The condition, as a result of which fetal growth stops and its intrauterine death sets in, is called a frozen or undeveloped pregnancy. Such pathology during gestation is considered one of the forms of miscarriage. With an undeveloped pregnancy, the child dies in the mother's womb, and its exit from the uterine cavity does not occur. A lifeless fetus can remain in the uterus for a long time and without medical intervention does not leave it. With spontaneous abortion, the fetal egg is ejected from the uterine cavity with the corresponding symptomatology.
Causes of undeveloped pregnancy
Not one of the women is insured against miscarriage. The onset of an undeveloped pregnancy can occur in any trimester, at any age of the future mother. After 40 years, the risk of miscarriage increases to 40%. Causes that have affected the fading of embryo development can be several. More often this genetic pathology is not compatible with the life of the fetus. But they will be determined only by a specialist - gynecologist or geneticist.
Among the most common factors that cause intrauterine fetal death are: genetic disorders, infectious diseases, immunological rejection of the fetus, endocrine pathologies of the mother, work in heavy or toxic industries. If fading pregnancy occurs two or more times in a row, they say, about a habitual miscarriage. But even a few miscarriages do not preclude the possibility of giving birth to a healthy child. It is necessary to find out the circumstances of what is happening and not to despair.
Symptoms of undeveloped pregnancy
At the beginning of the gestational period, in the first trimester, the distinctive features of an undeveloped pregnancy are dullness of the individual sensitivity characteristic of most women waiting for a child:
the engorgement of the mammary glands practically disappears (both breasts become soft);
decreased severity of nausea, vomiting and other signs of early toxicosis;
the frequency of emetic urgency is reduced,
Perception of sharp smells,
decreases and almost disappears drowsiness and weakness.
For the first trimester, 3-4 weeks of gestation are critical, when a fertilized egg is fixed to the uterine wall, many vital systems (digestive, bone, urogenital, etc.) continue to form in the 8-11 week, forming the umbilical cord. During these periods, genetic problems manifest themselves in full, which leads to serious consequences.
But not every pregnant woman will pay attention to such minor changes in health. For this reason, the embryo dies, but it is not immediately determined. For some time, many women expecting a child and do not know what happened. During the gynecological examination, the discrepancy in the timing of gestation and uterine size is determined. To make sure that the discrepancy is not caused by the fetal death of an embryo or fetus, an ultrasound (ultrasound) is prescribed.
A terrible sign of an undeveloped pregnancy is the smearing vaginal discharge from pinkish to brown, pain in the lower abdomen and altered tone of the uterus. The final verdict on the presence of an undeveloped pregnancy will be made on ultrasound. The absence of palpitation is determined at week 5-6, a deformed (often empty) fetal egg and a discrepancy between ultrasound and gestational age. Repeated ultrasound diagnosis can be scheduled in a week to eliminate errors with the diagnosis. If within 7 days there is no positive dynamics (growth of the fetal egg), the embryo does not visualize, then the pregnancy will be considered "frozen". The doctor chooses a tactic for further treatment.
The first signs of an undeveloped pregnancy in the early stages
The first signs of an undeveloped pregnancy in early pregnancy can be diagnosed by analyzing the level of HCG (human chorionic gonadotropin). Dynamics plays an important role here. If the development of the embryo occurs without pathologies, then the hCG indicators increase almost daily.
The measurement of basal temperature in case of suspicion of a frozen pregnancy will not be informative. In pregnancy with a normal course, the basal temperature is 37.3-37.5 ° C, and if the pregnancy does not progress, the temperature decreases.
Ultrasound also will not be informative, because on very small terms a fetal egg and an embryo will not be visualized.
Incompatible pregnancy in the second trimester
In the early stages of gestation, the possibility of terminating the development of the fetus is much higher than in the second trimester. But even at this time of gestation the child "fades" of pregnancy occurs quite often. Critical for the second trimester is considered two periods - 16-18 weeks and 22-24 weeks.
The causes that caused fetal death in the second trimester are hereditary and genetic pathologies, an incorrect lifestyle (smoking, alcohol and substance abuse), hormonal disorders, various infections.
Genetic malfunctions usually manifest themselves at earlier stages of pregnancy (by 6-7 weeks). If the pathology is severe, the embryo in most cases does not survive until the second trimester. Genetic abnormalities of the mother and father are very difficult to identify, and at what point they affect the development of the child can not be predicted.
Also for the normal development of the embryo, the balance of hormones is very important: if the balance is violated, the fruit stops development.
More often it occurs before 8-10 weeks, but happens and in II trimester. During the gestation period, the woman's immune system is weakened, and the degree of vulnerability of the body increases. Penetration of pathogens of some infections through the placental barrier can lead to fetal death. But such a danger persists throughout the 9 months. Therefore, it is necessary to be very careful of any infections, apply preventive measures and seek specialist help in a timely manner.
It is worth mentioning once again about the correct way of life, which is necessary to lead a future mother. Stress, work at a computer, smoking, alcohol or drugs, lack of sleep largely provoke the fading of pregnancy at any time.
The appearance of vaginal bloody discharge, aching pain in the lower abdomen, the cessation of breast augmentation (it becomes soft, the colostrum can be released from it), a feeling of chills, fever, tremors, severe weakness, all signs of toxicosis disappear, no stirring - these are very serious reasons for immediate medical attention. The gynecologist determines fetal fading in the second trimester of pregnancy due to inadequate timing and size of the uterus, a change in the color of the vagina and the absence of a heartbeat audible through the stethoscope. Pregnant in this case, without delay, sent to the ultrasound and, if necessary, urgently hospitalized. Signs of undeveloped pregnancy in the second trimester, unfortunately, are very late. For a long time, the development of the fetus does not manifest itself in any way, and the strongest poisoning of the mother's body by the products of decay is already taking place. A woman needs to promptly turn to a specialist in order to reduce the likelihood of tragic consequences. From 18-20 weeks the fetus moves, they must be repeated more than 9 times a day. If the movements are smaller or absent, this is an occasion for a visit to the doctor.
In normal pregnancy, the breast significantly increases, and in case of problems with the fetus, it decreases in size and softens.
If the doctor does not listen to the heartbeat with a stethoscope, then it is not necessary to panic in advance, because the fatty layer sometimes prevents auscultation. Ultrasound in this case will be very appropriate.
Normally, vaginal discharge is transparent or whitish, not very abundant, but if the volume of discharge increases, they are dark or bloody, this is an emergency situation for an immediate visit to a women's consultation.
Treatment for an undeveloped II trimester pregnancy is prompt.
Signs of a non-developing pregnancy in the third trimester
Cases of undeveloped pregnancy in the third trimester occur less frequently than at an earlier gestational age. This is because the fetus has already been sufficiently formed. But the risk of an undeveloped pregnancy in the third trimester still remains. The older the woman, the more likely the development of miscarriage, especially critical in the third trimester - 26-28 weeks.
The causes of antenatal fetal death in the third trimester can be: infection with infectious diseases (rubella, influenza, toxoplasmosis, cytomegalovirus, syphilis, gonorrhea, etc.), hormonal disorders, genetic abnormalities of the fetus, diseases of the genitourinary and cardiovascular systems. Especially dangerous is the antiphospholipid syndrome, a characteristic feature of which is the tendency to form blood clots, including in the vessels of the uterus, as a result of which the fetus lacks oxygen and nutrients and dies.
The first and most alarming sign of an undeveloped pregnancy in the third trimester is the absence of manifestations of the fetus (stirring) for more than 6 hours. This is a very serious cause for concern. To exclude the death of the fetus, a tocophe is assigned. It either confirms or refutes fear. Ultrasound on a long term of beremennosti is also informative. Brown spotting discharge from the vagina with "frozen" pregnancy in the III trimester is a consequence of the neglect of the process, which began long ago.
On a long term, an undeveloped pregnancy can be manifested by pains in the lower abdomen or lumbar region, altered tone of the uterus, secretions (watery, bloody, brownish) of smearing nature.
The probability of maceration of the deceased fetus and its decomposition is very high. Then the symptoms of intoxication and high body temperature will join certain signs of the undeveloped pregnancy of the third trimester, provided there is no ARVI. Complication with infection of an undeveloped pregnancy on a long term may be a septic condition. At the slightest anxiety and bad suspicions for the frozen pregnancy it is necessary urgently to address to the expert. Let him once again confirm that everything is normal with the fetus and the future mother.
Explicit signs of undeveloped pregnancy
Clear signs of a "frozen" pregnancy in the early stages are:
discrepancy of the fetal egg, the size of the uterus and the timing of pregnancy;
bloody or brown discharge from the vagina;
results of ultrasound (the fruit is absent in the fetal egg, the fetal egg is deformed)
stabilization or reduction of hCG;
subjective sensations with extinct pregnancy in the early stages:
pulling or cramping pain in the lower abdomen;
significant reduction or cessation of symptoms of toxicosis (nausea, vomiting, "sensitivity" to sharp smells);
spotting bloody vaginal discharge.
Gynecological examination : the gestation period and the size of the uterus are in substantial non-compliance; the basal temperature decreases; the color of the vaginal walls changes.
Signs of a "frozen" pregnancy at a later date:
prolonged absences of the fetus (more than 6 hours);
It is not audible by a stethoscope or the fetal heart is not detected by the tokograph;
there is a discrepancy between the gestational age and the size of the uterus.
Subjective sensations :
the phenomena characteristic of toxicosis disappear, the tension in the mammary glands decreases, and sometimes the colostrum is secreted;
there are aching pain in the waist and abdomen;
the body temperature rises for no apparent reason;
spotting from the vagina.
Gynecological examination : the doctor determines how great the difference in the discrepancy between the gestational age and the size of the uterus, ascertains a change in the color of the vaginal walls, a slight opening of the cervix and separation from the genital tract.
Diagnostics of undeveloped pregnancy
If there is a suspicion of a "frozen" pregnancy in any period, an ultrasound study will be quite informative.
Conclusion on the termination of embryo development at a small pregnancy period is done with ultrasound in such cases:
anembryonic finding of the fetal egg in the lower part of the uterus;
its deformation, distorted contour;
The embryo is much smaller than the normal size that is characteristic for this gestation period;
At 5-6 weeks, ultrasound is already determined by the heartbeat or lack of it in the fetus.
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