If the fetus froze what signs will there be. Frozen (non-developing) pregnancy in the early stages: symptoms, causes. Frozen pregnancy: what then

Didn't even hear. And not because it didn't exist. Just earlier, any arbitrary termination of pregnancy, regardless of the causes, was called a miscarriage. Today, thanks to technological progress, with the help of ultrasound and other examinations, doctors can make a diagnosis that no one even suspected a few decades ago. Frozen pregnancy - the same case.

According to some reports, in our time, about 40% of pregnant women make such a diagnosis. Their pregnancy ends already, which provokes just a frozen pregnancy. It occurs when the fetus stops developing. The reasons for this phenomenon can be different - ranging from the bad habits of future parents and ending with chromosomal abnormalities in the fetus. Most often, a frozen pregnancy is caused by various infections that a pregnant woman accidentally picked up (rubella, chickenpox) and hormonal disorders in the body.

Well, if a frozen pregnancy ends in itself with a miscarriage. This usually happens very early in pregnancy. Otherwise, the consequences for a woman can be extremely unpleasant. After all, the frozen fetus begins to collapse, causing inflammation in the uterine cavity. Therefore, when a missed pregnancy is diagnosed, a medical termination of pregnancy is clearly indicated by scraping the uterine cavity or taking drugs, after which a miscarriage occurs (if the gestational age does not exceed 8 weeks).

To avoid unpleasant consequences, it is important to identify the symptoms of a missed pregnancy as early as possible. But is it possible? Signs of a missed pregnancy can be both pronounced and hidden. The surest way to avoid an undesirable outcome is regular examination by specialists and respect for your health.

What are the symptoms of a missed pregnancy?

You are well aware of: and vomiting (toxicosis), swelling of the mammary glands, high basal temperature, and so on. All these symptoms occur due to the adaptation of the woman's body to a foreign body (fetus). And if this fruit stops developing, then, logically, everything should fall into place. However, most often this does not happen. Pregnancy freezes, and its symptoms continue. And only later is their abrupt cessation observed. It happens that a woman clearly feels the sudden termination of pregnancy. This should alert her and become a reason for going to the doctor.

Allocations. If a missed pregnancy occurred already in the first three weeks after conception, then, most likely, meager periods will appear on time, but their duration will be much longer than usual. with established pregnancy should always be the reason for an urgent visit to the doctor. Even if it's a small drop of blood, don't risk it. It is usually not a frozen pregnancy that causes bleeding, but the threat of its interruption. That is, the embryo continues to develop, and the uterus is trying in every possible way to get rid of it. It happens that a frozen pregnancy is combined with a miscarriage. In this case, spotting is sure to appear.
Pain. Most often, pulling pains in the lower abdomen indicate an incipient miscarriage, but they are not typical for a missed pregnancy. Only in the later stages of fading can pains resembling menstrual pain appear.
Breast. The most striking symptom of pregnancy is pain and swelling of the mammary glands. With a frozen pregnancy, these symptoms stop abruptly.
Toxicosis. If you were very tormented by nausea and vomiting in the first trimester and suddenly they stop abruptly, consult a doctor, especially if the gestational age does not exceed 10 weeks.
basal temperature. With a frozen pregnancy, it returns to the same marks as in the usual "non-pregnant" state. However, this is not the main symptom of pathology.

You should be more attentive to yourself if a similar situation has happened before. The threat of repeated missed pregnancy is quite common.

The most dangerous is a frozen pregnancy in the later stages. It has not only negative physiological consequences, but also psychological ones. Symptoms of a missed pregnancy in the second trimester can be both obvious and hidden.

Stomach. With a frozen pregnancy, it stops growing. The uterus does not increase in size.
Movement. The most obvious sign of a missed pregnancy is the cessation of fetal movements. A few days of “silence” in the stomach is an extremely dangerous situation.
Body temperature. If the fetus died a long time ago, and the woman does not suspect it, then serious changes occur in her body. An infection develops in the uterus, which causes a sharp increase in body temperature.
Bleeding. At any stage of pregnancy, any discharge should be a reason to see a doctor. With a frozen pregnancy, discharge may not be observed.

However, in no case can you make a self-diagnosis. Even if all the symptoms are the same - it still does not mean anything. Only a doctor can confirm the diagnosis by conducting a lot of different examinations.

Gynecological examination. By palpation, a discrepancy between the size of the uterus and the expected gestational age is detected. However, this method helps to detect missed pregnancy only in the second and third trimester. In the first weeks of pregnancy, the size of the uterus is not so different from the "non-pregnant" sizes.
Chorionic gonadotropin. A blood test for hCG levels is mandatory if a miscarriage is suspected. In this case, its performance first stops at a certain level, and then decreases.
ultrasound. With the help of this examination, a frozen pregnancy can be diagnosed at different times. The absence of a heartbeat in the fetus, the cessation of the growth of the embryo or its absence in the fetal egg are all clear signs of a missed pregnancy.

However, the doctor can establish the final diagnosis only by comparing all the results obtained. Before the verdict, and even after it, try not to panic. It's easy to say, but of course there's nothing worse for a mother than the loss of her baby. However, remember that after a frozen pregnancy, you have every chance of bearing a healthy baby.

Take care of yourself!

Especially for- Tanya Kivezhdiy

Spontaneous interruption of gestation, the frequency of which is on average 20% in the population, proceeds in the form of a spontaneous (complete or incomplete) miscarriage or as a non-developing (frozen) pregnancy, that is, a failed abortion. In the structure of all miscarriages, especially in the first trimester (up to 12 weeks), the latter occupies a leading position and accounts for 40 to 80% of all miscarriages, which is 10-15% of all pregnancies.

Why does pregnancy freeze?

A non-developing pregnancy is a pregnancy in which there is a long (one week or more) delay in the uterine cavity of a dead embryo or fetus in the early stages. Termination of development can be not only in the uterine cavity, but a frozen ectopic pregnancy is also possible.

Is it possible to get pregnant again?

Yes, but two consecutive spontaneous interruptions double their risk in the future, which averages 30-38%. This prognosis is even worse compared to women who have already had a normal birth. Given this, most experts believe that the second successive missed pregnancy is a sufficient reason to regard this condition as a habitual early termination of pregnancy.

Such couples should be included in the group at high risk of "recurrent miscarriage", a thorough examination after a miscarriage should be carried out and appropriate treatment should be recommended outside of it.

Non-developing pregnancy is regarded as a pathological symptom complex, which includes:

Lack of viability of the embryo or fetus.
Lack of response to this myometrium (pathological reactivity).
The development of disorders in the hemostasis system in the body.

This pathology is distinguished from spontaneous abortion by the absence of emptying of the uterus in an independent way.

Causes in the early stages

The immediate and main causes of missed early pregnancy are disorders and conditions grouped into 5 groups:

Congenital and acquired anatomical defects of the uterus.
Genetically and chromosomally determined anomalies in the development of the embryo.
Pathological changes in the uterine 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 provide the processes that occur during gestation.
Blood coagulation disorders.
Other reasons.

The last group mainly includes:

the presence of anti-paternal cytotoxic antibodies, antibodies against antibodies (anti-idiopathic antibodies), antibodies that block the lymphocytic reaction;
abnormal activity of natural killer cells (NK cells);
tissue incompatibility of partners (according to the HLA system).

Anatomical defects

Congenital anatomical defects that can cause miscarriage include a unicornuate, saddle-shaped or completely doubled uterus, the presence of a complete or partial intrauterine septum. This anatomical pathology of the uterus causes pregnancy disorders, as a rule, in the later stages, however, a cessation of development in the early stages can occur if a fetal egg is implanted on or near the intrauterine septum.

Acquired defects are intrauterine adhesions, most often resulting from a previous non-developing pregnancy or curettage of the uterine cavity with a curette, submucosal fibroids and isthmic-cervical insufficiency.

Miscarriage with anatomical defects is due to disorders in the implantation of the fetal egg, receptor insufficiency and insufficient blood supply to the endometrium, hormonal disorders with luteal phase deficiency, and chronic endometritis.

Genetic and chromosomal abnormalities of the embryo and trophoblast

They cause the majority (up to 80%) of pregnancy losses, including missed ones, 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 a paired chromosome in spermatozoa or eggs, in which monosomy or trisomy is formed;
in the process of fertilization, when the egg is fertilized by two or more spermatozoa, resulting in the formation of a polyploid embryo;
at the first mitotic divisions of a fertilized egg; if these failures occur at the first division, the development of complete tetraploidy (chromosomes are duplicated without cytoplasmic separation) is possible, which is the reason for the cessation of further development already 14-21 days after conception, and failures during 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 miscarriage and are a type of chromosome mutation in which a portion of one chromosome is transferred to another disparate (non-homologous) chromosome. Chromosomal mutations can be in the form of:

reciprocal translocations, which consist in the mutual exchange of chromosomes with their sections, they make up half of all chromosome anomalies during missed pregnancy;
fusion of chromosomes with partial or complete loss of genetic material in the zone of short arms (Robertsonian translocations);
changes in female sex chromosomes;
duplications, deletions, inversions and other disorders.

Pathology of the uterine mucosa

The main factor in the violation of the development of the embryo and fetus from the side 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.
Syndrome of regenerative-plastic insufficiency.

Autoimmune chronic endometritis

It is provoked by an acute or chronic viral-bacterial infection, stimulating the body's reaction 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 promote damage to the vascular endothelium, as well as abnormal penetration and damage of the endometrium by 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, a vicious pathological circle arises. In a typical course of gestation, the immune processes of rejection of the embryo are suppressed by the body and, in the absence of inflammation, it proceeds normally.

Syndrome of regenerative plastic insufficiency

The result of the syndrome of regenerative-plastic insufficiency of the uterine mucosa is endometriopathy, or endometrial atrophy. Dysfunction of the endometrium in half of the cases is not caused by inflammatory processes, but by the progression of this syndrome, which is the realization of tissue stress in the presence of predispositions, including genetic ones.

The syndrome is manifested by auto- and alloimmune reactions, a decrease in the secretory activity of the glandular epithelium, thinning of the endometrium, a decrease in the number of progesterone receptors, and a decrease or complete loss of receptor sensitivity to progesterone and estrogen.

The syndrome is based on adaptation in response to adverse factors while maintaining the basic functions of the endometrium. The subsequent depletion of adaptive reactions leads to the development of the stage of maladaptation, in which the processes are aimed only at the preservation of cellular and tissue structures, but no longer at their adequate functioning. In the syndrome of regenerative plastic insufficiency, chronic inflammatory and autoimmune factors are a vicious circle. Implantation of a fertilized egg in these cases is not possible without active therapy.

Blood coagulation disorders

Among them, the main ones are antiphospholipid syndrome and thrombophilia of hereditary etiology. Antiphospholipid syndrome, the causes of which are not completely clear and in which the fetus freezes after 10 weeks of gestation, refers to autoimmune and thrombophilic disorders. The main signs on the basis of which we can assume the presence of antiphospholipid syndrome:

arterial and / and venous thrombosis;
a decrease in the number of platelets and a history of hemolytic anemia;
late severe in history.

Causes of missed late pregnancy

In late 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 insufficiency with heart defects, renal failure, severe preeclampsia, uncontrolled intake of certain medications.

Mechanisms of fetal retention in the uterus

The prolonged presence in the uterus of a frozen embryo or fetus in its development is assumed to occur due to the following mechanisms:

Dense attachment of the developing 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 chorionic villi;
- structural and functional inferiority of the uterine mucosa at the site of implantation of a fertilized egg;
- incomplete preparation of endometrial changes in the implantation zone.

Inferiority of the immune system in relation to the reaction of rejection of immunologically foreign tissue.
Decreased contractility of the myometrium due to:

- chronic course of inflammatory processes in the uterus; as a result of this, a deficiency of the receptor apparatus is formed, which leads to a decrease in sensitivity to substances formed during the death of the embryo and causing a decrease in the tone of the myometrium;
- violations of enzymatic biochemical processes involved in protein metabolism;
- continuation (for some time after the death of the embryo or fetus) trophoblast production of progesterone and placental lactogen, specific trophoblastic beta-globulin, and the placenta - some peptide hormones, biogenic amines and immunosuppressive peptides that suppress uterine contractility.

Risk factors

The main risk factors for miscarriage are:

Age under 18 years old.
Pregnancy in the 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 natural selection processes, as well as with various disorders in the partner's reproductive system. For comparison: the risk at the age of 20 - 24 is about 9%, at the age of 30 - 40 - 40%, at the age of 45 - 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:

erased forms of hyperandrogenism of ovarian, adrenal or mixed etiology and ovarian hypofunction;
PCOS ();
the presence in the body of a persistent bacterial-viral infection; most often (in 52%) it is a mixed viral-bacterial infection, as well as chlamydial (in 51%), ureaplasma and fungal microflora (about 42%);
chronic inflammatory processes of the female genital organs, repeated abortions and;
acute or chronic infectious diseases, they rarely cause fetal death on their own, but lead to the development of fetopathies that contribute to fetal death under the influence of other factors;
endocrine diseases - insufficiently compensated diabetes mellitus, thyroid dysfunction, mainly hypothyroidism;
chronic renal pathology;
severe form of arterial hypertension and cardiovascular insufficiency;
various systemic connective tissue pathologies in the form of systemic lupus erythematosus, systemic scleroderma, antiphospholipid syndrome, etc.

Less significant factors include:

smoking;
alcohol and drug addiction;
certain medicines;
excessive consumption of drinks containing caffeine (strongly brewed tea, coffee and other tonic drinks);
low body mass index.

The sensitivity of the embryo or fetus to damaging factors is not the same in different periods of gestation. The shorter the term, the more vulnerable they are. The most critical periods are the 7th - 12th days, when the implantation of the fetal egg occurs, the 3rd - 8th weeks (the beginning of the development of the embryo), the 12th week (the period of placental formation) and the 20th - 24th weeks (the stage of formation of the most important fetal body systems).

In most cases, a missed pregnancy is based on any one dominant cause and several risk factors and interacting mechanisms for the development of this pathological condition. How to understand that the death of the embryo or fetus has occurred?

The main symptoms of a missed pregnancy

The peculiarity of a failed pregnancy is manifested in the disappearance of the subjective and objective signs of the latter.

How to determine a frozen pregnancy?

The cessation of nausea, increased salivation, vomiting, aversion to various odors that appeared in the first 12 weeks of the gestation period are characteristic subjective sensations during a missed pregnancy.

The retention 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. Periodically, pains of a cramping nature in the lower abdomen, pain in the lumbar region may appear. 2-6 weeks after the death of the fetus, bloody spotting from the genital tract periodically appears, and uterine bleeding is also possible, especially at later stages of gestation.

You can also recognize the resulting pathology by changes in the mammary glands. Three days - 1 week after the death of the fetus, the mammary glands decrease in size, their pain decreases, engorgement stops, and they soften, and milk may appear instead of colostrum. After 25 weeks of gestation, fetal death may be accompanied by engorgement and the release of large amounts of colostrum.

You can also determine a missed pregnancy at home by measuring the basal temperature, which in the early stages remains within 37.2-37.3 ° and above. The basal temperature during a frozen pregnancy quickly returns to normal.

What tests should be taken to determine an undeveloped pregnancy?

Of some importance in a frozen pregnancy is a blood test for hCG. Human chorionic gonadotropin is a specific hormone that is synthesized by the trophoblast as early as 24 hours after implantation of a fertilized egg. In a normal course, the level of hCG by 6-10 weeks of gestation becomes maximum, after which it gradually decreases.

In case of termination of the development of the embryo or fetus, its indicator decreases from 3 to 9 times. That is, it becomes below the norm corresponding to the gestational age, at 6-12 weeks by 8.6 times, at 13-26 weeks - by 3.3 times, at 28-30 weeks - by 2, 7 times. However, the diagnostic value of hCG analysis is low. It increases slightly with repeated analyzes.

Determination of an increase in the content of hCG in the urine is the basis of rapid testing at home.

With a frozen pregnancy, is the test positive or negative?

The express test does not show the concentration, but only an increase in the concentration of the hormone in the urine. With the early termination of embryonic development, the express analysis becomes negative after 2-3 days, but at later dates, chorionic gonadotropin is excreted from the blood rather slowly, and the test can remain positive for a long time (even up to 1 month).

Other tests are sometimes performed - for alpha-fetoprotein, the concentration of which increases from 1.5 to 4 times by the 3rd - 4th day after the death of the fetus, and for trophoblastic-beta 1-glycoprotein. The concentration of the latter in the blood of a woman immediately after the death of the fetal egg decreases, and if it is retained in the uterine cavity for 3 weeks, it decreases by 4-8 times.

Can there be toxicosis with a frozen pregnancy?

Preeclampsia (toxicosis) is a syndrome of multiple organ failure that develops during the gestational period. It is caused by a mismatch between the mother's body's ability to adequately meet the needs arising from the development of the fetus.

The development of early and late gestosis is possible only during pregnancy. If one already exists, then with the death of the fetus, that is, with the cessation of gestation, the cause of preeclampsia also disappears, the symptoms of which gradually decrease and disappear.

However, all these signs are not sufficiently reliable. Convincing signs of a missed pregnancy are the cessation of fetal movements or their absence at the expected time, as well as data from physical and instrumental studies.

Physical examinations that are of relative importance for diagnosis include a vaginal examination, in which they are noted with the death of the fetus for periods less than 12 and up to 20 weeks:

a decrease in the severity of cyanosis of the mucous membrane 4-5 weeks after the cessation of fetal development with a gestation period of 16 weeks and after 4-8 weeks - at later dates;
opening of the cervical canal up to 1-1.5 cm in nulliparous women and up to 3 cm or more in women who have given birth;
thick discharge from the cervical canal in the form of brownish mucus.

More convincing are the cessation of uterine enlargement or the lag of its size from the estimated gestational age. This is observed in the early stages due to the fact that the fetal egg is resorbed, and in the long term - due to the absorption of amniotic fluid into the mother's blood and a decrease in the size of the fetus as a result of its maceration.

The most informative diagnostic method that allows diagnosing pathology even before the appearance of subjective sensations of a woman is transvaginal ultrasound, which is informative from the 18th day after conception, especially in combination with a blood test for the level of hCG in the blood.

What is the danger of late diagnosis of pathology?

The consequences of a missed pregnancy can be severe, especially in cases of prolonged (from 2-4 weeks or longer) stay of the dead embryo in the uterine cavity. It is possible to develop an infection and a septic condition, coagulopathic disorders (DIC) and bleeding, etc. They are not only a negative factor in predicting the further reproductive function of a woman, the health of her offspring and the preservation of the family.

Complications pose 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 gestational age and the duration of the presence in the uterus of a dead fetal egg, embryo or fetus.

Treatment after a frozen pregnancy

Making a diagnosis requires immediate preparation of the woman and active treatment of the life-threatening condition. The point of treatment is to carefully terminate an undeveloped pregnancy by evacuating a dead ovum and to conduct 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, are used for missed pregnancy for up to 12 weeks. It is also possible to prepare the cervix with a hydrophilic dilator or with synthetic prostaglandin analogs, followed by vacuum aspiration. The latter is also recommended in cases where the traditional instrumental surgical method of scraping the walls and bottom of the uterus (curettage) and evacuating the remains of conception is used. However, routine curettage curettage during a missed pregnancy leads to structural and functional inferiority of the endometrium in the implantation zone.

The best way to empty the uterine cavity up to 6 weeks of the gestational period (in some regions of Russia - up to 9 weeks, abroad - up to 12 weeks) is a medical abortion. For this purpose, various schemes are used for oral and vaginal administration of the synthetic steroid antiprogestogen drug Mifepristone and the synthetic analogue of prostaglandin “E 1 ” Misoprostol. This method is more than 80% effective, but it can be used in the absence of signs of infection, bleeding disorders, severe anemia, liver or kidney failure.

After applying any method, it is necessary to conduct a control or echographic study. Interruption in the later stages (in the second trimester - from 13 to 22 weeks) is carried out mainly through one of the methods that stimulate labor:

Intra-amniotic (into the cavity of the fetal bladder) or extra-amniotic administration of a hypertonic (20%) solution of sodium chloride or (if there are contraindications to its use - arterial hypertension, renal pathology) glucose through the cervix (transcervical access) or with a needle inserted through the anterior abdominal wall (transabdominal access). The intraamnial method is the most optimal and effective.
Oral oral antiprogestogen (Mifepristone) in appropriate doses or (in the absence of effect) prostaglandin (Misoprostol) or the introduction of the latter into the vagina with repeated oral doses, or a combination of Mifepristone with Misoprostol.
Intra- or extramniotic administration of Dinoprost, which belongs to the F 2 -alpha prostaglandins and has a pronounced stimulating effect on the myometrium.
Imposing after the expansion of the cervical canal on the presenting department of the fetal bladder (after its opening) of the load with the help of special forceps. This method is used in case of contraindications for previous methods or in the absence of the effect of their use.

The principles of further treatment are to prescribe:

or progesterone preparations in order to restore the structure, secretory function and receptive activity of the endometrium;
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 identified;
anti-inflammatory therapy, including non-steroidal anti-inflammatory drugs;
drugs that contribute to the correction of the immune state of the body;
means of correcting vaginal microbiocenosis;
drugs and physiotherapeutic techniques that help restore microcirculation, normalize tissue regeneration, metabolic processes in them and local immunity.

When can I get pregnant after a missed pregnancy?

The term of its resolution is considered the first day of a new menstrual cycle. After it, menstruation is restored at the appropriate time, but sometimes they can occur after 1.5 months. However, the next pregnancy planning must be recommended no earlier than six months later.

This is the minimum period during which, when carrying out appropriate treatment, recovery occurs after those changes and disorders (hormonal changes and psychological disorders, endometritis, etc.) that occurred as a result of a pathological condition.

For the purpose of protection, it is recommended to take combined oral contraceptives (“Regulon”), as well as their combination with the active form of folic acid - calcium levomefolate (“Yarina Plus” and “Jess 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 an undeveloped 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 incoordination of contractions of the myometrium and fallopian tubes;
contribute to a more intensive production of factors (immunoglobulins "A" and "G") of local immunity, which significantly reduces the risk of developing 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 for the mother's body in terms of full preparation for a more successful implementation of the next attempt at motherhood.

Prevention

The elimination of the above 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, allow to prevent a missed pregnancy by excluding, if possible, the above risk factors.

In order to correct the ratio of sex hormones in case of their imbalance towards progesterone deficiency, women with habitual miscarriage and when planning the latter are recommended Duphaston, which has a progestogenic effect. Its active ingredient is dydrogesterone.

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 pregnancy need a comprehensive examination, preferably with the inclusion of medical genetic counseling, especially in case of repeated miscarriage, treatment and appropriate subsequent preconception preparation for a planned pregnancy.

The onset of pregnancy is characterized by certain signs that suggest its presence. Almost all of them in the early stages are due to hormones that are secreted by both the fetal chorion and the corpus luteum, as well as the reproductive organs of the mother. It should be noted that all of them are expressed in different women in different ways, and it is very difficult to focus only on them.

If a woman has early pregnancy, the fetus froze, her chorion stops the production of chorionic gonadotropin, and it is this hormone that causes early pregnancy symptoms, such as nausea, drowsiness, and much more. A sharp decrease in the level of hCG during a missed pregnancy is the cause of the weakening, and then the complete disappearance of these symptoms. Toxicosis with a frozen pregnancy stops. That is, a frozen fetus causes a sudden improvement in a woman's well-being.

These first signs of a missed pregnancy are difficult to assess adequately for the reason that the disappearance of symptoms of toxicosis is possible and normal, it worries women only up to 11-12 weeks of pregnancy, and not always and not in all cases.

Pain during a frozen pregnancy is not typical and far from being disturbing without fail. Usually they are associated with a threatened miscarriage, which does not always happen spontaneously, and the embryo does not always die if a miscarriage is threatened. Pain can be localized in the lower abdomen and are pulling in nature, resembling menstrual.

So how to determine a frozen pregnancy? Are there any special symptoms? How to recognize a frozen pregnancy at different times?

Frozen pregnancy, signs, first trimester:

The basal temperature (BT) during a frozen pregnancy decreases by 0.8-1 degrees, and becomes the same as in non-pregnant women. If you measured it, then in the presence of a progressive pregnancy, it rises after ovulation and remains high throughout pregnancy. Rectal temperature during a frozen pregnancy decreases, as there is no longer a living embryo. However, this does not always happen.

If the death of the embryo occurred in the first 2 weeks from conception, you have a miscarriage, your periods will come on time or with a delay, and will proceed unusually, with more bleeding and a few days longer. Prolonged unusual menstruation is a reason for consulting a gynecologist.

The chest during a frozen pregnancy stops hurting, engorgement disappears. After conception in the first trimester, the reaction of the breast to changes in hormonal levels is one of the most striking symptoms. The disappearance of soreness and engorgement should alert in combination with other symptoms. With a frozen pregnancy, the chest does not hurt.

Nausea during a missed pregnancy, so characteristic in the morning hours during a normal pregnancy, suddenly stops, and you feel better. Maybe it just ended toxicosis, but if not even 10 weeks - you should see a doctor. Do you feel sick during a missed pregnancy? No, this is not typical.

With a frozen pregnancy, the sensations may be similar to the fact that the pregnancy has suddenly ended. At the same time, nothing will bother you, no pain, no discharge, no symptoms of toxicosis. Sometimes a miscarriage and a missed pregnancy are combined, only then scanty or copious discharge may appear, any drop of blood on the underwear in the early stages of pregnancy should scare you and make you immediately contact a gynecologist. For many, a frozen pregnancy has a daub as the first manifestation. Be attentive to yourself, do not miss the symptoms of a frozen early pregnancy. The threat of a missed pregnancy is especially great for those women with whom this has already happened.

Signs of a missed pregnancy, second trimester:

What symptoms during a missed pregnancy in the second trimester can disturb a woman depends on the duration of pregnancy and how much time has passed since the death of the child. It is easier to find out a frozen pregnancy at a later date, but there may be more troubles and consequences because of it. A dead big child already begins to literally decompose in the uterus, which leads to intoxication of the female body and disorders of the blood coagulation system. This is very dangerous and can cause uncontrolled, fatal uterine bleeding.

In the later stages, it is vital to terminate a missed pregnancy as soon as possible in order to avoid serious consequences for the mother.

How to recognize a frozen pregnancy for a period of 13 to 17-18 weeks, when you have not yet felt the baby move?

Unfortunately, there are no specific symptoms. The uterus ceases to increase in size, the tummy does not grow. Discharge is possible during a frozen pregnancy, they are more often bloody in nature, but if an infection has become the cause of the fetal fading, they can be anything. The temperature during a frozen pregnancy rises for a fairly long time from the death of the fetus and is caused by an infection that develops in the uterus. It is often impossible to understand that the pregnancy has stopped on its own, which is why it is so important to be observed by the gynecologist regularly, without missing the deadlines for appointments. The doctor will immediately notice that your uterus has stopped growing and does not correspond to the gestational age.

How to feel a frozen pregnancy for more than 17 weeks?

You will notice that the baby has stopped moving, and this will be the earliest symptom. If you have already felt fetal movements before, and for more than a day you have not heard it, be alarmed if everything is fine. Let the alarm turn out to be false. There are other symptoms, such as pain, bleeding during a missed pregnancy, but not always, you should not rely on them as the only reliable signs of trouble. The tone of the uterus, any discharge (abundant watery, spotting, brown) should be a reason for you to contact a gynecologist.

Be attentive to yourself, this will avoid serious complications.

What is a frozen pregnancy
Frozen pregnancy, treatment

Read also

Most often, it is difficult to establish the exact cause that led to the development of this disease (each case is studied and considered individually), although doctors name several of the most common points. Among them:

uncontrolled intake of various medicines, which include biologically active additives and vitamins consumed by expectant mothers without consulting a specialist;
viral diseases (influenza, acute respiratory infections, acute respiratory viral infections, etc.);
smoking;
drinking alcoholic beverages during pregnancy;
taking illegal drugs, etc.

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During the period of bearing a baby, every woman is worried that the development of the fetus may stop. Unfortunately, this is what happens sometimes. In about one in three cases, a miscarriage is diagnosed after fertilization. Signs in the first trimester can be different. This article will tell you about them. You will find out what causes it in the first trimester, as well as find out about the methods of diagnosis and treatment.

What it is?

What has in the first trimester? Symptoms of the pathology will be described below. To begin with, it is worth saying what it is.

The fading of pregnancy is the cessation of its progression. The fetus at some stage simply stops developing, but does not undergo a reverse change. As a result, its decomposition and rotting of the masses may begin. It is very dangerous.

Causes of pathology

Why does a frozen pregnancy occur in the first trimester or later? Pathology can occur due to certain diseases. Viruses are especially dangerous. These diseases include rubella, influenza, acute respiratory infections, toxoplasmosis and others. Often, the fetus undergoes changes incompatible with further development due to diseases such as chlamydia, trichomoniasis, mycoplasmosis, and so on. These pathologies are sexually transmitted. That is why we can call a frequent change of sexual partners.

A variety of can lead to the fact that a frozen pregnancy will occur in the first trimester. Signs of it may appear immediately or be hidden for a long time. Often, the cessation of embryo development occurs due to previous abortions, diagnostic interventions and other manipulations in the area of the reproductive organ. It also includes congenital or acquired pathologies of other organs and systems. Not the last role in this problem is played by the hormonal background.

Another cause of missed pregnancy can be called genetic abnormalities. Often such a fetus dies in the very early stages. At the same time, the woman does not even have time to find out about her new position. In some cases, pathology develops due to external influences. For example, if the expectant mother uses alcohol, drugs or leads an inappropriate lifestyle.

Frozen pregnancy: signs in the first trimester

The most reliable symptom that the fetus is no longer developing is the absence of a heartbeat. It is worth noting that in the early stages this can be checked only with the help of ultrasound diagnostics. For longer periods, such manipulation can be performed using a special sensor or a cardiotocography apparatus.

During the study, the specialist always compares the estimated term and size of the embryo. Much attention is paid to the fetal egg. Also, an examination is performed on the area of \u200b\u200bthe corpus luteum. Frozen pregnancy in the first trimester ultrasound signs have the following:

discrepancy between the size and timing of pregnancy;
in some cases, the embryo is completely absent;
contraction of the heart muscle is not determined;
additional defects are established (absence of a corpus luteum, presence of detachment, and so on).

It is worth noting that it is impossible to talk about these signs without ultrasound diagnostics. It is this method of examination that is considered the most reliable in the formulation of the described diagnosis. Consider what signs of a frozen pregnancy in the first trimester it still has.

Painful sensations in the abdomen

Up to 70 percent of missed pregnancies are accompanied by pain in the lower abdomen. They develop due to the fact that the body tries to independently reject the pathological. In this way, the human self-preservation system works. Pain occurs as a result of the fact that the production of certain hormones stops. The uterus becomes more sensitive and begins to contract, the cervical canal slightly changes its position and expands. A woman may experience unpleasant pulling sensations in the lower abdomen or feel severe cramping pain. Each situation is individual and does not depend on the gestational age.

It is worth saying that such sensations often occur with the threat of interruption. If certain hormones are insufficiently produced in a woman's body, as well as under the influence of other factors, a reduction in the reproductive organ may begin. This process can be reversible in the early stages. You just need to take the appropriate drugs and follow the prescription of doctors. That is why it is so important to seek help from a doctor if you experience pain in the lower abdomen as early as possible and later.

Discharge from the genital tract of various nature

What other signs of a frozen pregnancy in the first trimester? A symptom of the development of pathology can be called vaginal discharge. During pregnancy, especially in the early stages, their number increases. This is considered the norm. However, the color of such a liquid should be clear or milky. Impurities of blood, pus and other substances are recognized as pathology. They should be cause for immediate medical attention.

Bloody discharge may indicate that the process of rejection of the fetal egg has already begun. As a result, small capillaries are damaged. When the bleeding gains strength, we can talk about a progressive spontaneous miscarriage. In the presence of purulent discharge, it may be suspected that the fading of the fetus occurred quite a long time ago, and the process of its decomposition has already begun. It is worth noting that, as in the previous paragraph, these signs can only indicate a threat of termination of pregnancy. The sooner you seek help from a gynecologist, the greater the chance to save the child.

Sensations in the area of the mammary glands

What other signs of a frozen pregnancy does it have? Symptoms of pathology can manifest themselves in the form of the disappearance of soreness and sensitivity of the mammary glands.

Under the influence of the pregnancy hormone (progesterone), the process of preparing for breastfeeding begins immediately after fertilization. The mammary glands will undergo changes throughout the duration of pregnancy. At first, the breast becomes larger, it acquires a special sensitivity. Some women even experience pain. All these signs persist until about 12 to 16 weeks. That's when the placenta starts working. A sharp disappearance of breast sensitivity may indicate that there has been a stop in the development of the fetus.

Toxicosis and its absence

What are the signs of a frozen pregnancy in the first trimester? A photo of the embryo is presented to your attention in the article.

Most expectant mothers are faced with toxicosis. It appears already a few weeks after fertilization and can be more or less strong. Reliable reasons for this condition still cannot be stated.

An abrupt cessation of severe toxicosis may indicate that the pregnancy has frozen. This symptom is indirect, but, like all of the above, requires additional diagnosis and confirmation. It is worth saying that some expectant mothers do not experience such sensations at all. They successfully endure the first stages of pregnancy. This does not mean that there is a risk of missed pregnancy.

Basal body temperature

What other signs of a frozen pregnancy in the first trimester? The causes of the pathology have already become known to you. Another symptom of the problem is a decrease in the high level of basal body temperature. If you have observed the work of your body in this way, you may notice that immediately after ovulation there is an increase in the level of the thermometer readings. After fertilization and implantation, it can become even higher. So, the average value of basal temperature in expectant mothers is 37 - 37.2 degrees. If suddenly there was a drop in the graph line to 36 - 36.5 degrees, then we can talk about a frozen pregnancy.

It is worth noting that this sign can only be checked by those women who have previously conducted appropriate observations. The initial measurement in most cases turns out to be unreliable, because you will have nothing to compare with.

Fever

Another sign of a missed pregnancy is an increase in body temperature. It happens due to the fact that the fetus in the uterus begins to gradually decompose. It is worth noting that this sign appears with a long course of the process. This can be very dangerous for a woman.

If you have a high temperature, and there are also additional signs described above, then you should immediately run to the hospital, but it is better to call an ambulance. The slightest delay in sepsis can lead to the death of a woman.

How to find out about a missed pregnancy before an ultrasound?

If you have suspicions, only an ultrasound can confirm them. Any indirect signs cannot be a reason for making a diagnosis, remember this.

There are studies that can help you learn about the problem even before the diagnosis. This is a blood test. During the study, the amount of human chorionic gonadotropin in your blood is determined. The results are compared with generally accepted standards. Based on this, you can judge whether your real term corresponds to the expected one. For a more accurate diagnosis, it is recommended to conduct a study several times with a break of three or five days.

Frozen pregnancy in the first trimester: treatment

If you find out about the presence of this pathology, then it must be eliminated as soon as possible. In most cases, gynecological curettage is performed. For short periods, it is possible to use other methods of cleansing the uterus, for example, medical abortion or In some situations, when an abortion (bleeding) has begun, doctors choose expectant tactics. If a complete cleansing of the uterus does not occur within a few days, then the patient is offered cleaning. What are the consequences of a frozen pregnancy in the first trimester?

In most cases, the pathology does not affect the future life and fertility of the patient. Only in especially severe cases can we talk about acquired infertility. Usually, a representative of the weaker sex is capable of a new pregnancy already 3-6 months after the incident. Often, after the manipulation, medications are prescribed to a woman to correct the condition. These can be antibiotics, immunomodulators, agents for restoring microflora, and so on.

Instead of concluding an article, or a short summary

You have learned what causes a frozen pregnancy in the first trimester. This is a very unfortunate occurrence. It is especially hard for those women who want to give birth to a baby for a long time, but nothing works out for them. If the situation with a frozen pregnancy is repeated more than twice, then the representative of the weaker sex, like her partner, is shown a consultation with a hematologist and genetics. In such situations, it is worth starting a full examination and finding the reason why conception occurs, but at some stage the embryo simply stops developing. Good health and success to you!