Medicine today 

At what time does the pregnancy fade. No increase in hCG. Genetic abnormalities lead to the termination of fetal development

In addition, absolutely every woman who plans to become a mother, you need to know the signs of fetal freezing... But you shouldn't constantly think about pregnancy fading and try to find signs of this problem in yourself.

What is the probability frozen pregnancy? In fact, pregnancy fading is rare.

According to statistics frozen pregnancies, for one hundred and seventy-six cases of perfectly normal pregnancies, there is only one case of fetal freezing.

But still, if you become familiar with the symptoms of fading, you may well be able to keep your condition under control.

What is a frozen pregnancy?

Frozen pregnancy- This is a pathology of fetal development, which most mothers have no idea about. A frozen pregnancy is an interruption in the growth and development of the fetus. In other words, his death.

How long does a missed pregnancy occur? A similar pathology can occur at all stages of pregnancy., but most often, fetal freezing occurs in.

The subsequent development of events may well provoke any inflammatory processes and other unpleasant consequences in the body.

How to determine this condition in time?

The correct growth and development of the fetus at each stage of pregnancy depends on a large number of explicit and implicit factors.

It also happens that some coincidence can lead to a halt in the growth and development of the embryo. This phenomenon is called a frozen pregnancy.

Symptoms

The symptoms of this pathology are quite accurate and its diagnosis does not cause difficulties for doctors.

One of the main symptoms of course, is that completely signs of pregnancy disappear.

But you shouldn't diagnose yourself on your own. If you have any suspicions, you must urgently see a doctor... The specialist will conduct an examination and do an ultrasound scan.

After that, the picture of the course of pregnancy will become completely clear: do you have symptoms of a frozen fetus or is it just nerves.

Signs

Often the first signs of a frozen pregnancy in the early stages it is possible to find out only at the next scheduled visit with a gynecologist. This can happen even a couple of weeks after the onset of this problem, since fetal freezing appears almost imperceptibly, without any obvious signs.

The first signal, which may mean the occurrence of problems, may be a sudden termination with a frozen pregnancy.

In addition, all obvious symptoms that indicate the presence of pregnancy disappear:.

The plan for such an examination after a frozen pregnancy is drawn up on the basis of the individual characteristics of the organism and the medical history.

To standard examinations, which are shown to absolutely everyone during the recovery period after fetal freezing and planning a re-conception, include:

  • Ultrasound of all pelvic organs;
  • a blood test that will show the level and autoantibodies;
  • smears to identify possible urogenital diseases;
  • examination of the thyroid gland;
  • ToRHC-complex, which will show whether there are infections in the body that carry a share of danger for pregnant women.

All of the above measures are urgently needed. Prevention of a missed pregnancy reduces the risk of a recurrence of the pathology and increases the chances of becoming a happy mother.

In conclusion, I would like to say that spouses who are planning to have a child must have an idea of ​​how a frozen pregnancy manifests itself and how it can be avoided.

This will make it possible to eliminate all causes in time. unfavorable for pregnancy, detect symptoms and take the necessary measures that will significantly reduce the likelihood of adverse effects of fetal freezing.

Maria Sokolova


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A frozen pregnancy is one of the types of miscarriage, in which the intrauterine development of the fetus stops. This happens most often in the first trimester, much less often in the second and third. At the same time, a woman may not notice for a long time that the embryo has stopped in development.

Therefore, today we decided to tell you about the first signs of a frozen pregnancy.

How to determine a frozen pregnancy in time?

In each trimester of pregnancy, the growth and development of the fetus depends on many factors (explicit and implicit). Sometimes it happens that an accidental coincidence of circumstances can lead to a stop in the development of the fetus. This is what is called a frozen pregnancy in modern medicine. How do you recognize it?

This pathology has rather accurate symptoms, so doctors can make a similar diagnosis without much difficulty.

The most important symptom is, of course, that any signs of pregnancy completely disappear... But in no case should you cheat yourself and make such a diagnosis yourself.

If you have any doubts, immediately see your obstetrician-gynecologist ... He will examine you and will do an ultrasound ... Only after that the whole picture will become clear: whether the child has stopped developing, or is it just your nerves are naughty.

The most certain symptoms of a frozen pregnancy

Unfortunately, in the early stages, there are no obvious signs of pregnancy fading. Such a diagnosis can be made after undergoing ultrasound .

A woman may feel that toxicosis, gastronomic whims, pain in the mammary glands, etc. have abruptly stopped. But this does not mean that there is no more pregnancy.

A similar diagnosis can only be made by a gynecologist after conducting an examination and identifying the following symptoms:

  • The fetus has no heartbeat;
  • The size of the uterus is less than it should be at a given stage of pregnancy;
  • In the blood of the pregnant woman decreased

Signs of a missed pregnancy in the early stages

  • Toxicosis disappeared. For women suffering from severe toxicosis, this fact will certainly cause excitement. Then you felt bad in the morning, you were sick from pungent odors, and suddenly everything returned to normal. But the second trimester is still quite a long way off.
  • Mammary gland stop hurting and become softer. All women can notice these manifestations of a frozen pregnancy. The chest stops hurting 3-6 days after the death of the fetus.
  • Bloody issues. This clear sign of miscarriage can only appear after several weeks have passed after the death of the fetus. Sometimes a small brownish discharge may appear and then disappear. In such cases, women often think, "carried over", but the fetus is no longer developing.
  • Headache, weakness, fever(above 37.5), mild nausea - these symptoms are a bit similar to toxicosis, however, some women observed them as early as 3-4 weeks after the pregnancy froze. This is due to the fact that the decay products of the embryo enter the bloodstream.
  • Decrease in basal temperature- women who are very worried about their unborn baby can continue to measure basal temperature even after pregnancy. Most often, in the first trimester of pregnancy, the temperature is about 37 degrees, when it freezes, it drops sharply, because the body stops producing hormones necessary for the development of the embryo.

But, unfortunately, not only in the first trimester of pregnancy, the embryo can stop developing, but also on later lines ... If we talk about miscarriage, then the risk persists until 28 weeks.

Therefore, we will tell you about the signs of a frozen pregnancy at a later date, because every expectant mother should know them.

Symptoms of a frozen pregnancy at a later date

  • Cessation or absence of fetal movements. Usually, women begin to feel weak jolts of the baby at 18-20 weeks of pregnancy. From that moment on, doctors recommend carefully monitoring the frequency of the baby's movements. More than 10 times a day is ideal. The number of movements will decrease, maybe only before childbirth, since the child is already large and there is not enough space for him. So, if you do not feel the baby's pushes for several hours, go to the hospital urgently. At first, this may be a sign of hypoxia (lack of oxygen), and if urgent measures are not taken, then pregnancy will fade.
  • The mammary glands have decreased in size , tension disappeared in them, they softened. After intrauterine death of the baby, the mammary glands become soft for 3-6 days. This sign is very informative before the mother begins to feel the baby's movements.
  • Fetal heartbeat cannot be heard ... Of course, this symptom can be precisely determined only by ultrasound. However, after 20 weeks, the doctor can independently check the baby's heartbeat using a special obstetric stethoscope. An independent pregnant woman cannot check this sign in any way.

No specialist will give you precise recommendations on how to identify a frozen pregnancy at home. However, if you develop any of the above symptoms, visit your obstetrician-gynecologist.
We talked with women who faced a similar problem, and they told us that they began to worry during a frozen pregnancy.

Many couples dream of having a child, but not everyone has this dream come true for different reasons. One of these reasons is a missed pregnancy.

The culprit for the occurrence of such a pathology may be not only the mother, but also the potential father, therefore it is very important when planning pregnancy to undergo a thorough examination and adhere to a healthy lifestyle for both partners.

According to statistics, missed pregnancies are recorded in 15-20% of all planned pregnancies, which is quite common.

Definition of "missed pregnancy"

Non-developing, or frozen, pregnancy is a pregnancy in which there is a sudden cessation of its progress, the fetus stops developing, grows and subsequently dies. At the same time, until a certain time there are no signs of spontaneous abortion, and the embryo continues to remain in the uterine cavity. Based on the foregoing, this pathology is also called a failed miscarriage. "Freezing" of pregnancy can occur at any gestational period (up to 28 weeks), but most often this situation occurs in the first trimester. Threatened periods of pregnancy due to the occurrence of a miscarriage are considered 3-4 weeks, 8-10 weeks, 16-18 weeks.

Miscarriage, like other options for spontaneous abortion, belongs to the category of miscarriage. However, they begin to talk about habitual miscarriage only if there are two or more cases of spontaneous abortion.

The essence of a frozen pregnancy is that the egg is fertilized, transported into the uterine cavity, where it is implanted and develops for some time, but after the development of the fetus stops. One of the options for a frozen pregnancy is the syndrome of "empty ovum", or anembryonia. In such cases, the membranes develop, the synthesis of chorionic gonadotropin occurs, which is confirmed by a positive response when performing a pregnancy test, but the embryo itself is completely absent. Quite often, such a pathology is the result of the presence of genetic defects.

Causes of a frozen pregnancy

There are many reasons for a frozen pregnancy. Therefore, they are divided into several groups:

    Genetic and chromosomal abnormalities.

It is one of the most numerous and important groups of etiological factors for the occurrence of a missed pregnancy. When an embryo has an abnormal gene or an extra chromosome, in the process of development, it develops multiple malformations that are incompatible with life, respectively, in this case the pregnancy is also interrupted. We can say that, thus, you can see natural selection in action, nature decides that it makes no sense to produce an incapacitated baby, therefore, to save the forces of the mother's body, pregnancy stops progressing.

But the occurrence of a genetic anomaly can occur both during a specific case of pregnancy when the mother's body is exposed to pathogenic factors (smoking, drug and alcohol use, radiation), and due to inheritance of pathology from parents, for example, the occurrence of a malfunction in the structure of "predisposition genes". Thus, if the ovum received the "thrombophilia gene" from the parents, then in the process of its attachment to the wall of the uterus and invasion of the chorionic vessels into the mucous membrane, microthrombi appear, respectively, this leads to disruption of the blood supply and nutrition of the embryo, and it dies.

    Infections.

The presence of infectious diseases plays a significant role in the origin of spontaneous abortion or missed pregnancy. First of all, these are the so-called TORCH infections (a group of viral diseases). This group of pathologies includes cytomegalovirus infection, herpes infection, toxoplasmosis, rubella. Primary infection with the above pathologies during pregnancy is especially dangerous.

In the early stages of infection, pregnancy "freezing" occurs, in later stages, fetal developmental abnormalities are formed. Sexual infections (gonococcal, ureaplasmic, chlamydial) are also essential. Even the presence of a common cold (ARVI, flu) in the early stages of pregnancy can cause a miscarriage to occur. The death of the embryo is realized by three mechanisms.

    On the one hand, penetrating the placenta, infectious agents directly affect the fetus.

    On the other hand, the maternal body, in response to infection, begins to produce prostaglandins, which either disrupt microcirculation between the endometrium and fetal membranes, or affect the embryo toxicly, which leads to the cessation of the supply of oxygen and nutrients to the fetus.

    The presence of a chronic inflammatory process in the uterine cavity leads to a violation of the normal implantation of the ovum, which leads to a nutritional deficiency in the embryo.

    Hormonal Disorders.

Lack of the most important hormone for the normal course of pregnancy - progesterone - quite often acts as one of the factors in the occurrence of miscarriage. In addition, a high androgen content or a violation of the hormonal functions of the thyroid gland plays a role.

    Autoimmune pathology.

Autoimmune diseases are distinguished by the fact that the mother's body begins to synthesize antibodies that fight its own cells, mistaking them for foreign agents. Since the embryo receives 50% of the mother's genes, the mother's antibodies begin to attack his body, which, in turn, ends with the fading of the pregnancy.

For example, if the mother has antiphospholipid syndrome, antibodies to phospholipids are present in the body, and without them, in principle, the formation of new cells is impossible. During pregnancy, these antibodies attack the developing embryo, causing it to die.

    Teratozoospermia.

The reason for the termination of the development of the embryo and its subsequent death may be the failed father. The presence of such a pathology as teratozoospermia is most often the cause of the partner's infertility, however, in some cases, pregnancy may occur, but in most cases it ends in miscarriage. Teratozoospermia is a pathological condition of spermatozoa, in which they have an irregular structure. Sperm abnormalities can manifest as thickening or kinking of the tail, the absence of a chromosome, the presence of vacuole cells in the head, an irregular head shape, and a short tail.

Teratozoospermia is said to be when there are more than 50% (in most cases about 80%) abnormal sperm in the patient's ejaculate. Conception in such cases is either completely impossible, for example, due to the fact that sperm with a short tail lose their mobility, or the egg is fertilized, but due to an anomaly of the sperm head, the embryo develops incorrectly and the progression of pregnancy stops. After examination and therapy, many couples are still forced to turn to additional assisted reproductive technologies, for example, artificial insemination.

    Wrong way of life.

It is obvious that bad habits, industrial hazards, daily routine, nutrition have a certain influence on the occurrence of undeveloped pregnancy. You also need to remember about the presence of dangerous side effects from some medications that a pregnant woman can take during gestation, especially in early pregnancy. The age of the woman is also essential. The older a woman is, the higher the risk of an undeveloped pregnancy (from 35 years).

    Other factors.

A sharp change in climate, constant stress and other factors can cause a frozen pregnancy. In addition, a history of numerous abortions causes endometrial failure, which, in turn, leads to a disruption in the supply of oxygen and nutrition to the embryo and the development of pathology. After performing in vitro fertilization, cases of frozen pregnancy also occur quite often, however, the causes of the pathology in this case are due to diseases due to which the woman resorted to this method of fertilization.

Failed abortion clinic

A frozen pregnancy has characteristic symptoms. First of all, the woman loses the probable signs of pregnancy (characteristic of the first trimester). Vomiting and nausea, odor intolerance disappear, the tension of the mammary glands is lost, they become soft. However, the loss of the described symptoms does not always mean that the embryo has died.

    Early toxicosis, like tension in the mammary glands, may be absent.

    Quite often, the moment of death of the embryo goes unnoticed.

    A positive pregnancy test may still be present for 2-4 weeks as hCG is gradually cleared from the mother's body.

    At the same time, the basal body temperature will be around 37 and even below degrees.

    If a dead embryo remains in the uterus for more than 3-4 weeks, a syndrome of intoxication of the body occurs (malaise, general weakness, an increase in body temperature), due to the fact that the embryo begins to decompose and infects the mother's body with tissue decay products and toxins.

    If a frozen pregnancy occurs in the 2nd trimester, then one of the first signs is the absence of fetal movement.

    If the embryo is in the uterus for more than 2-6 weeks, then the symptoms of spontaneous abortion (aching pains in the lower back and lower abdomen, dark spotting) are added to the symptoms described above.

    In addition, in the process of a gynecological examination, a lag in the growth of the uterus is recorded, compared with the approximate period. Therefore, gynecologists perform bimanual palpation of the uterus in the first trimester, each time they appear for examination.

Practical example: in the antenatal clinic, a woman was observed at 6 weeks of pregnancy, with a second pregnancy. After studying the anamnesis, it was found that childbirth was 3, and no medical and diagnostic curettage and abortions were performed. The woman and her husband did not have bad habits, as well as chronic diseases. The only negative aspect was the age of the pregnant woman (40 years) and the nature of the activity (night shifts, nurse). During the planned visit, the pregnant woman complained of pulling pains in the lower abdomen and periodic spotting. During a vaginal examination, it was found that the uterus is soft, painless with an increase of up to 12 weeks, while the approximate period is 16 weeks. After undergoing ultrasound and confirming the diagnosis of "frozen pregnancy", the woman underwent curettage followed by antibiotic therapy. There were no coagulopathic and infectious complications, and after 10 days the patient was discharged. The reason for the frozen pregnancy was never established, since the parts of the fetus that were sent for histology were lost in the laboratory.

Treatment for miscarriage

If you suspect a frozen pregnancy, a woman must be urgently hospitalized.

    After the examination (hCG, ultrasound in the early stages and ACE in the 2nd trimester, coagulogram), the embryo is carefully evacuated.

    A wait-and-see option is possible, when the fetus is dead for less than 2 weeks (if this happened in early pregnancy) and there are no signs of an abortion that has begun and an infection of the uterus. In such cases, the level of hCG in the woman's body drops rapidly, uterine contractions appear, the ovum is pushed out. However, most often they resort to using a surgical method, namely, the membranes with the ovum are scraped out or subjected to vacuum aspiration.

    It is also possible to use medical abortion (for periods up to 7 weeks) by prescribing a progesterone blocker "Mifegin".

After surgical or other release of the uterine cavity from the embryo, hysteroscopy is mandatory. In the postoperative period, antibiotics are required to prevent the development of chorianamnionitis and endometritis.

In case of fetal death after 14-16 weeks, its evacuation is performed by transcervical administration (amniocentesis) of a hypertonic solution of sodium chloride or prostaglandins, or by intravenous administration of a solution of prostaglandins.

Frozen pregnancy, what to do then?

The most frequent question of all patients is: "What to do after a frozen pregnancy?" The material obtained after scraping must be sent for histological examination without fail. In some cases (if there is a suspicion of a chromosomal pathology), additional genetic studies of the tissues of the embryo (quality and number of chromosomes) should be prescribed.

Women are advised to abstain from pregnancy for 6 months, while the doctor prescribes oral contraceptives ("Janine", "Yarina"). It is also necessary to be examined for the presence of TORCH infections. The hormonal status must be examined without fail, and, if necessary, its correction performed. An ultrasound examination of the blood coagulation system and pelvic organs is also performed, and a blood test is performed for the presence of antibodies to phospholipids.

When planning a new pregnancy, a couple is advised to abandon bad habits, if possible, eliminate the reasons why the previous pregnancy froze, treat infectious diseases, and lead a healthy lifestyle. Women are prescribed vitamin E and folic acid intake 3 months before the planned pregnancy and during the first 12 weeks of pregnancy.

Frozen pregnancy - one of the most terrible pathologies of pregnancy - the death of the fetus in the womb.

For those who waited a long time and wanted to conceive a baby, this is a great tragedy. However, the situation is far from hopeless, and the chances of conceiving and bearing a healthy child again are very high. In addition, this is also a good reason to reconsider your lifestyle, undergo an examination and take a responsible approach to pregnancy planning.

A frozen pregnancy is a stop in the development of an embryo or fetus that occurs before 28 weeks of gestation. Another option is also possible: the egg was fertilized, but the embryo did not begin to form in it.

The most dangerous weeks in which pregnancy stops most often:

  • from 3 to 4;
  • from 8 to 11;
  • from 16 to 18.

Deserves special attention 8 week... Since it is during this period that all the vital organs of the embryo are “laid down”, and it is most susceptible to negative factors.

Frozen pregnancy: early symptoms

If pregnancy freezes for up to 16 weeks, then it is characterized by the following symptoms.

A sharp disappearance of symptoms of toxicosis: nausea and bouts of vomiting pass, the mammary glands lose soreness and return to their normal volume, become soft.

Lower abdominal pain: often have a mild pulling character. However, pain during a frozen pregnancy is not always present.

The same is observed spotting, bloody or brownish.

Basal temperature with a frozen pregnancy falls to the level characteristic of the absence of pregnancy.

If a woman did not notice a frozen pregnancy in time, and the dead fetus is in the uterus for a long time, intoxication may begin, for her characters:

  • sharp pain in the groin and lumbar region;
  • temperature increase;
  • pallor of the skin;
  • weakness.

All this is fraught with the development of blood and tissue infection - sepsis, since the decay products of the dead ovum enter the woman's bloodstream.

It is worth noting that the manifestation of symptoms is extremely individual, and in some cases a woman does not know that the pregnancy has stopped in development, until the next examination. If a woman observes them at home, she needs to see a doctor, but do not immediately panic and commit rash acts. It is advisable to get advice from several specialists, at least two.

There are real cases when in one antenatal clinic a woman was diagnosed with a frozen pregnancy, and in another they said that everything was in order, and as a result, this pregnancy was resolved with a successful birth.

Frozen pregnancy: late pregnancy symptoms

It is possible to recognize a frozen pregnancy that has stopped developing in the second trimester (up to 28 weeks), first of all, by the lack of fetal activity - a child stops moving in a woman's belly.

As you know, the first movements of the baby fall on the period from 17 to 20 weeks. Everything here is individual - there are children who are active and not very active, but if the child does not move for 4-6 hours, this is a reason to consult a doctor. You should not wait any longer, at this time the fetus may suffer from hypoxia, which, in the end, can also lead to its death.

Another symptom of a missed pregnancy in the second trimester is change in the state of the mammary glands... It is noteworthy that if the development of the fetus stops for up to 25 weeks, the breast also returns to a "pre-pregnant" state, but if the pathology develops later than the 25th week, it is possible that the mammary glands will swell even more, and colostrum will begin to be released from them.

Pain in the groin or lower back, a general deterioration in well-being, nausea are also symptoms of frozen in late pregnancy, and appear a few days after the death of the fetus.

Freezing early pregnancy: causes

  • chromosomal abnormalities in the fetus, in particular, they can be caused by the consanguinity of the mother and father;
  • Rh-conflict between mother and child, and in most cases, negative Rh in the mother;
  • teratogenic effects, i.e. the impact on the developing body of drugs that a pregnant woman takes for a period of 1 to 10 weeks. Later, the child is already protected by the placenta, and earlier it is not yet sufficiently connected to the mother's body to perceive all the factors. However, some medicines accumulate in the body and exert their effect on it for a long time after use;
  • antiphospholipid syndrome; an autoimmune disease, expressed in the production of antibodies by the body to its own phospholipids (components of the cell walls). In pregnant women, the disease manifests itself in the form of blood clots in the vessels of the placental tissue, which interfere with the normal supply of the fetus with food and oxygen. It is noteworthy that almost half of the women suffering from this disease had 2 frozen pregnancies in a row. However, this diagnosis is not a sentence, and with it it is quite possible to endure and give birth to a healthy child - with timely detection and treatment;
  • disturbed hormonal balance, as a rule, a lack of progesterone. Women who have already had frozen pregnancies, miscarriages, menstrual irregularities and other manifestations of hormonal imbalance should be alerted in advance;
  • serious psychological stress and physical stress;
  • unfavorable environmental conditions and bad habits of one or both parents: smoking, alcohol consumption, drug addiction;
  • physiological features and anomalies of the structure of the uterus of a pregnant woman;

In addition, in some cases it is still not possible to find out why a frozen pregnancy occurs.

Freezing late pregnancy: causes

  • infectious diseases, including diseases transmitted through sexual contact (influenza, rubella, cytomegalovirus, mycoplasmosis, syphilis, gonorrhea, chlamydia, etc.);
  • hormonal disorders;
  • diseases of the kidneys and cardiovascular system of a pregnant woman;
  • genetic and other fetal abnormalities incompatible with vital functions.

Diagnosis of a frozen pregnancy

The most accurate way to determine a frozen pregnancy, both early and late, is an ultrasound scan, during which a specialist will check:

  1. The discrepancy between the size of the uterus and the gestational age;
  2. Lack of heartbeat and breathing movements;
  3. Incorrect position, deformation and contour around the body of the fetus at a later date, indicating tissue decomposition;
  4. Lack of visualization and embryo growth in early pregnancy. It is very rare, but it also happens that the ovum grows for some time, and the embryo does not form in it or has stopped developing.

This also explains the sometimes arising problems with determining a frozen pregnancy based on the results of an analysis for hCG, the second method for diagnosing pathology. It so happens that an ultrasound scan detects a halt in the development of pregnancy, and the level of hCG in the blood continues to grow, since it is produced by the membrane of the ovum, or it itself remains at a high level for several days after the death of the fetus.

As you can see and frozen pregnancy test may show a positive result, because and its action is based on the detection of hCG in urine.

Although, as a rule, the level of hCG during a frozen pregnancy drops sharply or is equal to zero.

Consequences and termination of a frozen pregnancy

As a result of a frozen pregnancy, there are two possible scenarios for the development of events:

  1. Spontaneous miscarriage in the early stages, when the uterus rejects the dead embryo and removes it from the body;
  2. Medical intervention. If it is not carried out on time, then in the later stages the decomposing fetus will poison the mother's body with decay products, which will lead to serious consequences for her health.

So, if a frozen pregnancy is diagnosed, then its termination at the moment is possible in several ways.

1. Medication. This is a way to terminate a frozen pregnancy in the early stages. A woman is prescribed drugs that provoke uterine contractions, and, as a result, a miscarriage.

2. Curettage, or scraping (cleaning) with a frozen pregnancy. A fairly popular, although not the most desirable, procedure, since during it tissues are injured and the likelihood of complications is high.

The operation is performed under general anesthesia and is a mechanical cleaning of the uterine cavity, removal of its upper mucous layer, with a special instrument, which is inserted into the cervical canal, having previously provided access there by installing dilators.

After the operation, bleeding or inflammation may develop, so the woman should be in the hospital for a few more days, where she will be monitored for her well-being.

3. Vacuum aspiration. The operation, carried out under anesthesia or local anesthesia, consists in cleaning the uterine cavity of a woman using a vacuum suction. It looks like this: the tip of a vacuum apparatus is inserted into the cervical canal (without expansion).

After the procedure, the woman should be under the supervision of a doctor for about two hours. Of course, this method of terminating a frozen pregnancy is more gentle than curettage. In addition, the woman will not have to stay in the hospital for a long time.

4. Childbirth. In the later stages, termination of a frozen pregnancy is much more difficult, mainly from a psychological point of view. The fact is that a non-developing pregnancy is a contraindication for a cesarean section (the contents of the uterus can be infected), so there is only one way out - artificial stimulation of labor. That is, a woman cannot simply disconnect from the process, for example, under anesthesia, she herself must give birth to a dead fetus on an emergency basis.

It is also worth noting that in the early stages, doctors sometimes do not make any attempts to terminate a frozen pregnancy, waiting for the uterus to reject the fetus itself.

Treatment and recovery after a frozen pregnancy

After a frozen pregnancy, an examination is prescribed to find out the cause of the pathology. If this can be established, it is recommended to undergo a course of appropriate treatment.

Usually analyzes after a frozen pregnancy include:

  • blood test for hormone levels;
  • smear and examination of the vaginal microflora for the presence of genital infections;
  • histology after a frozen pregnancy- study of the epithelium of the uterus. For analysis, a thin section of the upper layer of the uterus or tube is taken, or material obtained during curettage is used.

As for the restoration of the uterus after surgery, a course of antibiotics, haemostatic agents is usually prescribed, as well as abstinence from subsequent pregnancy for a certain time (depending on the accompanying factors).

In the case of identified genetic abnormalities of the fetus, after a frozen pregnancy, a geneticist will need to be consulted to determine the compatibility of partners.

Pregnancy after a frozen pregnancy

How much time a woman would not want to get pregnant is determined by doctors in each case, at least six months. Until that moment, a woman needs to use contraception and not worry that she will no longer be able to conceive a child. These fears are completely in vain.

A frozen pregnancy is, as a rule, a special case, which in no way indicates a violation of the woman's reproductive system.

However, remember, in order not to experience this blow again, a woman must undergo a thorough examination, adhere to a healthy lifestyle and competently approach the planning of the next pregnancy. In addition, it is very important that not only the expectant mother takes care of her health, but also the future father supports her in this. And the point here is not only moral support: it has been established that miscarriage in some cases is due to factors emanating from the man.

Of course, surviving a frozen pregnancy is very difficult, and in the later stages, the depth of this tragedy is simply beyond words. But instead of falling into despair, a woman needs to shift all her attention to taking care of her health, and soon, she will know the joy of motherhood.

Answer

Abroad, they begin to examine for the syndrome of habitual miscarriage after the 3rd termination of pregnancy. At the same time, the probability of a fourth pregnancy after 3 miscarriages in a healthy woman is 75%. In Russia, the diagnosis of "habitual miscarriage" is made after 2 unsuccessful outcomes. What are the reasons for the fading of pregnancies? In what time frame is pregnancy fading most likely? What to do if the trouble still happened?

What is a frozen pregnancy

When the fetus for some reason stops developing and dies. Most often this happens in the first trimester of pregnancy, but it also happens in the second and even in the third.

A frozen pregnancy is a type of miscarriage. The onset of such a pregnancy proceeds in the same way as in a normal one: a fertilized egg reaches the uterus and is implanted in it. At the same time, a woman has all the characteristic signs of pregnancy: menstruation stops, the mammary glands become engorged, the uterus increases in size. The moment of termination of fetal development often passes unnoticed by a pregnant woman, especially in the early stages.

As a variant of a frozen pregnancy, a case can be presented in which, after fertilization and implantation, the embryo does not develop at all, only extraembryonic organs (fetal membranes) are formed. This condition is called "empty ovum".

The timing at which most often there is a stop in the development of the fetus

Doctors calculated the timing at which the embryo is most vulnerable: 3-4 weeks, 8-11 weeks and 16-18 weeks of pregnancy. The 8th week of pregnancy is especially critical. It is at this time that the probability of a miscarriage and a frozen pregnancy is high. This is the time for laying the vital organs of the future baby and changes in the mother's body.

Causes of a frozen pregnancy

Genetic disorders- the most common cause of a frozen pregnancy. Up to 70% of non-developing pregnancies before 8 weeks of gestation are due to chromosomal abnormalities in the fetus. Fetal genetic abnormalities manifest themselves quite early, many of them are incompatible with life. Genetic “breakdowns” are inherited by the embryo from both the mother and the father, or they occur when the combination of parental genes is unsuccessful. It is believed that if the second, third or more pregnancies freeze in a row, genetics is to blame. However, doctors find it difficult to say with precision.

Hormonal Disorders- common. One of the hormonal reasons for a frozen pregnancy and spontaneous abortion is a lack of progesterone, without which the embryo cannot firmly "settle" in the uterus. The second is hyperandrogenism. In about 20% of women during pregnancy, the level of male sex hormones - androgens - increases - this is the second possible reason for the fading of pregnancy.

These disorders can be predicted by the analysis of hormonal status even before pregnancy and treatment can be started in advance. At the very least, it is recommended to be tested for hormones at the first visit to the gynecologist about pregnancy.

Up to 30% of missed pregnancies are due to infections. Pregnancy is a state of suppression of the immune system. Otherwise, how could the mother's organism come to terms with the appearance on its territory of a "stranger", half of whose genetic information is completely different? The child is reliably protected from the attack of antibodies by the placenta and fetal membranes, but the mother is vulnerable to various infections. In pregnant women, everything is exacerbated infectious diseases... The “local” harmless flora, having gained freedom, multiplies beyond measure, causing a lot of problems. The flora of the vagina is activated, and there is a danger of intrauterine infection of the fetus.

Cytomegalovirus (CMV) and rubella virus cause irreversible changes and multiple malformations. However, their infection is dangerous only during pregnancy, the "old" infection, on the contrary, creates an incentive for the production of antibodies of the IgG class and prevents the exacerbation of the disease. Another danger is the flu epidemic. In pregnant women, banal ARVI is difficult, because the immune system works half-heartedly. Moreover, the danger comes not so much from the pathogen itself, but from general symptoms: intoxication, fever, which leads to disturbances in blood flow in the mother-placenta-fetus system. The embryo lacks oxygen and nutrients and may die.

At IVF pregnancy freezes more often. Unfortunately, according to statistics, a pregnancy that occurs after IVF is more likely to end in a frozen pregnancy or to terminate spontaneously than a pregnancy after natural conception.

Wrong way of life can also cause a frozen pregnancy. Frozen pregnancy often comes from stress and overexertion. The kid is unlikely to like it if mom spends a full day in a stuffy room, staring at the computer, and getting up from a chair just to drink a couple of cups of coffee and make Doshirak for lunch. Such conditions can contribute to various complications, for example, early placental abruption, and lead the uterus to a state of increased tone. Both disrupt blood flow, and the unborn child receives little oxygen and nutrients.

In the overwhelming majority of cases, a missed pregnancy is the result of an unfortunate combination of circumstances, a bad combination of random and completely recoverable factors. The six-month interval required to restore the endometrium and hormonal status for the next pregnancy will allow all the necessary medical measures to be carried out and give the body a break.

Signs of a frozen (non-developing) pregnancy

Most often, it is not possible to independently suspect a frozen pregnancy. Cessation of pre-existing pregnancy symptoms (nausea, vomiting in the morning, tension in the mammary glands) may be initial. But these are far from accurate criteria for diagnosis. More alarming is the appearance of bloody secretions, which also does not allow a diagnosis to be made. A doctor's examination and an additional examination (ultrasound, hCG blood test) are required.

Most often, a non-developing pregnancy ends with a spontaneous miscarriage - the uterus contracts, bleeding begins (the ovum exfoliates) and the trophoblast or the placenta is already expelled from the uterine cavity. For several days, spotting bloody discharge from the uterus continues, then completely stops. However, in a number of cases, miscarriage does not occur, then the tactics of further actions are developed individually at the consultation of a gynecologist.

Basal temperature with a frozen pregnancy

With a frozen pregnancy in the first trimester, most often, the basal temperature decreases, but not always. The temperature can remain above 37 degrees and during pregnancy fading! If you suspect a frozen pregnancy, it is advisable to conduct an ultrasound scan.

Diagnostics of the undeveloped, frozen pregnancy

During a gynecological examination:

  • discrepancy between the size of the uterus and the gestational age (the uterus is less than the expected gestational age);

With ultrasound examination (ultrasound) of the small pelvis:

  • lack of fetal heartbeat;
  • anembryonia (empty fertilized egg, without embryo);

With hormonal blood tests:

  • stopping the progressive growth of the pregnancy hormone, hCG (choriogonic gonadotropin), characteristic of normal pregnancy.

The management tactics for detecting a non-developing pregnancy can be different and depends on each specific case:

1. Expectant. After a while, due to the death of the ovum, the level of placental hormones decreases and a spontaneous miscarriage occurs.

2. Medication interruption: If the pregnancy is less than 8 weeks, it is possible to use a progesterone antagonist drug (mifepristone), which is taken in pill form, in combination with a prostaglandin E1 analogue (misoprostol), which is administered vaginally; after a while, under the influence of drugs, a miscarriage occurs.

3. Surgical treatment: Curettage (curettage) of the uterine cavity.

The duration of the procedure depends on the individual characteristics of each woman. The need for further hospitalization depends on the course of the postoperative period, on the presence of any infection and on many other reasons. But, as a rule, treatment after such an operation continues in a hospital setting. In terms of the technique, this operation is similar to an abortion and is performed under general anesthesia. After emptying the uterus, depending on the situation, drugs that reduce the uterus and antibiotic therapy may be prescribed. After 1-2 weeks, it is necessary to undergo an ultrasound examination (ultrasound) of the uterus in order to assess the state of the uterine cavity (whether there are any remnants of the ovum) and how well the uterus contracted.

Pregnancy after "frozen pregnancy"

The prognosis after a missed pregnancy is generally favorable. Most women do not have problems with the onset and gestation of subsequent pregnancies. Approximately 80-90% of patients who had a single frozen pregnancy in the past safely carry and give birth to healthy children. If pregnancy losses have happened repeatedly (2 or more times) and we are already talking about habitual miscarriage, the prognosis is worse, and the couple needs a more in-depth examination.

  • Ultrasound examination (ultrasound) of the pelvic organs
  • Examination for urogenital infections (smears from the cervix using PCR diagnostics)
  • Determination of the level of homocysteine ​​in the blood
  • Determination of the level of autoantibodies in the blood
  • Determination of the titer of antibodies to rubella in the blood

Study of the level of thyroid hormones in the blood. However, an individual examination plan is developed only after consulting a gynecologist and can be expanded, taking into account individual characteristics.

Who is at risk for recurrent missed pregnancies?

The risk group for repeated non-developing pregnancy primarily includes women who have undergone abortions. Moreover, the greater the number of abortions, the greater the likelihood of encountering such a problem.

In addition, it includes women who have had an ectopic pregnancy, as well as those whose pregnancy "froze" at the very last moment, and an unviable child was born. This group includes all those suffering from infectious and viral diseases of the reproductive system.

Often a woman's age is also a risk factor for pregnancy fading. That is why it is advisable to have your first child before the age of 30. Also, some anatomical features of the female reproductive system can become an obstacle to carrying pregnancy. These include the two-horned and saddle-shaped uterus. These are congenital developmental disorders of this organ, in which its shape is so altered that it interferes with the normal development of pregnancy and the pregnancy fades. Such disorders include adhesions inside the uterine cavity, formed after inflammation, and a congenital septum, which, as it were, separates it from the inside.

Uterine fibroids can also interfere with the normal development of pregnancy. It deforms the uterine cavity and prevents the correct attachment of the ovum.

Risk factors for recurrence of a non-developing pregnancy include endocrine disorders: diabetes mellitus, thyroid diseases, especially a decrease in its function, menstrual irregularities, a failure in the production of progesterone, a hormone responsible for the normal development of pregnancy.