Dead embryo in the uterus. Signs and symptoms of a missed pregnancy in the early stages, which should alert

Frozen pregnancy is a pathology, the causes of which are not yet fully understood. A frozen pregnancy in medicine is called a failed abortion. The probability of developing a problem does not depend on the age of the woman, her social status and the number of previous pregnancies. The causes of pathology are still not fully understood. According to statistics, a missed pregnancy occurs in every 176th woman who plans to become a mother.

What is pathology?

Non-developing pregnancy - intrauterine death of the fetus associated with irreversible processes occurring in its tissues. The pathology does not have pronounced signs, such as, for example, a miscarriage. For this reason, it is important to know about the first signs of pathology in order to promptly seek help from a doctor.

Important! In gynecology, there is often such a thing as an empty fetal egg. The condition occurs when an egg is fertilized and attaches to the endometrium. However, the cell itself does not contain an embryo.

Causes of non-developing pregnancy

The most common cause of miscarriage is gene mutations. It is they who in 70% of cases are the cause of the death of the embryo for up to 8 weeks. Numerous factors can lead to genetic malfunctions in the body: chronic or hereditary diseases, drug use, alcohol consumption by future parents.

Important! During pregnancy, it is imperative to undergo screenings prescribed by a gynecologist and geneticist. This study will detect gene abnormalities in a child in the early stages.

The probability of a failed abortion increases if the expectant mother cannot give up bad habits: smoking, poor nutrition, drinking alcohol. Medications that a pregnant woman takes without the consent of a doctor are capable of provoking various deviations in the fetus.

Therefore, in the first trimester, potent drugs are prescribed only in extreme cases, for example, in severe infectious diseases. After 10 weeks of pregnancy, a strong placenta is formed, which protects the fetus from external negative influences. In this case, taking medication for him will not be so dangerous.

Other causes of missed pregnancy include:

Rh-conflict of mother and fetus. The problem is especially relevant for women who have had multiple abortions. Gradually, antibodies to the embryo accumulate in the woman's body, which reduce the likelihood of a successful pregnancy.
Severe infectious and viral diseases. Expectant mothers are vulnerable to pathogenic flora, so they quickly become infected during epidemics. Some diseases (rubella, chickenpox, measles) can not only provoke the death of the embryo, but also cause physical and mental abnormalities in the child in the future. In such cases, the mother may agree to an abortion or decide on the birth and upbringing of a special baby.
Hormonal disruptions. The cause of miscarriage may be a lack of prolactin or an excess of testosterone. If, before conception, a woman had irregular menstruation, this must be reported to the gynecologist.

Risk factors for the development of missed pregnancy:

old-bearing women over 35 years of age;
numerous abortions in the past;
the presence of defects in the structure of the uterus;
ectopic pregnancies previously diagnosed.

In the presence of at least one risk factor, a woman is put under special control to a gynecologist. The risk group for abnormal pregnancy also includes women who refuse to be observed by specialists.

Important! Every pregnant woman must register with a gynecologist at 7-8 weeks of pregnancy.

The timing of a missed pregnancy

The problem occurs at any stage of pregnancy (even a few days before delivery). Examining the statistical data, doctors noted several periods that are most dangerous for the formation of the fetus:

3rd and 4th weeks from the moment of conception;
7-11th week;
16-18th week.

After the 20th week, cases of stopping the development of the child are few. In the vast majority, the problem occurs for up to 14 gestational weeks. The cause of the anomaly in the first trimester is genetic abnormalities and hormonal disruptions, in the second or third trimesters - infectious diseases.

Symptoms of pathology in the early stages

A woman may not immediately notice a frozen pregnancy, especially if she does not show clinical signs. However, the condition poses a threat to the woman's life, as the decaying fetus poisons the body and harms the reproductive system. However, with a careful study of her condition, a woman may note the following signs characteristic of an undeveloped pregnancy:

Abnormal discharge. The woman's body tries to get rid of the fetus on its own after its death. Within 48 hours, she may have a whitish discharge of the usual consistency. After that, bloody streaks appear in the mucus. Gradually, the bleeding becomes more and more profuse.
Change in the intensity of toxicosis. After the implantation of the fetal egg, many women feel the urge to vomit. They are associated with increased production of hCG. If the fetus dies, then the production of the hormone stops. A day later, a woman can feel relief from the condition. 4-6 days after the death of the fetus, signs of toxicosis disappear altogether. This symptom does not always indicate pathological processes in the body. The intensity of toxicosis may decrease as a result of the woman's physiological addiction to the fetus.
Deterioration of general well-being. An embryo that decomposes in a woman’s body for a long time provokes intoxication of the body. Initially, the condition resembles a cold and is accompanied by fatigue, loss of strength. Two weeks later, more vivid signs of pathology appear: dizziness, anxiety, abdominal cramps, temperature.
Sudden changes in basal temperature. In pregnant women, the indicator is at a level exceeding 37 degrees. After the fetus dies, the mark on the thermometer drops to 36.7 degrees, and at the time of decomposition of the embryo rises to 37.5 degrees.

Symptoms of pathology in late pregnancy

From the second trimester, other manifestations join the listed symptoms of a missed pregnancy. A vivid clinical picture of the problem is due to the fact that the fetus is large.

The main manifestations of non-developing pregnancy in the second or third trimesters include:

absence of fetal movements for more than 24 hours;
drawing pains in the abdomen;
leakage of water with an unpleasant putrefactive odor.

The lack of movement in the fetus can also signal an insufficient supply of oxygen to it. The situation occurs when the umbilical cord is wrapped around the neck or torso of the child. If a woman consults a doctor in a timely manner, then the baby can be saved from suffocation.

One of the characteristic signs of late pregnancy fading is a change in breast size. If the ST appeared before the 25th week, then the breast returns to its previous size in a few days. At a later date, after the death of the fetus, colostrum may be secreted from the glands.

After the death of the fetus, not only the chest, but also the abdomen decreases in size. This is due to the fact that after the tragedy, the amount of amniotic fluid is reduced. The listed signs will be observed in a woman one to two days after the death of the fetus. In late pregnancy, the body tries to get rid of the dead child already on the 4-5th day.

Diagnosis of missed pregnancy

Examination during a frozen pregnancy includes the following types of procedures:

visual examination by a gynecologist;
blood sampling for hCG;
basal temperature measurement

The first two methods are considered the main ones in identifying signs of a missed pregnancy, the rest are auxiliary.

Important! If until the 7th week there are suspicions of a missed pregnancy, then the abortion is postponed until a second ultrasound examination. It may happen that the device did not detect the vital functions of the embryo or the doctor made a mistake when calculating the timing of conception.

early term - incorrect location of the fetal egg or its damage;
late term - the absence of a heartbeat in the fetus and the discrepancy between its size and the term.

Ultrasound data is not enough to make a definitive diagnosis - ST. Due to hormonal disruptions and psychological stress in women, a delay in fetal development can be up to four weeks. In this case, a second ultrasound is performed in two weeks. If the fetus has not increased in size, then this means that it is dead.

Treatment of pathology

A popular way to free the uterine cavity from a dead fetus is medical abortion. In Russia, it is carried out for up to 9 weeks of pregnancy, in European countries - up to 12. Mifepristone and misoprostol are used for therapy. This method gives an effective result, but has a list of contraindications:

blood clotting disorder;
severe anemia;
renal and liver failure;
ectopic pregnancy.

If a missed pregnancy is diagnosed at the 13-22nd week, then they resort to artificial stimulation of labor through one of the methods:

Intramial. A 20% sodium chloride solution is injected into the fetal bladder using a thin needle.
Isolated. Insertion into the vagina of mifepristone or misoprostol with oral administration of one of the drugs.

If the above methods of removing the fetus did not bring results or have contraindications for carrying out, then doctors resort to imposing a load on the presenting section of the fetal bladder.

In the third trimester, the deceased fetus is disposed of through artificial birth. Performing a caesarean section in this case is prohibited, as infection of the blood can occur. The woman will have to give birth to a dead child without anesthesia on an emergency basis.

After the treatment, the woman will need to adhere to the following rules:

Take hormonal drugs for the speedy recovery of the endometrium.
Drink antibiotics to prevent infection of the endometrium. Macrolides or cephalosporins are prescribed.
Undergo physiotherapy procedures aimed at regenerating damaged uterine tissues.
Take drugs to strengthen the immune system.

Another way to remove the fetal egg is scraping. For up to 12 weeks, vacuum aspiration of the uterus is acceptable. The standard curettage procedure is carried out only in extreme cases, as it can lead to irreversible damage to the epithelium.

Indications for traditional scraping:

ineffectiveness of drug therapy;
cleansing the uterus from the remnants of the fetus after an incomplete miscarriage.

Curettage is prescribed for women after ultrasound, blood tests and electrocardiograms. A preliminary consultation with the doctor who will perform anesthesia is mandatory.

The course of the scraping procedure:

Anesthesia is administered intravenously to the woman, which begins to act within a few seconds.
The genitals are treated with antiseptic agents.
The doctor uses a mirror to fix the cervix with forceps and expands the cervical canal.
The cleaning procedure is performed with a curette equipped with a loop at the end. With the help of it, all the mucous membranes of the cervical canal and uterus are scraped out.
After curettage, drugs that stimulate contraction are injected into the uterine cavity. The treated area is disinfected with iodine solution.

After the end of the operation, all fixing gynecological instruments are removed. Cold is placed on the woman's stomach, which helps narrow the small vessels and tone the uterus. The menstrual cycle in a woman should be restored 6-7 weeks after curettage. The operation is allowed to be carried out until the second trimester (less often at later dates).

Consequences of a frozen pregnancy

Termination of pregnancy is stressful for the female body, regardless of the chosen method of treatment subsequently. It will be possible to fully recover after the operation only after 6 months. During this time, the woman will need to drink hormonal drugs.

Complications after a frozen pregnancy:

Psychological trauma associated with the fear of an unsuccessful course of the next pregnancies or the inability to conceive a child.
Infertility. To prevent the development of complications, it is necessary to follow the doctor's recommendations and be regularly examined by a gynecologist. Symptoms for an urgent visit to the gynecologist - fever, severe vaginal bleeding.
Inflammatory diseases of the uterine cavity. A complication often develops after traditional curettage. During the operation, the mucous membranes of the genital organ are removed, which makes it more vulnerable to pathogenic flora.
Adhesion processes. Inflammation of the uterus leads to the fact that its individual sections stick together. Deformation of the organ cavity in the future becomes the cause of infertility.

Prevention of non-developing pregnancy

Each couple planning a child must first undergo a set of studies, which includes a blood test for infections, ultrasound of the pelvic organs, and genetic tests. It is recommended to refrain from conception if less than 6 months ago one of the partners had been ill with rubella, chickenpox or severe influenza.

Other measures aimed at preventing missed pregnancy include:

implementation of preventive vaccinations;
visiting a geneticist;
normalization of hormonal levels;
maintaining a healthy lifestyle;
abstinence from flights in the first months from the moment of conception.

With proper planning, the probability of a successful pregnancy is about 90%. This also applies to cases where a woman has suffered unsuccessful attempts to bear a child in the past. It is important not to ignore visits to multidisciplinary specialists who will draw up a competent treatment plan after a missed pregnancy.

A missed pregnancy is a condition in which the fetus inside the mother dies, and the pregnancy stops developing. Most often, this happens asymptomatically and a woman finds out about her diagnosis only with a planned ultrasound.

Why does pregnancy stop?

The life of the fetus, especially in the first 12 weeks, is very fragile and any, even minor factors can cut it off: air travel, prolonged exposure to the sun, stress, poor ecology, etc. Doctors name several of the most likely causes of pregnancy fading in the early stages:

congenital pathologies and malformations in the fetus- doctors consider this the most common reason and call it "natural selection": nature interrupts the development of a "poor-quality" fetal egg and thus prevents the birth of a child with genetic abnormalities;
the woman has an infectious disease(influenza, herpes, rubella, chlamydia, toxoplasmosis, etc.) is the second most common cause;
consequences of rhesus conflict between mother and child or hormonal disorders.

In addition, the risk of fetal death in the early stages significantly increases the bad habits of the expectant mother: smoking, alcohol, and, especially, drugs.

The fetus died, the pregnancy no longer develops, and the woman may not suspect anything. In the early stages, the signs of a missed pregnancy at home are difficult to recognize. But women, especially those who have already experienced a terrible diagnosis, carefully control the course of their new pregnancy. There are only indirect symptoms by which a pregnant woman may suspect something is amiss.

Causeless decrease or complete disappearance of toxicosis can be seen, but not always. If the pregnant woman suffered from severe toxicosis, then his disappearance, of course, will not go unnoticed. And if the signs of toxicosis were weak, then little attention is paid to this factor.

Breast softening may indicate intrauterine fading of the fetus. In almost all pregnant women, immediately after conception, the mammary glands swell and become painful. When the fetus dies, the chest relaxes. But you should not immediately panic when this symptom occurs. For 9 months of pregnancy, according to many women, the chest can relax and tighten several times. This is most likely due to hormonal changes during pregnancy.

Decrease in basal temperature may cause a missed pregnancy. This happens due to a decrease in the level of progesterone, a hormone that supports pregnancy. Basal temperature should be measured in the morning in the rectum, as soon as you wake up. Prepare the thermometer in the evening, as it is important to be motionless for at least 6 hours before and during measurements. But this method is also an unreliable indicator of pregnancy fading, as other factors can also affect the value of basal temperature: taking hormonal drugs, sex, illness with fever, etc.

Bloody discharge and pulling pains in the lower abdomen do not always happen with a frozen pregnancy. This is its difference from a miscarriage. But in any case, this is a very alarming sign during pregnancy, requiring immediate medical attention.

Mismatch between the size of the uterus and the gestational age a gynecologist may notice during a vaginal examination, but this fact does not always indicate precisely the fading of pregnancy. In this case, the dynamics of the development of pregnancy is monitored. And if in 2-3 weeks the uterus has not grown, but, on the contrary, has become smaller and softer, then the doctor can make a preliminary diagnosis of “missed pregnancy” and send the patient for an analysis of the hCG hormone and ultrasound to confirm it.

Decreased hCG hormone H - a regular pregnancy test can respond to this indicator (will show a negative result). But it is better to hand over the special analysis.

Ultrasound indications- this is the most reliable and reliable indicator confirming the presence of a missed pregnancy. Mistakes occur only in the early stages of pregnancy, when the doctor may mistake for an empty fetal egg that develops normally. In this case, if the patient's condition does not inspire concern, you can wait up to 6-7 weeks and repeat the ultrasound. At this time, an experienced doctor with the help of modern equipment already sees the embryo well and hears its heartbeat.

What's next?

If the terrible diagnosis is nevertheless confirmed, then two scenarios are possible.

First. Doctors are waiting for a spontaneous miscarriage, while monitoring the woman's health. They can help stimulate a miscarriage with the introduction of special drugs. Such expectant tactics are most often followed by foreign doctors.

Second. After confirming the diagnosis, the woman is immediately sent to clean the uterus, without waiting for a miscarriage and possible negative consequences from it. A long stay in the uterus of a dead fetus can cause an inflammatory process. This option for terminating a missed pregnancy is used by Russian doctors.

Doctors recommend planning the next pregnancy after a frozen pregnancy no earlier than six months later, and preferably a year later. During this time, it is advisable for both parents to take tests and undergo an examination to identify the cause of the fetal fading.

)

One of the pathologies of the development of pregnancy is the so-called frozen pregnancy. Doctors prefer to call this violation an undeveloped pregnancy or a failed miscarriage. But the essence of this does not change: behind any of these names there is a condition when the fetus in the uterine cavity suddenly stops developing and dies, but at the same time remains in the womb of a woman.

There are 3 types of missed pregnancy:

anembryony - at the same time, the embryo is not visible on ultrasound, only an empty fetal egg;
death of the embryo - on ultrasound it is possible to establish that there was a live embryo, but died;
multiple pregnancy in the early stages, followed by freezing of one of the embryos.

This pathology is a variant of miscarriage and occurs relatively often: in 12-20% of all pregnancies.

Important: Pregnancy can freeze in almost any woman, but with age, this pathology is more common.

In early pregnancy, almost 80% of cases of miscarriage are associated with this particular pathology. This is not surprising, because pregnancy most often freezes in the 1st trimester. Judging by the statistics, the most "dangerous" periods can be considered terms of 3-4 weeks and 8 weeks.

Causes of fading

Non-developing pregnancy does not arise from nowhere. The following main reasons have been identified:

The most common harmful factors	Description of causality
Infections and inflammations: acute or indolent infection of a bacterial or viral nature sexually transmitted diseases endometritis	Infections can affect the embryo directly, leading to its death. This happens when infected with toxoplasmosis, herpes, rubella, cytomegalovirus infection, etc. In addition, the infectious process in the uterine cavity can lead to a change in the structure of its mucous membrane, negatively affect the hormonal status of a woman - in combination, this does not allow pregnancy to develop further
Chromosomal abnormalities that lead to severe congenital pathologies in the unborn child	As a result of genetic failures, pathology of the development of the embryo or placenta may occur - such pregnancies are not viable and do not develop further according to the principle of natural selection
Endocrine: hormonal imbalance in the body of a pregnant woman	Progesterone deficiency, thyroid disease and diabetes mellitus are the cause of insufficient readiness of the body for pregnancy. Thus, conception occurs in initially unfavorable conditions, and as a result, pregnancy develops pathologically and everything ends with the death of the embryo
Autoimmune pathologies in the expectant mother	As a result of some autoimmune diseases, the characteristics of the blood of a pregnant woman change, which leads to gross violations of the uterine blood supply and the inability to bear a child.

Additional factors that provoke miscarriage are:

in vitro fertilization;
the woman's age is over 35;
bad habits of the expectant mother;
unfavorable environment: ecological, social or psychological;
tumor diseases;
chronic diseases of the cardiovascular system;
previous abortions or cases of miscarriage.

Important: The presence in the medical history of only one of the reasons why the pregnancy may freeze is not a reason for the tragic outcome of events. As a rule, a whole causal complex leads to an undeveloped pregnancy.

Symptoms of a non-developing pregnancy in the early stages

In the early stages of pregnancy, a woman cannot independently diagnose a missed pregnancy. But there are several signs, the appearance of which should alert the expectant mother and serve as a reason for an unscheduled visit to the doctor:

the previously existing signs of pregnancy suddenly disappear: toxicosis, drowsiness, breast swelling;
there are pulling pains in the lower abdomen;
discharge from the genital tract may be mixed with blood or dark mucus;
well-being worsens significantly: at first the temperature rises, and dizziness and signs of poisoning appear much later, a few weeks after the death of the embryo.

With a high degree of probability, the following results of self-diagnosis may indicate the fading of pregnancy:

decrease in basal temperature to 37 degrees or less;
fading or complete disappearance of the second strip on the pregnancy test.

Important: The change in basal temperature is more reliable if the woman measured it before pregnancy and in the early stages. If the future mother measures the basal temperature for the first time only in order to exclude the fading of pregnancy, then the data obtained by her have little diagnostic value.

To confirm a non-developing pregnancy, an obstetrician-gynecologist performs a number of diagnostic procedures:

Analyzes the patient's medical history to identify the degree of risk of pathology.
Performs a manual inspection on a chair. Signs of a fading pregnancy are: a discrepancy between the size of the uterus and the expected gestational age, a change in the cervix, and the release of brown mucus.
Ultrasound examination, with the help of which the doctor determines the fetal heartbeat, the presence or absence of a live embryo. If the heartbeat is not heard for up to 8 weeks, this is an unreliable indicator of the death of the embryo. It is recommended to repeat the ultrasound in a week.
Laboratory blood test to determine the level of hCG (human chorionic gonadotropin). With a significant decrease in hCG, it can be argued with a high degree of probability that pregnancy does not develop.

The table shows the normal and abnormal indicators of this hormone:

HCG levels in a normally developing pregnancy (mIU / ml)	Gestational age	HCG indicators that may indicate a missed pregnancy (mIU / ml)
10	1 Week	The result may not be reliable
105	2 weeks	12
1960	3 weeks	230
11300	4 weeks	1310
31000	5 weeks	3605
65000	6 weeks	7560
100000	7 weeks	11630
80000	8 weeks	9300
70000	9 weeks	8140
65000	10 weeks	7560
60000	11 weeks	6980
55000	12 weeks	6395

If the diagnosis of "missed pregnancy" is confirmed

Patients with a diagnosis of "non-developing pregnancy" are hospitalized in a hospital. To prevent possible complications due to intoxication with decomposition products of biological materials, the entire contents of the uterus must be removed. Doctors can use one of the following methods:

Take a wait-and-see attitude in the hope that a miscarriage will occur and the uterine cavity will clear itself spontaneously. Such a development of events occurs rarely and only if the patient is not in danger, and she does not have the slightest sign of intoxication. In any case, doctors must constantly monitor the condition of the woman.
Medical abortion. It is carried out with the help of the most powerful hormonal drugs that provoke uterine contractions and miscarriage.
Vacuum aspiration or mini-abortion with vacuum suction.
Scraping or cleaning is the most common method used by doctors in the event of a non-developing pregnancy. This is a surgical operation that is performed under anesthesia. As a result, the contents of the uterus are removed and the upper layer of its mucous membrane is scraped off.

Important: There is no reliable non-drug way to cope with a miscarriage. A visit to the doctors is a must!

Cleaning is a reliable way to avoid a large number of complications associated with the presence of decomposing biomaterials in the uterine cavity. But recovery after this operation is quite difficult:

postoperative pain lasts for several days;
spotting bothers about 2 weeks;
hospitalization will be required for 7-10 days;
it takes several months to restore the hormonal balance in the body.

Possible complications of missed pregnancy

Complications	Description
Infection of the uterus	A dead embryo in the uterine cavity can decompose and provoke the development of severe infectious complications. The risk increases when a woman refuses medical care or untimely hospitalization
DIC	The development of DIC is a life-threatening condition in which the body's reactions to prevent and stop bleeding are disrupted. The complication is quite rare, but without medical help it threatens with an inevitable fatal outcome.
Bleeding	It can occur both with spontaneous miscarriage, and during or after surgery to curettage of the uterine cavity. To prevent this complication, constant monitoring of the patient's condition in a medical hospital is necessary.
Perforation of the uterine wall during surgery	Violation of the integrity of the walls of the uterus during cleaning is rare. Eliminated in time, it does not threaten dire consequences
Hormonal imbalance in the body	After a frozen pregnancy and the elimination of its consequences, a woman may be haunted by malfunctions in the work of the endocrine glands, which is expressed in menstrual irregularities. In this case, it is necessary to consult a gynecologist-endocrinologist and competent treatment
Depression	Violations of the mental state of a woman for whom a frozen pregnancy was long-awaited and desired is a common occurrence. In this case, do not ignore the possibility of professional psychological or psychotherapeutic assistance.

Important: When providing competent and timely medical care, 9 out of 10 women do not have any serious complications after a missed pregnancy.

Consequences and prognosis after a missed pregnancy

Sometimes a woman is not even aware of her failed pregnancy. In this case, the fading remains unnoticed by her until serious consequences occur in the form of bleeding or the development of an extensive infectious process.

It is extremely rare that a dead embryo remains in the uterine cavity, mummifying or petrifying at the same time. And a failed mother, without even knowing it, can carry the so-called lithopedion (fossilized remains of an embryo) for years.

Much more frequent consequences of fading pregnancy are the strongest stress of a woman, and the fear of trying to conceive a child again. After all, there is a mythical "horror story" that if the pregnancy froze once, then this will happen again and again. Actually this is not true. For most women, a single fading of pregnancy does not at all affect further successful childbearing. Even doctors diagnose "recurrent miscarriage" only if the pregnancy of the same woman died more than 2 times.

The prognosis for a missed pregnancy, which happened for the first time and was timely diagnosed and cured, is positive. A huge number of women after that give birth to absolutely healthy and normal children.

Important: Without appropriate treatment and rehabilitation therapy, the likelihood of a successful childbearing in the future is reduced by about 4 times.

Algorithm of actions of a woman whose pregnancy froze at an early stage

It is imperative to cooperate with the doctor in search of the probable causes of pregnancy fading. Having established the cause, you can try to avoid its destructive effect on the body during the next attempts to get pregnant.
It is necessary to undergo a complete examination to identify hidden infections, endocrine diseases, pathologies of the development of the pelvic organs. To do this, you need to undergo an ultrasound examination, take blood tests.
All existing and identified diseases must be cured.
It is necessary to normalize the psycho-emotional state of a woman, set her up in an optimistic way. Indeed, in matters of successful conception and bearing a child, a lot depends on the internal mood of the future mother.

We are sorry that the information was not useful to you!

We will try to improve!

Tell us how we can improve this information?

Missed pregnancy is one of the types of miscarriage, in which the intrauterine development of the fetus stops. Most often this occurs in the first trimester, much less often in the second and third. At the same time, a woman may not notice for a long time that the embryo has stopped developing.

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

How to determine a frozen pregnancy in time?

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

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

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

If you have any doubts, immediately contact your obstetrician-gynecologist . He will examine you and will do an ultrasound . Only after that the whole picture will become clear: did the child stop in development, or is it just your nerves being naughty.

The most certain symptoms of a missed pregnancy

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

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

Such a diagnosis can only be made by a gynecologist after an examination and identification of the following symptoms:

The fetus has no heartbeat;
The size of the uterus is smaller than expected at this stage of pregnancy;
Decreased in the pregnant woman's blood

Signs of a missed pregnancy in the early stages

Eliminate toxicity. In women suffering from severe toxicosis, this fact will certainly cause unrest. Then you felt bad in the morning, you were sick from pungent odors, and suddenly everything returned to normal. But the second trimester is still quite far away.
Milk glands stop hurting and become softer. These manifestations of a missed pregnancy can be noticed by all women. The chest stops hurting 3-6 days after the death of the fetus.
Bloody issues. This clear sign of a miscarriage may only appear several weeks after the death of the fetus. Sometimes a small brownish discharge may appear, and then disappear. In such cases, women often think they “swept through”, but the fetus no longer develops.
Headache, weakness, fever(above 37.5), mild nausea - these symptoms are a bit similar to toxicosis, but some women observed them already 3-4 weeks after the pregnancy stopped. This is due to the fact that the decay products of the embryo enter the bloodstream.
Decreased basal body temperature- women who are very worried about the unborn baby can continue to measure basal temperature even after pregnancy. Most often, in the first trimester of pregnancy, the temperature stays around 37 degrees, when it fades, it drops sharply, because the body stops producing the hormones necessary for the development of the embryo.

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

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

Symptoms of a missed pregnancy at a later date

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

Not a single specialist will give you exact recommendations on how to identify a missed pregnancy at home. However, if you have any of the above symptoms, visit your OB/GYN.
We talked to women who faced a similar problem, and they told us what they began to worry about during a missed pregnancy.

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 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, in the presence of 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 ovum and lead to a disruption in 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 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 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.