How does a frozen pregnancy come out. Why does pregnancy freeze? Causes of a frozen pregnancy

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

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

The reasons for a missed pregnancy are very diverse. Thus, the arrest of the development of the embryo / fetus may be due to the inflammatory process as a result of the action of various microorganisms. The most common causative agents of inflammation are: streptococci, staphylococci, E. coli, Klebsiella, virus, cytomegalovirus, herpes simplex virus, Coxsackie virus, mycoplasma, chlamydia, treponema, mycobacterium, toxoplasma, plasmodia, fungi ().

Chronic infectious diseases in a woman, most often they do not directly lead to intrauterine fetal death, but they cause certain disorders that contribute to it. For example, as a result of the direct influence of 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. The influence of the infection in this case depends on the path of its penetration, involvement in the infection of the fetus and amniotic membranes, the type and activity of the pathogen, the number of penetrating microorganisms, the duration of the mother's illness, the activity of the body's defenses and other factors.

Microorganisms can enter the uterus from the lower 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 get to the fetus and from chronic foci of inflammation in the fallopian tubes and in the ovaries.

The death of the embryo / fetus may be due to a violation of the immune relationship, given that the ovum is half foreign to the maternal organism. In this case, rejection reactions are activated, aimed at affecting the ovum and removing it from the uterus. Non-developing pregnancy can be caused by various chromosomal abnormalities: in the first 6-7 weeks of pregnancy, chromosomal changes are present in 60-75% of cases of spontaneous abortion, at 12-17 weeks. - at 20-25%, at 17-28 weeks. - in 2-7%. With age, the likelihood of chromosomal abnormalities increases. The reasons for the development of chromosomal abnormalities are also unfavorable external factors. Stopping the growth and development of the embryo / fetus can cause thrombotic complications caused by genetic defects of 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.

Disorders of the blood coagulation system 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 ovum with subsequent spontaneous abortion is not excluded. With this pathology, the process of implantation of the ovum is disrupted. In addition, with antiphospholipid syndrome, there is a decrease in the formation of blood vessels in the placenta and a decrease in its function, which can cause a missed pregnancy. Another cause of impaired development of the embryo and placenta in antiphospholipid syndrome is thrombosis and damage to the uteroplacental vessels.

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

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

A number of consecutive violations are distinguished, typical for non-developing pregnancy: decrease and cessation of uteroplacental blood 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 ovum 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, it can be reduced, and it can even be enlarged if it is filled with blood during the detachment of the ovum.

For some time after the death of the embryo / fetus, the patient may feel pregnant. However, over time, the subjective ones gradually disappear. Spotting spotting from the genital tract and abdominal cramping are periodically noted. Chorionic gonadotropin in a woman's blood, as a rule, is at an extremely low level or even completely absent.

Diagnosis of undeveloped pregnancy

The most reliable identification of an undeveloped pregnancy can be based on the results ultrasound examination in the absence of fetal heartbeat. One of the most common types of non-developing pregnancy is anembryonia, i.e. the absence of an embryo in the cavity of the ovum after 5-6 weeks of pregnancy. In this case, the ovum is smaller than it should be, and the embryo is not visualized.

In other cases of non-developing pregnancy, according to ultrasound examination, the size of the ovum matches or lags behind in its development, the embryo can be visualized, but without a heartbeat. Often, retrochorial hematoma can be detected, which is an accumulation of blood at the site of detachment of the ovum 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 ovum with fuzzy contours.

Removal of the dead ovum

The death of an embryo / fetus is not always accompanied by its spontaneous expulsion from the uterus. Cases are often observed when a dead fertilized 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 inadequacy of the immune rejection reactions of the dead ovum, a 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 ovum enter the maternal bloodstream, which can cause massive bleeding when trying to terminate a pregnancy. Therefore, before curettage of the uterus, it is necessary to carry out studies of the state of the blood coagulation system and, if necessary, carry out appropriate treatment.

After a thorough examination and appropriate preparation of the woman (carrying out therapeutic and prophylactic measures aimed at reducing the risk of developing possible complications), it is necessary to interrupt. For this purpose, instrumental or medication 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. Immediately during the abortion or immediately after its completion, an ultrasound scan is necessary to make sure that parts of the fetus and placenta are completely removed. After removal of the ovum in non-developing pregnancy, regardless of the chosen method of termination, it is advisable to carry out anti-inflammatory treatment.

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

How to reduce the likelihood of embryo death?

To reduce the likelihood of the action 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 the early stages of pregnancy for urogenital infection. It is also important to conduct medical genetic counseling in order to identify high-risk groups for congenital and hereditary pathology. 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 death of the embryo / fetus are eliminated, and after the necessary treatment has been carried out. With a new pregnancy, an ultrasound examination is performed, the determination of markers of possible fetal developmental disorders in the blood, including: α - fetoprotein, chorionic gonadotropin, PAPP-A test in the most informative terms. According to indications, invasive prenatal diagnostics are also performed, including chorionic biopsy, amniocentesis or cordocentesis to determine chromosomal and a number of monogenic fetal diseases. In addition, they carry out therapeutic and prophylactic measures aimed at eliminating the infectious process, carry out specific anti-inflammatory therapy in combination with immunocorrectors, correct blood coagulation disorders and prevent placental insufficiency from 14-16 weeks of pregnancy.

The fetus froze - this is perhaps one of the most terrible words from a doctor for a couple dreaming of children. You can hear them for various reasons at the very beginning of the development of a new life (the most dangerous are considered from 3 to 4, from 8 to 11 and from 16 to 18 weeks from conception). Sometimes the diagnosis is made at a later date, but the likelihood of hearing it is significantly lower. An analogue is the development of an empty ovum: in this case, fertilization has occurred, but the embryo does not develop. Pathology occurs spontaneously, maybe several times in a row throughout a woman's life. Unfortunately, no one is immune from it. Nevertheless, it is better to know the causes and signs of a frozen pregnancy in the early stages, in order to take timely measures and consult a doctor, as well as prevent the development of pathology before conception. Anything can influence the development of a small life. And the worst thing is that it is not so easy to notice the changes.

Read in this article

Reasons why pregnancy does not develop

Why is there a missed pregnancy in the early stages? This question worries and scares young mothers. There are actually quite a few reasons:

• Genetic abnormalities are in the lead. They are diagnosed in 70% of cases for up to 8 weeks. They are associated with many factors, including hereditary diseases, as well as the result of taking drugs by one of the partners. That is why it is important not to give up screenings and other examinations suggested by a geneticist and gynecologist.

• Excessive use can also provoke a developmental arrest. It is especially dangerous if the mother cannot give up bad habits after conception.
• Medicines are also capable of provoking the development of abnormalities. That is why the doctors themselves strongly recommend giving up any medication. An exception can only be serious diseases, the treatment of which with folk remedies is simply impossible. It is worth noting that for up to 10 days and after 8-10 weeks, when the fetus becomes partially protected by the placenta, the effect of the drugs is not so significant. As for herbs, they also need to be taken only under the supervision of a doctor, because some of them can provoke a breakdown or stop in the development of the embryo.
• The causes of a frozen pregnancy in the early stages may lie in the mother and child. If a woman has had abortions before, then the chances of a happy development are not so great. Antibodies produced by the mother's body against the baby build up over time. And after several abortions, it is very difficult for a conceived baby to resist such an attack.
• Infections of both genital organs and viral (, influenza) are a serious threat at the very beginning of the birth of life. The mother's body is already weakened by the new position, so it is not at all difficult to get sick. But the consequences of a high temperature, a viral attack can be very serious. Rubella is a formidable enemy, in the event of which pregnancy not only freezes, the fetus may develop severe anomalies. And already in this case, the mother will have to decide whether she can raise a special child or whether it is better to terminate the pregnancy.

• Hormonal Disorders. Moreover, a non-developing pregnancy in the early stages, the reasons for which lie precisely in this factor, can freeze both due to a lack of prolactin and an excess of testosterone. If a woman has regular menstrual irregularities, then it is imperative to be examined during planning, and also to regularly check the state of the hormone after conception.
• Harmful factors at work, diabetes mellitus, weight lifting, stress - all these factors can also cause the development of pathology.

Women who have a higher risk of developing pathology

But this is not the only answer to the question of why pregnancy freezes at an early stage. Doctors identify a certain risk group, which includes:

• old-born or expectant mothers over the age of 35;
• if you have multiple abortions in the past;
• if during a previous pregnancy were ectopic;
• in the presence of a congenital anomaly of the uterus.

If one or all of the factors are present, the woman will be under constant medical supervision.

The risk group also includes expectant mothers who do not want to visit a gynecologist in the early stages. There may be many reasons for such a decision, but the result will be a serious threat to the health of not only the woman, but also the child.

What signs will indicate a frozen pregnancy

The saddest thing is that the symptoms of a frozen pregnancy in the early stages are not pronounced. Therefore, the expectant mother may not even suspect about the change in the state of the fetus. Only a qualified doctor, after examination and appointment of an additional examination, can state the absence of embryo development.

You should not look for symptoms of a missed pregnancy in your early stages, and even more so, ask your friends for advice or on the forums. In each case, everything is purely individual and depends on many factors.

Symptoms of an impending disaster

At a later date, it is easier for a woman to navigate, because she already feels the movement of the child. In the early days, this is very problematic. A frozen pregnancy, the signs in the first trimester of which may be similar to less serious abnormalities, manifests itself as follows:

• passes;
• no more ;
• lowered;
• cramping pains began to appear;
• smearing appeared (discharge during a frozen pregnancy in the early stages has exactly the same consistency and red-brown color);
• the overall body temperature has increased.

If any of the listed symptoms is detected, a woman needs to urgently consult a doctor! If signs of pregnancy have disappeared, then this should also alert mommy and become a reason to visit a specialist!

What does a pregnant woman feel with the development of pathology

Feelings of a frozen pregnancy in women are very different. They are even influenced by the fact whether this happened for the first time or a similar situation happened before. Fatigue, apathy, fever - all this, in any case, should alert the expectant mother.

It is worth noting that all symptoms that indicate the development of pathology may turn out to be false! There is no need to immediately set yourself up for the approach of a catastrophe. Quite often, they turn out to be similar to less serious ones, or the body is simply undergoing a readjustment.

Diagnostics of the fact of fetal freezing

Only a doctor knows exactly how to recognize a frozen pregnancy at an early stage. To do this, he will do the following:

1. , will assess the state of secreted mucus, ask to measure the basal temperature.
2. If you suspect a deviation from the norm, the doctor will send the pregnant woman to hand over. However, it is worth noting that hCG with a frozen pregnancy in the early stages can be completely within the normal range for several weeks after the death of the fetus. And yet, more often, urinalysis will show an underestimated level of the hormone, uncharacteristic for the first trimester.
3. The last stage of the examinations will be an ultrasound scan. With the help of an ultrasound examination, it will become clear whether the heart is beating in the embryo or not.

Tellingly, a test with a frozen pregnancy in the early stages may show all the same two stripes. This is again related to the level of hCG in the urine.

After the specialist makes sure of the diagnosis, he will choose the necessary set of procedures for the mother, and will also help her prepare for a new pregnancy in the future.

What do doctors do if the fetus froze

Depending on how a frozen pregnancy manifests itself in the early stages, as well as directly on the number of days from the moment of conception, the doctor will choose the most alternative method of treatment. Indeed, when establishing such a diagnosis, it is already a question of preserving the life and health of the mother. There are two main methods of treatment:

• With the help of drugs that provoke. It is used for up to 8 weeks.
• (vacuum aspiration). Under anesthesia, a woman is cleansed of the uterine cavity using a vacuum suction.

In any case, professional help will be required, since in order to avoid adverse consequences, it is necessary to clean the uterine cavity (the remnants of the amniotic egg, which will be indicated by an ultrasound scan).

There is a third option, in which even the woman herself does not have time to realize that she was pregnant. This is a spontaneous abortion. If the fetus froze almost from the first days of life, then the body can reject it like a foreign body. In this case, a woman will simply notice a delay in menstruation. Sometimes doctors prefer to observe the patient's condition, waiting for a spontaneous abortion, so as not to interfere with the body once again.

Why is it so scary not to see a doctor in time?

Sometimes a woman does not fully realize how severe the consequences of a frozen pregnancy at an early stage can be for her. But the organism does not always reject the fetus itself. If the embryo, which has stopped developing, is in the womb for a long time, then it is quite likely that intoxication will develop. In this case, not only the temperature rises, the woman begins to suffer from acute pains and weakness, it is quite possible to delay the time until the blood becomes infected with the elements of fetal decay.

If the gestation period is more than 6 weeks, then in this case the woman has every chance of earning desseminated intravascular coagulation (DIC syndrome). The danger is that the blood loses its ability to clot. As a result, the woman may die from bleeding.

How to prevent fetal freezing during pregnancy

A couple, regardless of whether they are preparing to become parents for the first time or have children, must be examined. It is he who will be able to reduce the risks and give an answer on how to avoid a frozen pregnancy in the early stages in their case. The doctor will offer to pass several tests: hormones, genetic tests, ultrasound of the pelvic organs, blood for infections and other additional tests that will be prescribed taking into account the parents' history. It is also recommended to refrain from conceiving for up to six months after diseases such as ARVI, flu, chickenpox.

If a woman works in a children's team, then she will be asked to get preventive vaccinations. Additional hormones will need to be adjusted. Do not ignore a visit to a geneticist. A healthy lifestyle will only increase your chances of becoming a parent. In the first months, it is recommended to refrain from flights, abrupt climate change and prolonged exposure to the sun.

If the previous pregnancy ended in stopping the development of the embryo - do not give up! With the right planning, the chance to endure and give birth normally is 80% -90%. And how to prevent a frozen pregnancy at an early stage will be advised by a gynecologist who is managing a couple.

Pregnancy after stopping fetal development

Doctors predict good chances of conception only on the condition that the couple does not ignore visits to specialized specialists, undergo a course of treatment, and also refuses to think about the child for the next six months after an unsuccessful experience. On average, such a period is necessary not only for a detailed examination and finding out the cause of the pregnancy fading, but also for the physical recovery of the mother's body.

Sadly, but with 100% certainty, it is quite rare to say exactly about the reasons for stopping pregnancy. However, parents do not need to despair! Try to avoid stress, harmful factors, and also do not forget to get tested - and may you succeed, and the baby will be born healthy and happy!

A frozen pregnancy is manifested by the cessation of fetal development as a result of violations that have arisen already during the expectation of the child. This condition is typical for early terms. The outcome of a frozen pregnancy is fetal death and premature termination of pregnancy.

Causes of a frozen pregnancy

The fetus is most vulnerable until the twelfth week, when the laying of important organs and systems of the unborn baby takes place. During this period, the greatest likelihood of miscarriage or pregnancy fading remains.

A frozen pregnancy can be triggered by many reasons. Among them are:

• genetic malfunction, which is accompanied by chromosomal abnormalities of the fetus. These developmental disorders appear very early and carry the threat of termination of pregnancy;
• disturbances in the hormonal system of a pregnant woman, arising against the background of a lack of progesterone or, conversely, too high a level of androgens. This complication can be detected before pregnancy if hormonal status tests are taken and treated in advance;
• suppression of the immunity of a pregnant woman. When pregnancy occurs, a woman's immunity weakens sharply: all reserves of strength go to protect the child. Weakened immunity causes problems with the microflora of the vagina, which provoke infection of the fetus;
• rubella. The disease causes multiple malformations;
• flu. In the expectant mother, it is very difficult and with multiple complications. Influenza contributes to the appearance of intoxication in a pregnant woman, disrupts blood flow and oxygen supply to the fetus;
• diabetes;
• drinking and smoking;
• treatment with certain medications;
• irrational and unbalanced nutrition;
• constant stress, overstrain;
• lack of oxygen in the room;
• work in hazardous production;
• lifting weights;
• living in an ecologically unfavorable area.

The risk group includes the following categories of women:

1. Over 35 years of age.
2. Those who have had an abortion in the past.
3. With abnormal development of the uterus;
4. Who have had an ectopic pregnancy.

Why is there a frozen pregnancy

A frozen pregnancy is caused by blood clotting disorders, which are based on antiphospholipid syndrome. It manifests itself in a decrease in the formation of blood vessels in the placenta, as a result of which its main functions are reduced. Another sign of antiphospholipid syndrome is blockage and damage to the uteroplacental vessels, contributing to the disruption of placental development (most often occurs in the sixth week).

Frozen pregnancy sometimes also occurs due to the wrong lifestyle of a woman. The first signs can immediately make themselves felt. The direct factors of fetal disruption include:

• poor nutrition;
• small stay in the fresh air;
• wearing clothes that strongly squeeze and tight the stomach;
• prolonged stay at the computer monitor.

Signs of a frozen pregnancy

The peculiarity of miscarriage is that the fetus has already died, and the symptoms of pregnancy are still continuing. If a woman feels a sharp cessation of pregnancy symptoms, she should be immediately sent to the hospital.

The main symptom of fetal freezing is a discrepancy in the size of the uterus: it becomes either sharply enlarged or significantly decreases in size. The woman does not feel these changes. This symptom can only be determined by a gynecologist at the next examination.

A frozen pregnancy is manifested by the following symptoms:

1. Lack of movement of the child for several days. During the ultrasound, the baby's heartbeat is not heard.
2. Profuse bloody discharge.
3. Feeling of weakness, chills and inner trembling.
4. Fever.
5. Drawing and aching pain in the lower abdomen, cessation of its growth. Also, there is no increase in the uterus.
6. Disappearance of signs of toxicosis.
7. A decrease in basal temperature and a sharp increase in body temperature, especially if the fetus died a long time ago, and the woman does not know anything.
8. Cessation of breast growth.
9. Lack of baby's heartbeat.

To avoid a frozen pregnancy, you must regularly visit your doctor and take the necessary tests. The doctor may be the first to see the discrepancy between the size of the uterus and the current gestational age. An ultrasound examination will help to accurately listen to the presence or absence of the embryo's heartbeat.

Freezing early pregnancy

The life of a fetus in the earliest stages of its development is very fragile. Even minor deviations can lead to a frozen pregnancy: psycho-emotional overstrain, stress, severe fatigue and overwork, a long stay in direct sunlight and long-distance flights. For the normal development of the baby in the womb, it is necessary to completely exclude all physical and psychological stress.

Freezing early pregnancy usually occurs up to 13 weeks for the following main reasons:

• certain chromosomal abnormalities, hereditary diseases. If a child is not viable, then nature does not give him the opportunity to be born;
• malfunction of the hypothalamus;
• Rh-conflict between the expectant mother and her baby, especially if the mother has a negative Rh factor and she has had abortions before.
• alcohol or drug use, smoking.

Freezing late pregnancy

The main reasons for miscarriage in late terms include: the transferred infectious diseases of the mother of the child, trauma to the abdomen, the situation if the child himself suffocated with his umbilical cord.

An almost one hundred percent symptom of a frozen pregnancy is the absence of fetal movement for more than five hours. Among other signs, it is worth noting: the disappearance of nausea, vomiting, cessation of abdominal growth and a decrease in the tone of the uterus. Bloody discharge may occur over time.

If a frozen pregnancy occurred at a later date, it is necessary to pay special attention to the issue of a woman's rehabilitation, both therapeutic and psychological.

Within three months, a woman must take hormonal contraceptives to normalize hormonal levels and restore the organs of the reproductive system. Also shown is the intake of multivitamins (to increase immunity) and sedatives (to tidy up the nervous system). A week after the pregnancy fades, it is worth conducting a control ultrasound examination.

For a woman who has experienced fetal freezing, the support of family and friends is very important. In some, especially severe cases, it is better to seek qualified help from a good psychologist.

It is necessary to plan the next pregnancy at least six months after the incident. This time should be used with maximum benefit: for the treatment of chronic diseases, for examining the endocrine system.

Full physical and psychological rehabilitation after the sudden termination of pregnancy is the key to successful bearing and the birth of a healthy baby in the future.

Diagnosis of a frozen pregnancy

A frozen pregnancy is diagnosed only by a doctor and with the help of a comprehensive examination, which includes:

1. Gynecological examination: will help to establish the correspondence of the size of the uterus to the gestational age.
2. Ultrasound, with the help of which it is possible to diagnose the absence of a heartbeat in the fetus, the arrest of its growth.
3. Blood test: will show a stop in the production of chorionic gonadotropin.

Examination after miscarriage

After a frozen pregnancy, it is necessary to undergo a long examination to find out the reasons for the death of the fetus. Not only the woman should be examined, but also her partner.

Also, a histological and cytogenetic study of the tissues of the embryo is carried out, which will help to establish the presence or absence of genetic failures.

If a frozen pregnancy occurred due to an infectious disease, it is established which infection caused the death of the fetus.

Treatment after a frozen pregnancy

After a frozen pregnancy, a woman needs to carefully take care of her health. Possible intoxication with the decay products of the tissues of the fetus and placenta, inflammatory processes in the uterus, so doctors take measures to completely remove the fetus from the uterine cavity.

Treatment of a frozen pregnancy is carried out in two main ways:

• Medication method. Consists in the fact that a woman uses medications that cause spontaneous miscarriage.
• The vacuum aspiration method is an operation under general anesthesia. With the help of vacuum suction, the uterine cavity is cleaned.

The procedure for cleaning the uterus with a frozen pregnancy:

Often, after a frozen pregnancy, hormonal contraceptives are used for treatment. They help to normalize the menstrual cycle and prevent inflammation of the female organs.

The question of further planning of pregnancy is decided by the doctor individually. It all depends on the period at which the missed pregnancy occurred, the woman's age, the presence of concomitant diseases. During treatment, you should carefully protect against possible pregnancy.

The preventive measures taken will help to avoid miscarriage in the future. Before planning the next pregnancy, a woman should be vaccinated against rubella and chickenpox, especially if she works in a children's educational institution, treat sexually transmitted diseases, drink a course of multivitamins and strengthen the immune system. The treatment regimen is agreed with the attending physician individually. In most cases, the prognosis after treatment is favorable.

A frozen pregnancy or miscarriage is a condition where the fetus stops developing and dies for up to 28 weeks.

The concept of "frozen pregnancy" came from the fact that the unborn child had already died, but his expulsion from the uterus did not happen. A frozen pregnancy is one of the options for miscarriage.

There is a similar condition, however sad it is to realize it, quite often, from 10 to 20% of all pregnancies (those who want to give birth and those who want to terminate). Moreover, the risk of pregnancy "freezing" increases with the age of the woman.

Threatened deadlines

Pregnancy can "freeze" at any time. But this happens especially often in the first trimester, that is, up to 13 weeks. Experts identify the most dangerous periods of pregnancy for "freezing" (however, they coincide with the timing of the threat of termination):

• 3-4 weeks,
• 8-11 weeks,
• 16-18,
• 22-24,
• 28-30 weeks.

The period of 8 weeks of pregnancy is considered especially dangerous.

Attention! You can read about ways to terminate a frozen pregnancy in the early stages in our special article.

Fading reasons

The reasons that lead to the state of "missed pregnancy" are very numerous. These include:

Hormonal imbalance

Lack of the pregnancy hormone - progesterone - inhibits the progression of pregnancy, which ultimately leads to the death of the fetus.

Androgens, or rather their excess or hyperandrogenism, may also be guilty. Accordingly, diseases such as: ovarian sclerocystosis, diseases of the thyroid and adrenal glands, and other endocrine pathology can lead to intrauterine death of the embryo / fetus.

Genetic disorders

Chromosomal aberrations of the fetus or the inheritance of an abnormal gene from one of the parents leads to the formation of a karyotype of the unborn child, with whom life is impossible. That is, nature itself eliminates defective embryos.

Infections

Sexually transmitted infections (chlamydia, ureaplasmosis, herpes and others), as well as general infectious diseases (rubella, influenza, toxoplasmosis, cytomegalovirus infection) in the early stages lead to the death of the fetus, and in the later stages to gross malformations. It is to identify infections and reduce the risk of pregnancy fading in women, smears are taken three times on the flora.

Often after IVF pregnancy "freezes", which is most likely due to the reasons that prompted the woman to turn to this method of getting pregnant.

Age

The older the woman, the higher the likelihood of a frozen pregnancy. The risk of this condition is especially high in primiparous women over 35 years of age.

Autoimmune conditions

Antiphospholipid syndrome, in which the amount of antibodies to blood phospholipids increases, leads to thrombosis, including in the uterus, as a result of which the fetus receives less oxygen and nutrients and dies.

Immunological factor

The fetus inherits equally genetic material from the father and from the mother; due to some conditions, the mother's body perceives the unborn child as a foreign agent and kills him.

Unfavorable environment

Symptoms of a frozen pregnancy

Early terms (I trimester)

In the early stages, the following signs can alert a woman about a frozen pregnancy:

• Early toxicosis. The sudden disappearance of all signs of early toxicosis (nausea, odor intolerance, vomiting, drowsiness) within 10 weeks indicates a frozen pregnancy
• Breast. The chest stopped hurting, there is no sensation of engorgement of the mammary glands.
• Basal temperature. A decrease in basal temperature to 37 degrees and below indicates both the threat of interruption and the death of the embryo.
• Pregnancy test. The pregnancy test began to show a weakly positive or negative result (decrease in hCG).
• Pain. Aching or pulling persistent pain in the lower abdomen and / or lower back.
• Minor bleeding from the genital tract is usually dark.

Late terms (II-III trimester)

• Lack of fetal movement (main symptom);
• Pain in the lower abdomen of a pulling character;
• Minor to moderate spotting.

Diagnostics

First of all, a gynecological examination plays a role in the diagnosis of a frozen pregnancy.

In the early stages, the doctor determines the discrepancy between the size of the uterus and the gestational age (it is for this purpose that a vaginal examination is performed in the first trimester at each visit to the appointment).

In later periods, the abdominal circumference and the height of the uterine fundus lag behind the normal, corresponding to this period. In addition, the fetal heartbeat is not heard.

The second stage in diagnosing a frozen pregnancy is an ultrasound of the uterus and the determination of hCG in the blood.

In the early stages, ultrasound does not determine the fetal heartbeat, the size of the embryo does not correspond to the norm, or anembryonia is diagnosed (the membranes are present, but the embryo is not).

The level of hCG in the blood decreases or does not increase. In the later stages, in addition to ultrasound, cardiotocography is performed, which confirms the absence of fetal heartbeat.

The consequences of a frozen pregnancy

The consequences after a frozen pregnancy are possible, but their probability is extremely low.

The risk of complications increases with the number of missed pregnancies in history.

Almost all women after a miscarriage in the future give birth to normal and healthy children.

Possible consequences:

Infection of a woman

With a long-term undiagnosed frozen pregnancy or if the woman does not go to the doctor, the fetus in the uterus begins to decompose and undergo aseptic inflammation. For the time being, this does not threaten the health and life of a woman, until an infection joins the aseptic inflammation. In this case, the infected dead fetus is a powerful source of bacteria and toxins, which penetrate the woman's bloodstream, leading to her infection and the development of sepsis. In addition, the development of DIC syndrome is possible, which is fraught with massive and intractable bleeding. Both sepsis and disseminated intravascular coagulation can be fatal.

Depression

Any termination of pregnancy, especially a miscarriage, leads to a disorder of emotional and mental strength and can cause long-term depression.

Mummification of the fetus

A similar phenomenon occurs in multiple pregnancies, when one fetus develops normally, and the other dies, while it turns into a "mummy" or paper fetus.

Lithopedion

Lithopedion is a fossilized fetus, that is, the dead fetus undergoes calcification (deposition of calcium salts). This phenomenon is very rare, today only 300 cases are known. Lithopedion can exist in a woman's body for years, although the “pregnant” woman herself is not aware of it.

Prophylaxis

In order to prevent miscarriage for pregnancy, it is necessary to carefully prepare not only those women who have this complication, but all the rest:

• quitting smoking, drinking alcohol and drugs for both sexual partners at least 3 months before the planned pregnancy;
• get the necessary vaccinations (rubella, hepatitis, flu and others) no later than 3 months before the expected pregnancy;
• take smears for sexually transmitted infections and, if necessary, undergo appropriate treatment (plan pregnancy 3 months after recovery);
• to treat and correct chronic extragenital diseases;
• investigate and, if necessary, normalize hormonal levels;
• refusal to abortion;
• adherence to a balanced diet (with the obligatory use of fresh vegetables and fruits);
• geneticist consultation (women over 35 and the presence of hereditary diseases);
• taking folic acid 12 weeks before the planned pregnancy (prevention of fetal neural tube malformations).

Some studies during pregnancy