of detecting an embryo earlier increases significantly.

On average, it is determined that visualization of the embryo is feasible at 7 weeks from the date of conception, with an active ongoing increase in the level of hCG in the blood. However, even if at this time the experts did not see the embryo in the fetal egg, you need to panic only if the growth of the hCG level has stopped or it has begun to decline. This picture indicates that the pregnancy is frozen. However, it won’t hurt to make sure of this once again, so it’s worth double-checking everything with another doctor or doing an ultrasound transvaginally.

A woman needs to see a doctor if, a few weeks after the growth of hCG levels has stopped, the embryo is not visible in the fetal egg, even when examined transvaginally, while the gestational age is approaching nine weeks. Stopping the growth of the embryo and the beginning of its decomposition may be accompanied by such concomitant symptoms:

An unreasonable jump in body temperature.
Appearance of nausea and vomiting.
Constant weakness, muscle pain.
Lower abdominal pain.
The appearance of discharge with blood impurities or open bleeding.

Do not delay a visit to the doctor and postpone the curettage procedure. The decomposition of the embryo can threaten a woman with serious health problems.

At what time should the embryo be visible on ultrasound?

While waiting for the birth of a baby, a woman wonders at what time the embryo can be examined on an ultrasound scan? During the diagnosis for a period of 5-6 weeks, the fetal egg is about seven millimeters in diameter. At this time, in most cases, the doctor already visualizes the embryo. Around this time, you also manage to hear how his heart beats.

If you have a regular menstrual cycle, an embryo should be visible at the end of the sixth week. If the ultrasound does not show the embryo, it is recommended to undergo a second examination in a week to exclude all possible deviations.

There are also cases when the fertilized egg is outside the uterus. During ultrasound, the egg is not visible well enough, or it is not visible at all. In this case, the heartbeat is heard outside the walls of the uterus.

What to do if the fetus is not visible on the ultrasound and what can this mean?

There are situations that during the ultrasound scan, the embryo is not visualized inside the fetal egg, and sometimes the fetal egg itself. First of all, try not to panic. Maybe there is no pregnancy at all, or there was an error with the calculation of its term, so it is still difficult to diagnose. If the frozen pregnancy is not exactly confirmed, there is no need to rush to clean. First, it is better to undergo an ultrasound scan again, in another clinic. It may be necessary to conduct one or more studies. The best option is when, in parallel with the diagnosis, the level of hCG in the blood is monitored. If the pregnancy develops without deviations, then its level increases. This helps specialists to exclude a possible frozen pregnancy.

If the ultrasound does not show the embryo in the fetal egg - what does this mean?

Very often, a fetal egg without an embryo is diagnosed in the uterine cavity in young and healthy girls. Why is the fetus not visible on ultrasound, and is it possible to avoid a missed pregnancy?

There are many reasons for this phenomenon. This can be caused by infections of various etiologies, exposure to toxic substances, etc. on the body. You can minimize the possibility that an embryo will not be visible on an ultrasound by planning your pregnancy in advance in order to accurately calculate the gestational age. Also, you need to undergo examinations and, before planning the conception of a baby, cure all existing infections. This is especially important for women who are planning a pregnancy over the age of 35. This category has a significantly higher risk of chromosomal abnormalities in the fetus.

The absence of an embryo in a fetal egg often does not give a woman any signs during pregnancy. There may be bleeding if a miscarriage has begun. Even a gynecologist during the examination will not be able to say for sure whether there is an embryo in the fetal egg, or whether it is empty. The diagnosis of anembryony can only be made by a doctor who performed an ultrasound examination for a period not earlier than 5-6 weeks. If the gestational age is considered from the first day of the beginning of the last menstruation, then the doctor can visualize the embryo on ultrasound at 1-2 weeks of delay.

It is extremely rare for a patient to be misdiagnosed after an ultrasound, therefore, if there is no embryo in the fetal egg, it is necessary to check the result in a week on other equipment if there are doubts about the professionalism of the doctor or the quality of the ultrasound machine. An error is also possible for other reasons: a short gestational age or late ovulation, a woman's overweight and.

Why can't you see an embryo on an ultrasound?

If the pregnancy test shows two stripes, and the embryo is not visualized on the ultrasound, the reason for this may be:

Incorrect calculation of the gestational age from the moment of conception. The embryo may not be visible because the woman is doing the test too early.
Ultrasound diagnostics was carried out on an old apparatus or the specialist did not have the proper level of qualification.
The study was done through the abdomen, not transvaginally.
The pregnant woman had a miscarriage, but she did not pay attention to it (confusing it with the onset of menstruation), while the level of hCG in the blood had not yet decreased to its previous value.

If the ultrasound does not show the embryo in the fetal egg, do not immediately panic. For a number of reasons, the diagnosis of anembryonia can be erroneously made, so it is necessary to control the level of hCG in the blood and undergo the diagnosis again.

If a doctor during an ultrasound examination reports that he sees a fetal egg in the uterine cavity, the woman can be congratulated, because in 9 months she will become a mother. It is possible to establish the presence of a fetal egg already on the 7-9th day of a delay in menstruation. If the fetal egg is in the uterus, then the pregnancy is normal, uterine. The specialist will immediately determine the size of the fetal egg, its shape and location. In addition, pay special attention to whether there are other pathological conditions.

What does a fertilized egg look like?

The fetal egg is an oval or round body with a diameter of several millimeters. The diameter of the fetal egg is measured during the first ultrasound. Given its size, a specialist can determine the gestational age. But in some cases, the error in the determination is 1-1.5 weeks. Therefore, the doctor, trying to establish a period, also takes into account the indicators of the coccygeal-parietal size.

3-8 weeks pregnant

the fetal egg looks like a formation in the form of a ball or oval. Already at 5-6 weeks, the yolk sac, which provides nutrition to the embryo and performs a hematopoietic function in the early stages of embryo development, looks like a bubble inside the cavity of the fetal egg. The size of the fetal egg at this stage of pregnancy is from 1.5 to 2.5 centimeters. It is already possible to consider the embryo at this time. It looks like a five millimeter strip located next to the yolk sac. And although it is not yet possible to determine where the embryo has what structure and part, the heartbeat is already being recorded. At this time, the baby's heart beats at a frequency of 150-230 beats per minute.

In addition, the neural tube is already forming in the fetus, and the cells distribute “duties” among themselves, who will create which organs.

By the end of the 7th week, the embryo is already acquiring its characteristic shape in the form of the letter C. At this time, it has already detached from the surface of the fetal egg. On ultrasound, it is already possible to distinguish the head, torso and tiny rudiments of arms and legs. In the fetal egg, an already formed umbilical cord is visible.

Irregular shape of the fetal egg

Normally, the shape of the fetal egg is oval or round. If it is flattened laterally and looks like a bean, this may indicate the tone of the uterus. This condition should be monitored by a doctor. If a woman is not worried about anything, then the deformation does not pose a threat to the pregnancy that has taken place. In case of increased uterine tone, doctors prescribe a set of measures (bed rest, medication) to relieve hypertonicity and return the correct shape to the fetal egg. This can be achieved by relaxing the muscles of the female reproductive organ.

But, if the fetal egg has an irregular shape, and the woman has pain, discharge, or symptoms of cervical dilatation, urgent action is necessary. In such cases, the woman is assigned to the inpatient department of the hospital for preservation.

Detachment of the fetal egg

It is called an incipient abortion. In this case, there is a premature rejection of the fetal egg from the uterine wall. An important note - with the onset of spontaneous abortion, timely assistance is very important, because, in most cases, the pregnancy can be saved. The main thing is to do everything quickly and competently. Detachment is accompanied by pulling pain in the lower abdomen, back pain, secretions of dark red, and sometimes brown, color. The causes of detachment of the fetal egg include ovarian dysfunction, various diseases of the woman (tumors, inflammation, infectious diseases), underdevelopment of the genital organs of the expectant mother, severe toxicosis, excessive physical exertion, stress. But the most obvious reason for the detachment of the ovum is the lack of progesterone, which is often called the pregnancy hormone.

If a pregnant woman shows signs of detachment of the ovum, she (or relatives) should urgently call an ambulance and call the obstetrician-gynecologist to inform him about what happened. Until the ambulance arrives, the woman should lie down and raise her legs up. You can rest them against the wall or put them on the back of the sofa.

Detachment of the fetal egg is dangerous because it can lead to an abortion or missed pregnancy. Therefore, at the slightest suspicion of detachment, you need to seek medical help.

Empty fertilized egg

At a very early stage, the embryo in the fetal egg is not yet visible, and this is the norm. But from five weeks the embryo should already be visualized. If the embryo is not visible, a second examination is prescribed after 1-2 weeks. If this time there is neither an embryo nor a heartbeat, they speak of anembryony. In this case, the woman needs to clean.

You need to know that even with an empty fetal egg, a pregnancy test will still be positive. This is due to the fact that certain mechanisms have started in the body, in particular, a special “pregnant hormone” has begun to be produced - human chorionic gonadotropin.

The reason for the absence of an embryo in a fetal egg, in most cases, is a failure at the genetic level. Also, anembryony can be provoked by taking certain medications that are strictly prohibited during pregnancy.

If a woman is diagnosed with an "empty fetal egg", which was confirmed in the case of a second ultrasound examination, then there is no chance of pregnancy this time. Then the woman is given the necessary manipulations, prescribed treatment and sent for rehabilitation. Many women need not only physical, but also psychological rehabilitation to cope with the feelings and emotions that arose as a result of loss.

The next pregnancy is advised to plan at least six months later.

Especially for Olga Rizak

The article talks about what a woman should do if she has a missed pregnancy. The methods of treatment for anembryonia are explained.

A woman waiting for the birth of a baby is absorbed in thoughts about the upcoming joyful chores. The diagnosis of anembryonia, which is usually made during an ultrasound examination, becomes a bitter sobering pill. It is especially difficult when the pregnancy did not occur for a long time, and the chances of giving birth were approaching zero.

Unfortunately, in 15% of women, doctors are forced to confirm the threat of anembryonic pregnancy (missed miscarriage). Inconsolable tears after hearing the diagnosis lead to a complete misunderstanding of what happened. Let's try to figure out what causes anembryony and how hopeless the situation is.

The main signs of anembryony. Why does anembryony occur?

A whole bunch of pathological symptoms leads to a frozen pregnancy or anembryony. This includes intrauterine death of the embryo, and inertia of the myometrium, and violations of the hemostasis system. Everything in the complex leads to a halt in the development of the fetus in the early stages. The fertilized egg is empty, without an embryo

The formation of the fetus with a failed miscarriage stops no later than the third semester of pregnancy. Until the fifth week, the embryo does not reach a size sufficient for examination by ultrasound. In other words, the device simply does not detect the presence of the embryo. Therefore, the diagnosis may be erroneous.

What to do after you have been diagnosed with anembryonia? Do not panic and do not fall into despair! By waiting a few weeks and insisting on additional tests, a misdiagnosis can be ruled out.

After confirming the diagnosis, the woman will undergo a gynecological curettage. You will also need treatment. But frozen pregnancy does not put an end to motherhood.

Psychological trauma after a failed miscarriage does not threaten a woman's health. Having become pregnant again, the woman will be able to carry the baby safely. Anembryony does not affect its development.

How to find out about a non-developing pregnancy?

A woman finds out that the embryo has stopped developing during an ultrasound examination or after testing for the level of hCG (using the test, pregnancy is confirmed or various deviations in its course are detected). She may not feel any changes in the body or discomfort.

Some of the cells that began dividing after fertilization form the embryo, some form the placenta and the fetal membrane. But with anembryony, fetal cells stop dividing
The fertilized egg continues to grow. Hormones that cause toxicosis are produced. But there is no embryo inside the fetal egg. Menses are absent. The uterus grows in size
At this stage, spontaneous miscarriage may occur. A woman has spotting, pain in the lower abdomen

Why does anembryony occur?

The female body is able to get rid of a weak, non-viable embryo on its own. The same applies to a fetus with an incorrect chromosomal combination. But among the causes of the genetic pathology of the embryo, there are others.

What causes fetal death?

genetic disorders (laying the wrong chromosome set, getting a defective sperm into the egg, or pathological changes in the egg, the coincidence of several wrong combinations at once)
infections carried by a woman in the first trimester of pregnancy, if they were accompanied by an increase in body temperature (has a devastating effect on the embryo)
toxic substances that enter the body of a pregnant woman in the early stages;
decreased secretion of hormones necessary for the normal development of the fetus;
bad habits (alcohol abuse, smoking, drugs)
the reasons can also be hidden in the stressful state of the pregnant woman, conflicts, tragedies in the family, which do not pass without consequences for the woman and the fetus;
excessive physical activity can cause an empty amniotic egg (this applies to athletes). Therefore, care for a beautiful and fit figure must be postponed until the baby is born.

But even with the modern development of medicine, not everything is known about the causes of a missed pregnancy. Absolutely healthy women may face the problem of pathological pregnancy.

When does anembryony occur?

The development of anembryony is exposed to a pregnant woman up to the 13th week of pregnancy. But even at later dates (up to 28 weeks) there is a threat of fetal fading

Anembryonic symptoms

It is impossible to independently determine in the early stages of pregnancy that the fetus has stopped developing. A feature of the course of the pathology is asymptomatic. The absence of subjective signs of pregnancy (toxicosis, if it was before), the appearance of spotting may indicate the onset of rejection of dead cells. Followed by a miscarriage

Video: anembryony

Characteristic features of anembryony

a decrease in the size of the mammary glands (the breast becomes less dense on palpation) manifests itself on the 6th day of fetal death in early pregnancy
at 25 weeks, the breast swells when the embryo dies and colostrum is released
in late pregnancy, there is a cessation of fetal movements, if they have already been observed
a sharp increase in temperature, weakness, headache (poor health is caused by a delay in a non-developing embryo inside the female body);
the appearance of cramping pains in the lower abdomen

Is it possible to get pregnant after anembryony

If the genes of future parents are normal, then a woman after primary anembryony has every chance to see two stripes on the test again and safely give birth to a healthy baby
But with "bad heredity", genetic incompatibility will have to be fought. Getting pregnant on your own in this case is tantamount to "Russian roulette"
Re-diagnosis is not ruled out. With a natural pregnancy, a woman runs the risk of losing her baby even after he is born.

After anembryony, it is important not only to become pregnant, but also to exclude all kinds of risks and malformations of the fetus. The safest way to get pregnant is in vitro fertilization (IVF).

Thanks to the IVF procedure, only healthy viable sperm will take part in fertilization. Thus, the possibility of "replanting" the embryo with genetic abnormalities is excluded.
Reproductive technologies make it possible to exclude not only anembryony, but also the development of congenital genetic diseases compatible with life. Remember: now you want to become parents and give birth to a healthy child
Soon your children will want the same. What they pass on to your grandchildren must be taken care of by you! A good genetic heritage of the genus will help you preserve medicine

Consequences of anebryonia

90% of women who have been diagnosed with anembryony successfully become pregnant and bear healthy children. After the experience, it will take some time to recover.

A frozen pregnancy is always a heavy physical burden on a woman's health and her mental state. But in some, the pathology of pregnancy may recur. Therefore, in the future it is necessary to be examined and eliminate the cause of a missed pregnancy.

After a frozen pregnancy, a woman physically remains healthy if the frozen fetus is identified and removed in a timely manner

Anembryony: how long can you walk with it?

Once a woman is diagnosed with anembryony, the most appropriate method is selected to remove the dead fetus.

In the early stages (up to 8 weeks) it can be:

medical method (performed to provoke an abortion) - pills are prescribed;
vacuum aspiration (the fetus is removed from the uterus by suction with an extractor)

At a later date:

curettage (carried out under anesthesia);
artificial labor is induced, followed by cleaning of the uterus

Doctors do not always resort to immediate surgery. Sometimes a waiting tactic is preferred. The condition of the woman is monitored until the body independently rejects the frozen fetus.

Treatment of anembryonia

A patient with a confirmed diagnosis of anembryonia is prescribed Duphaston. The drug is also necessary after cleansing to normalize the tone of the uterus
Further treatment consists in prescribing antibacterial and immunomodulatory drugs that prevent the development of sepsis and inflammation.
At least six months later, the woman's body will fully recover for a new pregnancy. Repeated consultation with the doctor and examination are mandatory, because you may need additional treatment

Anembryonic cleansing, pros and cons

Scraping does not relieve a woman from spotting, cramping pains (occur during uterine contractions). They continue for another week.

After the discharge has passed, it is necessary to visit a gynecologist to exclude inflammatory processes in the uterus and appendages. Curettage is performed with an incomplete miscarriage. In the event that a woman has a complete miscarriage, curettage is not done. In any case, an ultrasound is mandatory before the procedure.

Video: pregnancy after scraping

What to do if anembryony recurs?

If in a newly pregnant woman, after repeated ultrasound, the fetus is not located inside the fetal egg, there is no heartbeat, then curettage is performed. With repeated repetition of anembryony, a full examination of both spouses is shown.

Nadezhda, 42 years old: “With anembryony, the level of hCG decreases. Once every three days, you can take an hCG test so that you don’t worry once again, because a woman sometimes doesn’t suspect a missed pregnancy: she feels normal, and there are no other signs that the child is no longer there ”

Olga, 35 years old: “After a missed pregnancy is discovered in a woman for the first time, there is no need to try to find the cause. It is likely that there was a genetic failure. In my case, everything is different: the pregnancy ends with the fading of the fetus for the fourth time in a row! It is important not to give up. Check several times. Examine and listen to the advice of doctors. It is believed that a frozen fetus in a woman happens only once. But that's not my case."

Larisa, 29 years old:“The gynecologist put the gestational age at 6-7 weeks. But when examined by ultrasound, it turned out that the period was 3 weeks. The size of the fetal egg is 4 mm. But there is no fruit in it. Preliminary diagnosis of anembryony was made and sent for a second ultrasound in a week. It is also necessary to pass tests for hCG "

Svetlana Yurievna, obstetrician-gynecologist:“After cleaning, the patient developed nausea, her temperature rose. She decided to take a pregnancy test, which came back positive. This indicates the development of trophoblastic disease, in which hospital treatment is indicated.

Every fifth pregnant woman is faced with such a diagnosis as an empty fetal egg, the causes of which are almost impossible to find out. You can only minimize the risks if you lead a healthy lifestyle before planning a pregnancy and consume folic acid a couple of months before conception.

Causes

What does an empty ovum mean? This means that pregnancy does not develop, it stops at the stage when the cells begin to form an embryo. Such an anomaly can be triggered by some changes in the woman's body. If a woman was diagnosed with anembryony, she should immediately take all necessary measures, because the death of the fetus is not inevitable.

Why can a fertilized egg be empty:

genetic abnormalities;
infectious diseases;
environmental ecology;
avitaminosis;
malnutrition, etc.

It becomes clear that it is impossible to identify the causes of an empty fetal egg in a certain situation. The most important reason that an empty egg was formed during pregnancy is the incorrect division of the first cells, which entails genetic errors in all subsequent ones.

This provokes the formation of the creation of extra chromosomes (trisomy), sometimes the set of chromosomes is not complete. In such situations, the fertilized egg does not turn into an embryo. After the body has realized that this is a frozen pregnancy, it begins to reject the amniotic egg.

Manifestations

An empty pregnancy is a state of the female body that does not show itself at first. Even with an internal gynecological examination, it is impossible to identify signs of an empty fetal egg. They can become visible when the extreme stage has already begun - spontaneous abortion begins: brown discharge and a pungent odor from the vagina appear.

Does hCG grow with an empty ovum? The hCG index increases, but significantly less than during the normal course of gestation. Seeing the growth of hCG in dynamics is perhaps the only way to recognize an empty fetal egg during pregnancy. If there are problems with the development of pregnancy, the indicators are slowly growing or standing still.

The symptoms of an empty fetal egg are identical to those that appear with successful fertilization: nausea, dizziness, a constant state of fatigue, a delay in the monthly cycle.

An empty fetal egg can be very difficult to determine in the early stages, because the embryo for the first week of pregnancy is very small and can easily be overlooked. But at week 5, it becomes possible to detect the absence of a fetus.

With an embryo - the norm

Empty fertilized egg photo

An empty fetal egg at week 6 can be diagnosed during an ultrasound examination. At this stage of gestation, an ultrasound examination is performed to determine the location of the fetus: in the uterus or outside it. The expectant mother should be attentive to her health in the early stages of pregnancy, because the first trimester is considered the most dangerous due to frequent miscarriages.

Preventive actions

As you know, it is better to prevent a problem from occurring than to deal with the consequences. If, upon the onset of pregnancy, an empty egg is found, nothing can help.

But it is quite possible to help reduce the likelihood of such an anomaly. To do this, you will need to follow some recommendations during pregnancy planning.

You can minimize the risks of an empty fetal egg if:

undergo a full examination for both partners (take tests, do an ultrasound scan, consult a gynecologist, therapist to exclude the presence of chronic diseases);
start taking folic acid two to three months before the intended conception;
lead a healthy lifestyle: give up bad habits, drinking alcohol. You will need to review your diet and replenish it with vitamins and macronutrients and useful substances.

It is important to choose an obstetrician-gynecologist in a timely manner, who will manage the pregnancy from A to Z, and the sooner this happens, the better. Most importantly, if the pregnancy stopped once, this does not mean that any of the partners has problems with reproductive health. You should not be upset and after half a year, again take up the continuation of the family. And be sure the long-awaited two stripes appear on the test.

Now women often have to deal with problems during pregnancy. And a fertilized egg without an embryo is one of such terrible problems. Such a diagnosis - an empty fetal egg - must certainly be subjected to intervention by doctors, since the child will no longer be born, and an empty fetal egg inside the uterus will aggravate the situation.

Cause and effect

The diagnosis of "anembryony" is made by doctors quite often. According to statistics: out of 1000 women who become pregnant, 100 do not have an embryo - only an empty fetal face. This diagnosis is also called anembryony.

It is placed in a woman if the fetal egg develops and grows, but there is no embryo in it. This is due to the cessation of cell division, as a result, the embryo stops growing. In this case, the doctor announces the diagnosis to the woman: an empty fetal egg without an embryo.

There is also another case when a pregnant woman can be diagnosed with anembryony, in which case the embryo not only stopped developing, but its absence is generally observed. There is still one pathology associated with this diagnosis: when the embryo grows, but the fetal egg does not, and in the case of this pathology, anembryonic pregnancy can also be diagnosed.

In this case, the doctor may advise you to terminate the pregnancy, since later the pregnancy may become frozen and the embryo will stop developing, but the development of the fetal egg may even out, and the pregnancy will continue calmly, not being called frozen, and the embryo will grow. This situation is very uncertain, and you should not rely on the opinion of one specialist.

Signs of complications

Another pregnancy is called frozen if the fetus does not continue to develop and dies. An empty fetal egg can also be called a frozen pregnancy. A frozen pregnancy can become in the first 12 weeks, while the fetus is growing.

It is also worth clarifying about another complication - ectopic pregnancy or false.

This occurs when a fertilized egg attaches outside the uterine cavity, or rather, attachment occurs inside the fallopian tube. A diagnosis that speaks of WB (inside the tube) is dangerous for the health of a woman, a child and requires urgent medical intervention, otherwise this complication can be fatal if the tube ruptures without treatment. The percentage of incidence of ectopic pregnancy is only 2%, but almost all of them develop an embryo inside the fallopian tube. The reasons may be:

Hormonal failures or lack of any hormones;
Tumors of the uterus or its appendages;
The genital organs do not develop properly;
Surgical operations that take place in the abdominal cavity;
Violations in the transport function of the fallopian tube.

The first signs of fetal development inside the ectopic tube: drowsiness, nausea, weakness, pain in the lower abdomen, spotting.

The definition of the development of an ectopic pregnancy occurs before 4-6 weeks of the term, otherwise it can lead to a bad end.

To eliminate this complication, the WB performs an operation in which the fetal egg located inside the ectopic tube is eliminated, and if the tube ruptures, then it is removed. A false fetal egg in the uterus can serve as an indirect sign of an ectopic pregnancy, this is clearly visible if the so-called false fetal egg is smaller than normal. A false ovum in the uterus simulates a uterine pregnancy while another ovum may begin to develop inside the fallopian tube or inside the cervix, contributing to an ectopic pregnancy. A false fetal egg is an accumulation of blood inside the uterus or an accumulation of the secretion of tubular glands.

Signs of pathology

Now let's figure out what can cause the development of anembryony. The causes of anembryony are not completely known: pregnancy without an embryo or a fetal egg without an embryo, but there are some conditions that can lead to the death of an embryo in its early stages of development.

For example, bad habits lead to anembryony: nicotine addiction, too much alcohol, drug addiction and substance abuse. Harmful substances enter the fetus and have a detrimental effect on it, as a result of which the embryo may stop growing.

Genetic abnormalities can also serve as the cause of this pathology: initial violations during fertilization affect the development of the embryo in the initial stages.

Also, the cause of this pathology can be the fertilization of the egg by the sperm of a blood relative. Another reason is hormonal disorders: there is a lack or, conversely, an excess of any hormones in a woman.

Diagnosis "absence of an embryo in the fetal egg": signs of pathology. The absence of an embryo inside the fetal egg may in no way affect the external and internal sensations of a woman either in the first week or in subsequent ones. A woman may experience nausea, desire to eat something special, and other signs of pregnancy without feeling any discomfort. Therefore, a woman may be completely unaware of the diagnosis of anembryonia, without feeling. But some of the fair sex may feel unwell, excluding signs of pregnancy: pain in the lower abdomen, red discharge or discharge may be observed, which indicates anembryony. This happens because the body begins to reject an empty fetal egg or an egg with an embryo, which will not be able to develop and live in the future.

If a woman is concerned about the above symptoms, then you need to see a doctor and explain everything to him. An ultrasound examination is performed, in which the doctor observes the absence of the embryo or the suspension of its development. And in the absence of symptoms in a woman, she learns about anembryony at the next examination with an ultrasound machine, when the doctor notices a discrepancy between the development of the fetal egg and the embryo.

Methods of treatment

With such a pathology: pregnancy without an embryo - anembryony, medical intervention is necessary. There are two ways to treat this pathology:

Medication treatment. This pathology treatment can be offered if the woman is in position for no more than 6 weeks. This method is a medical abortion and happens like this: for this you need to drink the necessary medicine under the supervision of a doctor and wait until the contents of the uterus begin to be rejected and come out. After that, the woman will have to stay under the supervision of a doctor in the hospital for several days, until the bleeding finally ends. To complete the treatment, the doctor conducts an ultrasound examination and determines the purity of the uterine cavity;
Surgical intervention. This method is chosen by doctors more often, since it allows you to thoroughly clean the uterus from an empty fetus, without giving rise to the development of any complications, and the operation can be performed at any week of pregnancy. At the time of this operation, the woman is put into a state of deep sleep and does not feel any pain. The operation itself can last for 5-20 minutes. The operation is as follows: an empty fetal egg is cleaned from the uterine cavity by a gynecologist using special tools. In this case, the woman does not need to stay in the hospital, and after a few hours she can leave it. After the operation, the woman will be disturbed only by small spotting, after which she needs to visit an ultrasound room and make sure that there are no remnants of the fetal egg in the uterine cavity.

To find out the causes of this pathology, the doctor sends the material obtained after the operation for histological examination. During the course of the study, they find out such questions: was the embryo in the fetal egg or at what time did it stop developing, and what was the reason.

For recovery, a woman is prescribed anti-inflammatory and antibacterial drugs. It is also necessary to take sedatives, because the loss of a child, despite the term, is always the strongest stress for any woman. If a woman wants to try to get pregnant again, then it is recommended to do this no earlier than six months after the operation, and it is necessary to eliminate the causes that caused the development of the embryo to stop.

In this position, you should be attentive to your lifestyle, habits and especially well-being. You need to find out about all the possible causes of ah that can lead to this pathology or to any other pathology in order to prevent the development of false, ectopic and other types of pregnancy. And in case of any discomfort, contact a specialist.

Expecting a baby is one of the most beautiful periods in a woman's life, but, unfortunately, it does not always go without problems. There are times when the diagnosis of doctors is disappointing - "a fetal egg without an embryo." Why does this happen and how can you determine that the pregnancy has stopped?

What does "egg without embryo" mean?

Anembryonic, or frozen, pregnancy is a diagnosis confirming that the fetal egg develops without an embryo. As a rule, this fact is detected during the ultrasound procedure at 5-6 weeks after conception. By this time, it becomes obvious that there was no germ in the egg at all, or that, having turned out to be unviable, he had already died.

Important! If the gestational age was set erroneously, the diagnosis may be false. To confirm or refute anembryony, the examination is repeated after 2 weeks, since the ultrasound machine simply does not see the tiny future baby.

A frozen pregnancy is not a threat to a woman's health and in most cases does not have serious consequences. If the diagnosis is confirmed, gestation is interrupted, and young parents are advised to undergo a course of special treatment. Of course, anembryony is a lot of stress, but you should not get depressed. Subject to all the prescriptions of the doctor, the next pregnancy may well be successful.

Possible reasons

Most often, such a phenomenon as a fetal egg without an early embryo is due to genetic changes in the fetus at the initial stage of its formation. However, there are other reasons:

frequent stress, conflicts with loved ones or tragic events in the life of a pregnant woman;
hormonal imbalance;
smoking, drinking alcohol, stimulants or drugs;
viral diseases accompanied by high fever;
exposure to poisons or aggressive chemicals on the body of the expectant mother;
high loads in early pregnancy.

Quite often, female athletes who regularly train and test their body for strength are diagnosed with an ultrasound scan of a fetal egg without an embryo. The reasons for this are clear: high physical activity is contraindicated for any woman throughout pregnancy, and neglect of this rule is fraught with her breakdown.

Diagnosis of anembryony

It is very difficult to detect signs of a frozen pregnancy on your own. As a rule, it proceeds in the same way as normal. A woman has no menstruation, the mammary glands increase in size and hurt, symptoms of toxicosis appear.

Important! The only indicator of an embryonic pregnancy that can be seen in the early stages is a low level of the hCG hormone.

Many women are concerned about whether a fertilized egg can grow without an embryo and why they feel "totally pregnant." This pathology does not exclude the fact that an empty fetal egg will increase in size, but such a pregnancy must be interrupted in any case.

In some cases, the female body itself understands that the embryo is absent in the egg, and starts the natural process of its rejection. This is usually accompanied by sharp or aching pain in the pelvic area and odorless bloody discharge.

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If you have such symptoms, you should immediately consult a doctor - only he can confirm or refute the diagnosis. It can be reliably established that there is no embryo in the fetal egg, it is possible only after examination on the gynecologist's chair and an ultrasound procedure.

Treatment Methods

There are two methods to correct the pathology.

Medical abortion. Under the supervision of the attending physician, the woman takes a special medicine, after which the contents of the uterus are rejected, and it comes out. You need to be under the supervision of a doctor for several days until the bleeding process is completely completed.
Termination of pregnancy surgically. This method is preferable in most cases, as it allows you to completely remove the top layer of uterine tissue along with an empty ovum. The procedure is performed under anesthesia, and as soon as the woman's health stabilizes, she is allowed to go home.

4-5 days after the termination of pregnancy, it is necessary to undergo an examination by a gynecologist and ultrasound to make sure that no particles of the pathological fetal egg remain in the uterine cavity.

If anembryony is diagnosed in a woman for the first time, there is no reason for undue concern. Statistics confirm that due to spontaneous chromosomal mutations occurring in the process of fusion of the sperm with the egg, every eighth pregnancy freezes. And this is absolutely not the fault of future parents.

Unfortunately, not all pregnancies end in childbearing. Reproductive losses in this case can be due to various reasons. And one of them is a non-developing or missed pregnancy. According to medical statistics, this pathology accounts for up to 15-20% of reproductive losses.

Currently, there are 2 options for a missed pregnancy: embryonic death and anembryony. It is important to understand that the differential diagnosis between them does not affect the subsequent treatment tactics, but is taken into account when assessing the prognosis. Anembryony is more often determined, and this condition in many cases is not accompanied by spontaneous abortion and therefore requires artificial termination of a missed pregnancy.

Anembryony - what is it and why does it develop?

Anembryony is the absence of an embryo in a developing fetal egg. This condition is also called the empty gestational sac syndrome. This is by no means a rare pathology that can be diagnosed in primigravida and in women who already have healthy children.

Currently, a lot of possible causes of anembryony have been identified. These include:

Genetic anomalies, which are noted in almost 80% of the pathological condition. They are usually associated with gross and/or multiple chromosomal abnormalities. Moreover, with anembryony, such anomalies are of a qualitative nature, and with the death of the embryo and its abortion, they are predominantly quantitative. Unviable combinations of parental genes or mutations in key areas responsible for the early stages of embryogenesis and the synthesis of the main structural proteins of cell membranes are also possible.
Some acute viral and bacterial diseases that occur in the early stages of gestation and lead to damage to embryonic tissues or trophoblast. The most dangerous in this regard, although other pathogens can be embryotropic.
Persistent viral and bacterial infections of the reproductive system, leading to development. And in most cases, such a pathology occurs without obvious clinical symptoms and is detected after a frozen pregnancy.
Radiation exposure to the developing embryo.
Exogenous intoxications: taking drugs with an embryotoxic effect, drug addiction, exposure to certain industrial and agricultural poisons (toxins).
Endocrine disorders in a pregnant woman. And the most critical is the deficiency of progesterone and disorders of its metabolism, which is the main cause of the pathology of endometrial decidualization and abnormal implantation of the fetal egg.

In general, the causes of pathology in most cases remain undiagnosed. Usually it is possible to determine only a presumptive etiology.

Genetic diagnostics of aborted tissues can reveal obvious anomalies of hereditary material. But such a study, unfortunately, is carried out in a very small percentage of cases. Basically, it is indicated with a burdened obstetric history in a woman, when she already had frozen or spontaneously interrupted in the early stages of gestation in the past. But even such a diagnosis is not always informative enough, which is associated with the limited possibilities of modern genetics and the high probability of the impact of other etiological factors.

Pathogenesis

Anembryony is a consequence of the cessation of reproduction and differentiation of the embryoblast or inner cell mass - a group of cells that normally give rise to fetal tissues. And this happens at the earliest stages of pregnancy (usually at 2-4 weeks of gestation), and without disturbing the development of the fetal membranes from the trophoblast. As a result, a so-called empty fetal egg is formed, which continues to grow even in the absence of an embryo in it.

The pathogenetically important factors in the development of the disease include:

Inherited or acquired chromosomal aberrations and other genetic abnormalities. They can lead to a gross desynchronization of the development of embryonic tissues, critical changes in the structure of collagen and other proteins, disruption of the induction of differentiation and migration of dividing cells. The most common autosomal trisomy, monosomy, triploidy, tetraploidy.
Excess formation in the body of a woman of circulating immune complexes. Their deposition in the walls of small vessels leads to thromboembolism and other critical microcirculation disorders in the area of the implanting egg. Antiphospholipid antibodies are of the greatest clinical importance.
Excessive activation of T-helper cells with an increase in the concentration and aggression of the cytokines secreted by them. These substances are able to have a direct and indirect damaging effect on embryonic tissues with a violation of their proliferation and differentiation. In fact, the fetal egg in this case acts as a target for the cellular link of immunity. The reason for such an abnormal immune response of a woman's body may be a chronic infection of the endometrium, hormonal abnormalities, and some other endogenous factors.

It is important to understand that with anembryony, a woman's body produces substances that help prolong pregnancy. Therefore, in a significant proportion of cases, spontaneous abortion does not occur. The patient develops and maintains signs of pregnancy, there is an increase in hCG in the blood serum. Therefore, the basal temperature during anembryony usually does not have characteristic features. And the fact of successful implantation of the fetal egg in the uterine cavity is confirmed. After all, pregnancy does occur, but it develops without a key component - the embryo.

Subsequently, rejection of the abnormal fetal egg is possible. In this case, the threat of termination of pregnancy (including with the formation of exfoliating retrochorial hematomas) or spontaneous abortion (miscarriage) can be diagnosed. But often anembryony is diagnosed only during a routine examination, in which case the diagnosis is absolutely unexpected and shocking news. Such a pregnancy requires an artificial interruption.

How does it manifest itself?

Anembryony does not have its own clinical symptoms, all emerging disorders are usually associated with the threat of termination of such a pathological pregnancy. And the warning signs include the presence of clinical manifestations of relative progesterone deficiency, which creates the prerequisites for spontaneous abortion. Therefore, pain in the lower abdomen and bloody discharge can become a reason for contacting a doctor; with anembryony, they can appear at almost any time during the 1st trimester.

But often a woman learns about the existing pathology only when conducting a screening ultrasound for a period of 10-14 weeks.

Diagnostics

Like other forms of missed pregnancy, anembryonia is detected in the first trimester of gestation. And it is the main diagnostic tool, because it is this study that allows you to visualize the existing deviations.

At the same time, symptoms can be reliably detected only after the 8th week of gestation. At earlier dates, visualization is often insufficient due to the too small size of the ovum, so that an erroneous diagnosis is not ruled out. Therefore, if a missed pregnancy and anembryony are suspected, it is recommended to conduct an examination several times, repeating the procedure on expert-class equipment with an interval of 6-8 days. At the same time, the initial diagnosis of an empty fetal egg can be removed if subsequent ultrasound scans can visualize an embryo with signs of a heartbeat and sufficient developmental dynamics.

The main echographic features:

the absence of the yolk sac with a diameter of the fetal egg 8-25mm;
the absence of an embryo in a fetal egg with a diameter of more than 25 mm.

Additional signs include an irregular shape of the fetal egg, an insufficient increase in its diameter in dynamics, a weak severity of the decidual reaction, and the absence of a heartbeat at a gestational age of 7 or more weeks. And signs of the threat of its interruption are a change in the tone of the uterus and the appearance of areas of chorion detachment with the appearance of subchorial hematomas.

Anembryony can also be suspected with a dynamic assessment of the level of hCG in the blood. An increase in the level of this hormone along the lower limit of the norm should be the basis for further examination of a woman with an ultrasound scan. It is important to understand that hCG is also produced in the syndrome of an empty ovum. Moreover, its level in this pathology will be almost normal, in contrast to a frozen pregnancy with the death of a normally developing embryo. Therefore, monitoring of indirect signs of pregnancy and the growth of hCG during anembryony cannot be attributed to reliable diagnostic methods.

Varieties

There are several options for the syndrome of an empty fetal egg:

Anembryonic type I. The embryo and its remains are not visualized, the size of the fetal egg and uterus do not correspond to the expected gestational age. The diameter of the egg is usually no more than 2.5 mm, and the uterus is enlarged only up to 5-7 weeks of gestation.
Anembryony type II. There is no embryo, but the fetal egg and uterus correspond to the gestational age.
Resorption of one or more embryos at. At the same time, normally developing and regressing fetal eggs are visualized. According to this type, anembryony often occurs after IVF, if several embryos were implanted in a woman.

All these varieties are determined only with the help of ultrasound, they do not have characteristic clinical features.

What to do?

Confirmed anembryony is an indication for artificial termination of pregnancy. This does not take into account the gestational age, the woman's well-being and the presence of signs of a possible spontaneous abortion. An exception is the situation when anembryony of the second fetal egg is diagnosed during multiple pregnancy. In this case, a wait-and-see strategy is taken, evaluating the dynamics of the development of the preserved embryo.

Termination of a missed pregnancy is carried out only in a hospital. After the procedure for the evacuation of the fetal egg, the woman should be under medical supervision. In many cases, after it, additional medication and sometimes physiotherapy are prescribed, aimed at normalizing the hormonal background, preventing inflammatory and hemorrhagic complications, and eliminating the detected infection.

For medical abortion in this pathology, it is possible to use several methods, the choice depends on the technical equipment of the medical institution and the gestational age. Can be used:

medical abortion - termination of pregnancy with the help of hormonal drugs that provoke rejection of the endometrium along with an implanted fetal egg;
vacuum aspiration of the contents of the uterine cavity;
curettage is an operation involving the mechanical removal of the fetal egg and endometrium with a special instrument (curette) after the forced expansion of the cervical canal with bougie.

Medical abortion with anembryony is possible only for a period of 6-8 weeks. In later periods of gestation, preference is given to mechanical methods, which requires the use of general anesthesia. The choice of the method of artificial abortion depends on whether the stomach hurts after an abortion, the length of the rehabilitation period, the likelihood of early and late complications.

Examination after induced abortion necessarily includes ultrasound control. This allows you to confirm the complete evacuation of the membranes and endometrium, to exclude undesirable consequences of abortion in the form, perforation, etc.

Forecast

Can anembryony recur? Can I still have children? These questions concern all patients who have undergone this pathology. Fortunately, in most cases, the condition does not recur, the woman subsequently manages to safely become pregnant and bear the child. But at the same time, she is classified as a risk group for the possible development of complications of pregnancy and childbirth. Therefore, in the first trimester, she is usually assigned dynamic ultrasound control of the development of the fetal egg, determination of the hormonal profile and assessment of the state of the hemostasis system.

Pregnancy after anembryony is theoretically possible already in the next ovarian-menstrual cycle. But it is desirable to allow the body to recover. Therefore, planning for re-conception is recommended to start no earlier than 3 months after the induced abortion. If it proceeded with complications, the rehabilitation period, while maintaining reproductive rest, is extended for up to six months. If a woman has chronic endometritis and various infections, 2 months after the completion of treatment, a control examination is carried out and only then the possible timing of re-conception is determined.

To prevent pregnancy, preference is given to the barrier method and hormonal contraception. The choice of means is carried out individually. Intrauterine devices immediately after a frozen pregnancy are not used in order to avoid the development of endometritis.

Prevention

Primary prevention of anembryonia includes careful planning of pregnancy with a comprehensive examination. If deviations are found, they are corrected. Of course, such preparation does not allow 100% to exclude the possibility of pathology, but reduces the risk of its development.

Secondary prevention is carried out if a woman has a history of spontaneous abortion and anembryony. The first pregnancy with empty ovum syndrome is a reason for a subsequent examination of a woman for infections and hemostasis disorders. When the situation repeats, a genetic examination of the spouses is also shown to exclude anomalies in their hereditary material. In some cases, subsequent conception is preferably carried out using IVF, which will allow the use of preimplantation diagnosis to detect chromosomal abnormalities in embryos.

Anembryony is diagnosed quite often. And, unfortunately, at present it is not yet possible to completely exclude such a pathology already at the stage of pregnancy planning. After all, it can develop even in completely healthy and examined patients. At the same time, a missed missed pregnancy does not mean the impossibility of a repeated successful conception; most women after anembryony manage to safely give birth to a healthy child.