The phenomenon of missed abortion can occur in women of any age. The emergence of this pathology contributes to the confluence of many factors and circumstances. To prevent fetal death, you should strictly follow the recommendations and advice of your gynecologist, as well as carefully take care of your own health at the planning stage of the birth of a child.
Fortunately, this pathology is quite rare in women: out of 176 normally developing pregnancies, one is a missed abortion. Under missed pregnancy understand the pathology of pregnancy, in which there is a cessation of development and growth of the fetus, as a result of which he dies. This phenomenon occurs at all stages of pregnancy, but most often in the first three months of pregnancy (up to 13 weeks). Pregnancy during pregnancy may provoke inflammatory processes in the female body, as well as lead to other undesirable consequences. In particular, it poses some threat to future offspring. Symptoms of missed abortion may be observed in the early and late periods of gestation, while the symptoms in the second trimester will differ from those in the early stages.
How to determine a frozen pregnancy in time?
As a rule, the symptoms of fetal fading are very accurate, and medical diagnosis does not cause difficulties at all. The most important sign of the cessation of growth and development of the embryo is the disappearance of signs of developing pregnancy. When the first suspicions appear, it is necessary to consult a doctor who, according to the results of an ultrasound examination, will reveal the presence or absence of symptoms of a frozen embryo.
To date, doctors have calculated the terms of fetal development, in which the risk of fading is very high: the first 3-4 weeks, from 8 to 11 weeks and from 16 to 18 weeks of pregnancy. Particularly high is the likelihood of a frozen pregnancy in the eighth week, when changes are observed in the mother's body and the laying of the most important organs of the unborn child takes place.
Causes of missed abortion.
Anything can provoke a similar phenomenon, starting with a violation of the hormonal background of the mother and genetic disorders in the fetus, and ending with acute infectious diseases and harmful habits. The most common causes of missed abortion are the use of large amounts of alcohol, drugs and cigarettes, as well as diseases such as herpes, chlamydia, toxoplasmosis, etc. Of course, if a woman really wants to have a healthy baby, then she will eliminate all these dangerous factors even in the early stages of childbearing.
Genetic abnormalities of the embryo are the most common factor that causes fetal freezing (70% of cases) for up to eight weeks. In this case, the nature itself does not give life to the initially “sick” fetus. In the future, if both parents are completely healthy, there is a very high probability that this situation will not happen again. If the second, third and subsequent pregnancies in a row end in a fading embryo, this indicates the fault of genetic factors.
Hormonal disorders in the body of a woman also often provoke the development of missed abortion. This is mainly due to the lack of progesterone or pregnancy hormone in the female body, without which successful attachment of the embryo to the uterus cannot occur.
Hyperandrogenism is also one of the causes of fetal death. Approximately at twenty percent of women during the carrying of a child the level of male sex hormones (androgens) increases, as a result of which the woman begins to form male features (excessive vegetation, changes in the properties of skin, voice, body, etc.). Therefore, if there were previously missed abortion, miscarriage, frequent menstrual delays and body hair growth by the type of men, it is important to pass tests for determining hormonal status before planning pregnancy and, if necessary, to undergo treatment, thereby preventing or significantly reducing the likelihood of fetal death .
Various infections can cause fetal death not only in the early but also in the later stages of gestation (about 30% of cases). During childbearing, the woman’s immunity is completely depressed, because then the body would simply begin to deal with the appeared alien body, which is the embryo. As a result, the mother's body becomes very vulnerable to various infections. In women in position, all infectious diseases begin to worsen. Non-hazardous flora begins to multiply vigorously, vaginal microflora is activated, creating the threat of intrauterine infection of the fetus. But the particular danger is the infection of the future mother during the period of pregnancy, and not the aggravation of existing infectious diseases. In particular, infection with chickenpox or rubella, in addition to missed abortion, can cause abnormalities in the development of the fetus. In this situation, the question arises about the artificial termination of pregnancy. Irreversible changes can result in infection with cytomegalovirus (CMV), which provokes multiple embryonic developmental defects.
A serious flu hazard to the fetus is ordinary flu, which a pregnant woman can catch. Due to weakened immunity, even ordinary ARVI is very difficult. It is worth noting that the virus itself represents the danger, and how many of its manifestations are: intoxication, an increase in temperature, which, in turn, disrupts blood flow from the mother to the fetus. As a result of lack of oxygen and essential nutrients, the fetus may die.
Wrong lifestyle, including unbalanced diet and bad habits, frequent stresses and overvoltages can also cause fetal fading. In addition, insufficient walks in the fresh air, the use of coffee and other harmful drinks can cause complications in the form of early placental abruption and increase the tone of the uterus. All this leads to impaired blood flow, as a result, the fetus does not receive additional oxygen and necessary substances.
It should be noted that very often a pregnancy as a result of in vitro fertilization ends with a fading embryo or a spontaneous miscarriage.
The cause of missed abortion may also be the use of a woman (not guessing about her pregnancy) drugs, which are contraindicated during the carrying of the child. You should know that a few months before the planned pregnancy, as well as during it is not recommended to use any drugs without a doctor's prescription. However, medication in the early stages (7-10 days) cannot cause a frozen pregnancy, because at this time there is no close connection between the embryo and his mother. After 8–10 weeks of pregnancy, the placenta is protected from exposure to drugs, so the probability of missed abortion in later periods is slightly reduced. If the expectant mother works in hazardous production, the risk of missed abortion is very high.
After the fetus dies, the body needs six months to restore the endometrium and hormonal status in order to prepare for the next pregnancy. During this period, you can hold all the necessary medical procedures that will allow you to conceive and make a normal and healthy baby normally.
Symptoms of missed abortion and its diagnosis.
Unfortunately, in the early stages, missed abortion may not manifest in any way. The first signal indicating a problem is the sudden cessation of attacks of toxicosis, if any. At the same time, other obvious symptoms that indicate the presence of pregnancy disappear: a decrease in basal temperature, pain in the mammary glands. In the early stages, a woman may overlook such signs. At a later date of gestation, missed abortion may manifest as lower abdominal pain or bloody vaginal discharge. These symptoms may indicate flaking of the ovum when a miscarriage begins. Another major symptom in the later stages is the cessation of fetal movement. Unfortunately, at home it is very difficult to determine missed abortion. The abdomen may still grow, and blood tests may indicate pregnancy. However, this may not develop the fruit, and the empty inside the fetal membrane.
A missed pregnancy is diagnosed by gynecological examination, ultrasound examination of the pelvis and blood test for hCG. When viewed from a gynecologist pathology is determined by the size of the uterus, which must meet the norm at the current gestational age. Ultrasound shows the absence of the fetal heartbeat, as well as anembrionium (a disorder in which the fertilized egg is completely empty). On the hormonal blood test (hCG), this problem is characterized by a deviation of the level of the pregnancy hormone from the indicators characteristic of normal pregnancy.
As a rule, missed abortion ends with curettage (cleaning) of the uterus in stationary conditions using vacuum aspiration (with an early period) or under the supervision of a doctor cause miscarriage with the help of special medications. Sometimes it happens that a woman's missed abortion without medical intervention ends in a spontaneous miscarriage. If this does not happen within a certain time, and according to an ultrasound scan, there are residues of the ovum in the uterus, then resort to the measures described above, after which antibacterial therapy is carried out. Two weeks later, to assess the recovery of the body do ultrasound.
The consequences of missed abortion.
If there was a missed abortion, this does not mean that the woman will not be able to have children in the future. Very often, doctors are not fully able to identify the cause of this phenomenon, while in the vast majority of cases, women become pregnant and bear a child normally. If the cases of missed abortion occur more than once, it is necessary to undergo a full medical examination of both partners, since repeated cases may indicate the inability of the woman to bear the child.
The fact that missed abortion seriously affects the physical health of a woman is a fact. But psychological problems are more serious. A woman feels fear in planning the next pregnancy due to unsuccessful past experiences. Over time, all fears go away, especially if a woman hears the stories of women who have been in the same situation, who then conceived, carried out and gave birth to a baby normally.
Recovery and treatment after missed abortion.
Before prescribing treatment, both partners undergo a full course of examination: they are tested for sex hormones and thyroid hormones, smears for various sexually transmitted infections by PCR (to detect hidden genital infections), undergo an ultrasound examination, determine group compatibility and etc., which will make it possible to identify and eliminate the causes that caused the development of pathology.
After the doctors have identified the causes of the missed abortion and carried out appropriate treatment, if necessary, the woman should regain strength before planning the next pregnancy. For this, it will take about six months. During this period, it is important to take all possible preventive measures to prevent a recurrence of the situation (to lead a healthy lifestyle, take vitamins, use contraception). The woman herself needs to contact a psychologist who will help overcome fears and worries about planning for the next pregnancy.
A woman who has experienced a similar situation, with normal analyzes, may not need treatment, because, as I have already said, a frozen pregnancy most often develops due to a genetic failure, the recurrence of which is unlikely to occur in the future. However, in cases of repeated fetal death, treatment is necessary.
Prevention of missed abortion.
To prevent a recurrence of such a situation, it is necessary to observe preventive measures even before pregnancy planning. Prevention will help reduce the risk of recurrence.
So, in the presence of sexually transmitted infections, it is necessary to get rid of them at least three months before the planned conception. If you have not been ill with childhood diseases such as rubella or chickenpox, you need to be vaccinated, especially if you often come in contact with children (for example, you work in kindergarten).
For the prevention of missed pregnancies and other complications, all women need to eat rationally and balancedly, including more fresh vegetables and fruits in their diets. In addition, you must give up all bad habits, as they dramatically increase the risk of missed abortion. More to be in the fresh air.
Who is at risk for re-developing pregnancy?
- Women who have undergone abortions, and, the more abortions, the higher the probability of encountering such a complication.
- Women who have had an ectopic pregnancy, as well as those whose fetal heart stopped beating in the last weeks of pregnancy.
- Women with infectious and viral diseases of the genital organs.
- Women over thirty. Every woman is desirable to give birth to a first-born child up to thirty years.
- Women with some anatomical features of the reproductive system (two-horned and saddle-shaped uterus).
- Women with uterine myoma. It leads to deformation of the uterus and does not allow the fetal egg to attach.
- Suffering from endocrine disorders (diabetes mellitus, reduced thyroid function, cycle disorders, progesterone production disorders).
In conclusion, I would like to note that the best prevention of any complications of pregnancy is maintaining a healthy lifestyle, regular visits to the gynecologist and the strict implementation of its instructions.
The main causes of missed abortion
Pregnancy is a pathological condition in which the fetus stops growing, but is still in the abdomen of a woman. This situation often occurs during unsafe periods of the 1st trimester - at 3-4 and 7-11 weeks. At this time, all organs and systems of the fetus are formed. A high percentage of cases of fading pregnancy also occur in the 16-18 weeks.
To date, no gynecologist does not give a clear answer, because of what and why the embryo can stand still. Scientists identify a number of predisposing causes and situations that provoke stopping the development of the fetus.
Genetic abnormalities in fetal development
According to statistics, 80% of cases of fetal fading are directly related to abnormalities at the genetic level. Chromosomal abnormalities in the development of the embryo result from a violation of the quantitative and qualitative parameters of chromosomes. Causes of quantitative problems with missed abortion:
- the divergence of the paired chromosome in the separation of chromosomes is associated with trisomy, monosomy,
- the formation of a polyploid embryo, provided that several spermatozoa and one egg are involved in the fusion process.
If violations occurred in the first divisions, the embryo will die before the 21st day of existence. When they occur in the following divisions increases the risk of having a baby with mosaicism.
Quality issues are usually present in one of the spouses. Translocation is the most common cause of early fetal death or the birth of a baby with congenital anomalies. Such mutations are:
- reciprocal, when chromosomes exchange in the same segments,
- assimilation with the loss of a genetic sample,
- with a change in the structure of the female sex chromosomes,
- in the form of duplication, inversion and other types of mutations.
In a situation where pregnancy stops and does not develop, natural selection occurs. A child who could be born with such anomalies would not be able to lead a normal life, therefore nature terminates a non-developing pregnancy at an early stage. Frequent causes of genetic disorders, mutations and chromosomal disruptions in the fetus are bad habits (smoking, drugs, and excessive alcohol abuse by a parent).
Why does pregnancy stop?
Неразвивающейся называют беременность, при которой происходит длительная (одна неделя или более) задержка в полости матки погибшего эмбриона или плода на ранних сроках. Cessation of development can be not only in the uterus, but a frozen ectopic pregnancy is possible.
Can I get pregnant again?
Yes, but two consecutive spontaneous interruptions in 2 times increase their risk in the future, which is an average of 30-38%. This prognosis is even worse compared with women who have already completed normal deliveries. Given this, most experts believe that the second consecutive missed abortion is sufficient reason to regard this condition as a habitual early termination of pregnancy.
Such couples should be enrolled in the group with a high risk of “habitual miscarriage”, should be thoroughly examined after a frozen pregnancy, and recommend appropriate treatment outside of it.
Undeveloped pregnancy is regarded as a pathological symptom complex, which includes:
- Lack of viability of the embryo or fetus.
- No reaction to this myometrium (pathological reactivity).
- The development of disorders in the hemostatic system in the body.
This pathology from spontaneous abortion is distinguished by the absence of uterus emptying in an independent way.
Causes in the early stages
The immediate and main causes of missed abortion in the early period are disorders and conditions combined into 5 groups:
- Congenital and acquired anatomical defects of the uterus.
- Genetically and chromosomally caused anomalies of embryo development.
- Pathological changes of the uterus mucosa, including those associated with various chronic pathologies in women. They are characterized by the inferiority of the endometrium and the lack of its ability to support the processes occurring during gestation.
- Disorders of the blood coagulation system.
- Other reasons.
The latter group mainly includes:
- the presence of anti-father cytotoxic antibodies, antibodies against antibodies (anti-iopathic antibodies), antibodies that block the lymphocytic reaction,
- abnormal activity of natural cellular killer cells (NK cells),
- tissue incompatibility of partners (according to the HLA system).
Congenital anatomical defects that can cause a missed abortion include a single-horned, double-horned, saddle-shaped or fully double uterus, the presence of a full or partial intrauterine septum. This anatomical pathology of the uterus causes abnormalities of pregnancy, as a rule, in the later stages, however, termination of development in the early stages can occur if the egg is implanted in the intrauterine septum or near the submucous myoma.
Acquired defects are intrauterine adhesions, most often resulting from a previous non-developing pregnancy or curettage of the uterine cavity, curettes, submucous myomas and isthmic-cervical insufficiency.
Pregnancy failure in anatomical defects is caused by impaired implantation of the ovum, receptor insufficiency and inadequate blood supply to the endometrium, hormonal disorders with a luteal phase deficiency, and chronic endometritis.
Genetic and chromosomal abnormalities of the embryo and trophoblast
They caused the majority (up to 80%) of pregnancy loss, including frozen, in the first trimester. These disorders occur due to a quantitative or qualitative change in the structure of chromosomes. Quantitative changes are the result of failures:
- in any period of division of eukaryotic (nuclear) cells, for example, a violation of the divergence of the paired chromosome in spermatozoa or eggs, in which monosomy or trisomy is formed,
- during the fertilization process, when the egg is fertilized by two or more sperm, resulting in the formation of a polyfruit,
- during the first mitotic divisions of a fertilized egg, if these malfunctions occur during the first division, complete tetraploidy may develop (chromosomes double without cytoplasmic separation), which causes the termination of further development as early as 14-21 days after conception, and failures in subsequent divisions can lead to mosaicism.
Qualitative changes in the structure of chromosomes include translocations in one of the partners. They are one of the most common causes of missed abortion and are a type of chromosome mutation in which a portion of one chromosome is transferred to another disparate (nonhomologous) chromosome. Chromosomal mutations can be in the form of:
- reciprocal translocations, which consist in the mutual exchange of chromosomes by their sites, they constitute half of all chromosomal abnormalities during a frozen pregnancy,
- fusion of chromosomes with partial or complete loss of genetic material in the zone of short arms (Robertsonian translocations),
- changes in the female sex chromosomes,
- duplications, deletions, inversions and other disorders.
Pathology of the mucous membrane of the uterus
The main factor in the disruption of the development of the embryo and fetus on the part of the endometrium is its structural and functional changes in the form of atrophic processes and reduced receptor sensitivity to progesterone and estrogens. The most typical conditions are:
- Autoimmune chronic endometritis.
- Regenerative-plastic insufficiency syndrome.
Autoimmune Chronic Endrometritis
It is provoked by an acute or chronic viral-bacterial infection that stimulates the body's response in the form of local and general immunity. This leads to an increase in the synthesis of cytokines, growth factors and proteolytic enzymes. They stimulate the development of the inflammatory process and contribute to damage to the vascular endothelium, as well as abnormal introduction and endometrial damage by the cells of the outer layer of the embryo (trophoblast) already in early pregnancy, as well as cell proliferation and angiogenesis.
As a result, there is a new increase in the number of cytokines and growth factors. Thus, there is a closed pathological circle. In the typical course of gestation, the immune processes of embryo rejection are suppressed by the body and, in the absence of inflammation, it proceeds normally.
Regenerative-Plastic Failure Syndrome
The outcome of the syndrome of regenerative plastic insufficiency of the uterine mucosa is endometriopathy, or endometrial atrophy. Disruption of endometrial function in half of the cases is not caused by inflammatory processes, but specifically by the progression of this syndrome, which is the realization of tissue stress in the case of predispositions, including genetic ones.
The syndrome is manifested by auto-and alloimmune reactions, a decrease in the secretory activity of the glandular epithelium, a thinning of the endometrium, a decrease in the number of progesterone receptors and a decrease or complete loss of sensitivity of the receptors to progesterone and estrogen.
The syndrome is based on adaptation in response to the impact of adverse factors while preserving the main functions of the endometrium. The subsequent depletion of adaptive reactions leads to the development of a maladaptation stage, in which the processes are aimed only at preserving the cellular and tissue structures, but not at their adequate functioning. In regenerative-plastic insufficiency syndrome, chronic inflammatory and autoimmune factors are a vicious circle. Implantation of a fertilized egg in these cases is impossible without active therapy.
Blood Coagulation Disorders
Among them are the main antiphospholipid syndrome and thrombophilia of hereditary etiology. The antiphospholipid syndrome, the causes of which are not completely clear and in which fetal freezing occurs after 10 weeks of gestation, belongs to autoimmune and thrombophilic disorders. The main signs on the basis of which it is possible to assume the presence of the antiphospholipid syndrome:
- arterial or / and venous thrombosis,
- decrease in the number of platelets and hemolytic anemia in history,
- late severe preeclampsia in history.
Causes of missed abortion in late periods
In the later stages of gestation (in the second trimester), the main causes of fetal death are primary or secondary placental insufficiency due to infection (most often the herpes virus, chlamydia and cytomegalovirus), diabetes mellitus, hypertension, cardiovascular failure with heart defects, renal failure, severe preeclampsia, uncontrolled intake of certain drugs.
Detention mechanisms in the uterus
The long-term presence in the uterus of an embryo or fetus that has stopped in its development is supposed to occur as a result of the following mechanisms:
- The dense attachment of the forming placenta as a result of deep germination of chorionic villi. This may be due to:
- a high degree of activity (in terms of proliferation) of the chorionic villi,
- structural and functional inferiority of the uterine mucous membrane at the site of implantation of a fertilized egg,
- incomplete preparation of endometrial changes in the implantation zone.
- The deficiencies of the immune system in relation to the reaction of rejection of immunologically foreign tissue.
- Decreases in myometrial contractility due to:
- the chronic course of inflammatory processes in the uterus, resulting in the formation of insufficiency of the receptor apparatus, which leads to a decrease in sensitivity to substances formed during the death of the embryo and causing a decrease in myometrial tone,
- violations of enzymatic biochemical processes involved in the metabolism of proteins,
- continued (for some time after the death of the embryo or fetus) the production of progesterone trophoblast and placental lactogen, a specific trophoblastic beta-globulin, and the placenta - some peptide hormones, biogenic amines and immunodepressive peptides that suppress uterine contractility.
The main risk factors for missed abortion are:
- Age under 18 years.
- Pregnancy in older and late reproductive age of a woman or / and her partner - after 30 years for primiparas and over 35 years for multiparous. The risk in older and late reproductive age is associated with the gradual extinction of the processes of natural selection, as well as with various disorders in the reproductive system of the partner. For comparison: the risk at 20-24 years of age is about 9%, at 30-40 years of age 40%, at 45 years old 75%.
- Repeated episodes of miscarriage in history. The greater the number of such episodes, the worse the prognosis for subsequent conception.
In addition, chronic diseases of the female genital organs or acute and, especially, chronic extragenital diseases contribute to miscarriage.
The main ones are:
- Blurred forms of ovarian, adrenal or mixed etiology hyperandrogenism and ovarian hypofunction,
- PCOS (polycystic ovary syndrome),
- the presence of persistent bacterial and viral infections in the body, most often (52%) is a mixed viral-bacterial infection, as well as chlamydial (51%), ureaplasmic and fungal microflora (about 42%),
- chronic inflammatory processes of the female genital organs, repeated abortions and intrauterine contraceptives,
- acute or chronic infectious diseases, they rarely cause fetal death of the fetus on their own, but they lead to the development of fetopathy contributing to the death of the fetus under the influence of other factors,
- endocrine diseases - insufficiently compensated diabetes mellitus, dysfunction of the thyroid gland, mainly hypothyroidism,
- chronic renal pathology,
- severe hypertension and cardiovascular failure,
- various systemic pathology of connective tissue in the form of systemic lupus erythematosus, systemic scleroderma, antiphospholipid syndrome, etc.
Less important factors include:
- alcohol and drug addiction
- certain medications
- excessive consumption of drinks containing caffeine (strong brewed tea, coffee and other tonic drinks),
- low body mass index.
The sensitivity of the embryo or fetus to damaging factors varies in different periods of gestation. The shorter its duration, the more vulnerable they are. The most critical periods are the 7th-12th days, when the implantation of the ovum occurs, the 3rd-8th week (the beginning of the embryo development), the 12th week (the period of placental formation) and the 20th-24th week (the stage of formation of the most important systems of the fetus).
In most cases, a single dominant cause and several risk factors and the mechanisms of development of this pathological state interacting with each other are based on a missed pregnancy. How to understand that the death of the embryo or fetus occurred?
Main symptoms of missed abortion
The peculiarity of a failed pregnancy is manifested in the disappearance of the subjective and objective signs of the latter.
How to determine missed abortion?
Termination of nausea, increased salivation, vomiting, and aversion to various odors that appeared in the first 12 weeks of the gestation period are characteristic subjective feelings during a frozen pregnancy.
The delay of a dead fetus in the uterus for more than 2–6 weeks in some women (about 10%) is manifested by general weakness, dizziness, fever and chills. Occasionally, pains of a cramping character may appear in the lower abdomen, pain in the lumbar region. After 2-6 weeks after the death of the fetus, bloody spotting from the genital tract periodically appears, possibly also uterine bleeding, especially in the later stages of gestation.
Recognize the arising pathology can be and changes in the mammary glands. Three days - 1 week after the death of the fetus, the mammary glands shrink, their pain decreases, the engorgement stops, and they soften, and instead of colostrum, milk may appear. After a 25-week gestational period, fetal death can be accompanied by engorgement and release of large amounts of colostrum.
You can also determine frozen pregnancy at home by measuring the basal temperature, which in the early stages is kept within 37.2-37.3 ° and above. The basal temperature during missed abortion quickly returns to normal.
What tests need to pass to determine the non-developing pregnancy?
A blood test for hCG is of some importance when pregnancy is missed. Human chorionic gonadotropin is a specific hormone that is synthesized by a trophoblast already 24 hours after implantation of a fertilized egg. Under normal conditions, the level of hCG becomes maximal by 6–10 weeks of gestation, after which it gradually decreases.
If the development of an embryo or fetus stops, its index decreases from 3 to 9 times. That is, it becomes below the norm corresponding to the gestation period, at 6–12 weeks, 8.6 times, at 13–26 weeks - 3.3 times, at 28-30 weeks - at 2, 7 times. However, the diagnostic value of the analysis for hCG is low. It increases slightly when conducting repeated analyzes.
The determination of an increase in the content of hCG in the urine underlies the rapid testing at home.
Is pregnancy test positive or negative?
Rapid test does not show the concentration, but only an increase in the concentration of the hormone in the urine. With early termination of embryonic development, rapid analysis becomes negative after 2-3 days, but in later periods chorionic gonadotropin is removed from the blood rather slowly, and the test can remain positive for a long time (even up to 1 month).
Sometimes other tests are performed - for alpha-fetoprotein, whose concentration increases from 1.5 to 4 times by the 3rd to the 4th day after the death of the fetus, and for the trophoblastic beta 1-glycoprotein. The concentration of the latter in the blood of a woman immediately after the death of the ovum decreases, and when it is delayed in the uterus by 3 weeks, it decreases 4-8 times.
Could there be toxicosis during missed abortion?
Gestosis (toxicosis) is a syndrome of multiple organ failure that develops during the gestational period. It is caused by the discrepancy between the abilities of the mother's body and the adequacy of the needs resulting from the development of the fetus.
The development of early and late gestosis is possible only during pregnancy. If there is already one, then with the death of the fetus, that is, with the cessation of gestation, the cause of gestosis also disappears, the symptoms of which gradually diminish and disappear.
However, all these signs are not sufficiently reliable. Convincing signs of missed abortion are cessation of fetal movements or their absence within the expected time, as well as data from physical and instrumental studies.
К физикальным исследованиями, имеющим относительное значение для диагностики, относятся влагалищное исследование, при котором отмечаются при гибели плода на сроках менее 12 и до 20 недель:
- a decrease in the severity of cyanosis of the mucous membrane 4-5 weeks after cessation of fetal development with a gestational age of 16 weeks and 4-8 weeks later;
- disclosure of the cervical canal up to 1-1.5 cm in women who have not given birth and up to 3 cm and more in women who have given birth,
- thick discharge from the cervical canal in the form of mucus brownish color.
More convincing is the termination of the increase in the uterus or the lag of its size from the expected timing of gestation. This is observed in the early stages due to the resorption of the ovum, and in the long term due to absorption of amniotic fluid into the mother’s blood and reduction in fetal size as a result of its maceration.
The most informative diagnostic method, allowing to diagnose pathology even before the appearance of subjective sensations of a woman, is transvaginal ultrasound, which is informative from 18 days after conception, especially in combination with a blood test for blood levels of hCG.
What is the danger of late diagnosis of pathology?
The consequences of missed abortion may be severe, especially in cases of a long (from 2-4 weeks or longer) stay of the deceased embryo in the uterus. It is possible that infection and a septic condition, coagulopathic disorders (DIC) and bleeding, etc. may develop. They are not only a negative factor in the prognosis of a woman’s future reproductive function, the health of her offspring and the preservation of her family.
Complications are a threat to the health of the woman herself and a serious danger to her life. The severity and frequency of complications and their consequences increase with increasing duration of gestation and the duration of stay in the uterus of a dead ovum, fetus or fetus.
Treatment after missed abortion
Diagnosis requires the immediate preparation of a woman and the active treatment of a life-threatening condition. The meaning of treatment is to carefully terminate a non-developing pregnancy by evacuating the deceased ovum and in conducting anti-inflammatory therapy aimed at eliminating concomitant endometritis.
For these purposes, instrumental dilation of the cervix and vacuum aspiration, or vacuum cleaning of the uterus, with missed pregnancies for periods up to 12 weeks are used. It is also possible to prepare the cervix with a hydrophilic dilator or with the help of synthetic analogues of prostaglandins with subsequent vacuum aspiration. The latter is recommended also in cases when the traditional instrumental surgical method of curettage of the walls and bottom of the uterus (curettage) and evacuation of the remains of conception is used. However, routine curettage curettage during missed abortion leads to structural and functional inferiority of the endometrium in the implantation zone.
The best way to release the uterus up to 6 weeks of the gestational period (in certain regions of Russia - up to 9 weeks, abroad - up to 12 weeks) is a medical abortion. For these purposes, various schemes of oral and vaginal administration of the synthetic steroid anti-progestogen Mifepristone and the synthetic prostaglandin analogue “E1”Misoprostol. This method is effective in more than 80%, but it can be used in the absence of signs of infection, a violation of blood clotting, severe anemia, liver or kidney failure.
After the application of any method, it is necessary to conduct a control hysteroscopy or echographic examination. Interruption in late periods (in the second trimester - from 13 to 22 weeks) is carried out mainly by one of the methods that stimulate childbirth:
- Intraamnial (into the cavity of the fetal bladder) or extraamniotic administration of a hypertonic (20%) solution of sodium chloride or (in case of contraindications to its use - arterial hypertension, renal pathology) glucose through the cervix (transcervical access) or using a needle inserted through the anterior abdominal wall (transabdominal access). Intraamnial method is the most optimal and effective.
- Isolated administration in appropriate doses of antiprogestogen (Mifepristone) inside or (if no effect) prostaglandin (Misoprostol) or the introduction of the latter into the vagina with repeated doses of the drug inside, or a combination of Mifepristone with Misoprostol.
- Intra- or extramniotic administration of Dinoprost belonging to prostaglandins “F2-alpha ”and having a pronounced stimulating effect on the myometrium.
- After the expansion of the cervical canal, the overlay is placed on the presenting department of the fetal bladder (after it has been opened) with the help of special forceps. This method is used in the case of contraindications for previous methods or in the absence of the effect of their use.
The principles of further treatment are as follows:
- combined hormonal contraceptives or progesterone drugs in order to restore the structure, secretory function and endometrial receptive activity,
- broad spectrum antibiotics and antibacterial agents (protected semi-synthetic penicillins, cephalosporins, macrolides, imidazole derivatives), but only if a causative factor of chronic endometritis or its exacerbation is detected,
- anti-inflammatory therapy, including non-steroidal anti-inflammatory drugs,
- drugs that contribute to the correction of the immune state of the body,
- means of correction of the vaginal microbiocenosis,
- drugs and physiotherapeutic methods that help restore microcirculation, normalize tissue regeneration, metabolic processes in them and local immunity.
When can you get pregnant after a missed pregnancy?
The term of its resolution is considered the first day of the new menstrual cycle. After her menstruation is restored in the appropriate time, but sometimes they can occur in 1.5 months. However, the next planning of pregnancy should be recommended not earlier than six months.
This is the minimum period during which, when appropriate treatment is carried out, recovery occurs after those changes and disorders (hormonal changes and psychological disorders, endometritis, etc.) that occurred as a result of a pathological condition.
In order to protect it, it is recommended to take combined oral contraceptives (“Regulon”), as well as their combination with the active form of folic acid - calcium levofolatom (“Yarin Plus” and “Jes Plus”). These drugs, in addition to the contraceptive effect, have other positive properties in terms of the rehabilitation of the endometrial layer of the uterus after the resolution of a non-developing pregnancy:
- reduce the risk of developing infectious inflammatory processes in the internal genital organs by increasing the viscosity of the mucus of the cervical canal, reducing the diameter and increasing the length of the cervix, reduce blood loss during menstruation, eliminate the incoordination of contractions of the myometrium and the fallopian tubes,
- contribute to more intensive development of factors (immunoglobulins “A” and “G”) of local immunity, which significantly reduces the risks of the development of aseptic inflammation,
- The very prevention of pregnancy provides the body with time to restore plastic and energy sources.
The absence of conception within six months provides a chance to the mother's body in terms of full-fledged preparation for a more successful implementation of another attempt at motherhood.
To prevent a missed abortion, you can exclude, if possible, the above-mentioned risk factors, the treatment of gynecological infectious diseases and inflammatory processes, the restoration of the eubiosis of the vaginal environment, hormonal correction, as well as the correction of the immune state of the body and chronic extragenital somatic pathology.
In order to correct the ratio of sex hormones in their imbalance in the direction of progesterone deficiency in women with habitual miscarriage and when planning the latter, Duphaston, which has a gestagenic effect, is recommended. Its active ingredient is didrogesterone.
With timely rehabilitation, it is possible to prevent subsequent miscarriage in 67% of women, otherwise this figure is only no more than 18%.
All women who have had at least one missed abortion need to conduct a comprehensive examination, preferably with inclusion and medical genetic counseling, especially with repeated miscarriage, treatment and appropriate subsequent pregravid preparation for the planned pregnancy.
Diseases associated with hormonal failure
Undeveloped pregnancy happens with progesterone deficiency in the body of the expectant mother. Among the causes of missed abortion is hormonal imbalance caused by an excessive amount of androgenic hormones. In order to prevent fetal fading, it is recommended to undergo a general examination and pass the required hormone tests at an early stage of the baby’s planning. Thus it is possible to stabilize the hormones in a timely manner and prevent the development of pathological pregnancy.
Frozen pregnancy - the causes of the tragedy
Doctors put forward several major hypotheses of fetal death. It is possible to confirm the cause of his death with the help of a histological study of the obtained genetic material. But it also happens that the reason remains unproven.
Here are the most common factors affecting fetal death:
- Genetic disorders. At 8 weeks of pregnancy, the formation of important organs in the fetus. If this process is accompanied by chromosomal abnormalities, the development of the fetus stops. For this reason, more than 70% of embryos die. This is facilitated by the transfer of bad genetic material from one of the parents or the incompatibility of the gene pool of women and men. If a second missed pregnancy is diagnosed in a woman, the couple is sent for a consultation to genetics.
- Hormonal imbalance. For the fertile division of healthy embryonic cells, the female body must produce a lot of progesterone and few androgens. If a “breakdown” occurs at this level, the fetus dies. This situation can be eliminated at the planning stage of pregnancy, so pregravid preparation will be an excellent prevention of this pathology.
- Infectious diseases. Reduced immunity during gestation is normal, but for this reason, the woman becomes vulnerable to various diseases. Especially dangerous in this situation are: rubella, influenza, cytomegalovirus, ARVI. Intoxication of the body, an increase in temperature, stress on the immune system during the period of illness can provoke a developmental disorder and death of the baby. Symptoms of missed abortion will be invisible against the background of the disease.
- ECO. Although medicine has greatly succeeded in artificial insemination, but this method of getting pregnant is not yet fully understood. Scientists still can not prevent the frequent fading of the embryo after replanting into the uterus and often a woman has to undergo an IVF procedure several times.
- Sexually transmitted diseases. Pregnancy does not exclude sexual contact, which carries the risk of "catching up" to gonorrhea, genital herpes, chlamydia or syphilis. It often happens that there are no visible symptoms of the pathological course, but during pregnancy the fetus froze for no particular reason. In such a situation, a woman is recommended to undergo examination by a venereologist or infectious disease specialist.
- Antiphospholipid syndrome. This is a rare autoimmune disease, which is accompanied by excessive production of antibodies to phospholipids. Such a pathology in a woman can cause egg rejection, underdevelopment or blockage of placental vessels, which leads to the death of the embryo.
- Unacceptable lifestyle during gestation. What is meant by this judgment? First of all, it is poor nutrition, low activity, lack of resistance to stress, overwork, lack of oxygen, uncomfortable underwear and, of course, bad habits. Each of these factors can affect the stopping of the development of the baby.
Reasons for not developing a pregnancy
Why is missed abortion in the early stages? Such a question worries and scares young moms. The reasons are actually quite a lot:
- Genetic abnormalities occupy a leading position. They state in 70% of cases for up to 8 weeks. They are associated with many factors, including hereditary diseases, as well as the result of the use of narcotic drugs by one of the partners. That is why it is important not to refuse screenings and other examinations proposed by a geneticist and gynecologist.
- Excessive consumption of alcoholic beverages, smoking can also provoke a development arrest. It is especially dangerous if the mother can not give up bad habits after conception.
- Drugs can also trigger the development of abnormalities. That is why the doctors themselves strongly recommend to refuse any medication. The exception may be only serious diseases, the treatment of which folk remedies is simply impossible. It is worth noting that for up to 10 days and after 8-10 weeks, when the fetus becomes partially protected by the placenta, the effect of the drugs is not so significant. As for herbs, they also need to be taken only under the supervision of a doctor, because some of them can provoke a breakdown or arrest in the development of the embryo.
- The causes of missed abortion in the early stages can also be found in the Rh-conflict of the mother and child. If a woman had abortions before, then the chances for a happy development are not that big. The antibodies produced by the mother's body in relation to the child accumulate over time. And after several abortions, it is very difficult for the conceived baby to resist such an attack.
- Infections of both the genital and viral organs (ARVI, flu) are a serious threat at the very beginning of the birth of life. The mother's body is already weakened by the new situation, so getting sick is not at all difficult. But the consequences of high temperature, virus attack can be very difficult. Rubella is a formidable enemy, in the event of which the pregnancy does not only freeze, the fetus may develop severe anomalies. And already in this case, the mother will have to decide whether she can raise a special child or whether it is better to terminate the pregnancy.
- Hormonal disorders. Moreover, a non-developing pregnancy in the early stages, the causes of which lie precisely in this factor, may come to a standstill due to both the lack of prolactin and the excess of testosterone. If a woman has regular failures of the menstrual cycle, then it is imperative to be examined during planning, as well as to regularly check the state of the hormone after conception.
- Harmful factors in production, flights on airplanes, diabetes, weight lifting, stress - all of these factors can also cause the development of pathology.
The primary cause of a non-developing pregnancy can be autoimmune lesions. In the presence of autoimmune diseases, the woman's body produces antibodies that inhibit not other people's cells, but their own. Since the embryo is endowed with only 50% of the chromosomes of the mother, its cells attack the fetus, leading to its intrauterine death. One of the most common diseases of the autoimmune nature is chronic autoimmune endometritis. The disease causes a pathological process of inflammatory nature in the endometrium of the uterus, which is complicated by the destruction and fibrosis of the affected areas.
Women who have a higher risk of developing pathology
But not only in this lies the answer to the question of why pregnancy stops in the early period. Doctors allocate a certain risk group, which includes:
- old-aged or future mothers over the age of 35,
- with multiple abortions in the past,
- if during a previous pregnancy were ectopic,
- in the presence of congenital anomalies of the uterus.
If one or all of the factors are present, the woman will be under the constant supervision of a physician.
Symptoms of missed abortion in early and late periods
Undeveloped pregnancy has no signs, like a normal miscarriage, so a woman may not immediately notice that something is wrong with her pregnancy. And it is a serious threat to its health, because the dead fetus begins to decompose and can cause harm to the female reproductive organs. But some characteristic symptoms still exist and a very attentive woman will definitely notice them. Their nature and severity may be different.
Harmful habits of a pregnant woman
Tobacco, drugs and alcohol-containing drinks very often affect the state of the chromosomes of one of the partners, so bad habits are among the possible causes of a fading pregnancy. Специалисты рекомендуют женщине исключить из употребления спиртное и наркотические средства минимум за 6 месяцев до предполагаемого зачатия. Во избежание замершей беременности пациентке также стоит отказаться от работы во вредной среде.
Какие признаки укажут на замершую беременность
Печальнее всего тот факт, что симптомы замершей беременности на ранних сроках неярко выражены. Therefore, the expectant mother may not even be aware of the change in the state of the fetus. Only a qualified doctor, after examining and prescribing an additional examination, can state the absence of embryo development.
You should not look for the symptoms of an undeveloped pregnancy in the early stages and, even more so, ask your friends for advice or on the forums. In each case, everything is purely individual and depends on many factors.
Informative ways to diagnose fetal fading
It is impossible to establish the fact of pregnancy fading only by the symptomatic picture. Therefore, at first suspicion, a woman is sent for examination. And only after a thorough diagnosis, the woman is cleaned after a frozen pregnancy.
The diagnostic procedures include:
- Confirmation of the diagnosis on the gynecological examination. Often at the control gynecological examination, the doctor notices that the size of the uterus does not coincide with the established period of gestation, and blood secretions are coming from the genital tract. This may confirm the regression of fetal development. But as an option, it may indicate a threatening miscarriage with a live embryo. Therefore, it is still an additional study.
- Diagnosis in the process of ultrasound. Pregnancy after 8 weeks allows you to reliably determine the absence of a heartbeat in the fetus and possible developmental abnormalities. But a period of less than 5 weeks does not give a complete picture of the ultrasound, and the specialist may not see the embryo or signs of its vital activity. Therefore, in the first weeks of pregnancy, to confirm the diagnosis, a blood test is performed for the hgch level.
- Diagnose with hgc level detection. There are strictly established norms of concentration hgch in the blood for different periods of pregnancy. Therefore, it is enough to make a venous blood test to determine the fetal fading. At the same time the hgch level at the missed pregnancy will correspond to an indicator out of pregnancy.
Frozen pregnancy treatment
The management tactics of a woman with a missed abortion may be different, depending on the period of gestation, the physical and psychological state of the woman.
If the diagnosis is made early and there is time to wait, the woman is placed in the hospital conditions under the supervision of doctors and within a few days a spontaneous miscarriage is expected. If the period is less than 8 weeks, medical abortion is carried out with the help of special preparations.
After 3-4 days, if this does not happen, the woman is sent for cleaning during a missed abortion under general anesthesia. This is a simple gynecological manipulation, similar in principle to abortion. 14 days after the procedure, an ultrasound is performed to make sure that the uterus is clean, with no signs of inflammation.
After that, the woman is in the hospital, she is prescribed a course of antibiotics, hormone therapy (if indicated) and sedatives. Various tests are also assigned after missed abortion, depending on the causes of the pathology.. This may be hormonal studies, taking smears to hide the infection, general blood counts.
Important! Getting rid of a dead embryo is permissible only under medical supervision. Self-administration of herbs or hormone pills to reduce the uterus can lead to rapid bleeding or blood infection.
Freezing pregnancy - consequences for a woman
Serious complications in women are only with late treatment to a doctor. If the diagnosis is made on time, and the treatment is prescribed correctly, a woman in the future will be able to easily become pregnant and give birth to full-fledged babies. The most difficult thing in such a situation is to determine the cause of the death of the baby and make efforts so that it does not happen again.
Women are often interested in the question, can there be another missed abortion? Doctors unanimously answer that this can happen many times if the cause of the death of the embryo is not eliminated. Therefore, this problem must be approached comprehensively - to be examined, to cure those who have the disease, to visit the genetics and to insist on a positive result.
The loss of an unborn baby is a heavy shock for a woman. It affects not only its reproductive system, but also the psycho-emotional background. Therefore, in addition to treatment, a woman needs a long time to accept the current situation. Often a woman who has survived a missed abortion does not know what to do, so she needs the support of loved ones or the help of a psychologist.
Medication and external factors
Self-medication, uncontrolled intake of pharmaceuticals, non-compliance with the dosage is not the whole list of reasons that harm the embryo and cause a non-developing pregnancy. Other prerequisites that increase the risk of missed abortion include:
- an unacceptable way of life of the patient in the situation (poor diet, constant fatigue, stress, etc.),
- age (at 22–27 years, women in labor are much less likely to experience a sudden release of the ovum than the age after 30 years).
What are the symptoms of frozen pregnancy in the early and late periods?
The sensations of a woman very often cannot be distinguished from the usual, so the patient can walk for weeks with a frozen pregnancy. At this time in the uterus there is a slow process of decomposition of the tissues of the embryo, which ultimately manifests itself in the form of symptoms of general intoxication of the body, and in the worst case - bleeding, dangerous to the life of a woman.
Some signs of a missed pregnancy can be recognized independently at home without a doctor. The common signs of a non-developing pregnancy are:
- discharge with bloody patches,
- lethargy, chills,
- temperature from 37.5 degrees
- dull pain, which is localized in the abdominal cavity,
- abrupt cessation of vomiting and nausea (in the presence of toxicosis),
- no discomfort in the mammary glands,
- lack of signs of fetal life (stirring).
Many patients are interested in when a frozen pregnancy occurs in the early stages of gestation, with which the appearance of a pathological condition is caused and what are the main signs of a frozen pregnancy in the early stages. Indeed, the first trimester is considered to be the most dangerous, since it is mainly between the periods of 3-5 or 8-10 weeks and the pathology manifests itself. Fading pregnancy symptoms in the first trimester:
- Pain and discharge. If the patient has a stomach ache, she is disturbed by discharge with bloody patches, she should immediately call an ambulance.
- Temperature rise. If the pregnancy has stopped, the woman feels a general malaise. Most often, it is due to the fact that the temperature during a frozen pregnancy rises to subfebrile values (37.5–38 degrees) due to the development of inflammation associated with the decomposition of the tissues of the dead fetus.
2 and 3 trimesters
Starting from the 12-15th week, the expectant mother is waiting for the first movements of the fetus. If there is no movement before the 20th week, it should not be disturbed during the first pregnancy. Unscheduled medical consultation is necessary in the absence of movement after this time.
The patient should appear to the gynecologist if the movements of the baby suddenly ceased (the first sign of a missed abortion in later periods). A slight fever without cold symptoms also indicates to the patient that she should immediately visit a doctor.
To make a diagnosis and exclude a medical error, a woman needs to undergo an additional examination. It is possible to confirm or deny the fact of fetal death by means of the following research methods:
- Inspection. Includes measurements of the uterus, an assessment of the general condition of the woman and the nature of the discharge, if any. The doctor may make a mistake by confusing missed abortion with detachment of the placenta.
- Ultrasound. The specialist can determine the rhythm of the heart of the fetus for a period of 5 weeks. The absence of any signals during ultrasound may indicate a missed abortion. On a shorter period, the specialist performing the ultrasound may make a mistake.
- Blood test for chorionic gonadotropin. The gynecologist cannot make an accurate diagnosis, based only on the results of a standard examination, therefore, if a pregnant woman becomes suspicious of a pathological condition, she is recommended to take an analysis for hCG several times with a certain time interval. This is necessary in order to track the dynamics of growth or decline of hCG.
What to do after confirming the diagnosis?
When confirming the diagnosis, many women start to get nervous, not knowing what could be next. First of all, a woman should remove the ovum from the uterus. Up to 8–10 weeks, treatment of missed abortion involves the prescription of special tablets or suppositories, with the help of which it is possible to provoke a contraction of the muscles of the organ for the release of the ovum.
For a period of more than 12 weeks, patients are recommended to have a vacuum mini-abortion. The procedure is performed using local or general anesthesia using a special vacuum suction. If ultrasound examines the remains of fetal tissues in the uterus, curettage is performed with repeated examination of the woman after 14 days.
If the fetus is frozen, the woman will have a long rehabilitation period, including:
- Regular visits to the attending gynecologist.
- Passage of all necessary examinations. A detailed diagnosis is required to clarify the reason why the baby froze in the womb. A woman should be tested for latent infections, contact an endocrinologist to diagnose possible pathologies on the part of the endocrine system. In addition to blood sampling, the patient should be given a urogenital smear on the microflora, an ultrasound of the pelvic organs and the thyroid gland.
- Compliance with the principles of good nutrition by women, the use of vitamin complexes, moderate physical exertion.
- Stabilization of psycho-emotional state. Many patients are very afraid that the ST may be repeated. Against the background of fear, all their attempts to become pregnant end in failure. The woman in this case requires psychological support, primarily from her husband and loved ones.
- Subsequent therapy. After cleaning the uterus, doctors resort to long-term comprehensive treatment, which includes hormonal means to restore the structure and functionality of the endometrium of the uterus, antibacterial and nonsteroidal anti-inflammatory drugs, as well as physiotherapy techniques.
All the above rehabilitation measures will help eliminate the arrest of the embryo during the second pregnancy. Many women are interested in the attending gynecologist, is there such that you can get pregnant 2 months after the embryo subsides.
Despite this, the woman does not need to hurry. Experts say that the next conception can be planned no earlier than 4–6 months after a previous unsuccessful attempt. Full recovery of the body, including the physical and psycho-emotional aspects, occurs only after six months.
If a woman has an embryo in her womb, then combined oral contraceptives are recommended for the first six months after this situation. To enhance the effect, doctors most often prescribe calcium-based drugs levomefolata.
Implications for women
Basically, the serious consequences of missed abortion are in patients who are late in contacting a specialist. What is the term allowed to go with a non-developing pregnancy? Give a definite answer to this question, doctors can not. Some women may spend several weeks with a non-developing embryo in the womb, not paying attention to their condition. However, if the fetus lags behind in development from 2 to 4 weeks, and the woman ignores the warning signs, she puts herself at risk of developing dangerous complications. The consequences include:
- spread of infection
- risk of sepsis,
- development of DIC
Is it possible to prevent missed abortion?
Successful childbearing and the birth of a healthy baby - the work of both parents and professionals. In order to prevent fetal freezing, a woman must first of all follow all the recommendations of the attending physician. Preventive measures include:
- Visiting a specialist in the field of genetics in the planning period of conception. This is necessary in order to prevent the development of possible pathological abnormalities in the chromosomes of both partners, to pass the necessary tests and, if necessary, to undergo a course of special therapy.
- The rejection of all bad habits, moderate physical activity, increased immunity.
- Use of folic acid in consultation with your doctor. Reception of vitamin eliminates the development of malformations of the internal organs of the baby.
Symptoms of the approaching disaster
In later periods, it is easier for a woman to navigate, because she already feels the movement of the child. In the early days, this is very problematic. When a pregnancy is frozen, the signs in the first trimester of which may be similar to less serious deviations manifest themselves as follows:
- passes toxicosis,
- breast no longer swells,
- basal temperature lowered
- cramping pains began to appear
- there appeared bloody bleeding (discharge during a missed pregnancy in the early stages have exactly the same consistency and red-brown color),
- increased overall body temperature.
If any of these symptoms is detected, a woman should immediately see a doctor! If the signs of pregnancy are gone, then this should also alert the mommy and become a reason to visit a specialist!
What does a pregnant woman feel during pathology development?
Sensations with missed abortion in women are very different. They are influenced even by the fact whether such a thing happened for the first time or a similar situation happened before. Fatigue, apathy, fever - all this, in any case, should alert the future mother.
It is worth noting that all the symptoms that indicate the development of pathology may be false! No need to immediately adjust yourself to the approach of a catastrophe. Quite often they turn out to be similar to less serious ones, or the body just reconfigures.
Diagnosis of fetal fading
Only the doctor knows exactly how to recognize a missed abortion in the early period. For this, he will do the following:
- He will examine a woman, assess the size of the uterus, the state of secreted mucus, and ask to measure the basal temperature.
- If you suspect a deviation from the norm, the doctor will send the pregnant woman to pass urine for tests. However, it is worth noting that hCG with a frozen pregnancy in the early stages can be completely within the normal range for several weeks after the death of the fetus. Yet, more often, urinalysis will show an underestimated hormone level uncharacteristic for the first trimester.
- The last stage of the survey will be an ultrasound. With the help of an ultrasound examination it becomes clear whether the heart is beating in the embryo or not.
Tellingly, the test for missed early pregnancy can show all the same two stripes. This is again related to the level of hCG in the urine.
After the specialist is satisfied with the diagnosis, he will choose the necessary set of procedures for the mother, and also help her in the future to prepare for a new pregnancy.
What do the doctors do if the fetus froze
Depending on how the frozen pregnancy manifests itself in the early stages, as well as directly on the number of days from the moment of conception, the doctor will choose the most alternative method of treatment. Indeed, when establishing such a diagnosis, we are already talking about preserving the life and health of the mother. There are two main methods of treatment:
- With the help of drugs that provoke miscarriage. It is applied for up to 8 weeks.
- Vacuum abortion (vacuum aspiration). Under anesthesia, a woman cleans the uterus, using a vacuum suction.
In any case, professional assistance will be required, since in order to avoid adverse effects, it is necessary to clean the uterus (scraping the remnants of the amniotic sac, indicated by ultrasound).
There is a third option, in which even the woman herself does not have time to realize that she was pregnant. This is a spontaneous abortion. If the fetus froze almost from the first days of life, then the body can reject it, like a foreign body. In this case, a woman just notice the delay of menstruation. Sometimes doctors prefer to observe the patient's condition, waiting for a spontaneous abortion, so as not to interfere in the body once again.
Why is it so scary not to see a doctor in time?
Sometimes a woman is not fully aware of how serious the consequences of missed abortion can be at her early stage. But not always the body itself rejects the fruit. If the embryo, which has ceased to develop, is in the womb for a long time, then the development of intoxication is quite likely. In this case, not only does the temperature rise, a woman begins to be tormented by sharp pain and weakness, it is quite possible to delay the time before the blood is infected with the elements of fetal disintegration.
If the gestation period is more than 6 weeks, then in this case, the woman has every chance to earn a disseminated intravascular coagulation (DIC syndrome). Опасность заключается в том, что кровь теряет способность к свертыванию. В результате женщина может умереть от кровотечения.
Как предотвратить замирание плода при беременности
A couple, regardless of whether she is preparing to be parents for the first time or has children, should be examined. That he will be able to reduce the risks and give the answer, how to avoid a missed abortion in the early stages in their case. The doctor will offer several tests: hormones, genetic screening, pelvic ultrasound, blood for infections and other supplements that will be assigned based on the history of the parents. It is also recommended to refrain from conceiving for up to six months after diseases such as acute respiratory viral infection, influenza, rubella, chicken pox.
If the previous pregnancy ended in stopping the development of the embryo - do not give up! With proper planning, the chance to normally bear and give birth is 80% -90%. And how to prevent a missed abortion in the early period will tell the gynecologist involved in maintaining the pair.
Pregnancy after stopping the development of the fetus
Doctors predict good chances for conception only on the condition that the couple will not ignore the visits to specialized specialists, will undergo a course of treatment, and also give up the idea of a child for the next six months after a bad experience. On average, such a period is necessary not only for a detailed examination and finding out the cause of a fading pregnancy, but also for the physical recovery of the mother's body.
It is sad, but with 100% certainty, it is quite rare to say exactly about the reasons for the termination of pregnancy. However, parents do not need to despair! Try to avoid stress, harmful factors, and also do not forget to be examined - and let you have everything, and the baby will be born healthy and happy!
To make suspect the opposite can brown daub during pregnancy in the early stages. The uterus is trying to get rid of the frozen fetus.
Causes of curettage can also be directly abortion, missed abortion, the consequences of miscarriage (removal of residues of the placenta).
And it is quite difficult to calculate the missed abortion before 5 weeks. The heartbeat of the embryo is not fixed yet.