Why is a frozen pregnancy. Frozen pregnancy - why it occurs and how to determine the pathology in time. Possible complications of missed pregnancy
Many couples dream of having a child, but not all of these dreams come true for various reasons. One such reason is an undeveloped pregnancy.
The culprit for the occurrence of such a pathology can be not only the mother, but also the potential father, therefore it is very important when planning a pregnancy to undergo a thorough examination and adhere to a healthy lifestyle for both partners.
According to statistics, missed pregnancy is recorded in 15-20% of all planned pregnancies, which is quite common.
Definition of the concept of "frozen pregnancy"
A non-developing, or frozen, pregnancy is a pregnancy in which there is a sudden cessation of its progress, the fetus stops developing, growing, and subsequently dies. At the same time, until a certain time, there are no signs of spontaneous abortion, and the embryo continues to remain in the uterine cavity. Based on the foregoing, this pathology is also called a failed miscarriage. "Fading" of pregnancy can happen at any gestational age (up to 28 weeks), but most often this situation occurs in the first trimester. Threatened terms of pregnancy for the occurrence of a failed miscarriage are considered 3-4 weeks, 8-10 weeks, 16-18 weeks.
A failed miscarriage, like other options for spontaneous abortion, belongs to the category of miscarriage. However, they begin to talk about habitual miscarriage only if there are two or more cases of spontaneous abortion.
The essence of a frozen pregnancy is that the egg is fertilized, transported to the uterine cavity, where it implants and develops for some time, but after the development of the fetus stops. One of the options for a missed pregnancy is the "empty ovum" syndrome, or anembryony. In such cases, fetal membranes develop, chorionic gonadotropin is synthesized, which is confirmed by a positive response when performing a pregnancy test, but the embryo itself is completely absent. Quite often, such a pathology is the result of the presence of genetic defects.
Causes of a missed pregnancy
There are many reasons for missed pregnancy. Therefore, they are divided into several groups:
Genetic and chromosomal abnormalities.
It is one of the most numerous and important groups of etiological factors in the occurrence of missed pregnancy. When an embryo has a pathological gene or an extra chromosome, in the process of development it develops multiple malformations that are incompatible with life, respectively, in this case, the pregnancy is also terminated. We can say that, in this way, natural selection can be seen in action, nature decides that it does not make sense to produce an incapacitated baby, therefore, in order to save the strength of the mother's body, pregnancy stops progressing.
But the occurrence of a genetic anomaly can occur both during a specific case of pregnancy when the mother’s body is exposed to pathogenic factors (smoking, drug and alcohol use, radiation), and due to the inheritance of pathology from parents, for example, the occurrence of a failure in the structure of “susceptibility genes”. Thus, if the fetal egg received a “thrombophilia gene” from the parents, then in the process of its attachment to the wall of the uterus and invasion of the chorion vessels into the mucosa, microthrombi appear, respectively, this leads to disruption of the process of blood supply and nutrition of the embryo, and he dies.
Infections.
A significant role in the origin of spontaneous abortion or miscarriage is played by the presence of infectious diseases. First of all, these are the so-called TORCH infections (a group of viral diseases). This group of pathologies includes cytomegalovirus infection, herpetic infection, toxoplasmosis, rubella. Especially dangerous is the primary infection with the above pathologies during pregnancy.
In the early stages, when infection occurs, a "fading" of pregnancy occurs, in the later stages, anomalies in the development of the fetus are formed. Sexual infections (gonococcal, ureaplasma, chlamydia) are also of significant importance. Even the presence of a common cold (ARVI, influenza) in early pregnancy can cause a miscarriage. The death of the embryo is realized by three mechanisms.
On the one hand, penetrating through the placenta, infectious agents directly affect the fetus.
On the other hand, the maternal organism, in response to infection, begins to produce prostaglandins, which either disrupt the microcirculation between the endometrium and the fetal membranes, or have a toxic effect on the embryo, which leads to a cessation of the supply of oxygen and nutrients to the fetus.
The presence of a chronic inflammatory process in the uterine cavity causes a violation of the normal implantation of the fetal egg, which leads to a nutritional deficiency of the embryo.
Hormonal disorders.
The lack of the most important hormone for the normal course of pregnancy - progesterone - quite often acts as one of the factors in the occurrence of miscarriage. In addition, a high content of androgens or a violation of the hormonal functions of the thyroid gland plays a certain role.
Autoimmune pathology.
Autoimmune diseases are distinguished by the fact that the mother's body begins to synthesize antibodies that fight its own cells, mistaking them for foreign agents. Since the embryo receives 50% of the mother's genes, the mother's antibodies begin to attack his body, which, in turn, ends with the fading of pregnancy.
For example, if the mother has antiphospholipid syndrome, antibodies to phospholipids are present in the body, and without them, in principle, the formation of new cells is impossible. During pregnancy, these antibodies attack the developing fetus, causing it to die.
Teratozoospermia.
The reason for the termination of the development of the embryo and its subsequent death may be a failed father. The presence of a pathology such as teratozoospermia is most often the cause of partner infertility, however, in some cases, pregnancy may occur, but in most cases it ends in miscarriage. Teratozoospermia is a pathological condition of spermatozoa, in which they have an irregular structure. Anomalies of spermatozoa can manifest themselves as a thickening or bending of the tail, the absence of a chromosome, the presence of vacuole cells in the head, an irregular head shape, and a short tail.
Teratozoospermia is said to be in the presence of more than 50% (in most cases about 80%) abnormal spermatozoa in the patient's ejaculate. Conception in such cases is either impossible at all, for example, due to the fact that sperm with a short tail lose their mobility, or the egg is fertilized, but due to an anomaly of the sperm head, the embryo develops incorrectly and the progression of pregnancy stops. After examination and therapy, many couples are still forced to turn to additional assisted reproductive technologies, such as artificial insemination.
Wrong way of life.
It is obvious that bad habits, occupational hazards, daily routine, and nutrition have a certain influence on the occurrence of a non-developing pregnancy. You also need to be aware of the presence of dangerous side effects in some drugs that a pregnant woman may take during the gestation period, especially in early pregnancy. The age of the woman is also important. The older the woman, the higher the risk of an undeveloped pregnancy (over 35 years).
Other factors.
A sharp change in climate, constant stress and other factors can cause a missed pregnancy. In addition, a history of numerous abortions causes endometrial failure, which, in turn, leads to a disruption in the supply of oxygen and nutrition to the fetus and the development of pathology. After performing in vitro fertilization, cases of missed pregnancy also quite often occur, however, the causes of the pathology in this case are due to diseases, due to which the woman resorted to this method of fertilization.
Abortion clinic
Frozen pregnancy has a characteristic symptomatology. First of all, a woman loses the likely signs of pregnancy (characteristic of the first trimester). Vomiting and nausea, intolerance to odors disappear, the tension of the mammary glands is lost, they become soft. However, the loss of the described symptoms does not always mean that the embryo has died.
Early toxicosis, as well as tension in the mammary glands, may be absent.
Quite often, the moment of embryonic death goes unnoticed.
A positive pregnancy test result may be present for another 2-4 weeks, since hCG is excreted from the mother's body gradually.
At the same time, the basal body temperature will be in the region of 37 and even below degrees.
If the dead embryo remains in the uterus for more than 3-4 weeks, a syndrome of intoxication of the body occurs (malaise, general weakness, fever), due to the fact that the embryo begins to decompose and infects the mother's body with tissue decay products and toxins.
If a frozen pregnancy occurs in the 2nd trimester, then one of the first signs is the absence of fetal movement.
If the embryo is in the uterus for more than 2-6 weeks, then the symptoms described above are joined by signs of spontaneous abortion (aching pain in the lumbar region and lower abdomen, dark spotting).
In addition, during the gynecological examination, a lag in the growth of the uterus is recorded, compared with the approximate period. Therefore, gynecologists perform bimanual palpation of the uterus in the first trimester, every time during the examination.
Example from practice: in the antenatal clinic, a woman was observed at 6 weeks of pregnancy, with a second pregnancy. After studying the anamnesis, it was found that there were 3 births, and medical and diagnostic curettage and abortion were not performed. The woman and her husband had no bad habits, as well as chronic diseases. The only negative point was the age of the pregnant woman (40 years old) and the nature of the activity (night shifts, a nurse). During the planned turnout, the pregnant woman complained of the presence of pulling pains in the lower abdomen and periodic spotting. During the vaginal examination, it was found that the uterus is soft, painless with an increase of up to 12 weeks, while the approximate period is 16 weeks. After undergoing an ultrasound scan and confirming the diagnosis of missed pregnancy, the woman underwent curettage followed by antibiotic therapy. There were no coagulopathic and infectious complications, and after 10 days the patient was discharged. The cause of the miscarriage was never determined, as parts of the fetus that were sent for histology were lost in the laboratory.
Treatment of a missed miscarriage
If a missed pregnancy is suspected, a woman must be urgently hospitalized.
After performing the examination (hCG, ultrasound in the early stages and ACE in the 2nd trimester, coagulogram), the embryo is carefully evacuated.
A variant with expectant management is possible when the fetus is dead for less than 2 weeks (if this happened early in pregnancy) and there are no signs of an abortion and infection of the uterus. In such cases, the level of hCG in the woman's body drops rapidly, uterine contractions appear, and the fetal egg is pushed out. However, most often they resort to the use of a surgical method, namely, the membranes with the fetal egg are scraped out or subjected to vacuum aspiration.
It is also possible to use medical abortion (for periods up to 7 weeks) by prescribing the progesterone blocker Mifegin.
After surgical or other release of the uterine cavity from the embryo, hysteroscopy is mandatory. In the postoperative period, antibiotics are required to prevent the development of chorianamnionitis and endometritis.
In case of fetal death after 14-16 weeks, its evacuation is performed by transcervical administration (amniocentesis) of a hypertonic solution of sodium chloride or prostaglandins, or by intravenous administration of a prostaglandin solution.
Frozen pregnancy, what to do next?
The most common question of all patients is: "What to do after a frozen pregnancy?". The material obtained after scraping must be sent for histological examination without fail. In some cases (if there are suspicions of a chromosomal pathology), additional genetic studies of the tissues of the embryo (quality and number of chromosomes) should be prescribed.
Women are advised to refrain from pregnancy for 6 months, while the doctor prescribes oral contraceptives (Zhanin, Yarina). It is also necessary to be examined for the presence of TORCH infections. It is imperative that the hormonal status be examined, and, if necessary, its correction is performed. They also perform an ultrasound examination of the blood coagulation system and pelvic organs, conduct a blood test for the presence of antibodies to phospholipids.
When planning a new pregnancy, a couple is advised to give up bad habits, if possible, eliminate the reasons why the previous pregnancy froze, treat infectious diseases, and lead a healthy lifestyle. Women 3 months before the planned pregnancy and during the first 12 weeks of pregnancy are prescribed vitamin E and folic acid.
After a woman learns about her special position, she begins to dream and make plans for the future, in which she prepares a place for her future baby. But quite unexpectedly, misfortune happens, and she is informed that her pregnancy has died. This is a difficult test for every woman, and not so much physical as emotional. Immediately there are many questions, finding answers to which is difficult. But still, let's figure out why pregnancy freezes and what consequences should be expected.
Fetal freezing is a form of miscarriage that occurs in women regardless of age and number of previous pregnancies. This happens when circumstances are not fully understood, and in the end leads to the complete death of the embryo.
According to official statistics, fading occurs once in 176 pregnancies.
Frozen (non-developing) pregnancy is an irreversible violation of the development of the fetus, accompanied by a cessation of its growth, instantaneous death and destruction of its tissues. In obstetric practice, this pathology is called a failed miscarriage, since the death of the fetus occurred without clear clinical signs and subsequent discharge of the fetal egg from the uterus. Therefore, it is important to know the signs of a missed pregnancy in order to seek help from a doctor as soon as possible and prevent complications.
Sometimes fading of a false embryo is diagnosed. This happens when the egg is successfully fertilized and the fetal egg is implanted in the endometrial layer, but the embryo itself was not in it. This pathology is called "empty ovum".
Frozen pregnancy - terms appearance of pathology
This pathology occurs at any gestational age. There are even cases when fetal death occurs a few days before delivery. It also does not matter the age of the woman, but women over 40 are at greater risk.
Investigating thousands of cases of fetal freezing, doctors conditionally established the most critical periods of pregnancy, when the fetus is most vulnerable:
- 1 period - 3 and 4 gestational weeks.
- 2 period - from 7 to 11 gestational weeks.
- 3 period - 16 and 18 gestational weeks.
After the 20th week of pregnancy, cases of developmental arrest and fetal death are rare.
In the vast majority of cases, a missed pregnancy is diagnosed at an early stage (up to 14 gestational weeks). This occurs as a result of improper development of the embryo or disorders in the body of a pregnant woman. In the later stages, fading is caused by hormonal disorders, genetic abnormalities, or infections.
Frozen pregnancy - the causes of the tragedy
Doctors put forward several basic hypotheses of fetal fading. It is possible to confirm the cause of his death with the help of a histological examination of the obtained genetic material. But it also happens that the cause remains unproven.
Here are the most common factors that affect fetal death:
- genetic disorders. At the 8th week of pregnancy, the formation of important organs in the fetus occurs. If this process is accompanied by chromosomal abnormalities, the development of the fetus stops. For this reason, more than 70% of embryos die. This is facilitated by the transfer of bad genetic material from one of the parents or the incompatibility of the gene pool of a woman and a man. If a woman is already diagnosed with a second missed pregnancy, the couple is sent for a consultation with a geneticist.
- Hormonal imbalance. For the fertile division of healthy cells of the embryo, the female body must produce a lot of progesterone and few androgens. If a “breakdown” occurs at this level, the fetus dies. This situation can be eliminated even at the stage of pregnancy planning, so pregravid preparation will be an excellent prevention of this pathology.
- infectious diseases. Reduced immunity during gestation is normal, but for this reason, a woman becomes vulnerable to various diseases. Especially dangerous in this position are considered: rubella, influenza, cytomegalovirus, SARS. Intoxication of the body, fever, stress on the immune system during the period of illness can provoke a violation of the development and death of the baby. The symptoms of a missed pregnancy will be invisible against the background of the ongoing disease.
- ECO. Although medicine has greatly succeeded in artificial insemination, this method of getting pregnant has not yet been fully studied. Scientists still cannot prevent the frequent fading of the embryo after replanting into the uterus, and often a woman has to undergo an IVF procedure several times.
- Sexually transmitted diseases. Pregnancy does not exclude sexual contact, which carries the risk of "catching" gonorrhea, genital herpes, chlamydia or syphilis. It often happens that there are no visible symptoms of a pathological course, but during pregnancy the fetus froze for no particular reason. In such a situation, a woman is recommended to be examined by a venereologist or an infectious disease specialist.
- antiphospholipid syndrome. This is a rare autoimmune disease that is accompanied by excessive production of antibodies to phospholipids. Such a pathology in a woman can cause egg rejection, underdevelopment or blockage of placental vessels, which leads to the death of the embryo.
- Unacceptable lifestyle during gestation. What is meant by this judgment? First of all, these are poor nutrition, low activity, lack of stress resistance, overwork, oxygen deficiency, uncomfortable underwear and, of course, bad habits. Each of these factors can affect the development of the baby.
Symptoms of a missed pregnancy in the early and late stages
An undeveloped pregnancy has no symptoms like a normal miscarriage, so a woman may not immediately notice that something is wrong with her pregnancy. And this poses a serious threat to her health, because the dead fetus begins to decompose and can harm the female reproductive organs. But there are still some characteristic symptoms, and a woman who is very attentive to herself will definitely notice them. Their nature and severity may be different.
Signs of a missed pregnancy - first trimester
In the first weeks of pregnancy, you can suspect a problem by monitoring your well-being, the nature of vaginal discharge, toxicosis, and fluctuations in the basal temperature graph. These signs are indirect and do not give an exact guarantee that the fetus has died. Therefore, the appearance of one of the symptoms serves as an occasion to go to an obstetrician-gynecologist.
How to identify a missed pregnancy by signs:
- Allocations. In the event of a miscarriage, the rejection of the dead fetus occurs rapidly and it leaves the uterus on its own. And when it freezes, the embryo continues to stay on the ball of the endometrium, but the body tries to gradually get rid of it. The first 48 hours after the beginning of the regression of the development of the embryo, the nature of the discharge does not change. They remain whitish in color, the usual structure. Then the tissues of the embryo begin to decompose, and the fetal egg is already involved in this process. It is gradually rejected from the uterus, as indicated by the appearance of bloody veins in the discharge. If no fading was noticed within two weeks, the woman begins to bleed with complete rejection of the dead fetus.
- Toxicosis. If a woman has severe toxicosis from the moment of implantation of the egg, a change in its nature can be suspected to stop the development of the fetus. Vomiting and nausea provokes the synthesis of hCG, which increases with each week of pregnancy. If the embryo dies, the hCG level drops and after 24-36 hours the woman experiences a decrease in vomiting and nausea. After 4-6 days, toxicosis completely disappears. It is worth recalling that the weakening of toxicosis can also be the result of the physiological addiction of the female body to the fetus.
- General well-being. If a decomposing embryo is in the uterine cavity for a long time, it will cause intoxication of the whole organism. This condition can be confused with a cold or fatigue, but if a woman's first pregnancy was frozen, then she will immediately distinguish the normal state from the pathology. 2-3 weeks after the death of the embryo, a woman may notice dizziness, severe weakness, loss of strength, anxiety, aching pain in the projection of the uterus. After 4 weeks, the temperature begins to rise and the pain in the abdomen increases. After 5 weeks, the woman begins to have a fever, the pains become cramping, there may be a loss of consciousness. If a woman does not undergo curettage in time during a frozen pregnancy, she will experience severe inflammation of the uterine tissues and sepsis.
- Fluctuations in basal temperature. Often, women keep a chart of basal temperature to find out the time of ovulation and successfully become pregnant. After fertilization, they continue to measure the temperature and monitor the course of pregnancy. This is a reliable way to notice the fading of the fetus within a couple of days after its death. Normally, the temperature level during gestation exceeds 37⁰С. 48 hours after the fetus freezes, the temperature begins to drop from 37⁰С to 36.7⁰С. And after the fruit begins to decompose, the temperature will jump sharply above 37.5⁰С
Symptoms of a missed pregnancy - second trimester
Starting from the second trimester, a number of others join all the above symptoms. After the 16th week of pregnancy, the fetus is already large and actively makes itself felt, so it becomes easier to understand that something is wrong with it.
Common signs of pathology include:
- Lack of baby movement for two or more days.
- Drawing pain in abdomen and back.
- The appearance of blood in the vaginal discharge.
- Leakage of amniotic fluid with an unpleasant odor.
Unlike the first weeks of pregnancy, in the later stages the body rather gets rid of the dead fetus and after 4-5 days the woman begins premature birth.
Important! As soon as you notice the first sign of a missed pregnancy, immediately seek emergency medical help.
Informative methods for diagnosing fetal fading
It is impossible to establish the fact of pregnancy fading only by the symptomatic picture. Therefore, at the first suspicion, a woman is sent for examination. And only after a thorough diagnosis, a woman is cleaned after a frozen pregnancy.
Diagnostic procedures include:
- Confirmation of the diagnosis on a gynecological examination. Often, at a control gynecological examination, the doctor notices that the size of the uterus does not match the established gestational age, and blood discharge comes from the genital tract. This may confirm the regression of fetal development. But as an option, this may also indicate a threatened miscarriage with a live embryo. Therefore, further research is being carried out.
- Diagnosis by ultrasound. Pregnancy after 8 weeks allows you to reliably determine the absence of a heartbeat in the fetus and possible anomalies in development. But a period of less than 5 weeks does not give a complete picture during an ultrasound scan, and the specialist may not see the embryo or signs of its vital activity. Therefore, in the first weeks of pregnancy, a blood test for hCG levels is performed to confirm the diagnosis.
- Diagnosis by determining the level of hCG. There are strictly established norms for the concentration of hCG in the blood for different periods of pregnancy. Therefore, it is enough to do an analysis of venous blood to determine the fading of the fetus. At the same time, the level of hCG during a frozen pregnancy will correspond to the indicator outside of pregnancy.
Frozen pregnancy - treatment
The tactics of managing a woman with a missed pregnancy may be different, depending on the gestational age, the physical and psychological state of the woman.
If the diagnosis is made early and there is time to wait, the woman is placed in a hospital under the supervision of doctors and a spontaneous miscarriage is expected within a few days. If the period is less than 8 weeks, medical abortion is performed with the help of special preparations.
After 3-4 days, if this does not happen, the woman is sent for cleaning during a missed pregnancy under general anesthesia. This is a simple gynecological manipulation, similar in principle to abortion. 14 days after the procedure, an ultrasound is performed to make sure that the uterine cavity is clean, without signs of inflammation.
After that, the woman is in the hospital, she is prescribed a course of antibiotics, hormone therapy (if indicated) and sedatives. Various tests are also prescribed after a frozen pregnancy, depending on the causes of the pathology. . These can be hormonal studies, taking smears to hide the infection, general blood counts.
Important! It is permissible to get rid of a dead embryo only under medical supervision. Self-administration of herbs or hormonal pills for uterine contraction can lead to rapid bleeding or blood poisoning.
Frozen pregnancy - consequences for a woman
Serious complications in women occur only with a late visit to the doctor. If the diagnosis is made on time, and the treatment is prescribed correctly, a woman in the future will be able to easily become pregnant and give birth to full-fledged babies. The most difficult thing in such a situation is to determine the cause of the death of the baby and make efforts so that this does not happen again.
Women are often interested in the question, can there be a repeated frozen pregnancy? Doctors unanimously answer that this can happen many times if the cause of the death of the embryos is not eliminated. Therefore, this problem must be approached comprehensively - undergo examinations, cure existing diseases, visit genetics and insist on a positive result.
The loss of an unborn baby is a severe shock for a woman. Not only her reproductive system suffers from this, but also her psycho-emotional background. Therefore, in addition to treatment, a woman needs a long time to accept the current situation. Often a woman who has experienced a frozen pregnancy does not know what to do, so she needs the support of loved ones or the help of a psychologist.
Frozen pregnancy. Video
Sometimes a frozen pregnancy is called a non-developing or regressing pregnancy (pregnancy regression). Most often (in 70-80?% of cases) pregnancy fading occurs in the first trimester (up to 12 weeks). Most likely, fading can occur at 7-8 weeks - during the laying of most of the vital organs in the body of the unborn child.
Symptoms of a missed pregnancy
A frozen pregnancy may not manifest itself for some time and can be determined only by ultrasound, which is carried out in a planned manner.
A sign of a missed pregnancy may be the disappearance of such subjective signs of pregnancy as nausea, drowsiness, etc., if the expectant mother noted them earlier. And some don't have them at all. Often the moment of fetal death is elusive. There may be symptoms of a threatened miscarriage (bleeding, nagging pain in the lower abdomen or in the lumbar region), however, the appearance of these symptoms does not always indicate the death of the embryo, therefore, if you seek medical help in a timely manner, it is likely that the pregnancy will be saved.
In the second trimester, a sign of pregnancy fading may be the cessation of fetal movement (during the first pregnancy, fetal movements are felt from 18–20 weeks, with a second pregnancy, from 16 weeks).
Frozen pregnancy: Diagnosis
During a vaginal examination, which is carried out by a gynecologist, there is a discrepancy between the size of the uterus and the gestational age, that is, it is smaller than it should be at the time at which the examination is performed. However, in some cases, if the fading occurred a few days ago, the uterus may be of normal size for this gestational age.
Objective indicators are more valuable for diagnosing a missed pregnancy:
The content of the hormone hCG in the blood(human chorionic gonadotropin is a pregnancy hormone that is produced by the chorion, the future placenta) - with a frozen pregnancy, its level drops sharply relative to normal values at a given gestational age. Pregnancy tests after "fading" may remain positive for several days, and then begin to show a negative result (this is due to a gradual decrease in the level of hCG in the blood and urine).
Ultrasound does not determine the heartbeat and movement of the fetus. The embryo is smaller than it should be. An empty fetal egg (anembryony) may be detected. A woman can be referred for an ultrasound if a missed pregnancy is suspected, or this can be detected during a planned ultrasound (the term of the first planned ultrasound is 10-14 weeks).
Frozen pregnancy: Causes
genetic pathologies. This is the most common cause of pregnancy fading in the early stages. In 70?% of cases, when pregnancy fades in the fetus, chromosomal abnormalities are recorded (changes in the number or structure of chromosomes). Most chromosomal abnormalities in the fetus are incompatible with live birth, as they lead to multiple malformations of various organs and systems of the fetus, so a fetus with an altered set of chromosomes most often dies in utero, that is, pregnancy fades. Thus, we can say, "natural selection" is carried out.
A genetic pathology of the fetus can be “accidental”, that is, it has arisen only in this pregnancy due to some kind of harmful effect, without which everything would be fine. Usually, any harmful factor that affects the early period causes damage to the fetus according to the “all or nothing” type, that is, either the factor does not affect the development of the fetus at all, or it causes a pathology that is incompatible with life, and the pregnancy fades. Unfortunately, the number of harmful factors surrounding us is quite large, and the likelihood of a collision with them is quite high. These include environmental factors, radiation, malnutrition, bad habits (smoking, drinking alcohol, drugs), contact with household chemicals, the influence of drugs, deficiency of essential vitamins and minerals.
In the vast majority of cases, nature protects the unborn baby, but sometimes this protection does not work. Most often, doctors are unable to determine what specifically harmed this pregnancy. But the risk of repeating failure in this case is minimal, since newly occurring genetic damage (not received from parents) is quite rare, and the likelihood that this “accident” will happen again is small. However, sometimes a child can get a genetic "breakdown" from the parents. For example, in one of the parents, a section of one chromosome can “cling” to another, the total amount of genetic material (chromosomes) is not changed, and the person is healthy. But only one of these chromosomes can be transferred to the fetus, as a result of which it will have either an excess or a lack of genetic material, which can lead to its death.
In addition, a "breakdown" may occur in the "susceptibility genes" to miscarriage. This group includes, for example, genes for thrombophilia (increased blood clotting): their carriage can lead to the formation of microthrombi at the site of attachment of the fetal egg to the uterine wall, malnutrition of the embryo and its death. Mutations in “environmental genes” (this is a group of genes responsible for the production of enzymes that remove toxic substances that have entered the body from the environment) from the body also increase the risk of miscarriage, as the body’s resistance to harmful factors decreases. Mutations in these and other "susceptibility genes" are not a sentence and are not considered a pathology, but increase the risk of pregnancy fading. A large role in whether a genetic predisposition to miscarriage is realized is played by environmental factors and a woman's lifestyle. For example, the risk that an unfavorable mutation (“breakage”) in thrombophilia genes is realized increases significantly with smoking.
Infections. The greatest danger to the fetus is infection, mostly viral, especially if the mother met with this disease during pregnancy for the first time. We list the infections that are most dangerous for the fetus and often lead to its death or malformations:
- toxoplasmosis;
- rubella;
- cytomegalovirus;
- herpes.
Some viruses (for example, herpes, cytomegalovirus) after infection are in the body for life. A chronic infection is much less dangerous for the fetus than the primary infection during pregnancy, but its exacerbation while waiting for the baby can in some cases lead to an unfavorable outcome.
Increase the risk of pregnancy fading sexually transmitted infections (urealpasma, mycoplasma, chlamydia), other infections that cause inflammation in the genital tract, as well as the presence of foci of chronic infection in the body (chronic diseases of the digestive, respiratory, urinary system, carious teeth, etc.). d.). Colds and flu in the early stages, in some cases, can also be the cause of pregnancy fading.
Infection leads to fetal death through several mechanisms. First, the microorganism can have a direct effect on the fetus, penetrating into his body through the placenta. Secondly, if there is an infection in the body of a pregnant woman, biologically active substances are produced that can have a toxic effect on the fetus or disrupt blood flow in the area of the fetal egg and lead to disruption of the supply of nutrients and oxygen to the fetus. Thirdly, due to a chronic inflammatory process in the uterus, the normal attachment of the fetal egg and its nutrition may be disrupted.
Hormonal disorders. Most often, when pregnancy fades, female and male sex hormones, as well as thyroid hormones, play an important role.
The most important during pregnancy is the normal level of the hormone progesterone. It is called the "hormone of pregnancy", as it is necessary for its normal course. Low progesterone levels are one of the most common causes of miscarriage.
Thyroid hormones play an important role. The cause of fetal death can be either an excess or a deficiency of these hormones.
An increase in male sex hormones is also a common cause of pregnancy fading.
autoimmune disorders. Autoimmune processes are called when antibodies are formed by the immune system not to foreign agents (bacteria and viruses), but to the body's own cells. During pregnancy, these antibodies can also affect the fetus, which is half similar to the mother's body, which leads to its death.
Quite often, the cause of repeated fading pregnancies is antiphospholipid syndrome(AFS). In this state, antibodies are formed to their own phospholipids - substances that are involved in the formation of cell walls. Before pregnancy, this syndrome may not manifest itself in any way. APS can be suspected in repeated dying pregnancies. The examination includes both an analysis specifically for APS markers and an analysis for blood clotting (with APS, blood clotting increases, which leads to the formation of microthrombi, including in the vessels of the placenta, which leads to a disruption in the supply of oxygen and nutrients to the fetus, and if left untreated, to death).
Another fairly common autoimmune disease is autoimmune thyroiditis.
This is a disease in which antibodies are formed against the cells of one's own thyroid gland, as a result of which its function and the level of hormones that it produces are disrupted. And with a lack of thyroid hormones, fetal death is possible.
Wrong way of life. Bad habits during pregnancy are by no means harmless. Toxic substances contained in tobacco smoke and alcohol can lead to fetal death.
In some cases, the cause of pregnancy fading may be harmful working conditions (for example, radiation, vibration, etc.).
What will the doctor do
If the death of the fetus is detected, the woman is hospitalized in the gynecology department of the hospital.
The fetal egg is removed from the uterine cavity by curettage or vacuum aspiration (removal of the contents of the uterine cavity using vacuum suction). This procedure is performed under general anesthesia (intravenous anesthesia). Spontaneous miscarriage is not expected, since the toxic decay products of a dead fetal egg "poison" the mother's body, cause a violation of blood coagulation processes, and can lead to infectious complications (collapsing fetal tissues are a good breeding ground for pathogenic microbes).
Fetal tissues obtained by scraping or aspiration are always sent for histological examination (examination of the material under a microscope), and this is not additionally paid by the patient. In some cases, this study helps to identify the cause of pregnancy fading. For example, a histological examination may reveal changes characteristic of an infectious process in the uterine cavity. The result of a histological examination is usually ready in 1-2 weeks.
In some cases, the material is sent for genetic research - a karyotype (number and structure of chromosomes). In this case, the chromosomal set of the fetus is determined.
Sending material for genetic testing is most often done in case of repeated cases of pregnancy fading; most often this research is paid. The possibility of sending the material for genetic testing is discussed by the doctor and the patient in advance before the operation. The result of a genetic study is ready on average after 2 weeks.
However, a miscarriage can occur on its own, even before it has been established that the pregnancy has stopped. In this case, it is imperative to do an ultrasound scan to exclude the retention of parts of the fetal egg in the uterus, and if they are found, undergo an operation to curettage the uterine cavity.
When pregnancy fades in the second trimester, an artificial late miscarriage is performed. With the help of medicines, the contractile activity of the uterus is caused and fruition occurs.
How is this dangerous condition recognized and can it be avoided?
Frozen pregnancy: Prevention and prognosis
In 80–90?% of cases, after one missed pregnancy, women normally carry a subsequent pregnancy and give birth to a healthy child. However, if there were two fading in a row, then in the next pregnancy the risk of her fading will be 40?%, and if three, then 60?%.
It is recommended to plan the next pregnancy no earlier than six months after the dead one. This time is necessary for the uterine mucosa (endometrium) and the hormonal background in the body to fully recover after a failed pregnancy. During this period, it is recommended to take hormonal contraceptives, as they not only have a contraceptive effect, but also help the body recover from hormonal stress, regulate ovarian function and restore the menstrual cycle.
When planning the next pregnancy, you should definitely contact an obstetrician-gynecologist so that he can prescribe an examination to determine the cause of the pregnancy fading and the woman’s health status and, if necessary, therapeutic and prophylactic drugs. Before pregnancy, infectious diseases should be identified and treated. With a chronic infection, it is worth taking care of the state of immunity so that an exacerbation does not occur during pregnancy.
During the planning period for the next pregnancy, it is important to eat right, get the necessary amount of vitamins (with food or in the form of multivitamin complexes), and lead a healthy lifestyle. This will help the body protect the baby from negative environmental influences during pregnancy. It is also highly recommended to give up bad habits.
Without a doubt, a frozen pregnancy is a psychological trauma, so if a woman is tormented by obsessive thoughts that she will not be able to have children at all, if she sets herself up for failure, she should contact a psychotherapist or a perinatal psychologist.
The fetus froze - this is perhaps one of the most terrible words from a doctor for a couple who dream of children. You can hear them for various reasons at the very beginning of the development of a new life (the most dangerous are from 3 to 4, from 8 to 11 and from 16 to 18 weeks from conception). Sometimes the diagnosis is made at a later date, but the likelihood of hearing it is much lower. An analogue is the development of an empty fetal egg: in this case, fertilization has occurred, but the embryo does not develop. Pathology occurs spontaneously, maybe several times in a row throughout a woman's life. From it, unfortunately, no one is immune. However, it is better to know the causes and signs of a missed pregnancy in the early stages in order to take action in time and consult a doctor, as well as prevent the development of pathology before conception. Anything can influence the development of a small life. And the worst thing about it is that it’s not so easy to notice the changes.
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Reasons why pregnancy does not develop
Why is there a frozen pregnancy in the early stages? This question excites and frightens young mothers. There are actually quite a few reasons:
- Genetic deviations occupy a leading place. They are diagnosed in 70% of cases for up to 8 weeks. They are associated with many factors, including hereditary diseases, as well as the result of taking drugs by one of the partners. That is why it is important not to refuse screenings and other examinations proposed by a geneticist and gynecologist.
- Excessive use can also provoke developmental arrest. It is especially dangerous if the mother cannot give up bad habits after conception.
- Medications can also provoke the development of abnormalities. That is why the doctors themselves strongly recommend to refuse any medication. An exception can only be serious diseases, the treatment of which with folk remedies is simply impossible. It is worth noting that for up to 10 days and after 8-10 weeks, when the fetus becomes partly protected by the placenta, the effect of the drugs is not so significant. As for herbs, they also need to be taken only under the supervision of a doctor, because some of them can provoke a breakdown or stop in the development of the embryo.
- The causes of a missed pregnancy in the early stages may lie in the mother and child. If a woman has had abortions before, then the chances of a happy development are not so great. Antibodies produced by the mother's body in relation to the child accumulate over time. And after several abortions, it is very difficult for a conceived baby to resist such an attack.
- Infections of both the genital organs and viral (flu) are a serious threat at the very beginning of the birth of life. The mother’s body is already weakened by the new situation, so it’s not at all difficult to get sick. But the consequences of a high temperature, a viral attack can be very severe. Rubella is a formidable enemy, in the event of which pregnancy not only freezes, the fetus may develop severe anomalies. And already in this case, the mother will have to decide whether she can raise a special child or is it better to terminate the pregnancy.
Consequences of congenital rubella for a child - Hormonal disorders. Moreover, an undeveloped pregnancy in the early stages, the causes of which lie precisely in this factor, can freeze both due to a lack of prolactin and an excess of testosterone. If a woman has regular disruptions of the menstrual cycle, then it is imperative to be examined during planning, as well as regularly check the state of the hormone after conception.
- Harmful factors at work, diabetes, weight lifting, stress - all these factors can also cause the development of pathology.
Women who have a higher risk of developing pathology
But not only this lies the answer to the question of why early pregnancy freezes. Doctors identify a certain risk group, which includes:
- old-timers or expectant mothers over the age of 35;
- in the presence of multiple abortions in the past;
- if during a previous pregnancy were ectopic;
- in the presence of a congenital anomaly of the uterus.
In the presence of one or all factors, the woman will be under constant medical supervision.
Expectant mothers who do not want to visit a gynecologist in the early stages also fall into the risk group. There can be many reasons for such a decision, but the result will be a serious threat to the health of not only the woman, but also the child.
What are the signs of a missed pregnancy?
The saddest thing is the fact that the symptoms of a missed pregnancy in the early stages are not pronounced. Therefore, the expectant mother may not even be aware of a change in the condition of the fetus. Only a qualified doctor, after examining and prescribing an additional examination, can state the absence of embryo development.
You should not look for symptoms of an undeveloped pregnancy in the early stages and, even more so, ask for advice from friends or on forums. In each case, everything goes purely individually and depends on many factors.
Symptoms of an approaching disaster
At a later date, it is easier for a woman to navigate, because she already feels the baby move. This is very difficult to do early on. A frozen pregnancy, the signs in the first trimester of which may be similar to less serious abnormalities, manifests itself as follows:
- passes;
- no more ;
- lowered;
- cramping pains began to appear;
- smearing appeared (discharge during a frozen pregnancy in the early stages has just such a consistency and a red-brown color);
- increased overall body temperature.
If any of these symptoms are detected, a woman should immediately consult a doctor! If the signs of pregnancy have disappeared, then this should also alert mommy and become a reason to visit a specialist!
What does a pregnant woman feel during the development of pathology
Feelings during a frozen pregnancy in women are very different. They are even affected by the fact whether this happened for the first time or whether a similar situation has happened before. Fatigue, apathy, fever - all this in any case should alert the expectant mother.
It is worth noting that all the symptoms that indicate the development of pathology may turn out to be false! No need to immediately set yourself up for the approach of a disaster. Quite often, they turn out to be similar to less serious ones, or the body is simply reconfiguring.
Diagnosis of the fact of fetal fading
Only a doctor knows exactly how to recognize a missed pregnancy at an early stage. To do this, he will do the following:
- , evaluate the state of the secreted mucus, ask to measure the basal temperature.
- If there is a suspicion of a deviation from the norm, the doctor will send the pregnant woman to pass. However, it is worth noting that hCG during a missed pregnancy in the early stages can be completely within the normal range for several weeks after the death of the fetus. And yet, more often, a urine test will show an underestimated level of the hormone, which is uncharacteristic for the first trimester.
- The final stage of examinations will be an ultrasound. With the help of an ultrasound examination, it will become clear whether the heart of the embryo is beating or not.
Tellingly, a test with a frozen pregnancy in the early stages can show all the same two stripes. This is again related to the level of hCG in the urine.
After the specialist makes sure of the diagnosis, he will choose the necessary set of procedures for the mother, and also in the future will help her prepare for a new pregnancy.
What do doctors do if the fetus froze
Depending on how a frozen pregnancy manifests itself in the early stages, as well as directly on the number of days from the moment of conception, the doctor will choose the most alternative method of treatment. After all, when establishing such a diagnosis, we are already talking about saving the life and health of the mother. There are two main methods of treatment:
- With the help of drugs that provoke. Applies up to 8 weeks.
- (vacuum aspiration). Under anesthesia, the woman is cleaned of the uterine cavity, using a vacuum suction.
In any case, professional help will definitely be required, since in order to avoid adverse consequences, it is necessary to clean the uterine cavity (the remains of the amniotic egg, which the ultrasound will indicate).
There is a third option, in which even the woman herself does not have time to realize that she was pregnant. This is a spontaneous abortion. If the fetus froze almost from the first days of life, then the body can reject it like a foreign body. In this case, a woman will simply notice a delay in menstruation. Sometimes doctors prefer to observe the patient's condition, waiting for a spontaneous abortion, so as not to interfere with the body once again.
Why is it so scary not to see a doctor in time
Sometimes a woman does not fully realize how difficult the consequences of a missed early pregnancy can be for her. But the body itself does not always reject the fetus. If an embryo that has stopped developing is in the womb for a long time, then intoxication is likely to develop. In this case, not only the temperature rises, the woman begins to suffer from acute pain and weakness, it is quite possible to delay the time until the blood becomes infected with the elements of fetal decay.
If the gestational age is more than 6 weeks, then in this case the woman has every chance of earning disseminated intravascular coagulation (DIC). The danger is that the blood loses its ability to clot. As a result, a woman can die from bleeding.
How to prevent fetal fading during pregnancy
A couple, regardless of whether they are preparing to become parents for the first time or have children, must undergo an examination. It is he who will be able to reduce the risks and give an answer on how to avoid a missed pregnancy in the early stages in their case. The doctor will offer to pass several tests: hormones, genetic examinations, ultrasound of the pelvic organs, blood for infections and other additional ones that will be prescribed taking into account the anamnesis of the parents. It is also recommended to refrain from conception for up to six months after diseases such as SARS, influenza, chicken pox.
If a woman works in a children's team, then she will be asked to get preventive vaccinations. Additional will need to adjust the hormonal background. Do not ignore a visit to a geneticist. A healthy lifestyle will only increase the chances of becoming parents. In the first months, it is recommended to refrain from flights, a sharp change in climate and prolonged exposure to the sun.
If the previous pregnancy ended in a halt in the development of the embryo - do not give up! With proper planning, the chance of carrying out and giving birth normally is 80% -90%. And how to prevent a frozen pregnancy at an early stage will be prompted by a gynecologist involved in the management of a couple.
Pregnancy after fetal arrest
Doctors predict good chances of conception only on the condition that the couple does not ignore visiting specialized specialists, undergoes a course of treatment, and also refuses to think about a child for the next six months after an unsuccessful experience. On average, such a period is necessary not only for a detailed examination and finding out the cause of pregnancy fading, but also for the physical recovery of the mother's body.
Sadly, but with 100% certainty, it is possible to say exactly about the reasons for stopping a pregnancy in quite rare cases. However, parents do not need to despair! Try to avoid stress, harmful factors, and don't forget to get tested - and let everything work out for you, and the baby will be born healthy and happy!
Also sometimes called non-developing, it can occur both in the early and late stages of bearing a baby.
Causes of missed pregnancy
In fact, a frozen pregnancy is the death of the fetus inside the uterine cavity. At the same time, its main difference from a miscarriage is that during an undeveloped pregnancy, the fetus remains inside the woman's body, which can lead to negative consequences. Therefore, depending on whether the pregnancy is in question, the dead fetus is removed by taking medication or surgery.As a rule, the first suspicions of a missed pregnancy occur in the woman herself who is carrying the baby. At the same time, the symptoms that can lead to such suspicions differ depending on the gestational age. So, if the development of the embryo froze in the early stages, the characteristic symptoms characteristic of this period disappear in a woman: toxicosis, swelling of the mammary glands, and the like. If the development of the fetus has stopped at a later date, the symptoms of this fact may be the occurrence of pain in the lower abdomen, the appearance of discharge with blood content and other unusual manifestations that the woman has not observed until this moment. In addition, a striking symptom of this pathology is that the child stops moving.
In general, specialists in the field of obstetrics and gynecology divide pregnancy fading into several large groups. The first of them is various dangerous diseases of an infectious nature, including rubella, herpes, cytomegalovirus and others. The second group of possible causes is the innate characteristics of the woman's body, for example, immune or hormonal disorders and genetic abnormalities. Finally, the third group of possible causes of pregnancy fading is the influence of negative external factors such as stress, hypothermia, alcohol abuse, and the like.