Non-developing pregnancy: causes, signs, consequences. Frozen early pregnancy: consequences

Frozen or non-developing is a pregnancy in which the embryo or fetus dies before development, but does not develop contractile activity and there are no symptoms of external bleeding. In this case, the fertilized egg can linger in the uterine cavity for many weeks and even months.

information Frozen pregnancy occurs in 45-90% of all spontaneous abortions in the early stages. In the International Classification of Diseases, X revision, this pathology is called “failed miscarriage.”

Highlight 2 options of this pathology:

1. . In this case, the embryo is not laid at all or is resorbed (detected before -), while the fetal sac can grow for some time before spontaneous miscarriage begins due to the preserved blood flow.
2. Death embryo (before) or fetus (-).

Causes

The causes of fetal death are varied and often intertwined. The main ones are the following:

1. Infection. But here there are 2 options:
   • During acute infection in early pregnancy, direct damage to the embryo occurs by infectious agents.
   • The presence of chronic inflammation leads to disruption of the process of implantation of the fertilized egg into the wall of the uterus and disruption of its blood supply. All this leads to the primary placental insufficiency and, ultimately, to the death of the fetus.

1. Hormonal disorders. It is believed that severe disturbances in a woman’s hormonal status lead to infertility, and pregnancy is possible only with erased forms of the pathology, but it most often ends in termination at one time or another. To the main forms hormonal disorders leading to frozen pregnancy include:
   • with defective function of the corpus luteum, production decreases (the main hormone that supports pregnancy);
   • increased production of androgens (male sex hormones);
   • (especially an increase in her hormone levels);
   • neuroendocrine syndromes.

1. development genital organs, preventing the normal growth and development of the embryo.
2. Chromosomal abnormalities. Occur as a result of disruption of the process of fusion of maternal and paternal material.
3. Disorders of the blood coagulation system. This includes antiphospholipid syndrome, when the mother’s body produces antibodies to platelets and thrombosis occurs in the vessels feeding the fertilized egg.
4. Socio-biological factors: V last decades There has been significant deterioration of the ecological environment ( different kinds pollution, for example, radiation and chemical); bad living conditions(unbalanced diet, deficiency); various occupational hazards that can affect both before pregnancy and in its initial stages; mother's age.

Symptoms

In the early stages (before), the main clinical manifestation will be the disappearance of subjective symptoms (morning nausea and vomiting, drooling). At a later date, these symptoms lose their relevance, since normally they should have passed and the absence or cessation of sensation comes to the fore. On days 3-6 after the development of the embryo stops, the mammary glands soften and milk is released from them.

dangerous When you find dead fetus in the uterus for more than 4 weeks, some women develop signs of general intoxication (weakness, malaise, increased body temperature) associated with infection of the ovum.

Signs such as absence, emergence from the genital tract (as a sign that it has begun) most often appear only 6 weeks after the embryo has stopped developing.

Diagnostics

Treatment

Treatment of frozen pregnancy includes 2 main points:

• careful removal of the dead fertilized egg from the uterine cavity;
• anti-inflammatory therapy.

The method of evacuation of the fertilized egg depends on the stage of pregnancy:

• Up to 14-16 weeks perform instrumental emptying of the uterine cavity () or. The resulting material must be sent for histological examination. In some cases, it is possible to determine why the embryo stopped developing.
• When due more than 16 weeks Special solutions are injected into the amniotic cavity, and drugs that stimulate uterine contractions are also administered intravenously. After what happened
  • arising against the background of a non-developing pregnancy and in the near future after removal of the fertilized egg;
  • appearing later.

  If we talk about the first ones, then most often they are infectious in nature and depend on where the infectious agents ended up:

  • When the process is localized only in the uterus, acute endometritis can develop. And after treatment of a non-developing pregnancy, due to the fact that the inflamed uterus is not able to adequately contract, blood clots are retained in the cavity, and repeated curettage will be required.
  • If a dead embryo or fetus remains in the uterine cavity for a long time, peritonitis may develop. when infectious agents enter abdominal cavity, or sepsis if they get into the blood.
  • TO early consequences also include severe disorders in the coagulation system in women, which is associated with the entry of toxic products into the blood.

  As for the second group, they primarily depend on the cause of fading and the right approach to her treatment and rehabilitation. The possibility of subsequent pregnancy and its outcome will depend on this. According to research, when conducting rehabilitation in postoperative period pregnancy occurs in 85% of cases and ends in childbirth in 70%, without restorative treatment - in 83 and 18%, respectively.

  Conclusion

  In conclusion, it should be noted that no matter how difficult this loss was, this is not a point in history, but only a sad stage. Everything will be fine, the main thing is to take care of your health.

Gynecologists say that during each month a woman experiences all four seasons. After all, the level of hormones in her body fluctuates all the time, which affects both our well-being and mood. All these processes are aimed at ovulation and further fertilization of the egg. And if this happens, then hormonal activity will be aimed at preserving the fertilized egg and its successful development.

Not all, but the vast majority of women certainly feel these changes on a physical and emotional level. Often, even intuitively, a woman feels that she is pregnant. We listen to our body from the first weeks, trying to determine what is happening to us. AND sudden changes or the disappearance of certain signs and sensations can frighten us greatly. Most often this happens at the stage when the body is already getting used to functioning in a new mode, that is, closer to the second trimester. But still, if your intuition tells you that something is wrong, then it is better to play it safe and go to the gynecologist. Unfortunately, it is not so rare that a pregnancy stops developing due to the death of the embryo. And this can happen at any time.

A pregnancy that is not developing is also called a frozen pregnancy. Its outcome is always the same: interruption by natural, medicinal or surgical means. Such a pregnancy has no chance of developing, because there is either no embryo or it died.

In the first case, obstetricians talk about anembryonia- this is one of the types of non-developing pregnancy, in which the fertilized egg turns out to be empty, without an embryo inside. This pathology is detected at the earliest stages, usually during the first ultrasound.

But it also often happens that an embryo that has begun its development turns out to be non-viable or dies under the influence of certain pathological factors. The first signs of an undeveloped pregnancy may appear after a certain time, because at first there are no signals about the tragedy from within.

Most often, pregnancy stalls in the first trimester. It is not always possible to determine this on your own, but sometimes a woman can still suspect something is wrong based on changes in her condition.

Breasts during frozen pregnancy

The breast is one of the first to react to the new condition of a pregnant woman. It becomes heavier, fills up, increases in size, the sensitivity of the nipples increases, they darken, and a painful sensation may occur. These changes, like all others, occur under the influence of hormones. If pregnancy stops developing, then the level of these hormones will begin to decrease, and its early symptoms will begin to disappear.

So, if in the first weeks, in the early stages, the chest suddenly stopped hurting, toxicosis and other early signs (irritability, drowsiness, etc.) disappeared, and the woman no longer feels what she used to, then it is better to consult a doctor for consultation and examination . It is likely that early toxicosis has ended - and the most pleasant period in terms of well-being begins. However, if you are tormented by any doubts, it is better to dispel them.

Temperature during non-developing pregnancy

If a woman kept a chart of basal temperatures before conception and continues to do so in the first weeks after, then when the embryo freezes, she may notice some changes in the chart. In particular, BT, which was fixed at elevated levels, will begin to decline. However, very often it remains elevated long time after the death of the fetal egg, and in general, BT can behave differently in each individual case, and very often errors and errors are made when measuring BT. Therefore, doctors do not recommend using this method to assess the well-being of embryo development.

As for general health, then, of course, when a miscarriage begins due to a non-developing pregnancy, the body temperature may rise - as a reaction to the pathological process. But this is not prerequisite and does not always indicate ST.

The developing fertilized egg actively produces the hormone human chorionic gonadotropin, so pregnancy can be diagnosed at the earliest stages. A blood test for hCG is perhaps the earliest reliable method of determining it.

The level of hCG in the blood and urine of a pregnant woman doubles every two days in the first days and weeks. If there is a suspicion of pathological development of pregnancy or its fading, a woman is often prescribed this test to monitor the level of hCG over time. That is, if several studies conducted in a row (usually at intervals of a day) show that the hCG level does not increase or even decreases, then they come to a disappointing conclusion.

What will the test show during a frozen pregnancy?

For the same reason, a test carried out during a frozen pregnancy may show a pale second line or even give out negative result, if enough time has passed since the death of the embryo, and the level of human chorionic gonadotropin has significantly decreased.

However, you should never trust this method alone. Remember: tests quite often produce false positive and false negative results, for which there can be many different reasons.

By and large, none of the signs described above should lead a woman to think that the embryo has frozen. And only if these signs are combined with each other, you can start to worry. And if in addition there appear bloody issues from the vagina, then you should definitely consult a doctor, even if there are no other reasons for concern. Bleeding, brown discharge or even spotting indicate that the ovum has begun to detach, and it is very likely that the pregnancy can still be saved.

If the fetus has frozen for quite some time, then the woman will certainly notice that for a long period of time no movements are noted. However, even such a very eloquent sign cannot accurately indicate fetal freezing.

A woman's own feelings cannot be in any way reliable signs undeveloped pregnancy. In combination with various circumstances and associated symptoms they can only suggest that perhaps all is not well. But in general, gynecologists say that non-developing pregnancy often not accompanied by any specific characteristic clinical manifestations. The diagnosis of ST can only be made on the basis of laboratory tests.

Among the signs already mentioned, only the hCG level has an important diagnostic value. But even if its concentration is low, a woman who is suspected of fetal failure will definitely be sent for an ultrasound.

Even during a personal examination in the office, the gynecologist is able to predict a delay in the development of pregnancy if the size of the uterus, which he palpates with his hands, does not correspond to the expected gestation period. Ultrasound examination can more accurately determine this discrepancy. In addition, it will evaluate the signs of embryonic life: the presence of heartbeats, motor activity. In case of a non-developing pregnancy, the uzist will see damage to the structures of the placenta, deterioration or complete cessation of uteroplacental blood flow, damage to the endometrium of the uterus due to the decomposition of dead tissue, and a hematoma at the site of detachment of the fertilized egg.

If the pregnancy has stopped and begins spontaneous miscarriage (the immune system women reject foreign cells), then ultrasound will also show detachment of the fertilized egg or placenta.

In the short term, the doctor can take a wait-and-see approach: that is, wait until the fertilized egg leaves the woman’s body on its own. And very often this is exactly what happens.

However, it is also not uncommon for a dead embryo to remain inside the womb for a long period of time, soon beginning to decompose. This outcome is very undesirable and fraught with serious consequences, and therefore doctors are forced to intervene in this process: they resort to medical abortion(pregnancy is interrupted with the help of hormonal medications) or curettage is performed during a frozen pregnancy. A non-developing fetus is disposed of only when the absence of a heartbeat is confirmed by at least 2 ultrasound examinations.

I would like to note that, despite the prevalence of this problem, the majority of women who have had an undeveloped pregnancy successfully carry and give birth to healthy children in the future. In Western countries, even after three cases of fetal death in a row, 75% of women still get pregnant and give birth.

Therefore, you should not be overly upset and upset: the best is yet to come! However, doctors advise women who are at risk for miscarriage to prepare and plan their next conception:

• suffering from sexually transmitted infections;
• those who have had infectious diseases during pregnancy;
• suffering from endocrine disorders;
• those giving birth for the first time over the age of 30 or becoming pregnant after 40 years;
• have had abortions in the past;
• alcohol abusers, drug users, heavy smokers;
• taking antidepressants or suffering from nervous disorders;
• in whom the fetus has repeatedly died (especially on later);
• having a uterus with developmental pathologies (small, bicornuate, etc.) or uterine fibroids.

Especially for - Larisa Nezabudkina

The most dangerous are the first days and weeks of the baby’s development. In the early stages of its development, the fetus is most sensitive to damaging, destructive factors.

What should a pregnant woman be wary of?

Diagnosis of the disease

Signs and symptoms

In most cases, a stop in the development of a child is not felt by pregnant women and is not accompanied by pronounced symptoms.

In the early stages:

• disappearance;
• increase in appetite;
• reduction of pain in the mammary glands.

In the later stages:

• the appearance of bloody discharge;
• increased body temperature;
• nagging pain in the lower back.

Such signals can also accompany the normal course of pregnancy. Only a specialist can definitively confirm the death of the embryo through ultrasound and research. Who is to blame for failed motherhood?

Causes

As a rule, a frozen pregnancy is the result of a combination of unfortunate circumstances and factors.

The reasons can be divided into several groups.

Genetics. Sometimes during the formation of an embryo, various changes occur in chromosomes, genetic disorders (a larger or smaller set of chromosomes).

The reason for this may be hereditary predisposition, drug use, alcohol use, or living in environmentally unsafe areas.

Genetic disorders are the most important causes of this pathology (up to 70% of all cases). “Wrong” genes can be inherited from both parents.

Infections. Infectious diseases expectant mother is the second most common cause of undeveloped pregnancy:

• viral - enterovirus;
• bacterial - mycoplasmas, streptococci, gonococci, chlamydia, ureaplasmosis.

As a result of any infection, acquired or chronic, in a pregnant woman, the fetal egg becomes infected.

Infection can occur in three ways:

1. With the inflammatory process of the uterine mucosa and its appendages(endometritis, salpingoophoritis) microbes penetrate the fertilized egg. In this case, the woman’s uterus itself is not ready to bear a child, the fertilized egg is not attached tightly enough, and it is rejected.
2. With inflammatory processes in the vagina itself(fungi,) bacteria penetrate the fertilized egg through the cervix. The embryo becomes infected and amniotic fluid, which is fraught with rupture of the fetal bladder itself.
3. When transferred viral infections (, acute respiratory infections,) microbes penetrate the fertilized egg through the bloodstream through the placenta. The supply of oxygen and nutrients to the unborn baby is significantly deteriorating

When infected, the fetus stops developing and the child dies.

Do not forget that pregnancy is accompanied by severe suppression of the entire immune system. An exacerbation of all latent infectious diseases in a woman may begin.

Therefore, it is very important to treat all hidden infections in a timely manner before planning motherhood and do everything possible to avoid catching colds while pregnant.

Immunology. Sometimes a woman may have various predisposing factors that can cause the death of the embryo. This is the appearance of protective antibodies to the hormone produced by the fertilized egg (antiphospholipid syndrome), incompatibility at the immune level of the father and mother.

Immunological incompatibility can be expressed by increased thrombus formation. In all cases, the nutrition of the embryo is disrupted, its development stops and the fetus dies.

Endocrinology. Pathological condition endocrine system pregnant woman can cause fetal death. Reasons for violation proper operation There can be many endocrine system and hormonal disorders.

The most common of them are:

• increased amount of sex hormones male type(hyperandrogenism). In 20% of cases during pregnancy, there is a sharp jump in the level of male hormones.
• increased amounts of the hormone that stimulates milk production (hyperprolactinemia).
• violation of the proper development of the ovaries (), which affects menstrual cycle and the production of female sex hormones.
• improper functioning of the thyroid gland (dystrophy, obesity).
• underdevelopment of reproductive female organs(infantilism).

In case of disruption of the endocrine system The body produces in insufficient quantities a hormone that is responsible for preparing the entire female body for pregnancy. The embryo, which is weakly attached to the uterus, receives insufficient nutrients and dies.

Women may be considered at risk who lead an incorrect lifestyle that is harmful to the state of pregnancy. Constant stress, overexertion, long-term depression. Work in unsuitable conditions (high humidity, constant stuffiness).

All this can lead to the appearance and abruption of the placenta, which disrupts the supply of oxygen and nutrients to the fetus and, as a result, the death of the unborn baby.

Multiple abortions, transferred . Woman's age(in case of the first one), features of the anatomical structure of the uterus(saddle-shaped,) - all this refers to the provoking factors for the appearance of pathology during pregnancy.

According to the observations of experts, pregnancy, compared to natural pregnancy, has a greater chance of becoming frozen and ending in the death of the embryo.

What awaits a woman who has had one or more unsuccessful pregnancies, what do doctors say about this?

Consequences of a non-developing pregnancy

As a rule, the vast majority of women have every chance of conceiving a child again and carrying it safely to term.

According to statistics, this is 80-90% of all women who are faced with a frozen pregnancy.

If conception ends in the death of the fetus in two or more cases of pregnancy, then the non-developing pregnancy becomes a “habitual” pregnancy.

In this case, in order to safely carry the baby, a thorough examination of both spouses is required.

Pregnancy after illness

Planning your next pregnancy permitted six months after failure.

This break is aimed at the complete restoration of hormonal status and reproductive functions of the body and includes the following mandatory examinations:

• Ultrasound of the pelvic organs;
• PCR diagnostics (detection of urogenital infections);
• blood test for autoantibody levels;
• blood test to detect antibody titer;
• determination of the level of thyroid hormones in the blood.

This list can have many more items. Apply to every woman individual plan examinations prescribed by a gynecologist.

But how is a non-developing pregnancy treated, what do doctors do in this case?

Treatment of non-developing pregnancy

If a pregnant woman is found to have a frozen fetus, doctors develop tactics for taking measures for delivery, based on each specific case.

Spontaneous. Later for a short time after the death of the embryo, the woman’s level of placental hormones sharply decreases, which leads to spontaneous miscarriage.

With the help of medications. In the early stages of a frozen pregnancy (up to 8 weeks), doctors can use the antagonist drug mifepristone (progesterone) in combination with misoprostol (an analogue of prostaglandin E1). After these two drugs enter the body, the embryo is rejected and miscarried.

Surgical treatment. This method is carried out in a hospital setting. Curettage (curettage of the uterine cavity) is prescribed on an individual basis. The operation is similar to an abortion and is performed under general or local anesthesia.

Not a single woman is immune from this misfortune. Non-developing pregnancy– this is not a disease, not a diagnosis, not a sentence. This is a warning that motherhood needs to be carefully and wisely planned.

A non-developing pregnancy is a pathology in which, for some reason, the embryo (or fetus) stops developing and dies. There are many reasons for this pathology. In the first trimester there are serious chromosomal “breakages”. At any stage - infections, lack of progesterone and excess of androgens, Antiphospholipid syndrome - when a child dies due to blood clots forming in the vessels. In addition, the reasons for a non-developing pregnancy may include various toxic effects on the fetus. Radiation, the use of medications prohibited for expectant mothers, smoking, and drinking alcoholic beverages can cause pregnancy loss or severe malformations in the fetus.

How to recognize a frozen pregnancy

1. Stopping the growth of hCG or reducing it. HCG is the hormone that is formed thanks to the chorion. And in terms of dynamics increasing hCG various important conclusions can be drawn. However, the growth of hCG is usually not controlled in all women, since this is not practical. Only in cases where there is a high risk of spontaneous abortion. For example, when conceiving using IVF or with habitual miscarriage. HCG levels are determined through a blood test. But a pregnancy test will also help you draw some conclusions. Signs of an undeveloped pregnancy may include: negative test for pregnancy (due to low hCG level). However, this symptom is more often expressed in very early stages of pregnancy.

2. Lack of uterine growth. This symptom may be noticed by a doctor when gynecological examination when a discrepancy between the size of the uterus and the gestational age is detected. Or when measuring the length of the uterus on the couch with a measuring tape - usually such measurements are performed from the second trimester of each pregnant woman during a routine visit to the gynecologist. A frozen pregnancy may be suspected if the uterine fundus is low.

3. Abrupt disappearance of signs of toxicosis. They usually disappear gradually, by the second trimester of pregnancy. If the embryo dies, the nausea goes away almost instantly. The mammary glands may be soft and painless, which is not typical for pregnancy.

4. Bloody, spotting discharge from the genital tract, pain in the lower abdomen. Typically, these symptoms occur when a miscarriage has already begun. However, it is not at all a fact that with these signs the child is already dead.

5. Decrease in basal temperature. Some expectant mothers measure the temperature in the rectum before and during pregnancy. This method, which is not highly accurate, can help determine ovulation, pregnancy, and monitor its development. During pregnancy, basal temperature is usually above 37 degrees. But its decrease cannot be considered as an absolute sign of frozen state.

6. Absence of heartbeat in the fetus on ultrasound or the embryo in the ovum. If a baby’s heartbeat is not detected at 5-6 weeks of pregnancy, this may indicate the death of the embryo.
There are cases when the embryo is not detected in the fertilized egg, that is, it dies at a very early stage, when it is not yet visible during ultrasound examination. This pathology is called anembryonia.

7. Lack of fetal movements. Primiparas feel fetal movements every day from the 20th week of pregnancy, multiparous women - from the 18th week. In the absence or cessation of movements, the woman is urgently sent for an ultrasound scan.

Should the pregnancy be terminated and how?

Non-developing pregnancy, what to do - abortion or wait for a spontaneous miscarriage? Doctors abroad have adopted a waiting tactic. A woman weekly, in some cases even more often, performs an ultrasound and visits a gynecologist in order to promptly recognize the onset of the inflammatory process - grounds for surgical intervention. In our country, an abortion is usually immediately recommended if there are no signs of spontaneous miscarriage starting.

As a rule, doctors “treat” a non-developing pregnancy in the early stages with vacuum aspiration, that is, they suck out the contents from the uterus using a special cannula. This intervention can be performed under local anesthesia, without general anesthesia. Another option is to induce a miscarriage by medication. The woman takes medications prescribed by the doctor, and after 1-3 days she has a spontaneous miscarriage. This procedure is effective in the early stages. The longer the period, the more likely that the miscarriage will be incomplete and vacuum aspiration will have to be done.

If a non-developing pregnancy is proven by examination, curettage is recommended if the fetus is already quite large and will not pass through the cannula (vacuum aspiration is not possible). Curettage (popularly “cleaning”) is always performed in a hospital setting. The length of stay in the hospital after the procedure is up to several hours, if there are no complications.

What to do after a frozen pregnancy

In the absence of contraindications, a woman is recommended to take oral contraceptives for at least 3-6 months. They are believed to help restore hormonal background and reliably protect against pregnancy. If there are contraindications to taking pills, barrier contraception (condom) is recommended. You should plan for a child after undergoing treatment (if necessary), but not earlier than 3 months after the death, in otherwise there is a high risk of the situation repeating itself.

As for medical examination, doctors consider this mandatory only if a non-developing pregnancy is repeated more than 2 times (if the embryo stops developing in the first trimester of pregnancy). Since in in this case Most often, random chromosomal abnormalities are to blame, which are almost impossible to avoid. It should be noted that chromosomal abnormalities become more common the older a woman is.

If the situation repeats itself. It is necessary to undergo an examination to identify and eliminate the cause of pregnancy loss. A woman must take blood tests, smears for various infections and viral diseases, undergo an ultrasound of the pelvic organs, take tests for certain hormones, take a blood coagulogram and test for antibodies to phospholipids, and go for a consultation with an endocrinologist.

When planning pregnancy, she is prescribed an increased dosage of folic acid and potassium iodide.

Waiting for the birth of a baby is one of the happiest periods in the life of future parents. They endure all the hardships and hardships of pregnancy, hoping to soon see a miracle - their newborn child. However, some women may suddenly experience great grief, which is called a non-developing pregnancy. Most often this problem occurs in the 1st trimester, although it can occur at any time.

A non-developing or frozen pregnancy is a stoppage of fetal development due to its death, in which there are no signs of miscarriage. More often, this pathology occurs in the early stages - in the 1st trimester. Another type of it is a non-developing pregnancy of the anembryonic type. This is a situation in which fertilization has occurred and the membranes have begun to form, but there is no embryo in the fertilized egg.

A frozen pregnancy is a very terrible blow to the psychological and emotional state. However, knowing how a woman's body can recover from it is very important to increase her chances of having a baby. healthy child in future.

Causes of frozen pregnancy

Unfortunately, it is not always possible to establish why a particular woman has a non-developing pregnancy. If embryonic death occurs during the 1st trimester, it is usually caused by problems in the unborn baby. Approximately 3/4 of miscarriage cases occur during this period.

If the fetus dies during the 2nd or 3rd trimester, this may be due to the presence of diseases in the mother.

Causes of frozen pregnancy in the 1st trimester

Most often, a non-developing pregnancy in the early stages is caused by problems with the fetal chromosomes. They are made of DNA, which contains a detailed set of instructions that control a wide range of various factors– from the development of the cells of the unborn child’s body to the color of his eyes.

Sometimes an error occurs at the moment of conception due to which the embryo receives too many or not enough chromosomes. The cause of this phenomenon remains unknown, but its consequences include abnormal fetal development and miscarriage.

Doctors estimate that approximately 2/3 of early pregnancy loss cases are associated with chromosomal abnormalities. It should be remembered that the re-development of a non-developing pregnancy for this reason occurs very rarely, since most often future parents do not have any problems with chromosomes.

TO intrauterine death A fetus in the 1st trimester can also cause problems with the development of the placenta, the organ that connects the blood circulation of the mother with the child.

The following factors can increase the risk of a non-developing pregnancy in the early stages:

• Mother's age is more than 35 years.
• Obesity.
• Smoking during pregnancy.
• Drug and alcohol use during pregnancy.
• Use large quantity caffeine, which is found in coffee, tea, chocolate, energy drinks and some carbonated drinks.

Causes of frozen pregnancy in the 2nd and 3rd trimesters

As a rule, in the 2nd and 3rd trimesters, health problems of the expectant mother can lead to a non-developing pregnancy.

Causes of non-developing pregnancy in the 2nd and 3rd trimesters:

Myths about the causes of undeveloped pregnancy

Despite common stereotypes, miscarriage is not associated with:

• emotional state of the mother during pregnancy;
• fright;
• physical exercise (however, you should discuss its type and intensity with your doctor);
• working during pregnancy;
• having sex;
• traveling by plane;
• eating spicy food.

Symptoms of a non-developing pregnancy

Unfortunately, in most cases, a woman does not know that her child has already died, since a non-developing pregnancy in the early stages does not have the obvious symptoms that are characteristic of a miscarriage. With this pathology, the placenta does not stop producing hormones, which is why the woman continues to feel pregnant.

However, in some cases, a woman may notice that her symptoms such as breast tenderness, nausea and fatigue have disappeared. At later stages, fading pregnancy is characterized by the absence of fetal movements in the uterus.

Diagnosis of non-developing pregnancy

If you have any concerns or suspicions about the possibility of a frozen pregnancy, you should immediately consult a doctor for a full examination.

The diagnosis of a non-developing pregnancy is most often made after an ultrasound examination, which detects the absence of a heartbeat in the fetus. Ultrasound is performed through the anterior abdominal wall or transvaginally. The latter method is more accurate, but its implementation is accompanied by some discomfort. To exclude errors in diagnosis, at least two examination procedures are performed.

The doctor can detect the absence of a heartbeat in the fetus in later stages of pregnancy using auscultation with an obstetric stethoscope. Cardiotocography, a technique for recording the fetal heartbeat and uterine tone, will help confirm fears.

Levels of human chorionic gonadotropin and progesterone, hormones associated with pregnancy, may also be measured.

In some cases, a diagnosis cannot be made immediately. For example, it is difficult to confirm a non-developing pregnancy before the gestational age of 6-7 weeks, since only at this time does the fetus begin to have a heartbeat. In this case, doctors usually recommend re-examination after 1-2 weeks.

Sometimes fetal death is discovered accidentally during a screening ultrasound examination.

After a miscarriage, a man and woman need to undergo a full examination, with the help of which specialists will try to identify possible reasons fetal death. Unfortunately, in half of the cases the etiology of a non-developing pregnancy cannot be detected.

In case of repeated cases of miscarriage, women and men undergo an even more detailed examination, including:

• Karyotyping is a test to detect abnormalities in chromosomes that can cause fetal death during pregnancy. intrauterine development. If problems are detected, partners are referred for a consultation with a geneticist, who explains to the couple their chances of a successful pregnancy in the future and talks about possible solutions - for example, in vitro fertilization.
• Ultrasonography. To study the structure of the uterus and identify its pathology, a transvaginal ultrasound examination is performed.
• Blood tests that measure levels of antiphospholipid antibodies and lupus anticoagulant. Antiphospholipid antibodies increase the risk of blood clots and affect the formation of the placenta, which can impair the blood supply to the fetus, causing its death.

Treatment of non-developing pregnancy

After a diagnosis has been made, a woman often faces a difficult choice regarding which treatment tactics to choose for an undeveloped pregnancy. In any case, a long stay in the uterine cavity of a dead fetus is dangerous for the health and life of the woman, since this increases the risk of severe bleeding and infectious complications.

As a rule, a woman is offered one of the options:

1. Waiting tactics. In the early stages of pregnancy, if the embryo dies in utero, it is possible to wait for the natural rejection of its tissues by the woman’s body. During this time, careful monitoring and surveillance is carried out. However, you cannot wait too long - it is dangerous. As a rule, active treatment can only be delayed until 2 weeks after diagnosis. Doctors are not too fond of expectant management during a missed pregnancy.
2. Surgical tactics. After establishing and clarifying the diagnosis, a minor obstetric operation is performed - dilatation of the cervix and curretage (curettage of the uterine cavity). During this surgical procedure, fetal tissue, membranes and placenta are removed from the uterine cavity. The operation is usually performed under general anesthesia.
3. Medication tactics. Termination of a non-developing pregnancy in the early stages (up to 8 weeks of gestation) can also be carried out using a conservative method. For this purpose, drugs are used that cause the uterus to contract and push fetal tissue and placenta out of its cavity.

In case of intrauterine fetal death in the 3rd trimester, delivery is necessary. For this purpose, doctors either stimulate labor through the birth canal or perform a caesarean section.

It should be remembered that a non-developing pregnancy is a severe emotional blow. Therefore, a pregnant woman really needs the support of both medical personnel and people close to her.

Complications and consequences of frozen pregnancy

A serious danger to the health and life of a woman during a non-developing pregnancy is the risk of severe bleeding and infections.

Most often, a pregnancy that does not develop has serious emotional consequences not only for the woman, but also for her partner, as well as for people close to them. They may need psychological support during this time.

Survivors may develop fatigue, poor appetite and sleep disturbances, and experience feelings of guilt, shock, sadness and anger. People cope with loss in different ways. Some of them find solace in telling others about their feelings, while others do not want to communicate about their grief. Some women start planning their next pregnancy within a few weeks, while others cannot even think about it.

The child's father may also be suffering from loss. Men find it more difficult to express their emotions, especially when they know that they should support their partner with their actions. A miscarriage can sometimes cause relationship problems.

The concern for many women who have suffered this grief is whether pregnancy can occur again after suffering a non-developing pregnancy. Fortunately, in most cases they are born after a certain time. healthy child, because most often chromosomal abnormalities develop in the fetus itself and are not inherited from its parents. As a rule, doctors advise planning the next pregnancy 3-6 months after the previous one is terminated.

Prevention of antenatal fetal death

In most cases, the cause of a non-developing pregnancy remains unknown, so it is not possible to prevent this pathology.

However, compliance with certain conditions will help reduce the risk of frozen pregnancy:

• quitting smoking, alcohol, drugs;
• maintaining a healthy, balanced diet rich in vegetables and fruits;
• attempts to avoid exposure to certain infectious diseases during pregnancy (for example, rubella);
• refusal to eat certain foods that can harm a pregnant woman and her baby;
• normalization of weight before pregnancy;
• Taking prenatal vitamins and folic acid before pregnancy may also reduce the risk of antenatal fetal death and birth defects.

When the causes of a non-developing pregnancy are identified, they are treated to prevent similar cases in the future.

Useful video about non-developing pregnancy

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