Abnormal cessation of embryo development is a rare pathology that is observed only in every 176 pregnant women. It’s insidious because it can occur in women of any age. Deviation is possible at all stages of pregnancy, mainly characteristic of the first trimester.
The cessation of fetal development always has a serious impact on the condition of the pregnant woman. In addition to unpleasant sensations in muscles and joints, “internal” conflicts and tensions arise. The woman is afraid of the next pregnancy, of being childless. The death of the embryo is not a death sentence, and after rehabilitation she bears a healthy child and becomes a happy mother.
What is a frozen pregnancy
Frozen pregnancy is a pathology characterized by the fact that the embryo stops developing and dies, but there are no signs of termination of pregnancy (miscarriage).
Most often, a frozen pregnancy is detected in the first trimester, but the likelihood of fetal development stopping exists even later. Experts identify several critical periods when the likelihood of pregnancy fading is highest:
- during the period of attachment of the embryo to the walls of the uterus
- at the stages when all the most important organs and systems of the body are laid down and then formed
- during the period when the placenta is forming
In most cases (up to 70% on average), miscarriage or termination of pregnancy due to genetic abnormalities occurs before 7 weeks of pregnancy.
When does the fetus die: approximate timing
Specialists in the female reproductive system have long noticed that during the entire period of pregnancy there are certain periods of increased risk of losing a child. When dangerous periods coincide with pathological conditions that disrupt the natural state of gestation, the fetus dies.
Spontaneous abortion threatens a woman in the first trimester. During early gestation, which lasts 13 weeks, the embryo may stop developing but will remain in the uterine cavity for up to four weeks. During active growth of the fetus from the 13th to the 27th week, convulsions, edema, and eclampsia may occur due to hypovitaminosis or a sedentary lifestyle.
The resulting gestosis can lead to a non-developing frozen pregnancy. The most dangerous period of the second trimester is from the eighteenth to the twenty-first week. At this time, spontaneous abortion and discharge of amniotic fluid may occur. The most dangerous period is the 21st-22nd week; a non-developing pregnancy after this period is very rare.
The main threat of the third trimester is delivery at a gestational age of 28 to 37 weeks. Having been born at this time, the child may not be ready to be born. He may have low body weight or insufficient maturity of lung tissue. These two reasons contribute to stopping the development of a premature embryo or neonatal death of the baby.
Causes of non-developing pregnancy
- Chromosomal abnormalities
Fetal death in the early stages of pregnancy is often caused by this factor. The reason may lie in the fact that one of the germ cells (and possibly both) had a genetic defect. As a result, at different stages of development (zygote, embryo, fetus), developmental pathologies that are incompatible with life occur.
It is possible that in this particular case there was an incorrect combination of genes. This situation can be spontaneous, and in most cases the next pregnancy proceeds completely normally.
If a couple is faced with a non-developing pregnancy several times in a row, the spouses should seek advice from a geneticist.
- Hormonal disorders
One of the main hormonal disorders is considered to be a deficiency of progesterone, the “pregnancy hormone”, thanks to which the embryo successfully attaches to the walls of the uterus and begins to develop. A decrease in progesterone levels according to the test results may indicate a delay in fetal development and the threat of miscarriage.
Another reason for pregnancy failure can be hyperandrogenism - an excess of male hormones in the female body.
At risk are women suffering from PCOS (polycystic ovary syndrome), pathologies caused by ovarian dysfunction, and diseases associated with dysfunction of the thyroid gland.
Hormonal imbalances should be identified and corrected at the stage of pregnancy planning.
- Antiphospholipid syndrome
APS is an autoimmune pathology of the blood coagulation system, the essence of which is that the body begins to produce a large number of antibodies to blood plasma phospholipids. APS is associated with early termination of pregnancy, placental dysfunction, placental insufficiency, as well as chronic fetal hypoxia, which can lead to fetal death.
- Infections
The diseases that are the cause of missed abortion include, first of all, the so-called TORCH infections: rubella, CMV (cytomegalovirus), toxoplasmosis and herpes, as well as other infectious diseases (“O” in the abbreviation stands for “others” - others) , which include mycoplasmosis, ureaplasmosis, syphilis, gonococcus, chickenpox, enterovirus. The causative agents of these infections have a negative effect on the fetus, causing developmental disorders of varying severity and, in some cases, death. It should be noted that it is the primary infection during pregnancy that is dangerous, and therefore it is necessary to get tested in advance, take preventive measures by getting vaccinated against rubella and, if possible, excluding routes of possible infection with other diseases (refusal from contact with cats, from handling raw food). meat to prevent toxoplasmosis, etc.).
In addition, acute respiratory viral infections, influenza, tonsillitis, and infectious diseases of the urinary system can pose a danger.
- Negative external factors
Exposure of the body to radiation, various chemical compounds, significant changes in atmospheric pressure, and sudden climate change can lead to missed abortion.
- Lifestyle
Constant stress, emotional and physical stress, bad habits, improper sleep and wakefulness, and a sedentary lifestyle are also risk factors that must be eliminated whenever possible.
- Immunological factor
Advantages of modern fetal removal techniques
Emptying the uterine cavity from the remnants of the fertilized egg after a miscarriage using a vacuum is characterized by the following advantages.
- The cervix is not injured;
- The operation using this technique takes a minimum of time and is performed on an outpatient basis;
- Minimal trauma (compared to standard abortion) ensures rapid restoration of the uterine mucosa;
- Rapid restoration of menstrual function.
Hysteroscopy is another modern, highly effective method of curettage of the uterine cavity, which is used when curettage of the uterine cavity using a special device - a hysteroscope, which allows achieving more effective results.
Signs of a frozen pregnancy
First of all, you should pay attention to the fact that the manifestations of pregnancy that occurred before disappear: toxicosis, engorgement of the mammary glands, etc. It should be noted that the shorter the period, the fewer symptoms can be identified, and therefore a frozen pregnancy is often diagnosed only during a routine visit to an obstetrician-gynecologist.
Later, one of the most obvious signs is the absence of fetal movements. In addition, bloody discharge from the genital tract may appear. However, it is impossible to determine for sure whether a pregnancy is not developing on your own.
What to do during the recovery period
It is difficult to determine with your own hands that the fetus has frozen; the symptoms are practically not traceable. If a frozen pregnancy is suspected, the woman undergoes an ultrasound and laboratory analysis, during which the concentration of human chorionic gonadotropin is determined in the blood serum or urine. After confirming that the pregnancy is not developing, the doctor performs procedures to remove the dead baby from the mother's womb.
Next, the leading gynecologist prescribes a set of studies for the patient’s health status. After receiving the results and eliminating factors that may have a detrimental effect on the next pregnancy, the doctor prescribes a break in its planning. In order for the body to recover faster, the recommended pause must be used wisely:
· review the quantitative and qualitative characteristics of nutrition;
· engage in feasible physical training;
· stop drinking alcohol and cigarettes;
· strengthen the immune system by choosing the appropriate vitamin complex;
· check hormone levels;
Use reliable methods of contraception throughout the recovery period and maintain a positive attitude.
Diagnostics
The doctor checks whether the size of the uterus corresponds to the duration of pregnancy. If there are discrepancies, this may indicate that fetal development has stopped. It should be noted that in some cases, during a frozen pregnancy, the size of the uterus may be normal, because The growth of the fetal membrane continues.
It is important to evaluate the dynamics of hCG levels: normally, the level of the hormone is constantly growing. If the indicators do not change or decrease, this indicates a frozen pregnancy.
An ultrasound, depending on the stage of pregnancy, either reveals anembryony (the presence of an empty fertilized egg that does not contain an embryo), or there is no fetal heartbeat.
The connection between abortion and fetal death
Artificially interrupting the physiological process in which a new human organism develops in a woman’s uterus is contrary to human nature itself. The female body cannot determine whether pregnancy is desirable or undesirable. The consequences of abortion lead to the formation of an inferior layer lining the internal cavity of the uterus during the second phase of menstruation. This causes pregnancy, in which the implantation of a fertilized egg does not occur in the uterine cavity.
Even if the yolk sac is successfully placed, the quality of the mucous layer of the uterus will not meet all the needs of the fetus for the supply of nutrients and oxygen. Deviation can cause a non-developing pregnancy or death of the embryo.
Measures to prevent frozen pregnancy
In most cases, as we wrote above, the next pregnancy after a frozen one proceeds normally. However, in approximately 5-10% of cases, fetal death occurs again, and this indicates the need for a serious examination and identification of all causes.
In such cases, it is better to contact a reproduction center
, specializing in infertility problems. During the consultation, the gynecologist-reproductologist at Nova Clinic will prescribe the scope of examination required in this particular case and, if necessary, refer you to related specialists. Thus, to identify the causes of fetal death and plan pregnancy, the help of a geneticist, hemostasiologist (a specialist in the blood coagulation system), and a gynecologist-endocrinologist may be required.
What basic research is needed to identify the causes of missed abortion?
- Ultrasound examination of the pelvic organs
- Tests to detect infections using PCR
- A study to determine the level of hemocysteine, autoantibodies in the blood
- Tests for TORCH infections
- Hormonal studies
- Karyotyping (with aberrations)
- Spermogram
You should plan your pregnancy after at least six months - during this time the hormonal levels will return to normal, the endometrium will be restored, and the woman’s body will be ready to conceive and bear a child.
Additional Research
Genetic tests are mandatory for future parents over 35 years of age and are prescribed to partners whose families have relatives with hereditary pathologies. Determination of the karyotype allows you to see the violation of the morphology and number of chromosomes.
To identify functional pathologies of the pelvic organs - uterine prolapse, adhesions in the fallopian tubes - an ultrasound is prescribed simultaneously with the tests.
By appointment, you can comprehensively undergo all the listed tests and examinations in our center.
