Causes of pregnancy fading in the early stages. Frozen pregnancy: how to recognize the symptoms and what to do

A frozen pregnancy is a pathological condition of the fetus when the embryo stops developing in the womb. Most often, this phenomenon is observed at 5–6 weeks, when the placenta has not yet taken root in the uterus.

There are many reasons for the anomaly. Fetal growth is influenced by both external and internal factors. The disease occurs without pronounced symptoms. Only symptoms of normal pregnancy are observed: toxicosis, breast enlargement and halo, no periods. It would seem that healthy bearing of a baby should not provoke any problems, but sometimes the fetus freezes, which entails serious consequences.

What is a frozen pregnancy

Frozen pregnancy (FPM) is an abnormal development of the embryo. When the pathology begins to progress, the child stops growing and freezes inside the mother, resulting in the death of the baby. The pathological condition is also called failed miscarriage, since the death of the fetus occurs arbitrarily without clinical signs.

The abnormal condition occurs in any trimester of pregnancy. Most often, the diagnosis occurs in women over 40 years of age. The pathological condition is observed in the first trimester at 7–8 weeks of development. If the problem is not immediately identified, this will lead to inflammatory processes in the reproductive organs and provoke serious consequences.

Symptoms of the disease cannot always be determined in time, since in the initial stages of fertilization they are similar to the usual signs of a normal pregnancy.

With each trimester, the signs change and become more pronounced. Most often, the pathology can be identified after the 9th week of development, as the woman’s well-being begins to quickly deteriorate.

Why can a fetus freeze?

There are many causes and triggers for ST. At the initial stages, the disease is asymptomatic, which is detected through a clinical examination. If the process develops, then at 15–20 weeks of progression the girl will develop severe symptoms. In this case, the pregnant woman is hospitalized and given emergency medical care.

To avoid the occurrence of abnormal fetal development, you should know the main causes of the disease. By eliminating negative factors in a timely manner, there is a chance of avoiding the pathological process.

Pathogenic factors that provoke the disease include:

1. Genetic abnormalities during fetal development.
2. Infectious diseases.
3. Improper management of IVF or complications after the procedure.
4. Damage to the placenta during pregnancy by sexually transmitted infections.
5. Consumption of alcohol, cigarettes, drugs.
6. Late conception of a child.
7. Placental abruption due to weak attachment to the walls of the uterus.
8. Endometriosis.
9. Endometritis.
10. Antiphospholipid syndrome.
11. Constant stress, worries, nervous breakdowns.
12. Chronic diseases.
13. Heredity.
14. Physical fatigue.
15. Chromosomal and genetic abnormalities

According to doctors, the death of a baby in the womb occurs for a variety of reasons. However, there are the most significant factors that can cause the disease. These include:

Infections

Infectious lesions of the body are the most dangerous for the unborn child. For the most part, it is viral infections that can destroy the embryo in the early stages, especially if the girl has not previously suffered from such types of illness.

The most popular viral diseases include:

• herpes;
• rubella;
• toxoplasmosis;
• cytomegalovirus;
• thrush;
• gardnerella;
• urealiticum.

Particles of viruses such as herpes and cytomegalovirus remain in a state of remission in the human body throughout life. The chronic form of the disease is less dangerous for the unborn child, since the woman’s immune system already knows how to resist it. But sometimes an exacerbation of the disease leads to disastrous consequences.

Infections that are directly sexually transmitted significantly increase the likelihood of embryonic death. Viruses such as HPV, chlamydia, mycoplasma and ureaplasma cause severe inflammation of the genital and reproductive organs. In addition, flu and colds can have a negative impact on the development of the fetus and the health of the expectant mother. Such diseases are especially dangerous from the 3rd to the 5th week of gestation, when the egg has not yet strengthened.

Embryo death due to infection occurs for several reasons:

1. Harmful bacteria, once inside, have a direct effect on the egg, damaging its membrane.
2. When the body is infected by microbacteria, it produces additional biological components that help fight the virus. This process disrupts the blood flow to the egg, oxygen starvation occurs and the embryo dies.
3. With chronic inflammation, the walls of the uterus weaken, and the placenta fails to fully consolidate. Because of this, the required amount of nutrients does not reach it.

Due to the high risk of losing a baby in the early stages of fertilization, a woman after re-fertilization should be more attentive to her health. You should not overcool, walk in wet and damp weather, visit places where there is a high probability of contracting the flu, and use contraceptives during sex.

Hormonal disorders

When a girl is pregnant, her body undergoes dramatic changes. In the 1st trimester, hormonal levels change, so surges and disruptions may occur. Because of this, there is a lack of progesterone and estrogen. These components transport nutrients to the fetus. With their deficiency, the outflow of oxygen and microelements decreases.

Sometimes the pathological condition of the egg occurs due to malfunctions of the ovaries or thyroid gland. Malfunctions of organs worsen the condition of the uterus, and the fetus does not take root in the womb.

Autoimmune pathology

Autoimmune disorders are observed due to a large amount of antibodies in the blood plasma. The disease is the cause of the disease in almost 6% of cases. If fertilization is observed a second time, the disease is observed in 35% of women.

Due to autoimmune pathology, thrombophilia forms in the body, and the diagnosis of genetic predisposition of the fetus is most often made. Complications with this diagnosis arise if the woman is over 30 years old. The older the woman, the higher the likelihood that the embryo will not develop normally inside. Therefore, before becoming pregnant, it is worth undergoing a full medical examination and identifying whether there are any health problems that could be a threat to the life of the mother and the unborn child.

Teratozoospermia

Teratozoospermia is an abnormal condition of sperm. As the disease progresses, the sperm becomes deformed and its structure changes. The pathology is characterized by thickening or strong bending of the tail. And also the sperm sometimes lacks a chromosome.

Problems with the baby's growth in the womb often arise due to poor sperm count. The development of teratozoosperia subsequently leads to male infertility. But sometimes not all sperm die in the ovaries, and a woman can become pregnant. Such fertilization will ultimately lead to miscarriage or premature birth. The progression of the disease due to the presence of teratozoosperia in men is observed in 55–60% of cases of development of the anomaly.

Wrong lifestyle

When planning and carrying a baby, do not forget about such an important factor as the lifestyle of the expectant mother. Bad habits, poor nutrition, non-compliance with the daily routine - all this can adversely affect the health of the mother and the unborn baby.

The presence of toxic substances or some active components of the drug in the body can negatively affect the placenta and destroy it. Therefore, before taking pills, you need to consult a gynecologist and find out whether it will harm the baby. You also need to adjust your meager diet and completely give up bad habits, stress, and hard work.

Other factors

The growth of the embryo is negatively affected by: climate, stress, nervous breakdown. Any negative emotions release enzymes into the body that retard the baby's growth.

Don't forget about previous abortions. If the girl has already had several abortions and mechanical cleaning after miscarriages. There is a possibility that the uterus, ovaries or fallopian tubes have been damaged. Flabbiness of the uterus can also be the reason why the fetus did not take root and died. In cases where a girl has undergone IVF, subsequent natural pregnancy is usually difficult and the fetus risks dying even in the last weeks of pregnancy.

Who is at risk

Girls at risk of embryo freezing during gestation are:

1. Age over 30 years.
2. Those who had abortions at an early age.
3. If there were multiple abortions and spontaneous miscarriages.
4. Who have previously had an ectopic pregnancy.
5. With the presence of pathological diseases of the reproductive organs.

It is impossible to determine that an anomaly is developing on your own at home. During this period, nausea and vomiting often occur, as during normal pregnancy.

Treatment methods

Only a gynecologist can make a final diagnosis after examining the girl and conducting laboratory tests. The doctor examines and feels the woman's stomach. When deviating from the norm, a slight expansion of the uterus is observed. A diagnostic method such as ultrasound helps to make an accurate diagnosis.

Sometimes anembryony (absence of an embryo in the fertilized egg) is diagnosed. With this diagnosis, pregnancy also does not develop. It is also worth noting that a sign of a frozen pregnancy in the later stages of gestation is the absence of the baby’s heartbeat. Low levels of hCG and increased prolactin in the blood also indicate problems.

If such a diagnosis has been established, then treatment is carried out within the walls of the hospital. In the hospital, doctors carry out different therapeutic measures depending on the stage of pregnancy.

Treatment proceeds as follows:

• In the 1st trimester, a medical abortion is performed.
• In the 2nd trimester, oxytocin is used to dilate the uterus and allow the baby to come out naturally (in rare cases, a caesarean section is performed).
• In the third trimester - natural birth or caesarean section.

If the antennal death of the embryo has been established, then spontaneous miscarriage is observed. If the loss of a child occurs at 10–16 weeks of gestation, then the girl is prescribed medication.

In cases where the fetus has partially exited the body or has severely damaged the uterus, surgery may be performed to cleanse the body of the remaining placenta. After the operation, the woman is prescribed a medicinal course of rehabilitation in the hospital; if necessary, psychological help may be needed.

How to avoid a frozen pregnancy

If a girl has problems carrying a baby and the pregnancy is terminated, then there is no need to despair. There is always a chance of getting pregnant again. But you need to know how to avoid the negative consequences of ST and next time give birth to a healthy baby. Women need to undergo a full examination at the clinic. It is important that both parents undergo the test, since the reason for the interruption of pregnancy may lie precisely in the man.

A woman needs to reconsider her lifestyle. Eliminate alcohol and nicotine. Nutrition should be balanced and healthy. It is best to avoid fatty, salty and junk foods. Play sports and move more.

It is important to regularly visit a gynecologist. This minimizes the risk of contracting infections and prevents the development of serious diseases in the body. A girl's life should have positive emotions and a warm atmosphere. Only then will the risk of two frozen pregnancies occurring in a row be minimal.

You can find out in more detail about the reasons for the appearance of abnormal development of the embryo in the womb by watching an educational video for expectant mothers:

Conclusion

Retarded fetal development in the womb can occur at any period of gestation. This serious pathological condition leads to the death of the embryo; the causes of the disease vary. Therefore, it is important to plan for the future of the baby, approach the new position responsibly and regularly visit the gynecologist to prevent problems from arising during the gestation period.

A pregnancy that begins successfully does not always end in a positive outcome. In medical practice, the most dangerous period of time when carrying a child is considered the first trimester, during which various complications can arise, leading to the death of the fetus.

Frozen pregnancy is a pathology in which the fetus stops growing and developing and dies in the womb. Sometimes this complication ends in spontaneous miscarriage. However, quite often the dead embryo remains in the uterine cavity, which can cause inflammation, and if the process worsens, sepsis is a serious infectious disease in which microorganisms circulate in the blood.

10 signs of a frozen pregnancy

No toxicosis

The cessation of morning sickness and vomiting is a sign of frozen pregnancy in the first trimester. However, women do not always pay attention to this phenomenon, because they believe that the unpleasant symptoms have simply gone away and the body has adapted to the birth of a child. As a rule, toxicosis during a frozen pregnancy ends very abruptly. Typically, this symptom does not appear immediately after the death of the fetus, but after several days or even weeks.

Returning breasts to their pre-conception condition

The absence of swelling of the mammary glands and hyperpigmentation of the nipples is another sign of a frozen pregnancy. These changes in the chest are also drastic. In addition, signs of a frozen pregnancy include a one-time cessation of colostrum secretion, if it was secreted previously.

Decrease in basal temperature

If a pregnant woman monitors her pregnancy, then if it decreases, a frozen pregnancy can be suspected. If the fetus dies, the thermometer displays a temperature of less than 37 degrees Celsius (usually 36.4-36.9). However, based on this sign of a frozen pregnancy in the first trimester, it is impossible to accurately diagnose, since there may be an incorrect measurement or thermometer error.

Appearance of pain

The appearance of menstrual pain in the lower abdomen may indicate a missed pregnancy. However, this symptom appears after a long period of time, sometimes up to several weeks after the death of the embryo. On the contrary, nagging pain in the lower abdomen, accompanied by bloody discharge, more often speaks of.

Pathological vaginal discharge

The appearance of spotting vaginal discharge streaked with blood or red in color may be a symptom of a frozen pregnancy. But much more often, this sign indicates the onset of a spontaneous miscarriage.

Increased body temperature

If there is an infectious process in the uterus due to the disintegration of a dead fetus, a woman experiences an increase in body temperature to subfebrile values ​​(up to 38 degrees). However, if this process begins to be systemic in nature, hyperthermia to very high values ​​(40-41 degrees) and a general serious condition of the woman’s body are possible.

Frozen pregnancy is not a rare complication and can occur in a completely healthy woman, so when making this diagnosis you should not despair too much, since the probability of the next successful pregnancy and subsequent birth is 80-90%.

Lack of drowsiness, fatigue

When progesterone decreases due to fetal death, its effect on the woman’s body decreases. She loses her feeling of fatigue and drowsiness. This sign of a frozen pregnancy is extremely unreliable, however, if there are other symptoms, the woman should be examined.

No increase in hCG

During a frozen pregnancy, human chorionic gonadotropin stops increasing after the death of the fetus, and then it begins to decrease altogether. Therefore, if you suspect this pathology, you should monitor the dynamics of hCG by taking a repeat test after 2-3 days.

Gynecological examination

During the examination, the obstetrician-gynecologist measures the volume of the uterus. During a frozen pregnancy, there is a lag in size, which can serve as a diagnostic criterion for pathology. However, this sign cannot be used in the first weeks of gestation, since at this time the volume of the uterus is practically no different from its dimensions before conception.

Ultrasound

During an ultrasound examination, the doctor may detect a frozen pregnancy. This method is considered the “gold” standard for diagnosing this pathology. The absence of heartbeats and a lag in fetal size are the main symptoms of a frozen pregnancy during ultrasound.

Behavior during frozen pregnancy

If subjective symptoms of a frozen pregnancy appear, you should immediately consult a doctor for a thorough diagnosis. If this diagnosis is confirmed using a blood test for hCG and ultrasound, measures are taken to remove the embryo from the uterine cavity.

Sometimes doctors take a wait-and-see approach, the goal of which is the spontaneous onset of miscarriage. When this does not happen, or the fetus died long ago and there is a possibility of infection of the uterus, an abortion is performed. If the pregnancy is less than 8 weeks, artificial miscarriage can be used using.

At short stages of gestation, it is possible to use vacuum aspiration, the safest method of surgical abortion. In later weeks of pregnancy, cleaning the uterine cavity is used. This procedure is performed under general anesthesia, and the resulting materials are sent for histological examination.

Risk group

A frozen pregnancy can occur in any woman, even a completely healthy woman. It is usually associated with congenital abnormalities of the embryo that are incompatible with life, or due to increased emotional and physical stress. The risk group for this pathology includes those with an untreated sexually transmitted infection, as well as those who have a history of abortion or recurrent miscarriage. In addition, the chances of developing a frozen pregnancy are increased in persons with somatic diseases such as diabetes mellitus, thyroid dysfunction and thyrotoxicosis.

And his death (up to 28 weeks, more often before 13 weeks of pregnancy). Every fourth or fifth pregnancy ends this way, but statistics are little consolation for women who lose a long-awaited pregnancy. Having experienced two frozen pregnancies, architect Oksana Ivashchenko was faced with the fact that it is not customary to discuss the situation of a frozen pregnancy even with loved ones - and translated and adapted to our realities an English brochure, which was published to help families faced with pregnancy loss.

Why pregnancy freezes

The reasons for missed abortion are still unknown. In the early stages, as a rule, this occurs due to serious genetic disorders in the embryo - in 70% of cases. It can also be triggered by infectious diseases, trauma, etc.

Let us list the known causes of frozen pregnancy.

Genetic: the fetus does not develop normally and cannot survive.

Hormonal: Women with irregular menstrual cycles may have difficulty conceiving and are more likely to have a miscarriage.

Immunological: problems with blood vessels can lead to miscarriage, especially if the blood has increased clotting; some systemic and chronic diseases, in particular those causing bleeding disorders.

Infections: mild infections (for example, ARVI) do not affect pregnancy, but a strong increase in body temperature and some types of infections (for example,) can lead to miscarriage.

Surgical: previous pelvic surgery increases the risk.

Anatomical: Late miscarriages can be caused by a weak cervix. Miscarriages occur if the uterus is of irregular shape or has formed in it.

Why didn’t I feel any symptoms of a frozen pregnancy?

There are no clear signs of a frozen pregnancy. Sudden changes in well-being, such as the sudden disappearance of toxicosis (nausea, vomiting), a decrease in hypersensitivity in the mammary glands, a decrease (below 37 degrees) or spotting, may be a reason to consult a doctor. But a frozen pregnancy can only be established with the help of blood test for hCG(human chorionic gonadotropin, during a frozen pregnancy, hCG will not grow or will not correspond to the gestational age) and Ultrasound(determined by the absence of a fetal heartbeat or anembryony - an empty fertilized egg).

Could I have prevented a frozen pregnancy?

No. It is very important to understand: the chances that your actions led to the pregnancy fading are negligible. Doctors cannot always name the exact cause of a missed pregnancy, and this uncertainty is sometimes difficult to come to terms with, but they can rely on statistics: even if you have experienced several missed pregnancies in a row, you have every chance that the next pregnancy will result in a healthy baby.

When can you plan your next pregnancy after a missed abortion?

The best time to plan your next pregnancy is when you and your partner are ready—physically and emotionally. Recovery takes time; any loss is important to accept and survive. It’s important to allow yourself to grieve, so that one day, when the worries subside, you wake up with the thought: “Yes, I’m ready to try again. I believe that everything will work out, even if it didn’t work out before, even if I have to make more than one attempt, the time will come, and I will I'll meet my child."

You may want to get pregnant as soon as possible, or the very thought of another pregnancy may cause fear - any reaction is natural and there is no “norm” here. Women and their partners often have mixed feelings about their next pregnancy: hope mixed with fear, excitement mixed with anxiety.

If you or your partner are experiencing significant fear and anxiety about your next pregnancy, please see a neonatal psychologist who can help you cope with these feelings and prepare.

What are the chances that a missed pregnancy will happen again?

If this is the first and only case, then your chances of repeating a frozen pregnancy are the same as those of those women to whom this has never happened. If the frozen pregnancy recurs, then there is a possibility that there may be reasons for this other than genetic ones, and you will be prescribed additional examination.

What is my partner experiencing?

Your partner is also grieving and is worried about you. You can help each other and end up becoming even closer. But sometimes an experience can shake even the strongest relationships. Your partner may not know how to react, may not understand how best to support and comfort you, he may experience his own feelings, which are not always similar to yours.

When people need each other most, they may say or do hurtful things because of their own grief or confusion. A man sometimes tries very hard to “control himself” in a given situation, but this can be read by you as indifference and a desire to “get back to normal life” as quickly as possible. This is wrong. People don't always understand how to properly support each other, especially in difficult times. If you can, please share your feelings openly with your man. If you know what you need, tell him so gently but directly. And don’t forget that your man, no matter how strong he is, also needs your support these days.

How can I tell my loved ones and others about my frozen pregnancy?

Discussing a missed pregnancy with your parents and friends can be difficult. Your loved ones may sincerely worry about you and still not find the right words. They may indeed not know how best to support you, but this certainly does not mean that they love you little or are indifferent to your loss. The first reaction is most often followed by a second, calm, honest and very warm.

In the modern world, there are many ways to help a woman get pregnant, carry and give birth to a healthy child. Children come to us in different ways and at different times. All we can do is want to meet our child and do everything that depends on us for this. For some, this requires just a step, for others there is a long road ahead, but for those who want to become parents, a child will definitely appear.

In recent years, doctors have increasingly begun to recognize the fact that pregnancy is not developing. The real statistics are amazing - the percentage of frozen pregnancies at the beginning of gestation is on average 20%.

Why is the arrest of fetal development in the early stages so common? How to notice the signs of a frozen pregnancy? How does an embryo come out during a frozen pregnancy? How do you know what to do next at a later date? How to prevent the occurrence of a frozen pregnancy and avoid possible complications?

The main causes of frozen pregnancy

Frozen pregnancy is a pathological condition in which the fetus stops growing, but is still in the woman’s belly. This situation often occurs during unsafe periods of the 1st trimester - at 3–4 and 7–11 weeks. At this time, all organs and systems of the fetus are formed. A high percentage of miscarriages also occur between 16 and 18 weeks.

Today, not a single gynecologist gives a clear answer as to why and why an embryo may freeze. Scientists identify a number of predisposing causes and situations that provoke the arrest of fetal development.

Genetic abnormalities in fetal development

According to statistics, 80% of cases of fetal death are directly related to deviations at the genetic level. Chromosomal abnormalities in embryo development arise as a result of disturbances in the quantitative and qualitative parameters of chromosomes. Causes of quantitative problems during frozen pregnancy:

• divergence of a paired chromosome during chromosome separation - associated with trisomy, monosomy;
• the formation of a polyploid embryo, provided that several sperm and one egg are involved in the fusion process.

If violations occur in the first divisions, the embryo will die before the 21st day of existence. When they occur in subsequent divisions, the risk of having a child with mosaicism increases.

Qualitative problems are usually present in one of the spouses. Translocation is the most common cause of early fetal death or the birth of a baby with congenital anomalies. There are similar mutations:

• mutual, when chromosomes exchange identical sections;
• assimilation with loss of genetic pattern;
• with changes in the structure of female sex chromosomes;
• in the form of duplication, inversion and other types of mutations.

In a situation where a pregnancy freezes and does not develop, natural selection occurs. A child who might be born with such anomalies would not be able to lead a normal life, so nature terminates the undeveloped pregnancy at an early stage. Frequent causes of genetic disorders, mutations and chromosomal abnormalities in the fetus are bad habits (smoking, drugs, as well as excessive alcohol abuse by one of the parents).

Diseases associated with hormonal imbalance

A non-developing pregnancy occurs when there is a deficiency of progesterone in the body of the expectant mother. The causes of missed abortion include hormonal imbalance caused by excessive amounts of androgenic hormones. In order to prevent fetal fading, it is recommended to undergo a general examination and pass the required hormone tests at an early stage of planning the baby. In this way, it is possible to timely stabilize hormonal levels and prevent the development of pathological pregnancy.

Autoimmune pathologies

The root cause of a non-developing pregnancy may be autoimmune lesions. In the presence of autoimmune diseases, a woman’s body produces antibodies that suppress not other people’s cells, but their own. Since the embryo is endowed with only 50% of the mother's chromosomes, her cells attack the fetus, leading to its intrauterine death. One of the most common autoimmune diseases is chronic autoimmune endometritis. The disease causes a pathological inflammatory process in the endometrium of the uterus, which is complicated by destruction and fibrosis of the affected areas.

Bad habits of a pregnant woman

Tobacco, drugs and drinks containing alcohol very often affect the state of the chromosomes of one of the partners, so bad habits are among the possible causes of pregnancy failure. Experts recommend that a woman avoid alcohol and drugs at least 6 months before the expected conception. To avoid a frozen pregnancy, the patient should also refuse to work in a hazardous environment.

Taking medications and external factors

Self-medication, uncontrolled use of pharmaceuticals, non-compliance with dosage - this is not the entire list of reasons that harm the embryo and cause a non-developing pregnancy. Other conditions that increase the risk of miscarriage include:

• unacceptable lifestyle of a pregnant patient (meager diet, constant overwork, stress, etc.);
• age (at 22–27 years old, women in labor are much less likely to experience sudden release of the fertilized egg than after the age of 30 years).

What symptoms are used to determine a frozen pregnancy in the early and late stages?

A woman’s sensations very often cannot be distinguished from usual ones, so the patient can walk for weeks with a frozen pregnancy. At this time, a slow process of decomposition of embryonic tissue occurs in the uterus, which ultimately manifests itself in the form of symptoms of general intoxication of the body, and in the worst case, bleeding that is life-threatening to the woman.

A specialist can determine the pathological condition, so a pregnant woman should not neglect a routine examination with a local obstetrician-gynecologist.

Some signs of a frozen pregnancy can be recognized independently at home without a doctor. Common signs of a non-developing pregnancy are:

• bloody discharge;
• lethargy, chills;
• temperature from 37.5 degrees;
• dull pain localized in the abdominal cavity;
• abrupt cessation of gagging and nausea (in the presence of toxicosis);
• absence of unpleasant sensations in the mammary glands;
• absence of signs of fetal life (movements).

1st trimester

Many patients are interested in when a frozen pregnancy occurs in the early stages of gestation, what is associated with the appearance of the pathological condition, and what are the main signs of a frozen pregnancy in the early stages. Indeed, the 1st trimester is considered to be the most dangerous, since it is mainly between 3–5 or 8–10 weeks that pathology appears. Frozen pregnancy signs in the first trimester:

• Painful sensations and the appearance of discharge. If the patient has a stomach ache or is bothered by bloody discharge, she should immediately call an ambulance.
• Temperature increase. If the pregnancy has stopped, the woman feels a general malaise. Most often, it is due to the fact that the temperature during a frozen pregnancy rises to subfebrile values ​​(37.5–38 degrees) due to the development of inflammation associated with the decomposition of the tissues of the dead fetus.

2nd and 3rd trimesters

Starting from the 12th–15th week, the expectant mother waits for the first movements of the fetus. If movements are not felt before the 20th week, this should not be a concern during your first pregnancy. An unscheduled consultation with a doctor is necessary if there are no movements after this time.

The patient should see a gynecologist if the baby’s movements suddenly stop (the first sign of a frozen pregnancy in later stages). A slight increase in temperature without cold symptoms also makes it clear to the patient that she should immediately visit a doctor.

Diagnostic methods

To make a diagnosis and exclude a medical error, a woman needs to undergo additional examination. The fact of fetal death can be confirmed or refuted using the following research methods:

• Inspection. Includes measurements of the uterus, an assessment of the woman’s general condition and the nature of the discharge, if any. The doctor may make a mistake by confusing a frozen pregnancy with placental abruption.
• Ultrasound. A specialist can determine the fetal heart rhythm for a period of 5 weeks. The absence of any signals during an ultrasound may indicate a frozen pregnancy. In a shorter period of time, the specialist performing the ultrasound may make a mistake.
• Blood test for human chorionic gonadotropin. A gynecologist cannot make an accurate diagnosis based only on the results of a standard examination, therefore, if there is a suspicion of a pathological condition of a pregnant woman, she is recommended to be tested for hCG levels several times at a certain time interval. This is necessary in order to track the dynamics of the rise or fall of hCG.

What to do after confirming the diagnosis?

When the diagnosis is confirmed, many women begin to get nervous, not knowing what could happen next. First of all, a woman should remove the fertilized egg from the uterine cavity. Up to 8–10 weeks, treatment of a frozen pregnancy involves the prescription of special tablets or suppositories, with the help of which it is possible to provoke contraction of the muscles of the organ to release the fertilized egg.

For a period of more than 12 weeks, patients are recommended to have a vacuum mini-abortion. The procedure is carried out using local or general anesthesia through a special vacuum suction. If an ultrasound examination reveals remains of fetal tissue in the uterine cavity, curettage is performed and the woman is re-examined after 14 days.

Rehabilitation period

If the fetus is frozen, the woman faces a long period of rehabilitation, including:

• Regular visits to your gynecologist.
• Passing all necessary examinations. A detailed diagnosis is required to clarify the reason why the baby froze in the womb. A woman needs to be tested for hidden infections and consult an endocrinologist to diagnose possible pathologies of the endocrine system. In addition to blood sampling, the patient should undergo a urogenital smear for microflora, and have an ultrasound of the pelvic organs and thyroid gland.
• The woman’s compliance with the principles of proper nutrition, the use of vitamin complexes, and moderate physical activity.
• Stabilization of the psycho-emotional state. Many patients are very afraid that the disease may recur. Amid fear, all their attempts to get pregnant end in failure. In this case, a woman needs psychological support, primarily from her husband and loved ones.
• Follow-up therapy. After cleaning the uterus, doctors resort to long-term complex treatment, which includes hormonal agents to restore the structure and functionality of the endometrium of the uterus, antibacterial and non-steroidal anti-inflammatory drugs, as well as physiotherapeutic techniques.

All of the listed rehabilitation measures will help to prevent a stop in the development of the embryo during the second pregnancy. Many women ask their treating gynecologist if it happens that they manage to get pregnant 2 months after the embryo freezes.

In medical practice, such cases occur; conception can occur after 1.5 months. The restoration of the menstrual cycle signals the readiness of the egg for fertilization.

Despite this, a woman does not need to rush. Experts say that you can plan your next conception no earlier than 4–6 months after the previous unsuccessful attempt. Complete recovery of the body, including physical and psycho-emotional aspects, occurs only after six months.

If a woman has a frozen embryo in the womb, it is recommended to use combined oral contraceptives for the first six months after this situation. To enhance the effect, doctors most often prescribe drugs based on calcium levomefolate.

Consequences for a woman

Mostly, serious consequences of frozen pregnancy occur in patients who turned to a specialist late. How long is it permissible to walk with a non-developing pregnancy? Doctors cannot give a definite answer to this question. Some women can go several weeks with a non-developing embryo in the womb without paying attention to their condition. However, if the fetus is delayed for 2 to 4 weeks and the woman ignores the warning signs, she puts herself at risk of developing dangerous complications. The consequences include:

• spread of infection;
• risk of sepsis;
• development of DIC syndrome.

Is it possible to prevent a frozen pregnancy?

Safe pregnancy and birth of a healthy baby is the work of both parents and specialists. In order to prevent fetal freezing, a woman must first of all follow all the recommendations of the attending physician. Preventive measures include:

• Visiting a specialist in the field of genetics during the period of conception planning. This is necessary in order to prevent the development of a possible pathological abnormality in chromosomes in both partners, pass the necessary tests and, if necessary, undergo a course of special therapy.
• Refusal of all bad habits, moderate physical activity, increased immunity.
• Use of folic acid in consultation with your doctor. Taking the vitamin prevents the development of defects in the baby’s internal organs.

Frozen pregnancy is a pathology, the causes of which have not yet been fully studied. In medicine, a frozen pregnancy is called a failed abortion. The likelihood of developing the problem does not depend on the woman’s age, her social status or the number of previous pregnancies. The causes of the pathology are still not fully understood. According to statistics, frozen pregnancy occurs in every 176th woman planning to become a mother.

What is pathology?

Non-developing pregnancy is intrauterine death of the fetus associated with irreversible processes occurring in its tissues. The pathology does not have pronounced signs, such as, for example, a miscarriage. For this reason, it is important to know about the first signs of pathology in order to promptly seek help from a doctor.

Important! In gynecology, the concept of an empty fertilized egg is often encountered. The condition occurs when the egg is fertilized and attaches to the endometrium. However, the cell itself does not contain an embryo.

Causes of non-developing pregnancy

The most common cause of miscarriage is gene mutations. They are the cause of embryo death in 70% of cases up to 8 weeks. Numerous factors can lead to genetic malfunctions in the body: chronic or hereditary diseases, drug use, alcohol consumption by future parents.

Important! During pregnancy, you should definitely undergo screenings prescribed by a gynecologist and geneticist. This study will detect gene abnormalities in a child in the early stages.

The likelihood of a failed abortion increases if the expectant mother cannot give up bad habits: smoking, poor nutrition, drinking alcohol. Medications that a pregnant woman takes without the consent of a doctor can provoke various abnormalities in the fetus.

Therefore, in the first trimester, potent drugs are prescribed only in extreme cases, for example, in severe infectious diseases. After 10 weeks of pregnancy, a strong placenta is formed, which protects the fetus from external negative influences. In this case, taking medications will not be so dangerous for him.

Other causes of missed abortion include:

1. Rhesus conflict between mother and fetus. The problem is especially acute for women who have had multiple abortions. Gradually, antibodies to the embryo accumulate in the woman’s body, which reduce the likelihood of a successful pregnancy.
2. Severe infectious and viral diseases. Expectant mothers are vulnerable to pathogenic flora, so they quickly become infected during epidemics. Some diseases (rubella, chickenpox, measles) can not only provoke the death of the embryo, but also cause physical and mental abnormalities in the child in the future. In such cases, the mother may agree to an abortion or decide to give birth and raise a special baby.
3. Hormonal imbalances. The cause of miscarriage can be a lack of prolactin or excess testosterone. If a woman experienced irregular menstruation before conception, her gynecologist must be informed about this.

Risk factors for the development of frozen pregnancy:

• old-time women over 35 years of age;
• numerous abortions in the past;
• the presence of defects in the structure of the uterus;
• previously diagnosed ectopic pregnancies.

If there is at least one risk factor, the woman is put under special control by a gynecologist. The risk group for abnormal pregnancy also includes women who refuse to be observed by specialists.

Important! Every pregnant woman should register with a gynecologist at 7-8 weeks of pregnancy.

Timing of frozen pregnancy

The problem occurs at any stage of pregnancy (even a few days before delivery). Studying statistical data, doctors noted several periods that are the most dangerous for the formation of the fetus:

• 3rd and 4th weeks from the moment of conception;
• 7-11th week;
• 16-18th week.

After the 20th week, cases of child development arrest are few. In the vast majority of cases, the problem occurs before 14 gestational weeks. The cause of the anomaly in the first trimester is genetic abnormalities and hormonal imbalances, in the second and third trimesters - infectious diseases.

Symptoms of pathology in the early stages

A woman may not immediately notice a frozen pregnancy, especially if it does not manifest clinical signs. However, the condition poses a threat to a woman’s life, since the decaying fetus poisons the body and harms the reproductive system. However, upon careful examination of her condition, a woman may note the following signs characteristic of a non-developing pregnancy:

1. Abnormal discharge. The woman’s body tries to independently get rid of the fetus after its death. Within 48 hours she may have a whitish discharge of normal consistency. After this, bloody streaks appear in the mucus. Gradually the bleeding becomes more and more profuse.
2. Change in the intensity of toxicosis. After implantation of the fertilized egg, many women feel the urge to vomit. They are associated with increased production of hCG. If the fetus dies, the production of the hormone stops. After a day, the woman may feel relief. 4-6 days after the death of the fetus, signs of toxicosis disappear completely. This symptom does not always indicate pathological processes in the body. The intensity of toxicosis may decrease as a result of the woman’s physiological adaptation to the fetus.
3. Deterioration in general health. An embryo that decomposes for a long time in a woman’s body provokes intoxication of the body. At first, the condition resembles a cold and is accompanied by fatigue and loss of strength. After two weeks, more pronounced signs of pathology appear: dizziness, anxiety, abdominal cramps, temperature.
4. Sudden changes in basal temperature. In pregnant women, the indicator is at a level exceeding 37 degrees. After the fetus dies, the mark on the thermometer drops to 36.7 degrees, and at the time of decomposition of the embryo it rises to 37.5 degrees.

Symptoms of pathology in late pregnancy

From the second trimester, other manifestations join the listed symptoms of frozen pregnancy. The clear clinical picture of the problem is due to the fact that the fetus is large.

The main manifestations of a non-developing pregnancy in the second and third trimesters include:

• absence of fetal movements for more than 24 hours;
• nagging pain in the abdomen;
• leakage of water with an unpleasant putrid odor.

The absence of movements in the fetus may also indicate an insufficient supply of oxygen to it. The situation occurs when the umbilical cord is entwined around the baby’s neck or torso. If a woman consults a doctor in a timely manner, the baby can be saved from suffocation.

One of the characteristic signs of fading pregnancy in later stages is a change in breast size. If breastfeeding occurred before the 25th week, then the breasts return to their previous size within a few days. At later stages after the death of the fetus, colostrum may be released from the glands.

After the death of the fetus, not only the breasts, but also the abdomen decreases in size. This is due to the fact that after the tragedy the amount of amniotic fluid decreases. The listed signs will be observed in a woman one to two days after the death of the fetus. In the later stages of pregnancy, the body tries to get rid of the dead child already on the 4-5th day.

Diagnosis of frozen pregnancy

Examination for a frozen pregnancy includes the following types of procedures:

• visual examination by a gynecologist;
• blood sampling for hCG;
• basal temperature measurement

The first two methods are considered the main ones in identifying signs of a frozen pregnancy, the rest are auxiliary.

Important! If there is a suspicion of a frozen pregnancy before the 7th week, then the abortion is postponed until a repeat ultrasound examination. It may happen that the device did not detect the vital functions of the embryo or the doctor made a mistake when calculating the timing of conception.

• early term - incorrect location of the fertilized egg or its damage;
• late term - the absence of a heartbeat in the fetus and the discrepancy between its size and the term.

Ultrasound data are not enough to make a final diagnosis of BD. Due to hormonal imbalances and psychological stress in women, fetal development can be delayed for up to four weeks. In this case, a repeat ultrasound is performed after two weeks. If the fetus has not increased in size, this means that it is dead.

Treatment of pathology

A popular way to free the uterine cavity from a dead fetus is medical abortion. In Russia, it is performed up to 9 weeks of pregnancy, in European countries - up to 12. The drugs used for therapy are mifepristone and misoprostol. This method gives an effective result, but has a list of contraindications:

• blood clotting disorder;
• severe anemia;
• renal and liver failure;
• ectopic pregnancy.

If a frozen pregnancy is diagnosed at 13-22 weeks, then artificial induction of labor is resorted to using one of the methods:

1. Intramial. A 20% sodium chloride solution is injected into the amniotic sac using a thin needle.
2. Isolated. Insertion of mifepristone or misoprostol into the vagina followed by oral administration of one of the drugs.

If the above methods for removing the fetus do not bring results or have contraindications for implementation, then doctors resort to placing a load on the presenting section of the amniotic sac.

In the third trimester, the dead fetus is disposed of through artificial birth. It is prohibited to perform a caesarean section in this case, as blood infection may occur. The woman will have to give birth to the deceased child without anesthesia as an emergency.

After treatment, the woman will need to adhere to the following rules:

1. Take hormonal medications to speed up the restoration of the endometrium.
2. Take antibiotics to prevent endometrial infection. Drugs from the macrolide or cephalosporin group are prescribed.
3. Undergo physiotherapeutic procedures aimed at regenerating damaged uterine tissue.
4. Take medications to strengthen your immune system.

Another way to remove the fertilized egg is curettage. For periods up to 12 weeks, vacuum aspiration of the uterus is acceptable. The standard curettage procedure is performed only in extreme cases, as it can lead to irreversible damage to the epithelium.

Indications for traditional curettage:

• ineffectiveness of drug therapy;
• cleansing the uterus from fetal remains after an incomplete miscarriage.

Curettage is prescribed to women after an ultrasound, blood test and electrocardiogram. A preliminary consultation with the doctor who will perform the anesthesia is required.

Progress of the curettage procedure:

1. The woman is given intravenous anesthesia, which begins to take effect within a few seconds.
2. The genitals are treated with antiseptic agents.
3. Using a mirror, the doctor fixes the cervix with forceps and expands the cervical canal.
4. The cleansing procedure is performed with a curette equipped with a loop at the end. With its help, all the mucous membranes of the cervical canal and uterus are scraped out.
5. After curettage, drugs are introduced into the uterine cavity to stimulate contractions. The treated area is disinfected with iodine solution.

After the operation is completed, all fixing gynecological instruments are removed. Cold is placed on the woman’s stomach, which helps to constrict small blood vessels and tone the uterus. A woman's menstrual cycle should resume 6-7 weeks after curettage. The operation is allowed to be performed until the second trimester (less often in later stages).

Consequences of a frozen pregnancy

Termination of pregnancy is stressful for the female body, regardless of the chosen method of treatment subsequently. It will be possible to fully recover after the operation only after 6 months. During this time, the woman will need to take hormonal medications.

Complications after a frozen pregnancy:

1. Psychological trauma associated with the fear of unsuccessful subsequent pregnancies or the inability to conceive a child.
2. Infertility. To prevent the development of complications, it is necessary to follow the doctor’s recommendations and be regularly examined by a gynecologist. Symptoms for an urgent visit to the gynecologist are fever, severe vaginal bleeding.
3. Inflammatory diseases of the uterine cavity. The complication often develops after traditional curettage. During the operation, the mucous membranes of the reproductive organ are removed, which makes it more vulnerable to pathogenic flora.
4. Adhesive processes. Inflammation of the uterus leads to the fact that its individual parts stick together. Deformation of the organ cavity subsequently becomes the cause of infertility.

Prevention of undeveloped pregnancy

Each couple planning a child must first undergo a set of studies, which includes a blood test for infections, ultrasound of the pelvic organs, and genetic tests. It is recommended to refrain from conceiving if less than 6 months ago one of the partners had rubella, chickenpox or a severe form of influenza.

Other measures aimed at preventing frozen pregnancy include:

• performing preventive vaccinations;
• visit to a geneticist;
• normalization of hormonal levels;
• maintaining a healthy lifestyle;
• refraining from flying in the first months from the moment of conception.

With proper planning, the probability of a successful pregnancy is about 90%. This also applies to cases where a woman has had unsuccessful attempts to bear a child in the past. It is important not to ignore visits to multidisciplinary specialists who will draw up a competent treatment plan after a frozen pregnancy.