Early pregnancy. Early pregnancy: first signs and consequences

Early pregnancy, leading in some cases to motherhood at a young age, is a serious medical and social problem of modern society. The existence of this problem is due to the early onset of sexual relations in adolescents, combined with low medical literacy of the population regarding contraception.

So, every year in the world about 15 million children are born to young mothers. Infant mortality of such babies is 5-8 times higher than that of children in the general population.

What is considered an early pregnancy?

Synonymous with early pregnancy is pregnancy in young women who have not yet reached puberty. Their age ranges from 12 to 17 years inclusive. In different countries of the world, age and criteria for social maturity differ. Therefore, in a number of countries (for example, in some African countries), teenage pregnancy is a common phenomenon that only confirms the fertility of a young woman.

In our country, about 15% of all births occur to mothers whose age ranges from 15 to 19 years. About a third of all early pregnancies end in abortion. Miscarriages - about 14% of teenage pregnancies. Slightly more than half of early pregnancies end in childbirth.

The earliest pregnancy in the world, as a result of which a baby was born, is listed in the Guinness Book of Records. It happened to a five-year-old Peruvian named Lina Medina. This early pregnancy ended by caesarean section on time. A healthy son weighing 2 kg 700 g and 47 cm tall was born to such a young mother. This shocking event happened in 1939.

What caused this earliest pregnancy? The girl from birth developed very rapidly, she showed signs of premature puberty. Pubic hair began to grow from the age of three months, and by the age of 8 months (according to some sources at 3 years old) she had already started menstruating. At the age of 4 years, the mammary glands began to develop.

Who became the culprit of the earliest pregnancy in the world remains a mystery. Lina herself was silent about this fact all her life. She gave birth to another child in 1972. Lina Medina died in November 2015, and her first son died of cancer at the age of 40.

The earliest pregnancy in the Soviet Union was recorded in 1934 in Kharkov. Lisa Grishchenko became a young mother, who gave birth to a full-term baby at the age of 6 from her own grandfather. Unfortunately, the baby died during natural childbirth. She was not given a caesarean section due to the risk of septic infection.

Age at early pregnancy and menstrual cycle

The younger the mother's age during early pregnancy, the more likely it is that this pregnancy will proceed with pathologies. This is due to the fact that the biological maturity of the organism increases gradually.

In gynecology, there is a very important concept called "menstrual age". It reflects the number of years from the first menstruation to the onset of this pregnancy. Menstrual age during early pregnancy is of great importance in terms of the prognosis of this pregnancy for mother and baby. Regarding this indicator, all young mothers are divided into groups:

• Women with a menstrual age of 1 year or less;
• Women with a menstrual age of 2 years;
• Women with a menstrual age of 3 years or more.

Regarding the age of children and adolescents with early pregnancy can be divided into three groups:

• Super young primiparas (up to 9 years). These girls have accelerated sexual development.
• Young primiparous (9-15 years). Puberty is not over yet.
• From 15 to 18 years old. Adolescents who are already ripe for pregnancy and bearing a baby.

There are various reasons for early pregnancy. More often than not, there is a combination of causes. Factors that influence the high rate of early pregnancy in adolescents include the following:

• High sexual activity among minors.
• Exposure to violence (both physical and sexual), including in the family.
• Low material security and unfavorable living conditions.
• The birth of children at a young age among relatives, friends and the immediate environment of a teenager.
• Behavioral and psychological characteristics of a teenager: reduced ability to learn and learn new things, life "today" without plans for the future, a sense of invulnerability in relation to oneself.
• Rejection of contraceptives (not realizing their importance, unwillingness of a partner, personal motives, embarrassment to buy and use them, etc.).
• Intentional early pregnancy in adolescence for various reasons.
• Inaccessible or poor-quality medical care related to family planning.

In the event that an early pregnancy has occurred, the reasons for it must be sought not only from the side of the underage mother, but also from the side of the father, who also often turns out to be a teenager or a young man who faced the above problems at a young age.

Signs of early pregnancy

If there is a suspicion that an early pregnancy has occurred, its signs can be divided into probable and reliable. Some symptoms are noticed by the young pregnant woman herself, while others are alarmed by her environment (parents).

The first signs of early pregnancy may vary from woman to woman. Observing the following signs in yourself, it is impossible to say with certainty that pregnancy has occurred. But this fact cannot be ruled out either. Therefore, if there are likely signs of early pregnancy, it is recommended to contact the antenatal clinic as soon as possible.

If an early pregnancy is suspected in a teenager, the signs to look out for are the following:

Delayed expected menstruation.

It would seem that such a simple signal that pregnancy should be excluded in the first place turns out to be far from leading in the situation with adolescents. The fact is that failures of the menstrual cycle often occur in adolescence for various reasons. Especially for those girls whose menstrual age is not yet great. In addition, pregnancy is possible even if the girl has never had a period.

Increase in basal temperature.

Adolescents rarely face the need to measure basal temperature, but still its increase is one of the signs of pregnancy. In the absence of pregnancy after ovulation, the basal temperature decreases, if it is present, it stays above 37 degrees. They measure the basal temperature with an ordinary thermometer in the morning, without getting out of bed, in the rectum.

Nausea and vomiting.

These symptoms may be early signs of pregnancy, namely first trimester toxicosis. However, not all women have toxicosis. More often, these symptoms are disturbing in the morning. The appearance of toxicosis is mainly associated with hormonal changes in the female body. Nausea and vomiting can be observed in a number of somatic and infectious diseases, so you need to pay attention to other symptoms.

Change in taste preferences (craving for something, aversion from something).

These symptoms are not specific and often appear later in pregnancy.

Enlargement of the mammary glands and their soreness.

Sometimes the nipples become darker and more sensitive, the areolas increase. This is one of the first signs of pregnancy in the early weeks. The appearance of these symptoms is due to hormonal changes in the body of the expectant mother. It is possible that the appearance of such symptoms will be regarded by the expectant mother as signs of an approaching menstruation.

Pain in the lower back, sacrum, or lower abdomen.

The appearance of these symptoms is due to the release of the hormone relaxin, which from the first weeks of pregnancy affects the ligaments of the pelvic bones and makes them more supple and extensible. However, pulling pains in the uterus or cramping pains can be a sign of an incipient miscarriage during early pregnancy.

Frequent urge to urinate.

Worried about the feeling of a full bladder, although in reality there is very little urine. These symptoms are due to the onset of the release of human chorionic gonadotropin and an increase in the uterus, which begins to put pressure on the bladder. Similar symptoms can be confused with cystitis or urethritis, but with these diseases there are symptoms of inflammation.

Implantation bleeding.

At the time of implantation of the embryo into the uterine wall, its inner layer is damaged, which may be accompanied by small bleeding. These secretions differ in characteristics from menstrual blood, but in adolescence a similar symptom can be regarded as scanty menstruation.

The appearance of drowsiness, increased fatigue.

These signs of early pregnancy are due to hormonal changes. The appearance of such a symptom in adolescents is more likely to be regarded as overwork at school than as a sign of early pregnancy.

Increased secretions from the genital tract.

This is also a symptom of hormonal changes in the female body. Adolescence is often overlooked.

Frequent mood swings, emotionality.

Causeless joy, inability to hold back crying, unreasonable irritability - these are all symptoms of a hormonal surge during pregnancy.

The appearance of certain changes during a gynecological examination (changes in the mucous membrane of the vagina and cervix, changes in the consistency of the uterus, etc.). Determined only by the doctor.

In addition to these symptoms, there are other signs of early pregnancy (constipation, increased gas formation in the intestines, aversion to certain odors, increased salivation, etc.). Their main reason lies in the hormonal changes in the female body.

Signs of early pregnancy include the following symptoms:

Positive pregnancy test.

Based on the determination of the level of the hormone chorionic gonadotropin (hCG) in the urine of a woman. Can be used for early diagnosis of pregnancy, starting from the first day of delayed menstruation. Some doctors consider a pregnancy test to be a likely sign, since in some cases there are both false positive and false negative results. However, this symptom should be paid special attention. Its accuracy is from 90%.

High levels of hCG in a woman's bloodstream.

The level of this hormone gradually increases during the first trimester. The accuracy of this test is 99%.

Detection of a fetal egg or embryo in the uterus during an ultrasound examination.

This study helps to clarify the current situation, confirm the pregnancy or refute it.

Detection of the fetus in the uterus by palpation, listening to his heartbeat, sensation of fetal movements.

It is a 100% sign of pregnancy, but this is far from its first symptom.

Carrying an early pregnancy

Carrying an early pregnancy has its own characteristics. It depends not only on the young age of the mother, but also on the state of her health. If the expectant mother has concomitant problems from various organs, then this can affect the outcome of pregnancy and childbirth.

Pregnancy is always a big burden on the female body. And the body, which is not yet mature enough for such a difficult process of bearing a child, is hard at times. On average, in young expectant mothers, the duration of the entire period of pregnancy is somewhat shorter than in women at the optimal fertile age, and is 37.9 weeks. According to statistics, the lower the menstrual age of a minor, the earlier labor begins.

It is not always easy to make the decision to carry an early pregnancy. First of all, a young woman should have support from her parents, partner, relatives, friends. The material component of the issue, the social status of the family in which the teenage girl grows up, is important.

Both the young expectant mother herself and her parents must know that in most cases during pregnancy at an early age, complications and pathologies occur both during the bearing of the baby and during childbirth. The highest risks of adverse outcomes are in the group of women with a menstrual age of 1 year or less. Slightly less risk in women with a menstrual age of 1 to 2 years. The least pathologies and complications during gestation or the process of childbirth are observed in underage mothers with a menstrual age of 3 years.

The first trimester of pregnancy is very important and disturbing for expectant mothers who require special attention at this time. The first trimester lasts until the end of the 13th week of pregnancy. Powerful hormonal changes take place in the body. In the case of early pregnancy, a young expectant mother definitely needs help and support from parents and loved ones in such a serious period.

She needs to be informed that during this period all the baby's organs and his health are laid for life. Therefore, it is very important to lead a calm lifestyle, refuse to visit discos, reduce physical activity, go to bed on time, eat well, do not smoke, do not drink alcoholic and low-alcohol drinks. It is important to visit a gynecologist regularly, follow his instructions and undergo routine examinations.

In the first trimester, the risk of miscarriage is high. With the threat of this, most often the expectant mother is hospitalized. A minor who wants to bear a child must understand the degree of responsibility for the possible refusal of hospitalization.

Second trimester

The second trimester lasts from the 14th week of gestation until the end of the 26th week. The risk of miscarriage at this time is much less than in the last trimester. Expectant mothers tend to feel much better. They already have symptoms of toxicosis or significantly decrease, the stomach begins to grow. Behind shoulders already screening ultrasound. From 18 to 20 weeks, a young mother will be able to feel the movements of her baby. The baby is growing intensively, all his organs are being improved.

Reorganizations continue to occur in the body, the load on the heart, blood vessels, kidneys and other organs increases. In this period, the risk of exacerbation of chronic diseases is high. In the second trimester, a young expectant mother again expects a screening ultrasound of the fetus, blood tests. Regular visits to the antenatal clinic are extremely important.

The third trimester is the final one before childbirth, it begins at 27 weeks of pregnancy. The abdomen grows to a significant size, the load on the body also increases. Many women begin to tire of their pregnancy. The main task of the expectant mother in this period is to thoroughly prepare for childbirth. Especially important is the right psychological attitude, support for the expectant mother from the family and the doctor.

If possible, it is worth sending a pregnant minor to the mother's school or childbirth preparation courses. There she will be able to get reliable information about what childbirth is, how it goes, how to care for the baby and how important it is to breastfeed him.

In early pregnancy, the most optimal time for hospitalization in a maternity facility is a gestational age of 38-39 weeks. This is necessary in order to prepare the expectant mother for childbirth, to assess the condition of the birth canal and their readiness. It is important to decide in advance on the method of delivery.

Diagnosis of early pregnancy

Given the fact that early pregnancy in adolescents most often occurs unexpectedly and without desire, its timely diagnosis is difficult. Between a third and a half of all teenage pregnancies are either hidden by teenagers or not even suspected by them. Many adolescents seek medical advice already in late pregnancy. About 10% of young mothers are not registered at all for their pregnancy.

What methods of diagnosing early pregnancy are the most informative?

A pregnancy test is one of the ways to diagnose pregnancy, it is based on determining the level of the hormone human chorionic gonadotropin (hCG) in the urine of a woman. Despite the variety of tests on sale, the principle of their operation is the same. They are easy to use, but you must carefully follow the included instructions.

In the case when there is an early pregnancy, its diagnosis using a pregnancy test is informative from the first day of the expected menstruation delay. If the test results are questionable or if the result is negative, but if there are other likely signs of pregnancy, the test should be repeated after a few days, preferably in the morning. The level of hCG increases in early pregnancy with each passing day.

There are very sensitive pregnancy tests that can detect pregnancy even before a missed period (from the seventh day from the intended conception). They are more expensive than other tests.

A more accurate method for detecting pregnancy is the determination of hCG in a woman's blood. This analysis is informative even before the delay (from the seventh day from the moment of conception). In addition, it helps in the diagnosis of missed pregnancy.

Gynecologist's consultation

If the patient is suspected of early pregnancy, her diagnosis necessarily includes a survey and examination. Sometimes a girl denies the fact of sexual activity. This is not a reliable criterion in favor of the absence of her pregnancy.

It should alert the fact that the young woman does not have menstruation. Although during adolescence, irregular menstrual cycles often occur.

A gynecological examination provides a lot of information regarding the diagnosis of early pregnancy. The first signs of pregnancy in the early weeks (from 5-6 weeks) are as follows:

• Changed color of the mucous membrane of the vagina and cervix (cyanosis).
• Change in the size of the uterus, its consistency.
• Softening of the uterus, especially in the cervix. Because of this, the uterus becomes mobile.
• There may be bulging of one of the corners of the uterus (where implantation occurred). Gradually, this symptom disappears.
• The study noted mild excitability of the uterus.
• Deviation of the uterus anteriorly. Some women have a ridge-like thickening on the surface of the uterus in front.

In addition to the examination on the gynecological chair, the doctor conducts a survey regarding the general health of the minor, studies the anamnesis of life, measures the height, weight and size of the pelvis.

The doctor informs about the dangers of carrying an early pregnancy, but at the same time warns about the dangers of terminating it. Very often, after an abortion, due to early pregnancy, a woman cannot become pregnant or bear a child in the future.

The gynecologist gives directions to a number of additional laboratory and instrumental studies that are necessary to assess the health of the patient, confirm the fact of pregnancy.

In the event that a decision is made to carry an early pregnancy, the doctor sets the date of registration of the future mother, starts an exchange card for the pregnant woman.

The first signs of pregnancy in the early weeks are not always visible during a gynecological examination, or they are not very pronounced. Especially if the expected pregnancy is 4-5 weeks. However, in some cases it is very important to diagnose it in time.

In such cases, an ultrasound examination of the pelvic organs (ultrasound) will help. Ultrasound signs of early pregnancy are as follows:

• Detection of a fetal egg in the uterine cavity.
• Visualization of the yolk sac.
• Detection of the fetal pole (or embryonic).

A fetal egg can be found in the uterine cavity for a period of 4-5 weeks from the first day of the last menstruation, if examined with a transvaginal (through the vagina) sensor. Its diameter at this time is 2-3 mm.

When examining the uterine cavity with a transabdominal sensor (through the abdomen), you can see the fetal egg at a later date (5-6 weeks), its size will be about 5 mm.

The doctor compares the data obtained on ultrasound with the delay in menstruation. In some cases, this helps to recognize a missed pregnancy. Conversely, if a teenager does not remember the date of the last menstruation, or she has an irregular cycle, then with the help of ultrasound, you can approximately determine the gestational age. Sometimes it requires an examination with the help of an ultrasound diagnostic apparatus in dynamics in order to assess how well the pregnancy develops and whether it develops at all.

In addition to the fetal egg during uterine pregnancy, the ultrasound doctor must definitely see the yolk sac, which performs very important functions in the life of the embryo (nutrition, hematopoiesis, synthesis of important proteins, etc.). The yolk sac can be seen on ultrasound even before the appearance of the embryo. With a fetal egg about 5 mm in size, the yolk sac has a size of 3 to 6 mm.

The embryonic pole is understood as the visualization on ultrasound of two points that are as far apart as possible from each other. Dimensions increase every day by 1 mm. At 6 weeks gestation, fetal heartbeats can be detected. If there are doubts about heartbeats, then the study should be repeated after 3-5 days.

A planned ultrasound during pregnancy is carried out for a period of 10 to 14 weeks. It is also called screening. This study evaluates the development of embryos, their number, the formation of the main organs and systems, the limbs of the child. The doctor studies the motor activity of the embryo (fetus), the nature of its heartbeats. An assessment is made of certain indicators, which, when increased, are markers of chromosomal disorders. These include the thickness of the collar space, the size of the nasal bone.

Features of childbirth during early pregnancy

Childbirth during early pregnancy has its own characteristics. These births often occur with anomalies of labor activity and complications. The frequency of complications in childbirth is higher, the lower the menstrual age of a woman. The use of various obstetric aids in childbirth in young women in labor occurs no more often than in women of mature age.

When choosing a method of delivery during early pregnancy, the general health of the mother, the presence of concomitant diseases, the size of the pelvis and fetus, fetal presentation, the nature of the placenta and other factors must be taken into account.

In the first stage of labor, a young woman in labor is carefully monitored, fetal cardiotocography (CTG) indicators are recorded, and, if necessary, labor is stimulated and anesthesia is administered.

On average, the duration of labor in early pregnancy does not differ from that in more mature women. Prolonged labor is more common in mothers whose menstrual age is about 1 year. But rapid and rapid childbirth, on the contrary, is usually recorded by women with a menstrual age of 3 years or more. Postpartum complications in underage puerperas are quite common. The most serious are bleeding and endometritis.

What are the most common complications of natural childbirth during early pregnancy in women with menstrual age up to 2 years? These include:

• Mismatch between the size of the fetus and the size of the birth canal of the mother;
• Weakness of labor activity;
• Injury to the birth canal;
• Bleeding after childbirth, etc.

Complications of childbirth in young women in labor with a menstrual age of 3 years include:

• Rapid duration of labor;
• Weakness of labor activity or its discoordination;
• Injuries of the cervix and perineum, etc.

Caesarean section in early pregnancy

In some cases, childbirth during early pregnancy occurs operatively, that is, by caesarean section. In general, operative births in young mothers are less common than in older women. Indications for operative childbirth do not differ from each other.

Most often, an emergency cesarean section during early pregnancy due to a mismatch in the size of the fetus and the pelvis of a young mother, anomalies in labor, increasing fetal hypoxia during childbirth (lack of oxygen), the appearance of signs of placental abruption, etc.

In the event that there is an early pregnancy, and a planned cesarean section is indicated according to the available indications, the woman should go to the hospital in advance to prepare for the upcoming operation.

Complications in early pregnancy are more common than in later pregnancy. This is due to the fact that early pregnancy initially takes place in the body, which is not yet mature enough for this. In addition, about 75% of adolescent girls have chronic diseases, about 15% suffer from gynecological disorders. These factors have a significant impact on the complications of early pregnancy.

Due to the fact that early pregnancy occurs, as a rule, in sexually active young women who have not yet married, colpitis (inflammation of the vaginal mucosa) and other inflammatory processes in the genital area often occur. These processes can lead to premature termination of pregnancy at an early stage, the birth of a premature baby, or infection of the baby.

In adolescents, varying degrees of narrowing of the pelvis are more often recorded, which can adversely affect the presentation of the child and the process of childbirth. Although the ligamentous apparatus of the pelvic bones is quite malleable in adolescents. Very often, breech presentation of the fetus during early pregnancy occurs due to the narrow pelvis of a woman.

Anemia is three times more likely to be a complication of early pregnancy than with gestation in adulthood. Moreover, its severity depends on the age of the young mother: the younger the woman, the more severe the anemia. It is not always possible to keep hemoglobin at a normal level even with adequate treatment.

About half of young expectant mothers suffer from preeclampsia in the second half of pregnancy. These gestosis are moderate to severe and occur several weeks earlier than in older women.

Another serious complication of early pregnancy is chronic placental insufficiency. It arises due to the fact that the placenta does not cope with the tasks assigned to it. As a result, the fetus begins to suffer from oxygen starvation, which affects its physical development and maturity.

Various labor anomalies often complicate early pregnancy. Also, after childbirth, adolescents often develop infectious and inflammatory complications, which is due to the stress of the immune system at this age.

Improper attachment of the placenta most often becomes a complication of early pregnancy in underage mothers with a menstrual age of up to 2 years.

Children from early pregnancy

Children from early pregnancy can be born completely healthy. To achieve this, it is very important to eat well while carrying a baby, rest, engage in moderate physical activity, do not smoke, do not drink alcohol and drugs, regularly visit a doctor in a antenatal clinic and other specialists and follow their instructions.

Quite often children from early pregnancy are born prematurely. The deeper the degree of prematurity of the baby, the more health problems await him. But post-term children from young mothers are rarely born. In children from young parents, various malformations are more common.

Often, children from early pregnancy are fed with milk formulas due to the lack of desire of a young mother to breastfeed her baby, or because she could not cope with the first difficulties of breastfeeding on her own. However, an important fact in favor of breastfeeding is the economic component. The low or no income of underage parents does not allow them to buy quality milk formulas for their children. Therefore, they should be aware of this side of the issue in advance.

A large role in the promotion of breastfeeding among underage mothers belongs to the antenatal clinic and the maternity hospital.

The specialists of these medical institutions clearly talk about the benefits of breastfeeding the baby and help the young mother to start breastfeeding after the baby is born. After discharge from the maternity hospital, it is very important for a young mother to have the support of relatives, a district pediatrician, who should fight for breastfeeding and competently solve all the difficulties that arise.

Some young mothers consider their pregnancy desirable and plan to carry it. But most often, early pregnancy in adolescents is unwanted. Especially if it is the result of rape.

Miscarriage during early pregnancy

A miscarriage is the process of spontaneous termination of the gestation process until the moment when the fetus is considered viable (that is, up to 22 weeks of pregnancy). also called spontaneous abortion.

Miscarriage during early pregnancy is a very common outcome. The vast majority of miscarriages happen before 12 weeks of fetal development. Often, miscarriage during early pregnancy occurs even before the fact of pregnancy is established.

In the event that a minor has an early pregnancy, the common causes of miscarriage with her are as follows:

• Various chromosomal rearrangements and severe malformations in the developing child.
• Inflammatory processes in the uterus, which do not allow the fetal egg to attach to its wall and develop further.
• Smoking and drinking alcohol while carrying a baby, which is noted in 10% of young expectant mothers.
• The use of certain drugs in the first trimester of pregnancy and exposure to various toxic substances on the mother.
• Abortions or miscarriages prior to this pregnancy.
• Various acute diseases accompanied by high body temperature. In this case, both the very fact of the rise in temperature and the toxic effects of various microorganisms that caused the disease play a role.
• Folic acid deficiency in a woman's body.

To recognize that a miscarriage has begun during an early pregnancy, you need to pay attention to the following signs:

• The appearance of bloody discharge from the genital tract (against the background of a delay in menstruation).
• Pain in the lower abdomen and in the lumbar region. With the onset of a miscarriage, which can no longer be stopped, these pains become cramping.
• At later dates, leakage of amniotic fluid is possible.
• With massive blood loss, signs of shock may appear (low blood pressure, rapid pulse, thirst, etc.).

If the above symptoms appear, you should immediately seek medical help. In some cases, there is a chance to save the pregnancy when the doctor determines a viable embryo or fetus in the uterine cavity. For this, hemostatic drugs, drugs that relax the uterus, and hormonal drugs are prescribed in the hospital. A woman is advised to rest, bed rest, good nutrition, some vitamin preparations, antispasmodics and sedatives.

With massive blood loss, there is a threat to the life of a young woman. It is required to remove the remaining parts of the fetal egg as soon as possible and to cope with the bleeding and its consequences. Women with a negative Rh factor after interruption of the gestation process are shown the introduction of anti-Rhesus immunoglobulin in order to avoid hemolytic disease of the newborn in the future (with a gestational age of more than 7 weeks). Antibiotics are usually prescribed after a miscarriage.

In addition to miscarriage during early pregnancy, it happens that the embryo or fetus dies in utero, but there are no symptoms of spontaneous abortion. Such women require mandatory hospitalization in order to extract the fetal egg from the uterus. It is done either with the help of drugs or surgically.

When an early pregnancy is diagnosed in an adolescent patient, induced abortion will be the likely outcome for a great many young women. There are many reasons for this, the main ones being:

• Incomplete education, lack of profession.
• material difficulties.
• Unsettled personal life (partner left, ignorance of who the father of the child is, etc.).
• Lack of support from a partner, parents and other relatives.
• Condemnation from friends, school.
• Own unpreparedness to become parents at such a young age.
• Pregnancy after rape, etc.

abortion at will

In the event that an early pregnancy has come, an abortion of one's own free will can be done up to 12 weeks of gestation. As a rule, doctors do not recommend terminating the first pregnancy, because it threatens with very serious consequences, including infertility. A minor herself can decide on an abortion from the age of fifteen. The consent of parents or guardians, as well as their informing about this, is not required.

In the early stages of pregnancy, medical abortion is possible (up to 6-7 weeks of gestation). The method has its own contraindications and undesirable outcomes, so it is not harmless, as many teenagers believe.

In addition to medical abortion, in the early weeks (up to 5 weeks), a mini-abortion is possible, that is, aspiration of the fetal egg using a vacuum. Both of these methods may not be effective enough, which subsequently leads to curettage of the uterine cavity.

Given that very often the diagnosis of early pregnancy in young women is untimely, they have an abortion after a period of 7 weeks of gestation. From this period, only surgical abortion with curettage is possible. This method is the most traumatic, often leads to serious consequences.

Termination for medical reasons

For medical reasons, pregnancy can be terminated at any week of gestation. Such indications may be problems with the health of the mother or fetus. On the part of the mother in adolescence, the most common indications for abortion are infectious diseases, some hormonal disorders, pathology of the nervous system, chronic diseases of internal organs, complications of pregnancy.

Indications for termination of pregnancy on the part of a developing child are usually its congenital malformations and chromosomal diseases.

In the event of termination of pregnancy in the period of more than 22 weeks of gestation, the fetus is considered viable, so resuscitation is carried out. Termination of pregnancy at such a time is no longer considered an abortion, but premature birth.

Termination for social reasons

According to social indications, early pregnancy can be terminated up to 22 weeks of gestation. There is currently only one such indication. This is a pregnancy resulting from rape. Previously, the list of possible social reasons for abortion was much wider.

Prevention of early pregnancy is a complex medical and social problem. It is very important to delay the onset of sexual activity in adolescents. Various medical, pedagogical, public and social organizations that carry out activities to prevent early pregnancy play a role in this.

Adolescents should be taught safe sexual behavior, be aware of available contraceptive methods, have access to information about sexually transmitted infections and the dangers of abortion. This is the primary prevention of early pregnancy.

There is also secondary prevention of early pregnancy. It applies to those teenagers who have already become parents. These measures should be aimed at preventing subsequent unplanned pregnancies and childbirth.

Parents and early pregnancy in their children

The fact that the girl had an early pregnancy, parents very often blame themselves. They blame themselves for making mistakes in matters of sex education, or for not doing it at all.

The fact that their child had or currently has an early pregnancy, parents may not know for a long time or never find out. From the age of 15, a teenager is fully responsible for their health. They have the right to decide whether to carry a pregnancy or not, to inform their parents about this or not.

In the early pregnancy of a minor, the parents bear a huge responsibility for the life and health of their daughter and her child. The parents of the father of the child also play an important role in the development of the future of young mothers and fathers, and their baby. The main task of future grandparents is the psychological support of young parents, financial assistance, assistance in caring for the baby after he is born.

The role of the school in preventing early pregnancy

In many countries, schools discuss issues of sexual education for adolescents, lectures are given on contraception, family relationships, sexual infections, pregnancy, childbirth and abortion.

Unfortunately, in our country, very little or no attention is paid to this at school. The compulsory curriculum for schoolchildren includes only the study of the structure of the reproductive system and general issues of childbearing in the course of biology in high school.

In a number of schools, extra-curricular classes are held to prevent early sexual activity and, as a result, abortions. Discussed, including early pregnancy and as a way to prevent it. Doctors, psychologists, social workers are invited to these conversations with students.

Early pregnancy and contraception are serious problems, the solution of which is the prevention of abortion among adolescents and childbirth at a young age.

Adolescents have rather scarce and sometimes false information about contraception, so early pregnancy in them becomes most often unplanned and unwanted.

Of all the methods of preventing early pregnancy, the most effective method of contraception is considered to be female combined oral contraceptives (COCs), vaginal rings and male condoms, or even a combination of both.

COCs are serious drugs that have their own contraindications and side effects, so their use without a doctor's prescription is unacceptable. With an irregular sexual life, their use does not justify itself.

The vaginal ring does not protect against genital infections, but is quite effective in terms of preventing unwanted pregnancies. Its use does not cause difficulties, it is only important to learn how to do it correctly (when visiting a gynecologist).

Male condoms have practically no restrictions on their use. In addition, they effectively protect against genital infections. It is important to use a condom correctly to maximize its effectiveness.

The use of chemical contraceptives (gels, suppositories, etc.), female condoms and diaphragms require certain skills, so they are not convenient to use in adolescence.

Many teenagers prefer the calendar method of contraception and coitus interruptus, but it is these methods of contraception that fail most often. In addition to unwanted pregnancy, there is a high risk of contracting sexually transmitted infections.

Currently, the use of an intrauterine device in adolescence and long-term hormonal contraception are being discussed. But, given the possible risks and consequences, while these methods are not widespread in adolescence.

In any case, in order to minimize the risk of early pregnancy, it is best to discuss contraception with a gynecologist even before the onset of sexual activity.

Psychological consultation during early pregnancy in adolescents

Early pregnancy in adolescents is often accompanied by shock and panic, both in adolescents themselves and in their parents. In most cases, one has to face the problems of misunderstanding, lack of proper support, with the search for the right way to solve the problem that has arisen.

Psychologists provide significant assistance in such situations, advising both adolescents and their mothers and fathers. The psychologist helps to realize what happened, to accept this situation. Whatever the decision regarding early pregnancy (bearing or terminating), a competent specialist will give valuable advice and support in any case.

In the event of an early pregnancy in a teenager, it is best to turn to your own parents for help and advice. Many teenagers are afraid to tell their parents such news, they try to hide what is happening, thereby making even more mistakes and rash acts.

In addition to parents, you can turn to other older relatives (sister, aunt, grandmother). In the absence of support from loved ones, you should contact a psychologist. This can be done at a personal meeting with a specialist or by calling the helpline, which is available in most major cities.

In large cities there are crisis centers for those who find themselves in a difficult situation. In particular, they help young mothers who have nowhere else to turn for help.

A teenager must be convinced of the need to seek medical help, be examined and decide whether to carry or terminate this pregnancy.

Registration of marriage during early pregnancy

More than 60% of children from early pregnancy are born out of wedlock. There are two big reasons why this is happening. Firstly, very often the partner of a minor future mother does not recognize paternity, or he is not going to participate in the life of his child for personal reasons.

Secondly, in our country it is legally allowed to marry only after reaching the age of 18 years. However, local self-government bodies in certain regions of our country may allow minors to marry for valid reasons, but not earlier than the age of 14. The most common valid reason for teens to get married is pregnancy or the birth of a baby.

If the age of persons wishing to marry is between 16 and 18 years old, then they themselves must write a statement of their intentions, documenting their good reason. It does not require permission to marry from their parents or guardians.

In the event that the age of the future parents is between 14 and 16 years old, the written consent of the parents or legal representatives is required for marriage. In case of disagreement between a young couple and parents, the consent of the guardianship and guardianship authorities is required for marriage.

In any case, the last word remains with the local government, to allow marriage between minors or not. Their decision can only be challenged in court.

From the moment of marriage, young parents are recognized as fully capable citizens, they bear full responsibility for the life and health of their baby.

In the event that the parents of the child are not officially married, they exercise parental rights in relation to the baby from the age of sixteen.

If the parents are not yet 16 years old, and they are not married, then the child must appoint a guardian who will exercise parental rights in relation to him. More often, one of the adult family members (with his consent) becomes such a person. In the absence of candidates for the role of a guardian, the local guardianship and guardianship authorities temporarily play the role (until the child's parents reach the age of 16 years).

More than half of the children abandoned by their mothers at birth were born to them at a young age. The vast majority of early teen pregnancies occur in housewives, schoolgirls and vocational school (vocational school) students.

Why do parents abandon their children during early pregnancy? The main reasons for failures can be identified:

• Lack of support from the father of the baby, from the parents (guardians) and other relatives. In some cases, young mothers try to hide the birth of a baby from their parents by abandoning it.
• Negative attitude towards early pregnancy and motherhood on the part of the school or other educational institution, on the part of friends.
• Incomplete education (school, vocational school, other educational institutions).
• Insufficiently good material and living conditions: lack of separate housing and livelihoods.
• Rape of a minor that resulted in this pregnancy.
• The lack of a young mother's concept of a family model, especially if she herself grew up without parents.
• Psychological unpreparedness to become a mother at such a young age.
• The birth of a sick child (for example, malformations, chromosomal rearrangements, deep prematurity), whose care and treatment require a lot of attention, material investments and special conditions.

A woman who refuses a child in a maternity hospital has six months to think and change her mind. Six months later (in some cases earlier), the biological mother of the child loses parental rights, and the child can be adopted by third parties.

General information . In medical practice, there are episodes when young pregnant women need obstetric care (a primipara is called young if she gave birth before the age of 18). Her pregnancy proceeds, undoubtedly, in unusual conditions associated with the immaturity of adaptive mechanisms. A large load on an immature, fragile body due to pregnancy is a serious test.

Pregnancy in girls younger than 8 years becomes possible in case of accelerated puberty. At the age of 9 to 16 years, pregnancy can occur even in cases where the dynamics of puberty is not ahead of the norm.

The review, covering 310 cases of precocious and early puberty, includes 70 girls who became pregnant before the age of 14, of which 18 girls were between 5 and 10 years old.

Among domestic researchers who studied the course and outcome of pregnancy and childbirth in young primiparas, one should name V. I. Davydov (1964), S. A. Kudreyan (1971), A. S. Egorov, M. L. Lapchenko (1980), who in total described 668 pregnancies in girls under 18 years of age.

Pregnancy at a young age is usually unwanted. This is confirmed by the confessions of underage women in labor and their indications of attempts at criminal interference. However, a sharply negative attitude towards the unborn child is extremely rare (in 1.7%).

Classification of pregnancy. A distinction is made between pregnancy that occurred before puberty (violent ovulation occurs long before puberty) and pregnancy in a woman who has already entered puberty. In these two groups, the features of the course of pregnancy and childbirth and, of course, the tactics of their management differ significantly. In particular, during pregnancy and childbirth during puberty, there are fewer complications than at a younger age.

In addition, cases of pregnancy that occur in girls without signs of precocious puberty (on the one hand) and those who have them (on the other) are to be distinguished. With premature puberty, pregnancy often occurs with its true variant than with pathological (on the basis of a tumor, etc.).

Frequency . Comparison of data from different authors is difficult, since differences in the approach to accounting for young pregnant women affect. Thus, N. Vouse and A. Benoit report that in New York in 1976, 70,126 women aged 19 and younger gave birth or had an abortion. According to other authors, for 15,557 births, the number of underage women in labor was 0.64%. Within the same age limits, R. Kinch et al. indicates a high proportion (10.6%) of underage pregnant women in relation to all patients of the Toronto Children's Hospital.

According to the materials of the LPMI clinic, the number of pregnant women aged 8 to 17 years inclusive has been expressed in recent years by a stable figure, which is 1.3-1.6% in relation to all primiparas (for comparison: primiparas over the age of 35 - 1 .0-1.2%). In total, through this clinic in 1974-1979. 174 young pregnant women passed, which is 0.6% of all pregnant women admitted during this period.

The effect of pregnancy on the body of a girl. There is no doubt that pregnancy, if it occurs at a young age, accelerates the processes of somatic and puberty. The secretion of estrogen and progesterone is not inferior to that of adult pregnant women.

Changes in the bone pelvis are especially evident, which during pregnancy in 13-15-year-olds can reach sizes characteristic of 16-18 years old. However, the outer conjugate increases more slowly than the other outer dimensions. Of the young primiparous, 10.7% of births proceed in the presence of an anatomically narrowed pelvis; at the same time, to a greater extent than in adult women, hydrophilicity and elasticity of the ligamentous apparatus, symphysis and cartilaginous zones are expressed. All this provides some flexibility of the bone ring.

We have to observe how in a girl without pronounced secondary sexual characteristics before pregnancy, they appear even if the pregnancy was terminated at an early date.

As for the mental reactions of young pregnant women, according to our observations, they correspond to age, but do not outstrip it. Psychopathies and psychoses are rare, mostly with rape (reactive psychosis). A number of character traits revealed in. This group is explained by the shortcomings of education. So, R. Kinch and others, having interviewed 79 underage pregnant women, stated the predominance of their independent character, a tendency to experiment, impracticality, poverty of the emotional world, bad manners. American authors emphasize that 50% of them belong to the so-called lower class, and the other half belong to the "middle" class.

Many facts and results of our observations indicate that girls who began sexually prematurely, with a few exceptions (due to rape), grew up in dysfunctional families with deformed relationships between their members, as well as in families with one parent or in conditions of pedagogical neglect - connivance , lack of control or, conversely, petty guardianship.

The suspicion of oligophrenia, which quite often occurs in an obstetrician-gynecologist, is almost never confirmed by a special examination by psychiatrists.
Features of the course of pregnancy in adolescence. Pregnancy proceeds, as a rule, favorably. Its duration is 38 ± 0.9 weeks, i.e., slightly less than in adult women. Prematurity is 3%. Overlapping is almost not observed. Multiple pregnancy in young is less common (1: 100) than in older age groups.

Early toxicosis was diagnosed by us in isolated cases, which coincides with the observations of S. Poliakoff (1959). However, according to other authors, the frequency of early toxicosis ranges from 2.78% and even up to 33%.

6) activation of rheumatism, large collagenoses; blood diseases;

7) severe endocrinopathies, in particular cases of pathological precocious puberty; osteopathy;

8) a number of hereditary diseases; progressive retinal detachment, high myopia, etc.;

9) obstetric complications (premature detachment of a normally located placenta; bleeding due to placenta previa).

In all other cases, full-term pregnancy and spontaneous delivery should be preferred, since the risk to the health of a young pregnant woman from abortion in the middle of the term is extremely high. Most often, a small caesarean section is chosen, less often - intra-amniotic administration of a hypertonic solution of sodium chloride (after mandatory prior preparation with hormonal drugs, antispasmodics, etc.). Extra-amniotic administration of solutions for the purpose of termination of pregnancy for this contingent of pregnant women is absolutely unacceptable. Medical late artificial miscarriage began to be practiced after the appearance in clinical practice of such a drug as prostaglandins. However, even here it is difficult to avoid complications, in particular the development of thrombohemorrhagic syndrome.

If the question of early surgical termination of pregnancy arises in the third trimester, then it is resolved negatively: preference should be given to spontaneous childbirth. The exception is situations when there are vital indications for termination of pregnancy. Naturally, if there is a need for early delivery, labor induction is carried out, having previously completed more or less long-term preparation with estrogens, antispasmodic drugs, vitamins, phosphobion (ATP), lidase, and preparations containing potassium.

Any option for early termination of pregnancy is carried out not earlier than an ex consilio decision and after the appropriate paperwork.

We consider fair the position formulated in the 30s of the current century: minor age in itself is not an indication for termination of pregnancy.

If a schoolgirl continues to carry a pregnancy, then attending school is undesirable for ethical and pedagogical reasons. In addition, the study load adversely affects the formation of gestational dominance and can be an etiological moment in the development of late toxicosis of pregnant women. We must not forget that the need for frequent hospitalization also does not favor the continuation of studies.

The girl is registered at the antenatal clinic and periodically (at least 3 times during pregnancy) enters the antenatal department, where an in-depth monitoring of her health and the development of the fetus is carried out. Preventive or curative measures are taken as needed; in particular, foci of latent infection are eliminated and the vagina is sanitized. Particular attention in the hospital is given to physio-psycho-prophylactic preparation for childbirth, since this is difficult to implement in the antenatal clinic.

Given that at a young age, childbirth occurs 1-2 weeks earlier than in adult women, the last admission to the hospital should be made no later than 36-37 weeks of pregnancy. During this time, the next examination is carried out, preparations for childbirth are carried out and a plan for their maintenance is drawn up.

The course of childbirth. The course and outcomes of childbirth significantly depend on the girl's belonging to a certain age group. If at the age of 14 and younger the percentage of severe complications is high (15), then in the group of 15-17 years the percentage of complications decreases sharply (1-2).

In women in labor under the age of 14, the following structure of the main complications in childbirth can be outlined:

A) clinical discrepancy between the fetal head and the mother's pelvis,

B) weakness of labor activity,

C) trauma to the birth canal

D) hypotonic bleeding (listed in descending order).

In the same time in women in labor aged 15-17 years, the structure of complications is somewhat different:

A) fast delivery

B) primary weakness of labor activity,

C) rupture of the cervix and perineum,

D) hypotonic bleeding.

Thus, most of the complications owe their genesis to a violation of the contractility of the uterus, due to both the immaturity of the regulatory links and the inferiority of the executive tissues (myometrium).

If untimely discharge of amniotic fluid (61%) and childbirth in the presence of posterior occipital presentation (4%) are somewhat more common than in adults, then breech presentation, malposition of the fetus and premature detachment of a normally located placenta are less common. The average duration of childbirth is approximately 13 hours. Rapid labor was diagnosed 3 times more often than usual.

Intrauterine fetal hypoxia was registered in 18%, newborn asphyxia - in 24%. The condition of the fetus and newborn is directly related to the listed complications, in particular, prematurity. Perinatal mortality is 2.9% (according to S. Poliakoff - 5.9%, S.

Specialists point to the exceptional rarity of intrauterine development anomalies, which occur 3-5 times less often in children born to young pregnant women compared to those born to adult mothers. According to our data, out of 175 children, only one was born with severe developmental disorders due to the criminal attempts of a 15-year-old girl to get rid of her pregnancy.

The average weight of children was 3298 ± 73.0 g, which is somewhat less than the norm: 3399 ± 11.8 - 3558 ± 12.1 g. Large children were born in 3% of mothers (in adults - in 7%).

Curiously, 78% of young pregnant women give birth to boys, while the typical sex ratio of newborns in the population is 55:45 (in favor of boys). The same feature (60.96% of boys) was also revealed by A. Singhal.

The average blood loss during childbirth in young women in labor was 187 ± 52.0 ml, which does not exceed the physiological limit. Hypotension of the postpartum uterus was noted in 2%.

In the postpartum period, infectious and thromboembolic complications were not observed.

Birth management. Delivery of young pregnant women should be carried out in highly qualified institutions, preferably those with specialists with relevant experience and round-the-clock anesthesia and pediatric services. The doctor and midwife require a special approach to the young woman in labor, dictated by the need to reckon with the unusual position, emotional lability, low threshold of pain sensitivity and the constant threat of complications for the mother and fetus.

In the first stage of labor, in parallel with careful monitoring of the dynamics of structural changes in the cervix (external methods are preferable, for example, the Rogovin method), it is necessary to prescribe antispasmodic drugs (no-shpa, gangleron, viadril), thereby reducing pain.

The use of anesthesia is based on a sufficient choice of agents (nitrous oxide, halothane, trilene, electroanalgesia, epidural anesthesia). The widespread use of painkillers is not justified in cases where there is a high possibility of a clinical discrepancy between the fetal head and the mother's pelvis. For the same reasons, the appointment of strong uterine stimulants is contraindicated.

Due to the high frequency of intrauterine fetal hypoxia, it is desirable to avoid excessive pharmacological stress, in particular omnopon, promedol, quinine, pipolfen, barbiturates, chlorpromazine. Periodically, prevention of fetal hypoxia should be carried out.

Surgical interventions among young women in labor are undertaken no more often than usual in clinical practice: perineotomy - in 12%, obstetric forceps - in 1%, caesarean section - in 0.5%. Vacuum extraction of the fetus is not used at all. Those authors who point to a high incidence of late toxicosis in young pregnant women, naturally, give a high percentage of operative delivery (17-22%).

In pregnant women under the age of 14 (especially younger than 12), it is more likely than at an older age to tend to delivery by caesarean section in a planned manner for a period of 39-40 weeks. The determining circumstances are the size of the pelvis, the nature of the presentation, the estimated weight of the fetus and the state of health of the girl. 1-3 hours before the production of caesarean section, the fetal bladder is opened. This achieves gradual emptying of the uterus and, consequently, the prevention of hypotonic bleeding and lochiometers.

If the doctor has hope for a spontaneous completion of labor, then at first he conducts labor conservatively; in the future, the appearance of complications makes it necessary to proceed with operative delivery. With modern anesthesia, a caesarean section poses no greater risk for a pregnant woman under 14 years of age than, for example, delivery per vias naturales or a fetus-destroying operation. In addition, during the abdominal surgery, it is possible to revise the pelvic organs, in particular, to assess the condition of the ovaries.

Transfer to the postpartum department after spontaneous delivery and examination of the soft birth canal is usually carried out not after 2-4 hours, but after 10-12 hours due to fear of not noticing the onset of hypotonic bleeding.

In the postpartum period, the issue of breastfeeding is solved in different ways, depending on the plans of the guardians, the adoptive parents of the child. In relation to puerperas under 14 years of age and older who refuse children, measures are taken to stop lactation: sinestrol, restriction of drinking, camphor, saline laxative, ergot preparations, tight bandaging of the mammary glands.

Subsequent visits by the girl to the same group of students obviously cannot be considered justified from a pedagogical point of view.

Thus, pregnancy imposes additional requirements on all organs and systems of a young pregnant woman, which, due to age-related characteristics, are in a state of functional stress. Our experience convinces us that careful monitoring of such pregnant women in a antenatal clinic and especially a hospital, timely and targeted correction of the observed deviations, as well as careful management of childbirth naturally reduce the number of complications.

Early pregnancy today is a fairly common phenomenon that poses a serious threat to both the young mother and the unborn baby. After all, although a young organism is already physiologically capable of performing a reproductive function, the organs and systems of a teenager have not yet fully formed. This can cause numerous complications both during gestation and directly during the birth process. It is customary to consider early such a pregnancy, which occurs before the girl reaches the age of eighteen.

Reasons for early pregnancy

Pregnancy in adolescence is primarily a social and psychological problem. Some experts attribute early sexual education to the main reasons for this phenomenon, others, on the contrary, its absence. Psychologists managed to identify a number of reasons that can lead to early pregnancy:

1. Lack of contact and trusting relationship between parents and child. Of particular importance is the atmosphere of psychological trust between mother and teenage daughter.
2. Insufficient knowledge in the field of contraception and means of protection. When a girl enters the so-called childbearing age, that is, with the onset of the menstrual cycle, it is worth talking with her about where babies come from and how to avoid unwanted pregnancies.
3. Family problems. According to statistics, cases of teenage pregnancy are most often found in single-parent, asocial families, where the child is left to himself.
4. Early onset of sexual activity.
5. Following fashion. The increased popularity of sexual content in contemporary art and the media almost doubles the interest of teenagers in this topic, which leads not only to early, but also to turbulent sex life with frequent changes of partners and can lead to unwanted pregnancy at a tender age.
6. According to psychologists, girls with a fighting, conflicting nature, closed and having a number of bad habits are especially prone to early pregnancy.
7. Pregnancy at an early age may occur as a result of the rape of a girl or her desire to bind her lover to herself. Both of these reasons are serious problems that can cause deep trauma to the fragile teenage psyche, and the help of a specialist is simply necessary here.

The impact of early pregnancy on the female body

Pregnancy at a young age is quite dangerous for an unformed female body, which is still undergoing hormonal changes. At thirteen or seventeen years old, a girl is not yet physically prepared to become a mother. The body is not adapted for carrying and giving birth to a child. We should also not forget about the psychological factor. Even if the girl looks like a fully formed young woman, her psyche is still childish.

Fear of parents, fear of public condemnation, lack of funds for the maintenance of an unborn child often push a girl to have an abortion. Most parents support this decision, believing that in this way they choose the lesser of two evils. The disadvantages of early pregnancy are undeniable, but abortion in adolescence also entails many negative consequences. In particular, the early factor of pregnancy can greatly decrease or completely disappear, which in the future can result in problems with conception and even cause infertility.

Therefore, only a qualified gynecologist can make a decision on the basis of a comparison of a number of factors, individual indicators and the results of medical examinations.

If, nevertheless, a young girl decides to give birth, then certain changes begin to occur in her body:

1. Increased activity of the endocrine glands, leading to water retention in the body. In early pregnancy, this can cause serious damage to the kidney and cardiovascular system and adversely affect liver function.
2. The growth of muscle fibers leads to an increase in the size of the uterus, accompanied by an active growth in the mucous membrane of nerve connections, blood and lymphatic vessels. This is an extremely complex physiological process, which is especially difficult for young mothers, due to the fact that their genitals are not yet fully formed due to age.
3. The hormonal restructuring that occurs in a woman's body to prepare her for childbirth and breastfeeding is superimposed on the incomplete hormonal restructuring of a child's body into an adult, which can lead to a serious failure and a number of health problems.
4. Expansion of the pelvis.

Complications and consequences of early pregnancy

Why is early pregnancy dangerous? Gynecologists identify a number of the following possible complications:

1. placental insufficiency.
2. Development of severe forms of anemia.
3. Gestosis.
4. High risk of miscarriage.
5. Frequent cases of premature birth.
6. Hormonal disruptions.
7. Numerous complications during the birth process.
8. Weak tribal activity.
9. Polyhydramnios.
10. Immaturity of the egg.
11. Development of obesity after childbirth.
12. Termination of pregnancy in the early or, conversely, in the later stages.
13. Increased risk of maternal death during childbirth.
14. Insufficient body weight of the newborn.
15. Frequent cases of pathologies and congenital diseases in an infant (the probability of having babies with congenital anomalies in adolescents is eleven percent).
16. Accelerated process of somatic maturation, nervous breakdowns and psychological disorders.
17. Childbirth with early pregnancy, according to statistics, doubles the likelihood of developing cervical cancer.
18. A high risk of a newborn baby developing sudden death syndrome.
19. Statistics show that children born to mothers under the age of seventeen die in infancy twice as often as other newborns.

In addition, the psychological and social problems of early pregnancy should be highlighted. These include the following:

1. Psychological unpreparedness of the girl for motherhood.
2. Difficulties in personal relationships between the mother and father of a newborn child.
3. Possible difficulties in building the personal life of a young mother.
4. Lack of means of subsistence and maintenance of the child.
5. Problems with education and professional development.
6. Possible difficulties in further social adaptation.

How to diagnose early pregnancy

The general process for diagnosing early pregnancy is almost the same as for adult women. However, in most cases, a girl who becomes pregnant before the age of sixteen delays seeing a doctor, which can lead to additional problems. Sometimes the definition of pregnancy occurs completely by accident. For example, during palpation during an examination by a pediatrician or during a routine examination by a school gynecologist. Sometimes the expectant mother can for a long time and herself be unaware of her interesting position. Doctors have identified a number of characteristic signs that allow parents to assume that their daughter is pregnant:

1. Unreasonable permanent increase in body temperature.
2. Drowsiness, increased fatigue.
3. Characteristic nausea in the morning.
4. Possible changes in taste preferences.
5. Prolonged absence of menstruation. However, it should be noted that a delay in menstruation in adolescents can be caused not only by pregnancy, but also by hormonal disruptions, excessive physical activity, exhaustion of the body, etc.
6. Chills, feverish condition.
7. Frequent urination.

Parents should definitely pay attention to the psychological state of their child. If the girl has become overly nervous, secretive, withdrawn and irritable, then try to bring her to a frank conversation, especially if her daughter has the above signs.

How to prevent early pregnancy

Prevention of early pregnancy primarily lies in the trusting relationship of parents with a child of adolescence. What should parents do to protect themselves and their children from unexpected pregnancy? Psychologists suggest following these recommendations:

1. Talk to your teen about contraceptive methods and problems associated with early pregnancy.
2. Periodically provide the girl with specialized literature on this topic.
3. In the absence of contact with a teenager, try to seek help from a psychologist.

To prevent such a phenomenon as teenage pregnancy, it is important that school teachers and psychologists pay due attention to the issue of sex education. It is necessary to conduct thematic discussions, lectures, watching relevant films.

It is important that adolescents know not only how to prevent early pregnancy, but also what negative consequences its onset is fraught with.

Early pregnancy is a very common problem that is becoming more and more urgent every year. As statistics show, the number of adolescents under the age of 18 applying to medical institutions is constantly increasing. At the same time, the reason for early conception at a young age is not so much medical in nature as social.

It would seem that pregnancy among teenagers should not be massive. After all, contraceptives and contraceptives are sold not only in pharmacies, but also in many stores, so there should be absolutely no problems with their purchase. In addition, modern society condemns the early onset of sexual activity. Yes, and childbirth can be dangerous for both the health of the mother and her baby, since the female body fully matures only by the age of 20. Therefore, in order to avoid negative consequences, every girl who begins to have sex in adolescence should have an idea of ​​​​what early signs of pregnancy appear when conceiving a child.

How the body behaves

There is no single factor that fully explains teenage pregnancy. Here everything is much more complicated. Most often there are several factors that overlap each other. At the same time, it is important to understand that the fault of the girls themselves is not in this. The thing is that today's youth are going through puberty faster than their parents once did. Because of this, adolescents begin to be drawn to the opposite sex earlier. Therefore, so that early pregnancy does not affect children, their parents must psychologically prepare their offspring for adulthood. And you need to start doing this even before the child has the first sex.

The main causes of teenage pregnancy include:

1. Lack of sex education. As practice shows, most parents do not conduct any conversations on sexual topics with their children. Thus, boys and girls are not prepared to enter adulthood. They lack elementary knowledge about sexually transmitted diseases and methods of protection, which can be fraught with various negative consequences.
2. Sexual promiscuity. Many girls want to stand out from their peers and look more mature. In addition, as practice shows, early pregnancy very often occurs as a result of casual relationships under the influence of alcohol or drugs, when adolescents are not able to think clearly and keep their lust under control.
3. Inability to use contraceptives. Most boys and girls are negligent about protection during intercourse, believing that nothing will happen because of one time. In addition, many teenagers are simply ashamed to buy contraceptives.
4. Violence. In dysfunctional families in which one or both spouses regularly drink or use drugs, it is very common for fathers to resort to violence against their daughters. At the same time, girls most often hide manifestations of violence, because they are afraid of ridicule from others or physical violence. Therefore, violence becomes regular.

We looked at the most common causes that lead to problems in adolescence. A less common but also occurring factor is planned early pregnancy. Most often this happens when a girl is in love with a guy and wants to keep him in every possible way.

Why is pregnancy at a young age dangerous?

Adolescents are considered to be girls between the ages of 10 and 18. According to statistics, pregnancy most often occurs between 12 and 16 years. At this age, bearing a fetus is very dangerous, since the girl's body is not yet fully developed, which is fraught with various negative consequences.

At the same time, young mothers are threatened by the following:

• miscarriage;
• anemia;
• intoxication;
• abnormal development of the fetus;
• morphofunctional changes in the placenta;
• premature and difficult childbirth;
• stillbirth;
• SVSN.

It is important to understand that all these dangers are due to the unstable hormonal background that is characteristic of adolescents. Most births are very difficult and are accompanied by various complications for both the baby and his mother. In addition, about half of prematurely born dies in the first six months of their lives. And this is not to mention the psychological burden created on the girl.

Signs of pregnancy as a result of body restructuring

From the very first day of conception, various changes begin to occur in the body. It adapts and adapts to the developing fetus. This can lead to a complete change in the usual lifestyle and daily routine of the expectant mother.

As a rule, in pregnant women, immunity is greatly reduced, sleep is disturbed, and they also feel unwell. Early signs of pregnancy begin to appear, which can help the girl understand that a small miracle is growing in her tummy. In order to take the necessary measures in a timely manner, you need to know all these signs, so let's dwell on them in more detail.

How to recognize pregnancy before a delay?

Early pregnancy before a delay is very difficult to determine, since at this stage there are practically no obvious manifestations. Yes, and girls may not attach any importance to any changes in the body.

However, you can still recognize it by the following symptoms:

1. Increase in basal body temperature. During pregnancy, a woman's body produces a large amount of the hormone progesterone, which, in turn, leads to an increase in body temperature, which lasts for several weeks.
2. Malaise. It is very often similar to the common cold, so no one attaches much importance to this symptom.
3. Minor highlights. During pregnancy in the early stages, they have a yellow-brown hue and may contain small impurities of blood, which, in fact, is similar to the onset of menstruation. However, their duration and abundance are much less.
4. Increased sensitivity of the mammary glands. Very often, the chest begins to hurt, and minor discharge may also come out of the nipples.
5. Migraine and back pain. They are caused by hormonal changes and stretching ligaments.
6. Discomfort in the abdominal cavity. The belly in early pregnancy is an excellent indicator. A girl may feel slight tingling or pain in its lower part, which is not typical for adolescence.

All these symptoms appear at the very early stage of pregnancy, even before there is a delay in menstruation. Therefore, if a girl monitors the state of her body and pays attention to any changes occurring in it, then she will be able to determine the presence of an early pregnancy. But here it is important to understand that only a doctor can confirm the presence of an embryo. Therefore, if any suspicion arises, it is necessary to see a gynecologist.

Early pregnancy symptoms

Due to the lack of experience and knowledge, girls may not even be aware that a baby is growing in their stomach for a long period of time. Therefore, many continue to drink alcohol and have sexual intercourse with various partners. All this poses a threat to the fetus and can result in a miscarriage. To prevent this from happening, the expectant mother should know what are the first signs of pregnancy in the early stages that appear when carrying a baby.

The main ones among them are the following:

• toxicosis;
• frequent urge to urinate;
• breast and abdomen enlargement;
• chills and fever.

Also a very common symptom is abundant vaginal discharge during early pregnancy. At the same time, they have a light shade or are transparent, which indicates a change in the hormonal background.

If the discharge is dark and mixed with blood, and the girl experiences severe cutting pains in the lower abdomen, then these are harbingers of an imminent miscarriage or ectopic pregnancy. The latter is very dangerous and poses a threat to the life of the mother. Therefore, if a teenage girl has early symptoms of pregnancy, it is recommended not to postpone going to the hospital.

What changes occur in the uterus?

The first early stages of pregnancy are the most difficult for the body, since many changes take place in it. This is especially true of the uterus, which not only increases significantly in size, but also changes its shape. Ligaments and soft tissues begin to stretch and become stronger and more elastic. The biggest transformations fall on the sixth week of gestation, and by the eighth the uterus almost doubles in size.

What if conception has already occurred?

If you have early signs of pregnancy, and the test results confirmed them, then what to do in this case and what to do? It is very important to understand and support parents. In no case should you shift the entire responsibility for what happened to the child. According to medical statistics, about 70% of early pregnancies end in abortion. However, this is not the best way out, because in the future it will be very difficult for a girl to get pregnant.

If parents are set for childbirth, then much attention should be paid to the quality of nutrition of the expectant mother. After all, now useful substances are necessary not only for her body, but also for the baby. The diet must be balanced. Therefore, you should select foods rich in both proteins and fats and carbohydrates.

Early pregnancy is a very difficult physical and psychological test for a teenage girl. How she will endure all the trials depends largely on the parents, who must provide all kinds of support for their child. In addition, the bearing of the fetus at all stages should occur under the supervision of a physician. This will eliminate many negative consequences.

alarm bells

Expectant mothers must take their health very seriously throughout their pregnancy. Monitor your body and respond to the slightest changes occurring in it. Of particular concern to them should be pain during early pregnancy in the lower abdomen. Since they, most often, indicate the presence of any pathology that can pose a threat to the fetus and mother, as well as cause very serious consequences.

Norm

Pain and discomfort in the lower abdomen may not be a sign of abnormalities, but one of the symptoms of pregnancy. This is quite normal, since the uterus is growing rapidly and rapidly increasing in size, which cannot remain unnoticed. In addition, a large amount of blood flows to the pelvic organs, which is also accompanied by a certain discomfort.

Therefore, if the signs of pregnancy in the early stages do not make themselves felt too strongly, and the pains are of a short-term nature, then there should not be any special reasons for concern. However, consultation with your doctor will only benefit.

But if the spasms have become pronounced, then this is the first sign of any problems. Therefore, a visit to the doctor should not be postponed, since any delay can end very badly.

Deviations from the norm

Strong and sharp pains are a kind of alarm bells that give rise to an immediate visit to the doctor. In addition, copious discharge mixed with blood, fever that does not subside for several days or more, chills, nausea, and a constant feeling of malaise can make you panic.

All these manifestations can occur as a result of a number of reasons, among which the most common are the following:

• ectopic pregnancy;
• placental abruption;
• spontaneous abortion.

Each of these cases is very serious and fraught with many negative consequences. Therefore, in case of early pregnancy, it is recommended to register the girl in a medical institution.

Consultation with a doctor is necessary for the following reasons:

• only a specialized specialist can confirm or deny pregnancy;
• the doctor will perform an examination and prescribe all the necessary tests;
• he will observe the expectant mother and the development of the embryo throughout the entire gestation of the fetus.

It is necessary to register for pregnancy in the period from 9 to 12 weeks, when the first ultrasound is prescribed, which allows to identify the presence of any abnormalities in the embryo.

Basic abortion methods

Every teenage girl is interested in the question of whether it is possible to have an abortion in the early stages of pregnancy or not. Modern medicine not only allows this, but in some cases, interruption may be simply necessary, for example, if there is a threat to the health or life of the mother. And in general, abortions today are very common not only among adolescents, but also among adult women who, for whatever reason, do not want to give birth.

But here it is important to understand that an abortion can only be done within the first 12 weeks from the moment of conception. At this time, such procedures are completely safe and do not pose any threat to the woman's health. But here we are not talking about surgical intervention, after which it can be very difficult to get pregnant in the future. The best option is gentle procedures that allow you to terminate the pregnancy.

Medical termination of pregnancy is the most effective and safest. With strict adherence to the dosage prescribed by the doctor, women will have absolutely no complications. An alternative to the use of drugs is vacuum abortion. It is prescribed by a doctor only after examining the patient and is performed under local anesthesia. Therefore, a woman will practically feel nothing. As in the case of medical, vacuum termination of pregnancy does not cause any harm to the internal organs. Therefore, women retain childbearing function.

Finally

As mentioned at the beginning of the article, early pregnancy is a common problem in modern society. Therefore, in order to protect their children from such a situation, parents should conduct educational conversations with them on the topic of sexuality, tell both girls and boys about contraceptive methods, and also engage in psychological education of adolescents. As practice shows, many adults find it difficult to talk with their children on such topics. However, there is nothing shameful in this, and apart from parents, no one can prepare their offspring for entry into adulthood, full of many dangers and unforeseen situations. Remember: any problem is much easier to prevent than to deal with it later.

Be that as it may, in any situation, always try to support your child. After all, only parents can give the right advice, reassure and provide support. After all, it is very important for every teenager.

- this is a pregnancy that occurred before the age of 19 (according to some doctors, before the age of 21). The process of pregnancy and childbirth is no different from the processes that occur with the body of a mature woman, however, the risk of various complications increases significantly, as well as the development of pathologies, both in the mother and in the baby.

Teenage mother

this status frightens many parents of girls and the girls themselves who enter adulthood. In our society, the pregnancy of a teenage girl is considered a mistake, the irresponsibility of the parents and the girl herself, and so on. However, in many Asian and African countries of the world where early marriages are accepted, a 16-year-old mother is a normal social phenomenon. There is one BUT the mother of a teenager must be legally married before conceiving a child, otherwise it is also condemned.

Reasons for early pregnancy

It should be said that there is never a single cause of pregnancy in a minor girl. This is influenced by several factors at once, and it is not the teenager who should be blamed, but the circumstances. At present, puberty, and hence sexual desire, appears in children quite early. Therefore, parents should conduct a serious psychological preparation of their child for the onset of sexual activity, and this must be done in advance, and not when sex already plays a significant role in his life.

It is generally accepted that early pregnancy in Russia occurs more often in dysfunctional families. But at present this is not the case. Previously, a similar trend was observed, because children from asocial families were left to their own devices. But now there is some social imbalance, and the presence of financial wealth does not make children more secure. On the contrary, due to material opportunities, they become less prudent, especially with a lack of attention from their parents.

Competent psychologists, considering the problems of early pregnancy, believe that the main blame should be laid on the parents. Their incorrect behavior is the main reason that children become unprepared for sexual activity. If there is no frank relationship between mother and daughter (due to employment, lack of attachment to the child, antisocial behavior, or vice versa, due to too strong guardianship), then the likelihood of an early pregnancy in such a family is very high.

Many parents choose not to delve into the basics of their children's sex education. They place this responsibility on the media and the Internet. Purchasing books and contraceptives for children does not reduce the risk of pregnancy, since the first thing to do is to instill in them the desire to use such methods to preserve their health and social opportunities. Therefore, early pregnancy in adolescence is more often the result of improper sex education.

There are several factors that lead to teenage pregnancy:

1. Gaps in sexual education. It would seem that today's youth is quite aware of the close relationships of both sexes, of protected sex. In fact, everything is not so. Most teenage girls have a vague idea of ​​conception. False information that, they say, pregnancy cannot occur after the first sexual intercourse, often leads to disastrous consequences. Due to their age, adolescents are simply not able to understand the important aspects regarding sex. Therefore, the responsible mission for sexual education of the daughter falls, first of all, on the parents. It is necessary to inform the child in advance, when the young organism is still preparing for adulthood;
2. Peer pressure. Today's teenagers are used to interacting a lot with their peers. The social circle of a teenage company is usually formed according to interests. Some hobbies lead to negative results. For example, there are companies where an active sex life is encouraged. It will be difficult for a newcomer who does not share their priorities to get along in such a fraternity. It will simply be "pecked". Therefore, in order to avoid ridicule from peers, teenagers often fall under the influence of bad company;
3. Alcohol, drugs. Alcohol and drugs are known to reduce self-control over the actions performed. Therefore, about 90% of early pregnancies occur precisely in an inadequate state;
4. Violence. Sex is not always consensual. Often a second, older and more experienced partner insists on intimacy. Always obedient and trusting, the girl is simply afraid to say no. That is, this relationship can be considered coercive, which means it is nothing more than rape. A teenager may not fully understand all the horror and tragedy of what happened. Therefore, it is important to be able to build the most trusting relationship with your children in order to know about all their secrets, even such secret ones;
5. Misuse of contraceptives. Any method of contraception must be used correctly. For example, when using a condom, you need to pay attention to its expiration date, as well as the quality. Birth control pills must be prescribed by a doctor. Well, or, in extreme cases, you should carefully study the instructions for this drug.

As you can see, the reasons leading to early pregnancy are quite serious. One thing is clear - without the help and participation of parents in the life of a child, a teenager is inclined to do a lot of stupid things, which he will later regret.

Health problem in early pregnancy

The main problem is that the body of a young woman is not ready to physically bear a child at such a young age.

The teenager is confused, does not know whether to terminate the pregnancy or continue. If a girl decides to have an abortion, she must understand that later gynecological problems may arise, up to infertility. If she decides to give birth, she will subject herself to a serious test, because in the fragile body of a young woman, numerous complex changes will begin to occur that contribute to the intrauterine development of the fetus, prepare the body for childbirth and breastfeeding.

The body of a pregnant woman begins to accumulate building material for a growing body: nitrogen (for protein synthesis), fats (for the formation of fetal tissues), iron (for blood formation), potassium (for the heart muscle), magnesium, cobalt, copper. And all this is an additional burden on the body of the expectant mother. Also, during pregnancy, the work of the cardiovascular system is significantly enhanced, which, in turn, makes the liver and kidneys work in an enhanced mode.

An unprepared body simply may not be able to cope with such a difficult task as carrying and giving birth to a healthy child. Underweight babies or babies with birth defects are a common unfortunate outcome of teen pregnancy.

Harm of early pregnancy for the body of a teenage girl

The true purpose of a girl is, of course, to become a mother. But, all is well in due time. Pregnancy is a serious additional burden. Due to the fact that a young girl is not yet fully developed physically, during pregnancy her body will work for wear and tear.

Every young girl should know the dangers of early pregnancy. But because of it, serious complications can happen:

hormonal disbalance;

delayed fetal development;

• the risk of death of a pregnant woman during childbirth;

  pathology, anomalies or diseases in the newborn;

• low weight of the child;

  premature birth;

  circulatory disorders;

  the risk of having a dead baby;

  placental insufficiency;

  the struggle for calcium between the pregnant woman and the fetus.

Moreover, the younger the girl, the more severe the consequences may appear.

The consequences of early pregnancy are:

• Changes in lifestyle. Surrounding with condemnation will look at a pregnant teenage girl. These are superfluous and unnecessary experiences for the expectant mother. School will have to drop out. Communication with peers will not be the same as before. You have to be ready for this. It is important that during this period the girl feels the support of people close to her. Much depends on parents, including the issue of further education;
• Psychological trauma. Having become pregnant, the child will become an occasion for ridicule and will serve as an “anti-example” for classmates. The participation of parents is simply necessary, otherwise the young mother may be psychologically traumatized;
• Boy betrayal. Not all young guys, having learned about the pregnancy of their girlfriend, behave decently. Often, they pretend that it does not concern them at all. The girl is left with a problem called "pregnancy" one on one. The unstable psyche of a teenager is very unpredictable, especially in such a situation;
• The problem of financial support. Often, a young mother raises and raises a child alone, without the financial assistance of the father of the child. In such a situation, one has to rely only on the help of the state and relatives;
• Lack of responsibility. Due to the lack of life experience in young mothers and not a strong psyche, their children do not receive proper care, attention, affection. Often a teenager believes that the reason why life has failed is the child. All anger and resentment is taken out on the baby;

The threat of early pregnancy to the fetus

The unborn child, as well as his young mother, is in great danger.

The main risks to the fetus are:

• High probability of developmental deviations;
• The occurrence of pathologies;
• Threat of early death;
• risk of miscarriage;
• underweight;
• Fetal hypoxia;
• Traumatism during childbirth.

These are just the most common concerns about early pregnancy regarding the baby.

Of course, not all teen pregnancies are complicated. Everything can end quite well. The main thing is to approach this issue responsibly. The support of relatives and the correct management of pregnancy by a doctor will give the desired result as a result.

No less important is the psychological problem of early pregnancy. Upon learning of their situation, young girls are shocked and in a panic. Psychologists say that the usual reaction is guilt, anger and unwillingness to admit what happened. This leads to dangerous consequences, because the girl may be left without the necessary and timely medical care.

This is not surprising, because there is a sharp transition from childhood to adulthood, the girl is faced with the first major decision in her life. Moreover, she needs to make an important decision herself, young fathers, as a rule, immediately cease to be “tough guys” and prefer to step aside.

Early pregnancy: what to do

To begin with, the expectant mother should decide whether she will give birth (by the way, termination of pregnancy is also very dangerous for a young organism). So, if she decided to leave the child, then she needs careful medical supervision and compliance with all medical recommendations. In addition, she will need psychological counseling.

Parents should inspire the girl that she is not alone - this will save her from fears and possible negative consequences. For example, they may offer partner births (with a friend, sister, mother) to support her. A pregnant woman does not need negative emotions, so you should not deal with a showdown if the future father does not want to participate in the fate of the newborn.

In addition, a teenager will need help not only during pregnancy, but also after the baby is born. As soon as the baby is born, the girl can continue her education. She also needs to plan the day so that there is time for rest, personal affairs.

To prevent early pregnancy, parents should educate their child about pregnancy, childbirth, contraception, and how it can all end.

Outcome

The main decision should be made by the pregnant girl, but the parents and the future father should actively participate in the discussion. She should not feel reproach or condemnation, but at the same time, all facts and perspectives should be fully stated. Well, if you can get a full consultation of a gynecologist and a psychologist. The medical and social aspect is very important in this case.

The statistics of early pregnancy confirms that most often it ends in abortions (70%). Also, some pregnancies lead to childbirth (15%), and some are terminated due to an unsuccessful miscarriage.

The choice before the girl is very difficult, so it is better to approach this issue as seriously as possible.