Fetus - says Doctor of Medical Sciences, Professor Igor Makarov.

With a non-developing pregnancy, which is also called a "missed pregnancy", the death of the embryo / fetus occurs, but there are no clinical signs of spontaneous miscarriage.

The causes of non-developing pregnancy are very diverse. So, stopping the development of the embryo/fetus may be due to the inflammatory process as a result of the action of various microorganisms. Most often, the causative agents of inflammation are: streptococci, staphylococci, E. coli, Klebsiella virus, cytomegalovirus, herpes simplex virus, Coxsackie virus, mycoplasma, chlamydia, treponema, mycobacteria, toxoplasma, plasmodia, fungi ().

chronic infectious diseases in a woman, most often they do not directly lead to intrauterine death of the fetus, but cause certain disorders that contribute to it. For example, as a result of direct exposure to an infectious factor, a heart defect is formed in the fetus, which prevents its further normal development. However, not always and not every infection leads to the death of the embryo. In this case, the influence of the infection depends on the route of its penetration, the involvement of the fetus and amniotic membranes in the infection, the type and activity of the pathogen, the number of penetrating microorganisms, the duration of the mother's disease, the activity of the body's defenses, and other factors.

Microorganisms can enter the uterus from the underlying parts of the reproductive system, infecting the amniotic fluid, which is then swallowed by the fetus. The infection can spread through the amniotic membranes, and further to the fetus, causing damage to its internal organs, which, in turn, is the cause of its death. The infection can also get to the fetus from chronic foci of inflammation in the fallopian tubes and ovaries.

The death of the embryo/fetus may be due to a violation of the immune relationship, taking into account that the fetal egg is half foreign to the mother's body. At the same time, rejection reactions are activated, aimed at defeating the fetal egg and removing it from the uterus. Non-developing pregnancy may be due to various chromosomal disorders: in the first 6-7 weeks of pregnancy, chromosomal changes are present in 60-75% of cases of spontaneous abortion, at 12-17 weeks. - in 20-25%, at 17-28 weeks. - in 2-7%. With age, the likelihood of chromosomal abnormalities increases. The causes of the development of chromosomal disorders are also unfavorable external factors. Growth and development of the embryo/fetus can be stopped thrombotic complications caused by genetic defects in the blood coagulation system in a pregnant woman. The most common among them are: factor V Leiden mutation, prothrombin G202110A mutation, methyltetrahydrofolate reductase mutation, plasminogen activator gene polymorphism, platelet receptor polymorphism.

Blood coagulation disorders, caused, also determine the unfavorable development of the embryo / fetus. In the early stages of pregnancy, the role of the direct damaging effect of antiphospholipid antibodies on the structures of the fetal egg, followed by spontaneous abortion, is not excluded. With this pathology, the process of implantation of the fetal egg is disrupted. In addition, with antiphospholipid syndrome, there is a decrease in the formation of placental vessels and a decrease in its function, which can cause a non-developing pregnancy. Another cause of impaired development of the embryo and placenta in antiphospholipid syndrome is thrombosis and damage to the uteroplacental vessels.

Among the causes of miscarriage, there are also hormonal changes. Violation of the formation and decrease in the function of the corpus luteum in the ovary leads to a decrease in progesterone and inadequate preparation of the uterus for implantation of the fetal egg. In this regard, the formation of uteroplacental circulation is disrupted, which entails a decrease in the blood supply to the embryo/fetus, and its death. Often, such disorders occur with excessive accumulation in the body of a woman of male sex hormones (Stein-Leventhal syndrome, adrenogenital syndrome), with reduced or increased thyroid function.

The shorter the gestation period, the higher the sensitivity of the embryo/fetus to the action of damaging factors. However, it decreases unevenly throughout fetal development. There are critical periods during pregnancy, in which the ovum, embryo, fetus are especially vulnerable to adverse effects: the implantation period (7-12 days), the embryogenesis period (3-8 weeks), the placenta formation period (up to 12 weeks), the formation period the most important functional systems of the fetus (20-24 weeks).

There are a number of consecutive violations, characteristic of non-developing pregnancy: decrease and cessation of uteroplacental circulation against the background of damage to the structures of the placenta; cessation of uteroplacental circulation; violation of the structure of the inner layer of the uterus (endometrium), caused by the presence of dead elements of the fetal egg in the uterine cavity.

Clinical signs of non-developing pregnancy can be extremely scarce against the background of the cessation of the increase in the size of the uterus and their inconsistency with the gestational age. However, the uterus can be of normal size, can be reduced, and can even be enlarged if it is filled with blood during detachment of the fetal egg.

For some time after the death of the embryo / fetus, the patient may feel pregnant. However, over time, the subjective ones gradually disappear. Smearing bloody discharge from the genital tract and spastic pain in the abdomen are periodically noted. Chorionic gonadotropin in the blood of a woman, as a rule, is at an extremely low level or even completely absent.

Diagnosis of non-developing pregnancy

The most reliable way to identify a non-developing pregnancy is by the results ultrasound in the absence of a fetal heartbeat. One of the most common options for non-developing pregnancy is anembryony, i.e. the absence of an embryo in the cavity of the fetal egg after 5-6 weeks of pregnancy. In this case, the fetal egg is smaller than expected, and the embryo is not visualized.

In other variants of a non-developing pregnancy, according to ultrasound, the fetal egg corresponds in size or lags behind in its development, the embryo can be visualized, but without a heartbeat. Often, a retrochorial hematoma can be detected, which is an accumulation of blood at the site of detachment of the fetal egg from the uterine wall.

With a longer stay of the dead embryo in the uterus, visualization of the embryo is impossible, there are no signs of its vital activity. The size of the uterus lags behind the gestational age, there is a deformation of the fetal egg with fuzzy contours.

Removal of a dead fetal egg

The death of the embryo/fetus is not always accompanied by its spontaneous expulsion from the uterus. Often there are cases when a dead fetal egg lingers in the uterus for an indefinitely long time. The reason for such a delay may be: the primary tight attachment of the ovum to the uterine wall during implantation, the inferiority of the reactions of immune rejection of the dead ovum, the decrease in the contractile activity of the uterus.

When a dead embryo is in the uterus for more than 4 weeks, the elements of the decay of the fetal egg enter the maternal bloodstream, which can cause massive bleeding when trying to terminate the pregnancy. Therefore, before curettage of the uterus, it is necessary to perform studies of the state of the blood coagulation system and, if necessary, to carry out appropriate treatment.

After a thorough examination and appropriate preparation of the woman (carrying out therapeutic and preventive measures aimed at reducing the risk of developing possible complications) must be interrupted. For this purpose, instrumental or drug-induced dilation of the cervix and instrumental removal of the contents of the uterus are performed. It is also possible to use special medications for non-operative removal of the ovum from the uterus. An ultrasound scan should be performed immediately during the abortion or immediately after it is completed to ensure that parts of the fetus and placenta have been completely removed. After removal of the fetal egg in a non-developing pregnancy, regardless of the chosen method of termination, it is advisable to carry out anti-inflammatory treatment.

In each case, with a non-developing pregnancy, an in-depth examination is required to identify possible causes of abortion with their subsequent elimination or weakening of the effect.

How to reduce the chance of embryo death?

To reduce the likelihood of possible damaging factors on the course of pregnancy, it is necessary to carry out screening examination patients planning pregnancy, as well as women in early pregnancy for urogenital infection. It is also important to conduct medical genetic counseling in order to identify high-risk groups for congenital and hereditary pathologies. In the presence of endocrine causes of miscarriage, appropriate corrective hormonal therapy should be selected.

It is also important to identify various autoimmune disorders and their correction. Re-pregnancy is possible when the identified causes of embryo/fetal death are eliminated, and after the necessary treatment has been carried out. In case of a new pregnancy, an ultrasound examination is performed, markers of possible fetal development disorders are determined in the blood, including: α - fetoprotein, chorionic gonadotropin, PAPP-A test in the most informative terms. According to indications, invasive prenatal diagnostics is also carried out, including chorion biopsy, amniocentesis or cordocentesis to determine chromosomal and a number of monogenic diseases of the fetus. In addition, they carry out therapeutic and preventive measures aimed at eliminating the infectious process, conduct specific anti-inflammatory therapy in combination with immunocorrectors, correct violations of the blood coagulation system and prevent placental insufficiency from 14-16 weeks of pregnancy.

About what a non-developing pregnancy is, what are its causes and consequences, today the site for mothers will tell the site.

Any woman, having learned that she will soon become a mother, is looking forward to the first trip to the ultrasound. But women's plans for a happy future can collapse in one short moment - if the device detects the absence of the baby's heartbeat. And one of the reasons for this phenomenon may be.

Most of these cases occur in the early stages of pregnancy, up to 14 weeks, and suggest the death of the child. A pregnant woman may not know about it, because there are no obvious signs of fetal death, such as in a miscarriage.

Causes of fetal fading

There are no exact answers to the question why the pregnancy is not developing. Factors affecting the formation of the fetus in the first few weeks can be very different. Especially if the woman did not suspect that she was pregnant.

Most likely causes:

• global hormonal restructuring of the whole organism;
• predisposition to hereditary diseases that caused abnormalities in the development of the fetal egg;
• infections, incl. including sexual and TORCH infections;
• the presence of antiphospholipid syndrome (APS) in a pregnant woman;
• bad habits;
• too early or late pregnancy;
• nervous tension..

Signs of a non-developing pregnancy in the early stages

With the help of hCG indicators, you can determine the further development of pregnancy. A week after fertilization, this hormone begins to be produced by the cells surrounding the fetus. From this time until the tenth week of pregnancy, the level of hCG rises rapidly, doubling daily.

Each week of pregnancy has its own hCG level. If its indicators are lower than it should be in this period, and a re-analysis a day later showed a continuation of the fall, then the doctor can diagnose a miscarriage.

A decrease in the level of chorionic gonadotropin is one of the first signs of an undeveloped pregnancy.

Another reliable sign of fetal fading is ultrasound procedure in the early stages. It will help determine the presence of a baby's heartbeat (cardiac activity begins at week 5). But if the features of the embryo are clearly visible, and there is no heart rhythm, this may mean intrauterine death of the fetus.

To accurately diagnose a non-developing pregnancy, you must re-pass the ultrasound in a week.

Symptoms of an undeveloped pregnancy

A woman may notice some signs of a missed pregnancy:

• in the early stages, such signs of pregnancy as toxicosis, soreness and swelling of the mammary glands, changes in taste preferences, increased salivation, etc. disappear;
• normalization of basal temperature;
• during an external examination, the gynecologist may note a lag in the size of the uterus from the size corresponding to the probable gestational age;
• for periods of more than 16 weeks, the absence of fetal movements;
• detachment of the fetal egg due to its fading causes pain in the lower abdomen with the release of blood contents from the genital tract. The temperature may rise. This happens a couple of weeks after the death of the embryo.

The process of terminating a missed pregnancy

Unfortunately, the "non-developing pregnancy" must be terminated. The doctor for choosing the appropriate therapy should build on each specific case.

Most of these pregnancies end spontaneous miscarriage. Sometimes, for periods up to 8 weeks, a medical termination of pregnancy is required. For this, drugs that weaken the action of progesterone and prostaglandin analogues are used.

After their introduction in the body, a natural mechanism for the expulsion of the fetus in the form of a miscarriage is launched.

Surgical intervention in the later stages involves the process of curettage of the uterine cavity in order to extract the dead fetal egg.

Scraping tissues are sent for laboratory studies for histology and cytogenesis. The woman is given oxytocin to contract the uterus and is given a course of antibiotics to prevent infection. After the procedure in a couple of weeks it is necessary to undergo another ultrasound to exclude the presence of residual fragments of the fetal egg in the uterus.

Consequences of non-developing pregnancy

A delay in terminating a missed pregnancy can cause the development of an intrauterine infection, an inflammatory process in the tissues of the uterus and appendages.

The decomposition of the cells of a dead embryo saturates the woman's blood with dangerous toxins. As a result, reduced blood clotting and the risk of severe bleeding.

During the curettage procedure, damage to organ tissues is possible. Along with the physical difficulties suffered, the mental state of the woman also requires rehabilitation. After all, there is nothing worse than losing a very tiny, but already so dear and long-awaited creature.

All of these factors can reduce the likelihood of having children in the future. Therefore, upon detection of the first alarming signs, you should immediately contact your gynecologist. Timely removal of a dead embryo can significantly reduce the risk of complications.

So that the next pregnancy after the non-developing one is not terminated in the same way, it is better not to plan conception for another six months after the rehabilitation course. Before this, both partners should undergo a full examination in order to identify the causes of the previous fetal fading.

Gynecologists say that during each month a woman experiences all four seasons. After all, the level of hormones in her body fluctuates all the time, which affects both our well-being and mood. All these processes are aimed at ovulation and further fertilization of the egg. And if this happens, then hormonal activity will be aimed at preserving the fetal egg and its successful development.

Not all, but the vast majority of women, of course, feel these changes on a physical and emotional level. Often, even intuitively, a woman feels that she is pregnant. We listen to our body from the first weeks, trying to determine what is happening to us. And sudden changes or disappearance of some signs and sensations can scare us a lot. Most often this happens at a stage when the body is already getting used to functioning in a new mode, that is, closer to the second trimester. But still, if intuition tells you that something is wrong, then it is better to play it safe and go to the gynecologist. Unfortunately, it is not so rare that a pregnancy stops its development due to the death of the embryo. And this can happen at any time.

A non-developing pregnancy is also called a dead one. Its outcome is always the same: interruption by natural, medical or surgical means. Such a pregnancy has no chance of development, because the embryo is either not there, or it has died.

In the first case, obstetricians talk about anembryos- this is one of the types of non-developing pregnancy, in which the fetal egg is empty, without an embryo inside. Such a pathology is detected at the earliest possible time, as a rule, during the passage of the first ultrasound.

But it also often happens that the embryo that has begun its development is not viable or dies under the influence of certain pathological factors. The first signs of a non-developing pregnancy may appear after a certain time, because at first there are no signals of a tragedy from the inside.

Most often, pregnancy stops in the first trimester. It is far from always possible to independently determine this, but sometimes a woman can still suspect that something is wrong with changes in her condition.

Breast during a frozen pregnancy

The breast reacts to the new condition of a pregnant woman one of the first. It becomes heavier, pours, increases in size, increases the sensitivity of the nipples, they darken, a painful sensation may occur. These changes, like all others, occur under the influence of hormones. If the pregnancy stops developing, then the level of these hormones will begin to decrease, and its early symptoms will begin to disappear.

So, if in the first weeks, in the early stages, the chest suddenly stopped hurting, toxicosis and other first signs disappeared (irritability, drowsiness, etc.), and the woman no longer feels what she used to, then it is better to consult a doctor for consultation and examination . It is likely that early toxicosis is over - and the most pleasant period in terms of well-being is coming. However, if there are any doubts, it is better to dispel them.

Temperature during non-developing pregnancy

If a woman kept a chart of basal temperatures before conception and continues to do so in the first weeks after, then when the embryo freezes, she may notice some changes in the chart. In particular, BT, fixed at elevated levels, will begin to decline. However, very often it remains elevated for a long time after the death of the fetal egg, and in general, BT in each individual case can behave differently, and very often errors and inaccuracies are made when measuring BT. Therefore, doctors do not advise using this method to assess the well-being of embryo development.

As for general health, then, of course, with a miscarriage that has begun due to an undeveloped pregnancy, body temperature can rise - as a reaction to a pathological process. But even this is not a prerequisite and does not always indicate the ST.

The developing fetal egg actively produces the hormone human chorionic gonadotropin, so that pregnancy can be diagnosed already at the earliest possible date. A blood test for hCG is perhaps the earliest reliable method for its determination.

The level of hCG in the blood and urine of a pregnant woman doubles every two days in the first days and weeks. If a pathological development of pregnancy or its fading is suspected, a woman is often prescribed this analysis to monitor the level of hCG in dynamics. That is, if several consecutive studies (usually at intervals of a day) show that the level of hCG does not increase or even decreases, then they come to a disappointing conclusion.

What will the test show with a frozen pregnancy

For the same reason, a test performed during a missed pregnancy may show a pale second stripe or even give a negative result if enough time has passed after the death of the embryo, and the level of chorionic gonadotropin has significantly decreased.

However, this method cannot be trusted alone. Remember: tests often give false positive and false negative results, which can be for a large number of different reasons.

By and large, none of the signs described above should lead a woman to the idea that the embryo is frozen. And only if these signs are combined with each other, you can start to worry. And if, in addition, bloody discharge from the vagina also appears, then it is imperative to consult a doctor, even if there are no other reasons for concern. Bleeding, brown discharge, or even daubing indicate the onset of detachment of the fetal egg, and it is very likely that the pregnancy can still be saved.

If the fetus has already froze for quite a long time, then the woman will certainly notice that for a long period of time no movements are noted. However, even such a very eloquent sign cannot accurately indicate the fading of the fetus.

A woman's own feelings cannot be any reliable signs of an undeveloped pregnancy. In combination with different circumstances and accompanying symptoms, they can only lead to the idea that perhaps not all is well. But in general, gynecologists say that an undeveloped pregnancy is often not accompanied by any specific characteristic clinical manifestations. The diagnosis of ST can only be made on the basis of laboratory tests.

Among the already mentioned signs, only the level of hCG has an important diagnostic value. But even in the case of its low concentration, a woman who is suspected of fetal fading will definitely be sent for an ultrasound scan.

Even during a personal examination in the office, the gynecologist is able to assume a delay in the development of pregnancy if the size of the uterus, which he probes with his hands, does not correspond to the estimated gestation period. Ultrasound is able to more accurately determine this discrepancy. In addition, it will evaluate the signs of the life of the embryo: the presence of heart contractions, physical activity. In case of a non-developing pregnancy, the ultrasound specialist will see damage to the structures of the placenta, deterioration or complete cessation of utero-placental blood flow, damage to the endometrium of the uterus due to decomposition of dead tissues, hematoma at the site of detachment of the fetal egg.

If the pregnancy freezes and a spontaneous miscarriage begins (the woman's immune system rejects foreign cells), then the ultrasound will also show detachment of the fetal egg or placenta.

For a short time, the doctor can take a wait-and-see attitude: that is, wait until the fetal egg leaves the woman's body on its own. And very often that is exactly what happens.

However, it is also not uncommon for a dead embryo to remain inside the womb for a long period of time, soon starting to decompose. Such an outcome is very undesirable and fraught with serious consequences, and therefore doctors are forced to intervene in this process: they resort to medical abortion (interrupt gestation with the help of hormonal drugs) or curettage during a missed pregnancy. A non-developing fetus is only disposed of when the absence of a heartbeat has been confirmed by at least 2 ultrasounds.

I would like to note that, despite the prevalence of this problem, most women who have had an undeveloped pregnancy successfully bear and give birth to healthy children in the future. In Western countries, even after three cases of fetal fading in a row, 75% of women still become pregnant and give birth.

And therefore, one should not be unnecessarily upset and upset: all the best is yet to come! Nevertheless, doctors advise to prepare and plan the next conception for women who are at risk of pregnancy fading:

• suffering from sexual infections;
• who have had infectious diseases during gestation;
• suffering from endocrine disorders;
• giving birth for the first time over the age of 30 or pregnant after 40 years;
• having had abortions in the past;
• alcohol abusers, drug users, heavy smokers;
• taking antidepressants or suffering from nervous disorders;
• in whom the fetus repeatedly froze (especially in the later stages);
• having a uterus with developmental pathologies (small, bicornuate, etc.) or uterine myoma.

Especially for - Larisa Nezabudkina

The concept of non-developing pregnancy is relatively unfamiliar to a wide range of women, although such a pathology in real practice is not so rare. This does not mean that information about the disease is artificially hidden by doctors. It’s just that the features of its development and course do not ultimately represent a vivid clinical picture, typical, for example, for spontaneous abortion in the early stages. The disease proceeds relatively latently, and at the time of detection is usually irreversible.

In fact, a non-developing pregnancy in the early stages is a “hidden” analogue of abortion. But at the same time, the appearance of vivid symptoms is not noted - pain, deterioration, bleeding from the genital tract. For certain reasons, the development of the embryo stops, and its intrauterine death occurs. But the expulsion of the fetal egg from the uterine cavity is not observed, as a result of which the pregnancy takes on a non-developing character.

Like spontaneous abortion, this pathology has a fairly rapid and rapid course, as a result of which it is difficult to prevent its occurrence. Therefore, the embryo dies long before a clinical diagnosis is established. Moreover, during the diagnostic search, special attention is paid to identifying concomitant conditions that most often underlie the growth arrest and development of the fetal egg, and lead to its death.

Causes

Non-developing pregnancy is always secondary in nature, occurring against the background of any diseases or conditions affecting the mother or fetus. Moreover, most of them come from the female body, which leads to a violation of the normal processes of growth and development of the embryo:

1. If such an effect occurs acutely, then it usually ends with a termination of pregnancy similar in mechanism. There is a widespread thrombosis of the vessels of the membranes, and their parallel detachment from the uterine wall. Simultaneous contraction of muscle fibers leads to their expulsion from the cavity of the organ - spontaneous abortion occurs.
2. If the effect is continuous, existing even before conception, or gradually increases during the first weeks, then the growth of the embryo is inhibited in a similar way. At a certain point, compensation mechanisms are exhausted, which makes it impossible for the further development of pregnancy. At the same time, it seems to freeze - the fetal egg dies, and begins to gradually collapse in the uterine cavity without expulsion.

The underlying causes of non-developing pregnancy are currently combined into two groups - according to the general mechanism of the changes that occur.

Endocrine disorders

Hormonal regulation in humans is characterized by good compensatory abilities. Long enough chronic pathology of the endocrine system can proceed without any clinical manifestations. Therefore, most often the basis of non-developing pregnancy is precisely such violations:

• The main share among the entire group is occupied by subclinical hypothyroidism - reduced production of hormones by the thyroid gland. The timely and correct development of all structures and membranes of the embryo depends on a sufficient level of these biologically active substances. Accordingly, their initial deficiency during pregnancy is further enhanced, which ultimately causes first growth retardation, and then the death of the fetal egg.
• The next in frequency is diabetes mellitus, but it does not occur during late pregnancy (gestational), but is present in a woman before it develops. With its insufficient or incorrect control, insulin deficiency is created, which also plays an important role in the processes of growth and development of the embryo.
• Less commonly, there are violations of the regulation of sex hormones, which have any organic nature behind them - more often a tumor. In this case, a competitive effect on the level of progesterone in the blood is created, which inhibits the progression of pregnancy.

The problem is that even the conception planning system does not always allow you to effectively and timely identify these conditions. The situation is also aggravated by the fact that in most cases they are asymptomatic.

Immunological disorders

Another group of disorders underlying miscarriage includes some autoimmune processes that are realized only in certain situations. But the most common in practice is the Rh incompatibility of mother and child:

• A similar situation occurs only in women who do not have a specific antigen in the blood - the Rh factor.
• Their first pregnancy usually proceeds normally, and ends with a natural birth or caesarean section.
• But if the fetus was Rh-positive, then its red blood cells can enter the mother's bloodstream directly at the time of birth, or subsequent manipulations.
• As a result, immunological mechanisms are triggered that recognize fetal red blood cells as foreign. Then they are destroyed, followed by the formation of a kind of "immunity" to them.
• In subsequent pregnancies, if the embryo also has Rh-positive blood, a similar mechanism is realized, only on a larger scale. Depending on the speed of exposure, fetal death is possible without expulsion from the uterine cavity.

When planning a pregnancy, the Rh affiliation of the mother's blood must be examined. In this way, it is possible to carry out preventive measures in time, excluding the development of complications in the future.

Manifestations

A negative feature of the pathology is its relatively latent course - as a result, diagnosis is almost always late. The disease is detected already “in fact”, when the intrauterine death of the embryo occurred. And since the first screening is carried out in the period from 11 to 13 weeks, the clinical data are only compared with the results of ultrasound and analysis of the level of hCG in the blood.

But often women turn much earlier, feeling some changes in their own well-being. But in such a situation, it is even more difficult to suspect the correct diagnosis - for a period of about 8 weeks, the size of the fetal egg can still only slightly lag behind its age norms. Therefore, the observation continues for some time to accurately establish the arrest of the growth and development of the embryo, as well as changes in the level of hormones.

Symptoms

In the early stages, it is almost impossible to assess the objective signs of pregnancy, therefore, complaints and doubtful manifestations are mainly assessed. With their following combination, the diagnosis of a non-developing pregnancy becomes most likely:

1. The symptoms characteristic of the first trimester of pregnancy disappear - mood swings, drowsiness or insomnia, transient nausea, intolerance to certain odors.
2. Changes in food addictions and the severity of appetite also disappear. Moreover, this happens quite suddenly, in contrast to normal and physiological reactions.
3. Increased pigmentation of the skin in the area of ​​the midline of the abdomen, genitals, areolas of the nipples gradually disappears. The process also proceeds quite quickly, which differs from natural adaptation reactions.
4. The transient engorgement of the mammary glands, accompanied by an increase in their density and soreness, completely disappears.

Normally, in many women, some signs may disappear or be completely absent even with a normal pregnancy. Therefore, the assessment of such complaints and symptoms should be carried out only in conjunction with an additional examination.

Confirmation

To establish a clinical diagnosis of a miscarriage, the same diagnostic procedures are required that include the first screening. Therefore, its actual implementation is an excluding or confirming factor for this pathology:

• With an ultrasound examination, a fetal egg is determined in the uterine cavity, which, in size, is significantly behind the terms of normal development. Sometimes it even lacks the actually formed embryo - there are only empty shells in the image.
• For additional confirmation, the level of human chorionic gonadotropin (hCG) is evaluated in parallel in the blood. This active substance, within certain limits, characterizes the normal development and course of pregnancy. When its progression stops, a significantly reduced level of hCG is observed, lagging behind weekly norms.

Obtaining confirmation of the diagnosis is the reason for the implementation of artificial abortion. This procedure will allow you to fully remove the dead embryo from the uterine cavity.

Consequences

If the fact of non-developing pregnancy is confirmed, then its further preservation is no longer possible. Many women think that with the help of any medications it is possible to stimulate the growth of the embryo so that it has time to reach normal size. But such an opinion is fundamentally wrong, and contradicts the very mechanisms of the development and course of the disease. Like spontaneous abortion, progression stops abruptly and is accompanied by fetal death.

Therefore, the only method of assistance in this case is the artificial completion of the process - medical or surgical interruption. It is necessary for the complete removal of the dead embryo with its surrounding membranes. Otherwise, they become a substrate for the development of another pathology, which can be detrimental to the entire reproductive system of a woman.

Early

Despite the fact that the death of the embryo occurs in the sterile conditions of the uterine cavity, the immune system still triggers the mechanisms of its destruction. Depending on the period at which the progression stopped, the following outcomes are possible:

• If the regression developed during the first weeks after conception, then by the time of detection, autolysis of the embryo occurs. At the same time, under the influence of immune cells, and the enzymes secreted by them, the complete destruction of its tissues is carried out.
• If the fetal egg has already reached a significant size, then its simultaneous destruction becomes impossible. Therefore, the destruction proceeds gradually, accompanied by the processes of necrosis and maceration. The outcome in this case is the formation of a focus of chronic inflammation in the uterine cavity, delimited by a capsule.
• A rather rare consequence is spontaneous abortion, which is realized under the influence of the destruction of the embryo. In this case, incomplete expulsion of the fetal egg from the uterine cavity is more often observed.

After confirming the diagnosis, expectant tactics are usually replaced by active ones - in the near future, the woman undergoes an artificial termination of pregnancy.

distant

Unlike spontaneous abortions, even with a single development of regression, a thorough search for its causes is carried out. This is necessary in order to prevent the occurrence of a similar pathology during the next conception:

1. Timely and complete artificial interruption is the main way to prevent long-term consequences. Removal of the fetal egg along with the membranes will ensure the reverse development of changes in the reproductive system, and the restoration of the menstrual cycle.
2. Given the prevalence of causes, an examination is carried out to identify endocrine or immunological disorders.
3. Active identification of other comorbidities that can affect the course of pregnancy is also being carried out.
4. If necessary, a woman is prescribed long-term maintenance or replacement therapy, which allows to normalize the hormonal background.
5. With a negative Rh factor, immunological prophylaxis is carried out using a special serum.

In general, if a woman is responsible for planning a subsequent pregnancy, then she usually does not have long-term problems with identified violations in the future. Thanks to continuous monitoring and correction of existing diseases and conditions, doctors manage to ensure the successful bearing of a child.

Symptoms of an undeveloped pregnancy

Signs of non-developing pregnancy are varied. Conventionally, they can be divided into subjective and explicit (proven with the help of medical examinations). Let's consider both of them.

Likely Symptoms

1. Disappearance of toxicosis. Of course, it should not last throughout the entire pregnancy, but unpleasant symptoms in the form of nausea and vomiting usually disappear gradually, over several days or even weeks. If there was severe toxicosis, which suddenly stopped - this should alert.

2. Disappearance of soreness of the mammary glands- such frozen pregnancy symptoms can have. Moreover, not only the tension of the chest can disappear, but even its size may decrease somewhat. The chest seems to fall off. This symptom is especially noticeable in case of pregnancy of 8-10 weeks or more.

3. Bloody, beige, brown vaginal discharge, abdominal pain- usually such signs of a non-developing pregnancy in the early stages mean the onset of a miscarriage. But not in all cases, such a natural ending of a missed pregnancy is possible. Often a miscarriage does not occur for 1-2-3 weeks, and then curettage of the uterine cavity is necessary. In addition, do not forget that these signs can also occur when there is a threat in the case of a normal developing uterine pregnancy, and an ectopic one - which is especially dangerous.

4. Decrease in basal temperature. Many women know that in the second phase of the menstrual cycle and during pregnancy, the temperature in the rectum should be elevated - above 37 degrees. A decrease in temperature may be due to a lack of the hormone progesterone or to the death of the embryo.

5. The first signs of a non-developing pregnancy can also be determined by a doctor during a gynecological examination when he notices a discrepancy between the size of the uterus and the gestational age (it is considered on the first day of the last menstruation). Or if since the last gynecological examination, carried out 1-2 weeks before, the uterus has not grown at all.

Absolute signs

1. The absence of a heartbeat in the embryo(determined from the fifth week of pregnancy during ultrasound examination). If the heartbeat is not detected, the woman is recommended to repeat the examination in a few days. If the heartbeat does not appear, it is recommended to remove the non-developing fetus and its membranes by scraping the uterine cavity.

2. Lack of growth, low human chorionic gonadotropin- this is how a frozen pregnancy always manifests itself in the early stages - the first weeks. Chorionic gonadotropin is a hormone produced by the chorion (future placenta) that rises rapidly during the first trimester. There are its norms, deviation from which indicates pathologies. For women who are at risk of miscarriage, doctors prescribe periodic blood tests for hCG. And in the absence of hormone growth, they are sent for an ultrasound scan.

At the end of the article, it is worth saying that an undeveloped pregnancy is a very common occurrence. According to statistics, approximately every 8th pregnancy ends with the death of the embryo. In most cases, chromosomal abnormalities are the cause, but cases of the detrimental effect of infections, toxic substances and drugs are not uncommon. To minimize the likelihood of this unpleasant pathology, plan your pregnancy, take all the necessary tests, undergo examinations, listen to the doctor's recommendations and do not self-medicate.