There are many pathologies that affect the female body during pregnancy. Among them, frozen pregnancy is quite common, when the development of the fetus stops and it dies. This condition can occur for many reasons and under the influence of various negative factors.

What is a frozen pregnancy

In the case of a non-developing or frozen pregnancy, the growth and development of the fetus suddenly stops, which leads to its death. This phenomenon is not accompanied by symptoms of spontaneous abortion, and the embryo does not leave the uterine cavity. This pathology is also known as missed miscarriage. Most often, pregnancy fading occurs in the first trimester. The periods of 3-4, 8-10 and 16-18 weeks are especially dangerous.

The occurrence of an unsuccessful miscarriage and other types of spontaneous termination of pregnancy belongs to the category of miscarriage. Such a condition is defined as habitual if pregnancy terminations occurred two or more times.

The occurrence and development of frozen pregnancy occurs in a certain order. First, the egg is fertilized, then it is transported to the uterus, implanted and developed over a period of time. Then, the development of the embryo suddenly stops. One of the reasons for this condition is considered to be an empty ovum, in which the development of membranes and the synthesis of human chorionic gonadotropin occur. In this case, there is a lack of embryo, although the pregnancy test gives positive results. Sometimes this syndrome occurs due to chromosomal pathologies.

The culprit of a frozen pregnancy is often not only the woman, but also the man. Therefore, both partners are recommended to undergo a full examination at the pregnancy planning stage and switch to a healthy lifestyle. According to medical statistics, this pathology occurs in 15-20% of cases of the total number of pregnancies.

Signs of a frozen pregnancy

The symptoms of this pathology are quite pronounced and make it easy to make an accurate diagnosis. First of all, there is a complete disappearance of signs of pregnancy. However, you should refrain from self-diagnosis and do not panic. If in doubt, you should immediately visit a gynecologist. In the early stages, pathology can only be determined by ultrasound examination.

In the early stages, the main signs of pathology are:

• Disappearance of toxicosis. If a woman has severe toxicosis, then its absence immediately becomes a cause for concern. After feeling unwell, suddenly everything returns to normal, although in terms of timing, this should not happen.
• The pain in the mammary glands goes away, the breasts become softer. As a rule, this condition occurs after the death of the fetus on days 3-5. Women immediately notice this discrepancy.
• The presence of bloody discharge is a clear sign of miscarriage. They appear approximately a few weeks after fetal death occurs. In some cases, slight brown discharge may appear, which then quickly disappears. Many women believe that the situation has returned to normal, but by this time the development of the fetus has already stopped.
• Symptoms of toxicosis may appear, manifested in the form of headache, fever, mild nausea and weakness. In some women, they are observed even after 3-4 weeks after the end of pregnancy. This is due to the release of embryonic decay products into the blood.
• The final diagnosis is established by a gynecologist after examination and identification of the absence of a heartbeat in the fetus, the inappropriate size of the uterus for a given period and a decrease in the level of hCG in the woman’s blood.

Causes of frozen pregnancy

Until now, gynecologists have not established exactly why fetal fading occurs in certain situations. In the first weeks, at a very early stage, the embryo stops developing and dies due to severe developmental defects incompatible with life. In 70% of cases of fading, the influence of genetic disorders is noted.

If the fetus dies after the 14th week, this may be the result of infectious and viral diseases suffered in the early stages of pregnancy. In some cases, fetal death occurs due to abdominal trauma received by the mother from a blow or fall. Situations arise when freezing occurs for no apparent reason, during a normally developing pregnancy. Sometimes this condition can occur several times in a row. In any case, you need to visit a gynecologist and find out the reasons for what happened.

In many cases, cessation of fetal development occurs under the influence of negative factors. First of all, this is smoking when planning pregnancy, alcohol and drugs used by a woman in the early stages of pregnancy. Infections such as herpes, rubella, cytomegalovirus and others, as well as sexually transmitted infections such as gonorrhea, syphilis or trichomoniasis, have a negative effect.

The development of pregnancy may stop due to serious diseases of the endocrine system, for example, the presence of diabetes mellitus in the mother. A negative role is played by the Rh conflict between mother and fetus, when pregnancy is perceived by the female body as a foreign condition that needs to be gotten rid of as soon as possible. In addition, risk factors include early heavy lifting, exposure to constant stress, numerous previous abortions, and congenital abnormal development of the uterus.

At what stage does a frozen pregnancy occur?

Pregnancy miscarriage most often occurs in the first trimester of pregnancy, but this phenomenon also occurs in later stages. This pathology can appear at any age, but, as a rule, it affects women over forty years of age. One of the forms of fading is considered to be anembryony, when after fertilization the embryo does not develop, although its amniotic membranes are formed.

The risk of miscarriage increases, and the fetus becomes most vulnerable at 3, 4, 8, 9, 11, 16 and 18 weeks of pregnancy. The period of the 8th week, during which vital organs are formed, is especially dangerous. Thus, the greatest danger is posed by the 1st trimester, up to the 8th week inclusive, during which 70% of undeveloped pregnancies remain. The timing of the appearance of a frozen pregnancy is closely related to the causes of its occurrence.

Diagnostics

The basis for the diagnosis of this pathology are certain deviations identified during examination by a gynecologist. As a rule, the size of the uterus remains unchanged and does not increase. There is a discrepancy between the level of beta-hCG and the specific stage of pregnancy. This figure does not double within 72 hours, which is also a noticeable deviation. The most accurate diagnosis is carried out using ultrasound.

Among the main criteria by which the diagnosis is established:

The last two symptoms are determined using transvaginal ultrasound. In addition, diagnostic measures involve conducting a genetic analysis of parents susceptible to recurrent miscarriage. Anticardiolipin antibodies, antilupus antibodies and anticoagulant to antibeta 2 and glycoprotein 1 are determined. The level of thyroid-stimulating hormone is checked, and ovarian reserve is established using measurements of the level of follicle-stimulating hormone carried out on the third day of the cycle.

Structural abnormalities of the uterus are diagnosed by performing hysterosalpingography or sonohysterography. There are other methods that can complement the picture and establish a final diagnosis.

Pregnancy after a frozen pregnancy

After a woman has suffered fetal loss, subsequent attempts to become pregnant are fraught with certain difficulties. Before planning a new pregnancy, it is necessary to wait a period, usually at least a year. The fact is that when removing a dead fetus, scraping was performed, which disrupted the normal state of the tissues. Therefore, a gynecologist can give permission for a new pregnancy only after an examination, during which the condition of the uterine cavity and cervix and the degree of their recovery after the intervention are assessed. A new pregnancy must be planned and prepared to avoid relapse.

Planned activities include histological examination of the fetus and chromosome analysis, gynecological ultrasound and blood tests. Quite often, miscarriage of pregnancy occurs due to sexually transmitted infections, so a course of antibacterial therapy may be prescribed before conception. If sexually transmitted diseases are detected, the partner also undergoes treatment.

If two fetal deaths occur, the subsequent pregnancy should be planned with special care. In this case, the list of studies and analyzes expands significantly. First of all, a general blood test and a clinical urine test are taken. Hormonal and immunological studies are carried out. Antibodies against protozoa and viruses are determined, and bacteriological culture is prescribed. Diagnosis of sexually transmitted infections and blood clotting characteristics are performed. Both partners are recommended to take vitamin complexes and medications containing folic acid. This remedy prevents the occurrence of intrauterine pathologies that negatively affect the viability of the fetus.

What to do during a frozen pregnancy

As a rule, a frozen pregnancy ends in spontaneous miscarriage, which occurs within 14 days after the cessation of fetal development. The reason is a reduced level of placental hormones. But, if the fetus continues to remain in the womb, it is necessary to urgently terminate the pregnancy by medical means. Otherwise, tissue necrosis occurs, the products of which cause inflammation and subsequent intoxication of the body.

The drug method is used in early pregnancy, up to 8 weeks. For this purpose, progesterone antagonist tablets are prescribed. In addition, vaginal administration of a prostaglandin E1 analogue is carried out. After some time, the effect of these drugs leads to miscarriage.

At a later stage, pregnancy is terminated surgically, by curettage of the uterine cavity. This operation is performed under general anesthesia. In the case of a negative Rh factor, the woman is prescribed anti-Rhesus immunoglobulin after the procedure. Tissues obtained from curettage are sent for histological examination. In some cases, antibiotics and drugs to contract the uterus are prescribed. After 1-2 weeks, the condition of the uterus is assessed using ultrasound control.

Consequences

Every woman after an interrupted pregnancy thinks about the possible consequences, difficulties and problems. Most of them believe that this unsuccessful attempt will negatively affect their ability to become pregnant again. According to experts, fetal freezing very rarely leads to. These cases are considered isolated, due to untimely and improper treatment.

However, pathology has a negative impact on women’s health, primarily on their mental and emotional state. In addition, the physical condition is also impaired in a certain way. All consequences largely depend on how the frozen pregnancy was terminated.

Often the pathological condition is eliminated without cleaning. The main condition for this is timely initiation of treatment, depending on the stage of pregnancy. At the earliest stage, observation is carried out in a standby mode. In this case, the body itself must cope with the frozen fetus and bring it out. This path is considered the easiest for a woman.

If the period is long enough, but does not exceed 8 weeks, the practice is to remove the embryo using a special medication. Such a decision can lead to severe hormonal imbalances and menstrual irregularities. This is due to a sharp drop in hormone levels during pregnancy termination. There are other side effects, so medical abortions are not recommended for all women.

Timely medical care is of great importance. The presence of dead tissue in the uterine cavity can lead to numerous complications and severe intoxication of the body. Uterine bleeding may occur, infectious inflammation and sepsis develop, and reproductive functions are disrupted.

The consequences of scraping are much more serious and dangerous. The membranes may not be completely removed from the uterine cavity. The operation often causes bleeding. As a result of infection, inflammatory processes develop. Taking antibiotics prescribed after curettage leads to disruption of the intestinal microflora. Scars form on the surface of the uterus, which may make it difficult for the fertilized egg to attach in the future.

Treatment

With the final diagnosis of fetal freezing, it is necessary to get rid of the pregnancy as soon as possible. As already noted, in the early stages, termination of a frozen pregnancy occurs through medical abortion using special drugs. The release of the uterus from a dead embryo occurs in the same way as during a normal pregnancy. After about two weeks, a control ultrasound is performed to determine the condition of the uterus and the possible presence of remnants of the fertilized egg. In addition to the main treatment, antibacterial therapy is often prescribed.

In later stages, the frozen fetus is removed by scraping. During the operation, local anesthesia or general anesthesia is used. In the postoperative period, mandatory antibiotic therapy is carried out. After the operation, bloody discharge is observed, which continues for several days.

After the uterus is freed from the remnants of the endometrium, its mucous membrane is gradually restored. If there is heavy bleeding, consult a doctor immediately. After discharge from the hospital, it takes several days to regain good health. Treatment after curettage is carried out on an individual basis. At the same time, an examination is carried out to identify the causes of the pathology. If the examination revealed a disease that caused the death of the fetus, it must be treated.

How to avoid miscarriage in the future

Every woman who has suffered this pathology thinks about how to avoid this in the future. When diagnosed with a frozen pregnancy, doctors recommend undergoing an examination on an individual basis, even at the stage of planning a new conception. In this case, the personal characteristics of the female body and medical history must be taken into account.

Conducting a comprehensive examination reduces the risk of recurrence of the pathology and increases the chances of happy motherhood.

In obstetric practice, the problem of miscarriage (fading) of pregnancy is relevant for the reason that the number of cases of this pathology increases every year. Depending on the etiology and pathogenesis of the complication, various procedures are performed.

A stop in the development of the embryo occurs at different stages of gestation:

• 70% of freezing is recorded during early embryogenesis (up to 12 weeks);
• the remaining 30% of cases are diagnosed in the late stages (12-26 weeks).

Common infectious diseases of the mother (rubella, malaria, toxoplasmosis, influenza) are a provoking risk factor for fading at any stage. The percentage of intrauterine fetal mortality is 95%.

Dangerous terms

Embryogenesis, or the period of embryonic development of the fetus in the uterine cavity, at different stages is associated with the peculiarities of the development of one or another system of the child.

By concentrating energy on the process of pregnancy, the body weakens the protective functions of the uterus. At such moments there is the greatest risk of freezing.

Dangerous periods for fetal development by week:

• 7-12;
• 16-19;
• 24-26.

At this time, especially important functions and systems of the baby’s growing body are laid down and developed. If negative factors interfere with the process, then development becomes impossible and the fetus freezes.

You should not be afraid of these periods, but be more attentive to your health.

Signs in the early stages

Diagnosis of non-developing gestation in the early stages is difficult. This is due to the following factors:

• the woman does not know about her situation;
• no obvious clinic;
• no complaints.

Early stages - the period of embryo development up to 10 weeks according to obstetric calculations. If you have an irregular menstrual cycle, it is impossible to determine early fertilization.

Risk of miscarriage by week

Functional diagnosis of pathology in cases of suspected abnormal development of the process begins at the time of planning.

It is important to establish, exclude or confirm all existing risks of developing pathologies, chromosomal abnormalities and genetic damage. If these factors are not identified in time, there is a risk of fetal death.

Diagnosis of pregnancy pathologies was not carried out until the 19th century. Women who suffered complications during pregnancy died during pregnancy or childbirth in 85% of cases. Today, diagnostics make it possible to identify disorders even in the early stages.

Symptoms by week

Symptoms of abnormal fetal development differ in intensity, nature and timing. In the later weeks, the following manifestations are pronounced:

• opening of the cervix;
• bleeding in any amount;
• soreness;
• cramping pain;
• outpouring of water

In the early stages, symptoms are less pronounced and manifest themselves as a decrease in symptoms:

• absence of vomiting, nausea, heartburn;
• reduction of breast pain and swelling.

Until what week can it freeze?

Fading is the cessation of fetal development at various stages of its formation. However, for such a manifestation, a period of up to 26 weeks is considered typical.

Cases of fetal death after this time are associated with the formation of a blood clot in the umbilical cord or exposure to infections.

In case of a frozen pregnancy of more than 18 weeks, obstetricians recommend induction of labor to avoid complications.

Statistics by week

Statistical data differ depending on the specific region and the material security of the population. Thus, cases of late frozen pregnancy in third world countries are 12-18% higher than in developing and developed countries. According to statistics from the World Health Organization in Russia and the countries of central and western Europe:

• 70% of pathologies occur in the first trimester;
• 25% in the second;
• 5% in the third.

Freezing in the first trimester

Determining frozen pathological development of the fetus in the first two to three months is difficult due to its size.

Diagnostics and specialized tests help to identify a complication in a timely manner only if a study and a comprehensive study of clinical indications in the anamnesis are carried out.

3-5 weeks

The third to fifth obstetric week is a delay of 5-10 days. It is possible to detect pregnancy at this stage only if the woman was planning to conceive. Otherwise, development stops, usually accompanied by vaginal discharge, and the woman thinks about a late menstrual cycle.

6-7 weeks

With a delay of a month, a woman can independently determine the pathological development and course of a previously established pregnancy:

• there is a brown or red discharge;
• there is no chest pain;
• nausea and heartburn are not recorded.
• As a rule, there are no pain or spasmodic manifestations.

8-9 weeks

In addition to the reduction in nausea and pain that was recorded earlier, nagging pain in the lower back, lower back, and abdomen is added.

Basal temperature is also normal, as before fertilization. However, this indicator can only be said if the woman kept a monitoring diary.

10-12 weeks

The third month is the result of the chromosomal consistency of the fetus. Normally, complications do not occur. If there are abnormalities or an incomplete chromosome set, formation stops, which is accompanied by painful bleeding, swelling of the lower extremities, fatigue due to hormonal imbalance.

The first trimester is a dangerous period if there is a bad heredity of miscarriage in the family. If the embryo develops abnormally again, the woman is included in the high-risk group.

Frozen pregnancy in the second trimester

A woman's body usually recognizes fetal chromosomal abnormalities before the start of the second trimester.

In this case, a natural voluntary abortion occurs. When the fetus freezes in the second trimester, doctors consider:

• risk factors that led to late anomaly;
• reasons why the body did not recognize the anomaly in the first trimester.

Abnormalities of the uterus that could provoke freezing are difficult to diagnose during pregnancy. 4-11% of cases remain without identified pathogenesis.

Frozen pregnancy at 13-14 weeks

At the beginning of the second trimester, when gestation fading, the following symptoms are observed:

• bloody issues;
• uterine spasms;
• lower back pain;
• fatigue;
• decreased appetite.

At 15-16 weeks

The formation of the fetal circulatory system leads to the fact that the blood supply to the uterus also increases.

When the fetus freezes at this stage, bloody discharge is observed, which is accompanied by painful sensations, with changes in the hormonal levels of the mother. Palpation of the abdomen also causes pain and the temperature rises.

At 17-19 weeks

Lack of progesterone in the mother provokes insufficient nutrition of the fetus inside the uterus. During this period, the pregnant woman feels the movements of the fetus; with abnormal development, the tremors stop.

If the placenta is attached to the front of the uterus, a woman may not feel kicks even with repeat pregnancies until the 21st week. There is no need to worry prematurely; you need to go to the hospital, and if you suspect a frozen pregnancy, it is better to be hospitalized and conduct cardiac monitoring.

Frozen pregnancy at 20-23 weeks

At the end of the second and beginning of the third trimester, an alarming symptom is the absence of fetal movements for more than two days. Pain and discharge are usually absent. The fetus is rejected due to intoxication of the mother's body. This condition is deadly.

Gestation period after frozen pregnancy

A frozen pregnancy is stressful for a woman. But even after such a tragedy, many people do not lose their desire to become a mother, and therefore the question arises about the possibility of such an event in the future.

Obstetricians recommend starting to plan a new pregnancy no earlier than in a year, but if an artificial birth was carried out, the period can be reduced to six months. In this case, an important condition remains to undergo a full examination of the body and find out the causes of freezing.

Abroad, people are starting to be examined for recurrent miscarriage syndrome after the 3rd miscarriage. At the same time, the probability of carrying a fourth pregnancy after 3 miscarriages in a healthy woman is 75%. In Russia, the diagnosis of “habitual miscarriage” is made after 2 unsuccessful outcomes. What are the reasons for the fading of pregnancies? At what time is pregnancy miscarriage most likely? What to do if trouble does happen?

What is a frozen pregnancy

When the fetus for some reason stops developing and dies. Most often this happens in the first trimester of pregnancy, but it also happens in the second and even third.

Frozen pregnancy is one of the types of miscarriage. The beginning of such a pregnancy proceeds the same as in a normal one: the fertilized egg reaches the uterus and is implanted in it. In this case, the woman has all the characteristic signs of pregnancy: menstruation stops, breast engorgement occurs, and the uterus increases in size. The moment of cessation of fetal development often goes unnoticed by the pregnant woman, especially in the early stages.

As a variant of a frozen pregnancy, a case can be presented in which after fertilization and implantation there is no development of the embryo at all, only extra-embryonic organs (fetal membranes) are formed. This condition is called “empty sac”.

The timing at which fetal development most often stops

Doctors calculated the periods at which the embryo is most vulnerable: 3-4 weeks, 8-11 weeks and 16-18 weeks of pregnancy. The 8th week of pregnancy is especially critical. It is at this time that the likelihood of miscarriage and frozen pregnancy is high. This is the time of laying the vital organs of the future baby and changes in the mother’s body.

Causes of frozen pregnancy

Genetic disorders- the most common cause of frozen pregnancy. Up to 70% of non-developing pregnancies before the 8th week of pregnancy are caused by chromosomal abnormalities in the fetus. Genetic abnormalities of the fetus manifest themselves quite early, many of them are incompatible with life. Genetic “breakdowns” are inherited by the embryo from both the mother and the father, or arise from an unsuccessful combination of parental genes. It is believed that if the second, third or more pregnancies in a row fail, genetics is to blame. However, doctors find it difficult to say with accuracy.

Hormonal disorders- common. One of the hormonal causes of missed abortion and spontaneous abortion is a lack of progesterone, without which the embryo cannot “settle” firmly in the uterus. The second is hyperandrogenism. In approximately 20% of women during pregnancy, the level of male sex hormones - androgens - increases - this is the second possible reason for the fading of pregnancy.

These disorders can be predicted by analyzing hormonal status even before pregnancy and treatment can be started in advance. At the very least, it is recommended to take a hormone test at your first visit to the gynecologist about pregnancy.

Up to 30% of missed pregnancies are due to infections. Pregnancy is a state of immunosuppression. Otherwise, how could the mother’s body come to terms with the appearance of a “stranger” on its territory, half of whose genetic information is completely different? The child is reliably protected from the attack of antibodies by the placenta and fetal membranes, but the mother turns out to be vulnerable to various infections. Everything gets worse in pregnant women infectious diseases. The “local” harmless flora, having gained freedom, multiplies beyond measure, causing a lot of problems. The vaginal flora is activated, and there is a danger of intrauterine infection of the fetus.

Irreversible changes and multiple malformations are caused by cytomegalovirus (CMV) and rubella virus. However, infection with them is dangerous only during pregnancy; an “old” infection, on the contrary, creates a stimulus for the production of IgG antibodies and prevents the exacerbation of the disease. Another danger is the flu epidemic. In pregnant women, a common ARVI is difficult because the immune system is working at half capacity. Moreover, the danger comes not so much from the pathogen itself, but from general symptoms: intoxication, increased temperature, which leads to disturbances in blood flow in the “mother-placenta-fetus” system. The embryo lacks oxygen and nutrients and may die.

At IVF pregnancy freezes more often. Unfortunately, according to statistics, a pregnancy that occurs after IVF is more likely to end in a frozen pregnancy or spontaneously terminate than a pregnancy after natural conception.

Wrong lifestyle can also cause a missed abortion. A frozen pregnancy often comes from stress and overexertion. The baby is unlikely to like it if the mother spends a full working day in a stuffy room, staring at the computer, and gets up from her chair only to drink a couple of cups of coffee and brew Doshirak for lunch. Such conditions can contribute to various complications, for example, early placental abruption, and lead the uterus to a state of increased tone. Both interfere with blood flow, and the unborn child receives little oxygen and nutrients.

In the vast majority of cases, a frozen pregnancy is the result of an unfortunate combination of circumstances, a poor combination of random and completely correctable factors. The six-month interval required to restore the endometrium and hormonal status for the next pregnancy will allow all necessary medical measures to be carried out and give the body a break.

Signs of a frozen (non-developing) pregnancy

Most often, it is not possible to suspect a frozen pregnancy on your own. The initial symptoms may be the cessation of pre-existing pregnancy symptoms (nausea, vomiting in the morning, tension in the mammary glands). But these are far from accurate criteria for diagnosis. More alarming is the appearance of bloody discharge, which also does not allow a diagnosis. A doctor's examination and additional examination (ultrasound, blood test for hCG) are necessary.

Most often, a non-developing pregnancy ends in spontaneous miscarriage - the uterus contracts, bleeding begins (the fertilized egg exfoliates) and the trophoblast or placenta is expelled from the uterine cavity. For several days, spotting and spotting from the uterus continues, then stops completely. However, in some cases, a miscarriage does not occur, then the tactics for further action are developed individually in consultation with a gynecologist.

Basal temperature during frozen pregnancy

During a frozen pregnancy in the first trimester, the basal temperature most often decreases, but not always. The temperature can remain above 37 degrees even when pregnancy is fading! If you suspect a frozen pregnancy, it is advisable to perform an ultrasound.

Diagnosis of non-developing, frozen pregnancy

During a gynecological examination:

• discrepancy between the size of the uterus and the gestational age (the uterus is smaller than the expected gestational age);

During an ultrasound examination of the pelvis:

• lack of fetal heartbeat;
• anembryony (empty fertilized egg, without embryo);

For hormonal blood tests:

• stopping the progressive increase in the numbers of the pregnancy hormone, hCG (choriogonic gonadotropin), characteristic of normal pregnancy.

Management tactics when a non-developing pregnancy is detected can be different and depend on each specific case:

1. Expectant. After some time, due to the death of the fertilized egg, the level of placental hormones decreases and spontaneous miscarriage occurs.

2. Medication interruption: If the pregnancy is less than 8 weeks, it is possible to use a progesterone antagonist drug (mifepristone), which is taken in tablet form, in combination with a prostaglandin E1 analogue (misoprostol), which is administered vaginally; after some time, under the influence of the drugs, a miscarriage occurs.

3. Surgical treatment: Curettage (curettage) of the uterine cavity.

The duration of the procedure depends on the individual characteristics of each woman. The need for further hospital stay depends on the course of the postoperative period, the presence of any infection and many other reasons. But, as a rule, treatment after such an operation continues in a hospital setting. In terms of technique, this operation is similar to an abortion and is performed under anesthesia. After the uterus has emptied, depending on the situation, uterine contractions and antibiotic therapy may be prescribed. After 1-2 weeks, it is necessary to undergo an ultrasound examination of the uterus to assess the condition of the uterine cavity (whether there are any remnants of the fertilized egg) and how well the uterus has contracted.

Pregnancy after a “frozen pregnancy”

The prognosis after a non-developing pregnancy is generally favorable. Most women do not have problems with the onset and carrying of subsequent pregnancies. Approximately 80-90% of patients who have had a single frozen pregnancy in the past successfully carry and give birth to healthy children. If pregnancy losses have occurred repeatedly (2 or more times) and we are talking about recurrent miscarriage, the prognosis is worse, and the couple requires a more in-depth examination.

• Ultrasound examination (ultrasound) of the pelvic organs
• Examination for urogenital infections (cervical smears using PCR diagnostics)
• Determination of homocysteine ​​level in blood
• Determination of the level of autoantibodies in the blood
• Determination of the titer of antibodies to rubella in the blood

Study of the level of thyroid hormones in the blood. However, an individual examination plan is developed only after consultation with a gynecologist and can be expanded, taking into account individual characteristics.

Who is at risk for repeated non-developmental pregnancy?

The risk group for repeated non-developing pregnancies primarily includes women who have had abortions. Moreover, the greater the number of abortions, the greater the likelihood of encountering a similar problem.

In addition, it includes women who have had an ectopic pregnancy, as well as those whose pregnancy “froze” at the very last moment, and a non-viable child was born. This group includes all those suffering from infectious and viral diseases of the reproductive system.

Often, a woman's age is also a risk factor for miscarriage. This is why it is advisable to have your first child before the age of 30. Also, some anatomical features of the female reproductive system can become an obstacle to pregnancy. These include the bicornuate and saddle uterus. These are congenital developmental disorders of this organ, in which its shape is so altered that it interferes with the normal development of pregnancy and pregnancy falters. Such disorders include adhesions inside the uterine cavity, formed after inflammation, and a congenital septum, which seems to separate it from the inside.

Uterine fibroids can also interfere with the normal development of pregnancy. It deforms the uterine cavity and prevents the proper attachment of the fertilized egg.

Risk factors for the recurrence of a non-developing pregnancy include endocrine disorders: diabetes mellitus, diseases of the thyroid gland, especially a decrease in its function, menstrual irregularities, failure of the production of progesterone, the hormone responsible for the normal development of pregnancy.

The fetus froze - these are perhaps one of the most terrible words from a doctor for a couple dreaming of children. You can hear them for various reasons at the very beginning of the development of a new life (the most dangerous are considered to be from 3 to 4, from 8 to 11 and from 16 to 18 weeks from conception). Sometimes the diagnosis is made at a later date, but the likelihood of hearing it is significantly lower. An analogue is the development of an empty fertilized egg: in this case, fertilization has occurred, but the embryo does not develop. The pathology occurs spontaneously, maybe several times in a row throughout a woman’s life. Unfortunately, no one is safe from it. However, it is better to know the causes and signs of frozen pregnancy in the early stages in order to take timely measures and consult a doctor, as well as prevent the development of pathology before conception. Anything can influence the development of a little life. And the worst thing about this is that it is not so easy to notice changes.

Read in this article

Reasons why pregnancy does not develop

Why does frozen pregnancy occur in the early stages? This question worries and frightens young mothers. There are actually quite a lot of reasons:

• Genetic deviations occupy a leading place. They are detected in 70% of cases for up to 8 weeks. They are associated with many factors, including hereditary diseases, as well as the result of drug use by one of the partners. That is why it is important not to refuse screenings and other examinations suggested by a geneticist and gynecologist.

• Excessive consumption can also cause developmental arrest. It is especially dangerous if the mother cannot give up bad habits after conception.
• Medicines can also provoke the development of abnormalities. That is why doctors themselves strongly recommend that you stop taking any medications. The only exceptions can be severe diseases, the treatment of which with folk remedies is simply impossible. It is worth noting that for up to 10 days and after 8-10 weeks, when the fetus becomes 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 reasons for frozen pregnancy in the early stages may lie in both the mother and the child. If a woman has had abortions before, then the chances of a happy development are not so great. Antibodies produced by the mother's body towards the baby accumulate over time. And after several abortions, it is very difficult for a conceived baby to resist such an attack.
• Infections, both genital organs and viral (flu), are a serious threat at the very beginning of life. The mother's body is already weakened by the new position, so it is not at all difficult to get sick. But the consequences of a high temperature or a viral attack can be very serious. Rubella is a formidable enemy, in the event of which the pregnancy not only stops, but the fetus may develop severe anomalies. And 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 reasons for which lie precisely in this factor, can freeze due to both a lack of prolactin and an excess of testosterone. If a woman has regular irregularities in her menstrual cycle, then it is imperative that she be examined during planning, as well as regularly check her hormone status after conception.
• Harmful factors at work, diabetes mellitus, heavy lifting, stress - all these factors can also cause the development of pathology.

Women who are at higher risk of developing pathology

But this is not the only answer to the question of why pregnancy falters in the early stages. Doctors identify a certain risk group, which includes:

• old-time mothers or expectant mothers over 35 years of age;
• if you have had multiple abortions in the past;
• if your previous pregnancy was ectopic;
• in the presence of a congenital anomaly of the uterus.

If one or all factors are present, the woman will be under constant medical supervision.

Expectant mothers who do not want to visit a gynecologist in the early stages are also at risk. There may be many reasons for such a decision, but the result will be a serious threat to the health of not only the woman, but also the child.

What signs indicate a frozen pregnancy?

The saddest thing is that the symptoms of a frozen pregnancy in the early stages are not clearly expressed. Therefore, the expectant mother may not even be aware of the change in the condition of the fetus. Only a qualified doctor, after examining and ordering additional examinations, can determine the absence of embryo development.

You shouldn’t look for symptoms of an undeveloped pregnancy in the early stages, and even less so, ask for advice from friends or on forums. In each case, everything is purely individual and depends on many factors.

Symptoms of an approaching disaster

At later stages, it is easier for a woman to navigate, because she can already feel the baby moving. This is very difficult to do in the early stages. A frozen pregnancy, the symptoms of which in the first trimester may be similar to less serious abnormalities, manifests itself as follows:

• passes ;
• no more ;
• reduced;
• cramping pain began to appear;
• spotting appeared (discharge during a frozen pregnancy in the early stages has exactly the same consistency and red-brown color);
• general body temperature increased.

If any of the listed symptoms are detected, a woman should urgently consult a doctor! If the signs of pregnancy disappear, this should also alert the mother and become a reason to visit a specialist!

How does a pregnant woman feel when pathology develops?

Women experience very different sensations during a frozen pregnancy. They are even influenced by the fact whether this is the first time this has happened or whether a similar situation has happened before. Fatigue, apathy, fever - all this in any case should alert the expectant mother.

It is worth noting that all symptoms that indicate the development of pathology may turn out to be false! There is no need to immediately prepare yourself for the approaching disaster. Quite often they turn out to be similar to less serious ones, or the body is simply undergoing a reconfiguration.

Diagnosis of the fact of fetal freezing

Only a doctor knows exactly how to recognize a frozen pregnancy in the early stages. To do this he will do the following:

1. , will assess the condition of the mucus secreted, and will ask you to measure your basal temperature.
2. If there is any suspicion of a deviation from the norm, the doctor will send the pregnant woman for a test. However, it is worth noting that hCG during a frozen pregnancy in the early stages can be completely within normal limits for several weeks after the death of the fetus. And yet, more often than not, a urine test will show a low level of the hormone, which is not typical for the first trimester.
3. The last stage of examination will be an ultrasound. With the help of an ultrasound examination, it will become clear whether the embryo’s heart is beating or not.

Typically, a test for a frozen pregnancy in the early stages may show the same two lines. This is again related to the level of hCG in the urine.

After the specialist confirms the diagnosis, he will select the necessary set of procedures for the mother, and will also further help her prepare for a new pregnancy.

What do doctors do if the fetus is frozen?

Depending on how a frozen pregnancy manifests itself in the early stages, as well as directly on the number of days from the moment of conception, the doctor will choose the most alternative method of treatment. After all, when establishing such a diagnosis, we are talking about preserving the life and health of the mother. There are two main treatment methods:

• With the help of medications that provoke. Can be used for up to 8 weeks.
• (vacuum aspiration). Under anesthesia, the woman's uterine cavity is cleaned using vacuum suction.

In any case, professional help will definitely be required, since in order to avoid adverse consequences, it is necessary to clean the uterine cavity (remnants of the amniotic sac, which will be 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 as a foreign body. In this case, the woman will simply notice a delay in her periods. Sometimes doctors prefer to observe the patient’s condition, waiting for a spontaneous abortion, so as not to interfere with the body again.

Why is it so scary not to see a doctor on time?

Sometimes a woman does not fully realize how severe the consequences of a missed early pregnancy can be for her. But the body does not always reject the fetus itself. If an embryo that has stopped developing remains in the womb for a long time, then intoxication is likely to develop. In this case, not only does the temperature rise, the woman begins to suffer from acute pain and weakness, and it is quite possible to delay the time until the blood becomes infected with elements of fetal decay.

If the pregnancy is more than 6 weeks, then in this case the woman has every chance of developing disseminated intravascular coagulation (DIC syndrome). The danger is that the blood loses its ability to clot. As a result, the woman may die from bleeding.

How to prevent fetal death during pregnancy

The couple, regardless of whether they are preparing to become parents for the first time or have children, must undergo an examination. It is he who will be able to reduce the risks and give an answer on how to avoid a frozen pregnancy in the early stages in their case. The doctor will suggest taking several tests: hormones, genetic examinations, ultrasound of the pelvic organs, blood for infections and other additional ones, which will be prescribed taking into account the parents’ medical history. It is also recommended to refrain from conceiving for up to six months after diseases such as acute respiratory viral infections, influenza, and chicken pox.

If a woman works in a children's team, she will be offered preventive vaccinations. Additional hormonal levels will need to be adjusted. Don't ignore visiting a geneticist. A healthy lifestyle will only increase your chances of becoming parents. In the first months, it is recommended to refrain from flying, sudden climate changes and prolonged exposure to the sun.

If your previous pregnancy ended in stopping the development of the embryo, don’t give up! With proper planning, the chance of a normal pregnancy and birth is 80%-90%. A gynecologist who cares for a couple will tell you how to prevent a frozen pregnancy in the early stages.

Pregnancy after fetal growth arrest

Doctors predict good chances of conceiving only if the couple does not ignore visiting specialized specialists, undergoes a course of treatment, and also gives up the idea of ​​having a child for the next six months after an unsuccessful experience. On average, this period is necessary not only for a detailed examination and finding out the reason for the fading of pregnancy, but also for the physical restoration of the mother’s body.

As sad as it may be, it is quite rare to say with 100% certainty about the reasons for pregnancy termination. However, parents do not need to despair! Try to avoid stress, harmful factors, and don’t forget to get examined - and may everything work out for you and the baby will be born healthy and happy!

Non-developing pregnancy(intrauterine fetal death, frozen pregnancy) - the death of an embryo or fetus without obvious signs of termination of pregnancy. Unfortunately, this can happen to every woman and at any stage of gestation, but this does not mean that subsequent pregnancies will have complications (unless this is a repeated case).

information Fading of pregnancy in the early stages of development occurs most often. The critical time frame for a non-developing pregnancy (NP) is most often before 8 weeks of gestation. It is at this time that all organs and tissues are formed, so any pathological factor can disrupt the development of the fetus and lead to its death.

The consequences of NB in ​​the early stages both for the woman’s body and for her psychological state are less than if it happened during the period when the mother already felt movement. In any case, you should not dwell on what happened and be afraid of a subsequent pregnancy. Try to treat this as natural selection of nature.

Causes

Unfortunately, even modern medicine is not always able to answer why a child died in utero. There are many reasons, but it is not always possible to get to the truth. Moreover, in the early stages the law applies: “all or nothing.” This means that under the influence of unfavorable factors, the embryo either tolerates them and develops further correctly, or dies.

• Genetic factor

Most often, a frozen pregnancy in the early stages occurs due to a genetic breakdown of the embryo itself, which occurred at one or another stage of its development. The fetus is simply not viable, so it is rejected. This is a kind of natural selection.

• Infectious factor

Another common cause of NB is infection. Most often this is the herpes simplex virus and various respiratory diseases, sexually transmitted infections (chlamydia, mycoplasma, gonococci) and others. When these pathogens act in the early stages of development, cell division may be disrupted and the genetic material of the embryo may be damaged, which will cause its death.

• Immune factor

Immunological disease of the mother (antiphospholipid syndrome, systemic lupus erythematosus and others), immunological incompatibility of spouses can also cause fetal death, and more often this occurs before 12 weeks of pregnancy.

• Endocrinological factor

Insufficient synthesis of progesterone (the hormone that maintains pregnancy), thyroid disease, excessive synthesis of male sex hormones and prolactin can interfere with the normal development of the fetus.

• Other factors

We should not forget about the lifestyle of future parents. Bad habits, contact with chemicals, living in an area of ​​high radiation, stress can affect the favorable course of pregnancy, especially in the very early stages.

Symptoms

important The main signs of miscarriage at different stages are pain in the lower abdomen. The difficulty with NB is that all these symptoms do not bother the woman. She may not know for several weeks that fetal death has occurred.

The main signs of frozen pregnancy in the early stages are a decrease in subjective sensations, characteristic of many women in the following position:

• engorgement of the mammary glands;
• sensitivity to odors;
• unusual food preferences;
• nausea, vomiting;
• drowsiness.

Of course, not every pregnant woman will treat such symptoms with caution, and often these signs disappear with the progression of pregnancy (gestation). This is why fetal freezing is often not diagnosed immediately, but after several weeks. Often spotting from the genital tract may occur, which indicates the onset of pregnancy rejection.

Ultrasound signs of frozen pregnancy

The main ultrasound signs of arrested embryo development at the earliest stage are deformation of the fertilized egg, uneven contours, and its location in the lower part of the uterus. It is characterized by a discrepancy between the gestational age according to ultrasound and menstruation, and the absence of a fetal heartbeat (usually from 5-6 weeks it can already be determined).

additionally However, the embryonic and menstrual periods of pregnancy do not always coincide. This can happen for various reasons (irregular periods, hormonal disorders, stress, ovarian cysts and others), and the difference can be up to four weeks.

Therefore, in some cases (for example, the monthly gestation period is 7-8 weeks, and ultrasound shows only the ovum characteristic of 4 weeks), in order not to make a mistake with the diagnosis, it is worth repeating the study after 5-7 days. If during this time the fertilized egg does not grow and the embryo is not visualized, then fetal death occurs.

Signs of NB during gynecological examination

During a gynecological examination, the doctor assesses the size of the uterus, its correspondence to the expected period of pregnancy, and the condition of the cervix. If the size of the uterus is assessed as smaller, it is necessary to perform an ultrasound examination to confirm or refute suspicions. Some women have physiological characteristics (initially smaller size of the internal genital organs) or there may be a difference in the timing of menstruation and the embryo, so it is important to make sure that the delay in uterine enlargement is actually caused by fading pregnancy.

Determination of human chorionic gonadotropin (hCG)

Determining the concentration of human chorionic gonadotropin helps in making a diagnosis, especially in the earliest stages. So, when it is still impossible to see the fetal heartbeat using ultrasound, but there are doubts about its viability, you can donate blood to check the hCG level. It is important to observe the dynamics here, since with a normally developing embryo, the level of the hormone almost doubles every day.

Measuring basal temperature for suspected NB

It should be said right away that this method is only additional and indicative, since it is imprecise and its results can change under the influence of many factors. Basal temperature is measured in the rectum, without getting out of bed, at the same time after a night's sleep. Under the influence of the hormone progesterone (maintains pregnancy), this temperature rises by 0.3-0.5 degrees Celsius and is 37.2-37.5. When the embryo freezes, the level of progesterone decreases, and as a result, the basal temperature decreases.

Treatment

If intrauterine fetal death is confirmed, the woman must be hospitalized in a gynecological hospital. In the early stages, the main method of treating a non-developing pregnancy is the immediate removal of the embryo or fetus and its membranes. If the pregnancy period allows, it is better to do this by vacuum aspiration. This method is more gentle. At later stages, curettage of the uterine cavity is performed (similar to an abortion). Before surgery, it is worth preparing the cervix, especially in nulliparous women. For this, kelp (algae sticks) and catheters are used. This is done to gently and gradually dilate the cervix. Vacuum aspiration of the fetal egg and curettage of the uterine cavity is carried out under general anesthesia.

Also, expectant management and medical abortion are being used more and more often in short term periods. These methods will allow the pregnancy to be terminated more carefully (but always under the supervision of doctors).

Rehabilitation

important It is very important to rehabilitate a woman after a non-developing pregnancy. It includes taking oral contraceptives (for at least 3 months), treating genital diseases (infections) and hormonal disorders.

Also, do not forget about the psychological aspect. It’s good to change the environment and get positive emotions. Try to avoid conflicts. It is important to feel support from others.

Consequences

The consequences for a woman’s reproductive health are reduced to zero if the embryo and its membranes are carefully removed and rehabilitation is carried out.

Prognosis for the next pregnancy

In 90% of cases, women who have suffered early fetal death are able to become pregnant and bear a healthy child. However, if a non-developing pregnancy recurs, it is necessary to undergo a full examination to identify the cause, since disturbances can be at the hormonal and immune levels.

You should plan your pregnancy no earlier than 6 months later. During this time, the body will be able to recover to become capable of bearing a healthy child. It is very important during this period to undergo examination and preparation for a subsequent pregnancy.

The main thing is to believe in the good and not let your fears prevent you from becoming happy parents.