Causes of non-developing pregnancy in the early stages. Only ultrasound can confirm the diagnosis of "non-developing pregnancy", but errors also occur. Why does the fetus freeze

Non-developing pregnancy is a very delicate and exciting topic, which is always difficult to talk about not only for women themselves, but also for doctors. Unfortunately, this phenomenon is not uncommon today.

Non-developing pregnancy

An undeveloped pregnancy, or, as it is called in medical circles, a missed pregnancy, is a condition in which a spontaneous stop occurs in the intrauterine development of the embryo. As a rule, this happens in the first trimester, but the second and third trimesters can also be affected by this anomaly.

According to statistics, about one sixth of all pregnancies end prematurely due to non-developing pregnancies.

Causes of missed pregnancy

1. The causative factors of this anomaly include a number of different diseases. For example, infections of the reproductive system, such as, and so on. Diseases of the central nervous system.
2. The risk of a frozen or non-developing pregnancy is increased in those women who, in the period before its onset, abused drugs, nicotine, antidepressants or did.
3. Age can also be a cause of non-developing pregnancy. Usually this phenomenon occurs in pregnant women.

In general, it is impossible to assume and predict a frozen pregnancy, and any woman has a chance to meet her.

Consequences of non-developing pregnancy

Embryoscopy of missed pregnancy 8-9 weeks

Manifestations of non-developing pregnancy

This is always a problem, because, as a rule, for a long time after the fetus inside the womb of the expectant mother has frozen, the woman does not feel it. Manifestations can appear only on the eighth - tenth day after the "catastrophe", and even then, this period is not absolutely accurate. In medicine, many cases have been recorded when a woman did not feel any alarming symptoms for two to three weeks, and only at a doctor's appointment did it become clear that the pregnancy had stopped in its development.

The doctor determines a missed pregnancy by the discrepancy between the size of the uterus and the gestational age (the uterus in this case will be much smaller in size than it should be at a particular time), according to (for this, the woman will have to take a blood test for this hormone), and according to the results, where the absence of the fetal heartbeat and its motor activity is found.

According to your own feelings, sometimes you can also suspect a non-developing pregnancy. If this happened after the twentieth week, the expectant mother may notice that her baby has stopped all movement inside the womb. And if there is a special device at home that makes it possible to hear the baby's heartbeat, it can also be used to make sure that the fetal heart muscle is no longer contracting.

All these signs can appear individually or all at once, all together. Everything is very individual and not predictable in advance. But, the main thing is to know that an undeveloped pregnancy is “not the end of the world.” After such a diagnosis and rehabilitation, a normal pregnancy with a safe and healthy delivery is quite possible.

Causes, signs, treatment of non-developing pregnancy

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, these are serious chromosomal "breakdowns". At any time - infections, lack of progesterone and an excess of androgens, Antiphospholipid syndrome - when a child dies due to blood clots forming in the vessels. In addition, the causes of non-developing pregnancy may lie in various toxic effects on the fetus. Radiation, the use of drugs prohibited for expectant mothers, smoking, drinking alcohol 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 due to the chorion. And according to the dynamics of the increase in hCG, various important conclusions can be drawn. However, not all women usually control the growth of hCG, since there is no practical need for this. Only in cases where the risk of spontaneous abortion is high. For example, when conceiving with the help of IVF or with habitual miscarriage. The level of hCG is determined by a blood test. But a pregnancy test will help draw some conclusions. Signs of a missed pregnancy may show up on a negative pregnancy test (due to low hCG levels). However, this symptom is more often expressed in the very early stages of pregnancy.

2. Lack of growth of the uterus. This symptom can be noticed by a doctor during a gynecological examination, when a discrepancy between the size of the uterus and the gestational age is revealed. Or when measuring the length of the uterus on the couch with a centimeter tape - usually such measurements are performed from the second trimester of each pregnant woman during a scheduled visit to the gynecologist. Frozen pregnancy may be suspected with a low location of the bottom of the uterus.

3. Abrupt disappearance of signs of toxicosis. Usually they disappear gradually, by the second trimester of pregnancy. In the event of the death of the embryo, nausea disappears almost instantly. The mammary glands can be soft, painless, which is not typical for pregnancy.

4. Bloody, spotting discharge from the genital tract, pain in the lower abdomen. Usually, these symptoms occur already when the miscarriage has 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 very accurate, can help determine ovulation, pregnancy, and monitor its development. During pregnancy, the basal temperature is usually above 37 degrees. But its decrease cannot be considered as an absolute sign of a frozen one.

6. Absence of a heartbeat in a fetus on ultrasound or an embryo in a fetal egg. If the baby does not have a heartbeat at 5-6 weeks of gestation, this may indicate the death of the embryo.
There are cases when an embryo is not found in the fetal egg, that is, it dies at a very early date, when it is not yet visible by ultrasound. This pathology is called anembryony.

7. Absence of fetal movements. Primiparas feel fetal movements daily from 20 weeks of pregnancy, multiparous - from the 18th week. In the absence or cessation of movement, the woman is urgently sent for an ultrasound scan.

Whether to terminate the pregnancy and how

Non-developing pregnancy, what to do - abortion or wait for a spontaneous miscarriage? Doctors abroad have a waiting tactic. A woman weekly, in some cases even more often, performs an ultrasound scan and visits a gynecologist in order to recognize the onset of the inflammatory process in time - the basis for surgical intervention. We usually immediately recommend an abortion if there are no signs of an incipient spontaneous miscarriage.

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 with medication. A woman takes drugs that a doctor gives out, and after 1-3 days she has a spontaneous miscarriage. This procedure is effective in the early stages. The longer the term, the more likely it is that the miscarriage will be incomplete and vacuum aspiration will have to be done.

If a non-developing pregnancy is proved 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 "cleansing") 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. It is believed that they help restore hormonal levels and reliably protect against pregnancy. If there are contraindications to taking pills, barrier contraception (condom) is recommended. A child should be planned after undergoing treatment (if necessary), but not earlier than 3 months after a frozen one, otherwise there is a high risk of a recurrence of the situation.

As for the medical examination, doctors consider it mandatory only if an undeveloped pregnancy is repeated more than 2 times (if the embryo stops developing in the first trimester of pregnancy). Since 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 frequent the older the woman.

If the situation repeats. It is necessary to undergo an examination to identify and eliminate the cause of pregnancy fading. A woman should 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 an analysis for antibodies to phospholipids, go for a consultation with an endocrinologist.

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

This topic is very exciting and delicate. Talking about it is always difficult and joyless. But it is also impossible to remain silent, because an undeveloped pregnancy, unfortunately, is not so rare today.

If the fetus froze at a time when a rather large tummy was already visible, then it may slightly decrease in size. At a later date, the fading will be indicated by the absence of movements for an extended period of time.

Whenever misfortune occurs, a woman can feel very bad for no apparent reason, as it seems to her.

The described signs of a non-developing pregnancy can appear individually or in combination, several at once, or completely absent - in each individual case, everything happens differently.

We sincerely hope that this information will forever remain theoretical and unclaimed for you. But if, God forbid, it happened otherwise, then do not be discouraged: 80-90% of women safely bear the next pregnancy. Moreover, the chances of success increase if the pregnancy is planned in advance, passed and properly prepared for motherhood (and fatherhood too).

Specially for- Elena Kichak

Every woman dreams of the happiness of motherhood, and when she sees the cherished two strips of dough, she already plans how she will name the baby and how she will lead him to first grade. However, it is not enough to get pregnant, it is still necessary to endure and give birth. Unfortunately, some have to face such a terrible diagnosis as a “frozen” or “non-developing pregnancy”. This concept means intrauterine death of the embryo, which usually occurs before 20 weeks of gestation. From 10 to 20% of all pregnant women experience such a pathology, regardless of their desire to give birth.

Why does the fetus freeze?

Doctors distinguish several of the most dangerous periods, which often account for missed pregnancy:

• Implantation period (first 7 - 11 days after conception).
• The period of formation and fixation of the embryo in the uterine cavity (from 3 to 8 weeks of pregnancy).
• The period of formation of the placenta (up to 11 weeks).
• The periods from 16 to 18 weeks of pregnancy, 20 to 24 weeks and 28 to 30 weeks, when the most important functions develop in the body of the fetus.

There are several reasons why an undeveloped pregnancy occurs:

• endocrine disorders.
• Genetic disorders. This factor is the most common. Signs of some genetic disorders of the fetus can be detected at screening at 10 to 13 weeks and at 16 to 18 weeks.
• Infections.
• Autoimmune diseases.

In addition, the risk increases in women:

• leading an unhealthy lifestyle;
• having certain structural features of the uterus;
• whose age is over 30 years;
• pregnant with IVF.

How to recognize a frozen pregnancy at different times

It is difficult to name any characteristic signs on the basis of which it would be possible to judge a missed pregnancy for sure. Especially if the period is quite small - up to 16 - 18 weeks. After all, a woman does not yet feel the movements that signal her about the normal development of the fetus.

The first movements will appear at about 16 weeks for multiparous mothers, and for those who are pregnant for the first time and even later - at 18-20 weeks. Therefore, in a short period of time, a woman can walk for several weeks and not be aware that the embryo is frozen. At this time, she may feel certain changes in her well-being, but often associates them with pregnancy, and not with her fading.

However, there are some signs to watch out for:

Any signs of pathology and sudden changes in the state of health of the pregnant woman should prompt her to go to the clinic.

Doctors have enough of their own methods for determining a missed pregnancy:

• in a fetal egg measuring 20 mm (which corresponds to the 7th week of pregnancy), an embryo is not detected;
• in an embryo larger than 5 mm (transvaginal ultrasound) or more than 9 mm (transabdominal ultrasound), a heartbeat is not visible;
• the cardiac activity of the embryo is not detected when the size of the fetal egg is more than 16 mm (transvaginal ultrasound) or more than 25 mm (transabdominal ultrasound).

Treatment of non-developing and planning subsequent pregnancy

The only way to treat a missed pregnancy is to remove the frozen embryo from the uterine cavity. There are several methods for this, the choice of which depends, first of all, on which week the fetus froze.

Frozen pregnancy is not a sentence for life. After it, most women manage to safely become pregnant and give birth to a healthy child. However, for this it is necessary to exclude the causes that led to the fetal fading in the past and responsibly approach the issue of planning pregnancy in the future. Doctors recommend planning another conception no earlier than 3 months after an undeveloped pregnancy.

Prevention of a missed pregnancy is as follows:

• 11-12 weeks before the intended conception, it is recommended to start taking folic acid.
• Planning for pregnancy must begin with a complete examination.
• Give up bad habits, as well as take care of proper nutrition.
• Seek advice from a geneticist if a previous pregnancy was affected by this particular factor, or if the woman's age is over 35 years.

It is also necessary to remember that the period at which pregnancy stopped developing in the past is critical for the subsequent bearing of the baby. Therefore, if, for example, in the past, the fetus froze at 16-18 weeks, then it is during this period that it is necessary to be as protected as possible from all negative factors.

It is impossible to single out specific signs of a non-developing pregnancy, but if you skip this pathology and do not remove the dead embryo from the uterine cavity in time, this can lead to serious consequences. Therefore, pregnant women should regularly visit their doctor, regardless of their health. The main thing after such a tragedy is not to despair, but to take appropriate measures in order to exclude such a scenario in the future.

About what a non-developing pregnancy is, what are its causes and consequences, today the site for mothers will tell the site.

Any woman, having learned that she will soon become a mother, is looking forward to the first trip to the ultrasound. But women's plans for a happy future can collapse in one short moment - if the device detects the absence of the baby's heartbeat. And one of the reasons for this phenomenon may be.

Most of these cases occur in the early stages of pregnancy, up to 14 weeks, and suggest the death of the child. A pregnant woman may not know about it, because there are no obvious signs of fetal death, such as in a miscarriage.

Causes of fetal fading

There are no exact answers to the question why the pregnancy is not developing. Factors affecting the formation of the fetus in the first few weeks can be very different. Especially if the woman did not suspect that she was pregnant.

Most likely causes:

• global hormonal restructuring of the whole organism;
• predisposition to hereditary diseases that caused abnormalities in the development of the fetal egg;
• infections, incl. including sexual and TORCH infections;
• the presence of antiphospholipid syndrome (APS) in a pregnant woman;
• bad habits;
• too early or late pregnancy;
• nervous tension..

Signs of a non-developing pregnancy in the early stages

With the help of hCG indicators, you can determine the further development of pregnancy. A week after fertilization, this hormone begins to be produced by the cells surrounding the fetus. From this time until the tenth week of pregnancy, the level of hCG rises rapidly, doubling daily.

Each week of pregnancy has its own hCG level. If its indicators are lower than it should be in this period, and a re-analysis a day later showed a continuation of the fall, then the doctor can diagnose a miscarriage.

A decrease in the level of chorionic gonadotropin is one of the first signs of an undeveloped pregnancy.

Another reliable sign of fetal fading is ultrasound procedure in the early stages. It will help determine the presence of a baby's heartbeat (cardiac activity begins at week 5). But if the features of the embryo are clearly visible, and there is no heart rhythm, this may mean intrauterine death of the fetus.

To accurately diagnose a non-developing pregnancy, you must re-pass the ultrasound in a week.

Symptoms of an undeveloped pregnancy

A woman may notice some signs of a missed pregnancy:

• in the early stages, such signs of pregnancy as toxicosis, soreness and swelling of the mammary glands, changes in taste preferences, increased salivation, etc. disappear;
• normalization of basal temperature;
• during an external examination, the gynecologist may note a lag in the size of the uterus from the size corresponding to the probable gestational age;
• for periods of more than 16 weeks, the absence of fetal movements;
• detachment of the fetal egg due to its fading causes pain in the lower abdomen with the release of blood contents from the genital tract. The temperature may rise. This happens a couple of weeks after the death of the embryo.

The process of terminating a missed pregnancy

Unfortunately, the "non-developing pregnancy" must be terminated. The doctor for choosing the appropriate therapy should build on each specific case.

Most of these pregnancies end spontaneous miscarriage. Sometimes, for periods up to 8 weeks, a medical termination of pregnancy is required. For this, drugs that weaken the action of progesterone and prostaglandin analogues are used.

After their introduction in the body, a natural mechanism for the expulsion of the fetus in the form of a miscarriage is launched.

Surgical intervention in the later stages involves the process of curettage of the uterine cavity in order to extract the dead fetal egg.

Scraping tissues are sent for laboratory studies for histology and cytogenesis. The woman is given oxytocin to contract the uterus and is given a course of antibiotics to prevent infection. After the procedure in a couple of weeks it is necessary to undergo another ultrasound to exclude the presence of residual fragments of the fetal egg in the uterus.

Consequences of non-developing pregnancy

A delay in terminating a missed pregnancy can cause the development of an intrauterine infection, an inflammatory process in the tissues of the uterus and appendages.

The decomposition of the cells of a dead embryo saturates the woman's blood with dangerous toxins. As a result, reduced blood clotting and the risk of severe bleeding.

During the curettage procedure, damage to organ tissues is possible. Along with the physical difficulties suffered, the mental state of the woman also requires rehabilitation. After all, there is nothing worse than losing a very tiny, but already so dear and long-awaited creature.

All of these factors can reduce the likelihood of having children in the future. Therefore, upon detection of the first alarming signs, you should immediately contact your gynecologist. Timely removal of a dead embryo can significantly reduce the risk of complications.

So that the next pregnancy after the non-developing one is not terminated in the same way, it is better not to plan conception for another six months after the rehabilitation course. Before this, both partners should undergo a full examination in order to identify the causes of the previous fetal fading.