The diagnosis of "frozen pregnancy" is perceived by a woman as a sentence without the right to appeal. In the soul of the unfortunate sticky stick of doubt stirs: have I done everything to save my baby? Meanwhile, the situation is not due to the fault of the future mother( as she herself is inclined to think), but becomes the reason for the confluence of numerous factors that a woman may not even know about.
Signs of a frozen pregnancy: what is a frozen pregnancy
- Frozen pregnancy: why an embryo dies
- Signs of a frozen pregnancy in the first trimester
- External manifestations of frozen pregnancy in the second and third trimesters
If you ask for information about the pathology to the impartial statistics, the figures do not look intimidating at all: on average, 180 cases of normal gestation of the fetus have only one case, ending with fading. Nevertheless, the frequency of termination of pregnancy for this reason remains stable: about 15 - 20% out of 100.
Discrimination is no different: a terrible diagnosis can hear both a couple expecting a baby for the first time, and a family that already has one, andThen two kids. But to have a child with a subconscious fear of losing him is by no means impossible! You can protect yourself and your "puzozhitelya" if you take care of your own health before conception and follow the recommendations of your doctor after the miracle has already happened. In addition, the expectant mother should be aware of the frozen pregnancy in general and know what its symptoms look like in particular, so that in case of a possible danger, respond to the problem with lightning speed. All these issues we will discuss in this article.
Signs of a frozen pregnancy: what is a dead pregnancy
Pregnancy fading is an anomaly that leads to the death of an embryo or fetus. It can also be referred to as an abortive miscarriage, since the death of tissues is not accompanied by symptoms characteristic of miscarriage. The diagnosis can be made both at the beginning and at the final stage of gestation. Today there is a trend of increased fetal fading in pregnant women who have crossed the 40-year threshold: this often happens in the first weeks of an "interesting" situation( up to 13 weeks inclusive).
At first nothing bad foreshadows troubles. Fertilization occurs successfully, the formed embryo, getting into the uterus, is introduced into its friable surface. But for a number of reasons the ideal program for the birth of a new life fails and the embryo( or fruit) suddenly ceases to grow. Despite fading, there is no immediate miscarriage, so the picture of a normal pregnancy continues to some extent: the size of the uterus is still increasing, the blood levels are stable, the level of chorionic gonadotropin( this substance appears in the body only with the onset of pregnancy) and the woman continues to feel thatShe is "in position".These false signs and sensations persist until placental abruption. When this happens, all visible signs of a normal gestation of the fetus gradually fade.
Sometimes the embryo as a result of conception is not formed at all, only the so-called fetal membranes appear. This phenomenon, which is called an empty fetal egg, is also considered to be a particular case of fading.
Causes of frozen pregnancy
Due to the fact that the reasons for stopping the development of the embryo( fetus) are numerous and almost always complex, it is very difficult to determine any one factor that caused this pathology. Even genetic and morphological analysis does not always clarify the situation, since specialists invariably encounter difficult research on the maceration of the material - the wet, aseptic death of tissues after the death of the fetus.
Fetal pregnancy: why the embryo is killed
The embryo retains the status of the embryo from the moment of the formation of the zygote up to the 8th week of pregnancy. What determines its viability by physicians is not fully understood, therefore, a number of factors that somehow influence the state of the embryo are singled out:
- Hormonal pathologies. An unstable concentration of "pregnant" hormones, for example, a sudden acute shortage of progesterone and its inconsistency with estrogen levels, does not allow the embryo to receive life-saving substances in full. And since this happens, as a rule, in the early stages of pregnancy, the embryo is still very fragile to put up with this state of affairs - it simply ceases to develop. There are also problems that should ideally be found before the alleged conception: dysfunction and polycystic ovary, anomalies of the thyroid gland, diseases of the endocrine system.
- Natural hostility of the immune system. The body of the mother perceives the fetal egg as a foreign object, because it consists of half of the paternal genetic material. The reaction to such an invasion is the formation in the body of specific antibodies that can behave very aggressively towards the embryo. In other words, the immune system destroys the fetus.
- A so-called antiphospholipid syndrome( AFS), caused by genetic predisposition, can become the cause of frozen pregnancy at an early stage. On average, this diagnosis is confirmed in 4 - 6% of cases of embryo fading. APS - violations of autoimmune origin, as a result of which a large number of antibodies hostile to blood plasma phospholipids are formed. Against the background of this phenomenon in the female body, thrombi form in the veins of the lower limbs, kidneys and liver, which makes the forecast of embryo development unfavorable. When the AFS was found after the onset of pregnancy, a woman should be under constant surveillance in the hospital. Pathology can complicate not only the course of labor, but also postnatal rehabilitation.
- Infectious diseases. A huge danger to the life of the embryo is represented by infections in the face of cytomegalovirus, mycoplasmosis, chlamydia, ureaplasmosis. Before conception, the body copes with these diseases quite successfully, but when immunity is tested in pregnancy, the destructive effect of infections on the health of the mother and her unborn child increases several fold. For example, cytomegalovirus in the first trimester of pregnancy can kill an embryo, in later terms, the infection leaves a mark on the fetus in the form of various congenital malformations( problems with the liver, spleen, jaundice).Influenza, gonorrhea, pyelonephritis, syphilis is a list of diseases that are peculiar antonyms of a healthy pregnancy, unfortunately, very long.
- Chromosomal "wars".This factor, perhaps, is the only one that is considered the absolute cause of a stagnant pregnancy. Anomalies in the development of the zygote, embryo, fetus, pathology in the structural development of the placenta are a direct result of the genetic breakdown that has come from the mother or father. Also, an abnormal combination of both parents' genes may be potentially fatal for the fetus. If it was diagnosed that the misfortune had occurred precisely for this reason, the couple necessarily undergoes a genetic examination, planning to become parents for the second time. Unfortunately, a dangerous combination of genes can not be prevented, but it is possible to assume a vulnerable position in the chromosome chain. In this case, this site can be replaced by donor material instead of the data of the mother or father.
- Rubella. The most dangerous disease, which can cause not only severe pathologies in the development of a future child, but also its fatal outcome. When the mother is infected with rubella early in pregnancy, a wide area of malicious activity opens up for the disease. Due to the fact that the first trimester is fundamental in the formation of the embryo, in 10 - 45% of cases of infection of a woman there is a spontaneous miscarriage, and in 10-25% of cases the baby dies in the first year of life because of developedIn the womb of the mother of vices.
- The impact of environmental factors on the state of the embryo is also of great importance. So, long stay in the plane, climate change, lifting of a heavy object, excessive insolation( sun bathing) or going to a solarium can affect the course of pregnancy in the most disastrous way.
- Constant stress and unsupervised reception of sedatives and antidepressants.
- Alcohol, smoking, drugs.
- Unexplained reasons. As already noted, the phenomenon of the sudden disappearance of all signs of life of the embryo is not fully understood, so sometimes doctors only have to spread their hands. It's time to remember superstition, which claims that the baby just was not destined to be born.
Fetal pregnancy: why the fetus of the
perishes. Only 10% of the baby's deaths in the womb are directly related to the woman's diseases, for example, with diseases of an infectious genesis. However, chronic infectious conditions of a pregnant woman become the causes of the development of phenopathies - intrauterine fetal death under the influence of other factors. All kinds of heart defects are a vivid example of this process. The susceptibility of the fetus to various potentially fatal situations is, of course, lower than that of the embryo. Nevertheless, during the period of bearing the baby there are critical time points when the life inside the mother is extremely vulnerable:
- 7 - 12 days after conception - embryo implantation;
- 3 - 8 weeks of gestation - embryogenesis;
- 8 - 12 weeks - formation of the placenta;
- 20 - 24 weeks - laying the most important systems in the baby's body.
And here is a list of specific causes of fetal fading:
- Severe anemia.
- Endocrine diseases.
- Late toxicosis with complications.
- Incorrect development of the placenta( detachment before the due date, fetal presentation).
- Pathologies of the umbilical cord( knot, crochet).
- Polyhydramnios or hypochondria.
- Conflict of mother and child by Rh factor.
- Severe woman poisoning( eg, carbon monoxide or mercury).
- Incorrect medication.
- Acute or chronic oxygen starvation of the fetus.
- Avitaminosis or hypovitaminosis.
- Mechanical injuries.
- Poor social and economic living conditions of a pregnant woman.
- Anomalies and pathologies in fetal development that are not compatible with life.
Fetal pregnancy: how to detect the fading of the fetus
The development of a child without deviations in each trimester of pregnancy is determined by a number of obvious and hidden factors, among which an important role is assigned to a healthy genetic base, the regular intake of nutrients into the body, the mother's infectious diseases, And diet.
To understand for certain that something is wrong with the baby, a woman is unlikely to be able, and premature conclusions about his condition can not be made. Meanwhile, for a gynecologist, it is not particularly difficult to detect the absence of fetal growth, since the symptomatic picture of this case is quite accurate. In addition, the specialist receives reliable data due to the results of tests and ultrasound, assesses the overall course of pregnancy from the moment of conception.
From this it follows that future mothers need to come to routine examinations and listen to all the recommendations of a doctor, then the risk of seeing signs of a stagnant pregnancy becomes minimal.
Symptoms of a Frozen Pregnancy
Signs of fetal fading should be known to every woman - so she immediately pays attention to the suspicious signals of her body and promptly informs them about the competent specialist.
Signs of a frozen pregnancy in the first trimester
It is necessary to carefully and carefully watch your pregnancy feelings at the very beginning of an "interesting" situation - it is during this period that symptoms of an early, frozen pregnancy may appear.
After the exhausted toxemia of the future mother, she can feel that the discomfort associated with it suddenly disappeared: in place of nausea and heightened sensitivity, a healthy appetite comes to the smells, breast engorgement stops, the basal body temperature decreases, whims disappear( strawberries in the middle of the FebruaryNights do not feel like it, etc.)
Attention! In no case can you set yourself to terrible diagnoses and panic! A reliable and definitive verdict can only be voiced by a doctor. The complex of "suspicious" symptoms described above can also be observed with normal fetal bearing. This is due to the very blurred symptoms of an early, frozen pregnancy. Anyway, with a cardinal change in the state of health for the better or worse, the pregnant woman should immediately visit her doctor.
External manifestations of frozen pregnancy in the second and third trimesters
Signs of a frozen second trimester pregnancy are more eloquent: the general condition of the expectant mother is sharply worsening, the body temperature is set at 37.5-380 C, the woman is shivering. In addition, it begins to torment the drawing pain, which covers the lower back and lower abdomen, on the underwear there are bloody stains. The breast loses the poured form and becomes less elastic. The abdomen visually decreases in volume and becomes "stone", and the child stops moving. Unfortunately, the first signs of a frozen pregnancy can appear only 5 to 7 days after the actual death of the fetus.
Sometimes the symptomatic picture of a frozen pregnancy does not appear at all, and the woman does not bother until the tissues begin to break down. In some cases, the abdomen continues to grow, while blood tests will confirm the presence of pregnancy. This phenomenon can be explained by the fact that it is not a child that grows, but an empty intra-fetal membrane. True, the future mother still needs to pay attention to the fact that usually knocking baby legs suddenly calmed down and died down.
Methods for diagnosing an abortive pregnancy
Fetal fading is accompanied by stabilization of the uterine volume and its incompatibility with the term of pregnancy( the size of the uterus indicates a period of 10-14 days less than this).In blood, the level of chorionic gonadotropin is sharply reduced. The dead pregnancy at any time is determined by the following procedures:
- Determination of the size of the uterus during the examination - Normally the volumes should be suitable for the actual period.
- ultrasound can determine whether there is an embryo in the membranes, whether the heart beats the fetus.
- The analysis of blood on hormones shows whether the female body produces specific "pregnant" hormones in the quantities that are necessary for the normal development of crumbs.
Fetal pregnancy: what happens to the fetus after death
Miscarriage from pregnancy is characterized by the fact that the fetus remains in the uterus for an undetermined number of days, months, or even years( isolated cases).This means that without medical intervention, the mother's body can not cope with the rejection of dead tissue. In the conditions of intrauterine storage, a dead child can undergo the following processes:
- Maceration. Occurs in 90% of cases. This moist, aseptic transformation of dead tissue in the first days after fetal fading is aseptic, but after a while, infection inevitably develops. The fruit becomes soft, wrinkles, in some areas of its body exfoliate the tissue in the form of blisters, and exfoliates the epidermis. When the infection begins to develop, the fetus turns greenish.
- Mummification, as a result of which the fruit dries up. Often this process occurs with the death of one of the children with multiple pregnancies, when the umbilical cord wraps around his neck and blocks the oxygen. The fetus is so dehydrated that it becomes "paper" in appearance.
- Petrification. Salts of calcium begin to be deposited in the tissues of the dead macerated fetus. The dead clot of matter is stony. In medical terminology, there is a name for it - the lithopedic. This formation can remain asymptomatically in the body for several years. Most often, petrification develops as a result of a frozen intrauterine pregnancy, which the woman does not know about.
The diagnosis of "frozen pregnancy" is confirmed. What to do?
If there are signs of a dead fetus, the victim is immediately hospitalized. The frozen pregnancy is ascertained through the procedures of the FCG, the child's ECG and ultrasound. The victim is examined with the help of an amnioscope, which in the first day after the extinction of a new life shows amniotic fluid of a green hue stained with meconium. X-rays are rarely used. Explicit radiographic signs of child's fading are the difference in its size from the norms of the current month of pregnancy, fuzzy outline of the head, drooping lower jaw, twisted back bones.
Treatment begins immediately: for medical reasons, pregnancy is interrupted. If you do not have an abortion on time or contact the hospital for help too late, the fetus will start to decompose, which will lead to inflammation and strong intoxication of the woman's body. In early terms, a frozen pregnancy can result in an arbitrary miscarriage. Based on the period of pregnancy, doctors can choose several options for action:
- Wait until the body itself will reject the fruit. This is relevant for the natural development of pathology and a decrease in the number of placental hormones in the blood.
- Provoke miscarriages with special medications for a period not exceeding 8 weeks( eg, prescribe a patient receiving progesterone antagonist medications).
- Perform an operation for surgical curettage of the uterine cavity followed by a course of antibiotic therapy. After 10-14 days after abortion, ultrasound is performed to evaluate the postoperative rehabilitation of the victim.
Treatment after a stiff pregnancy
Strange as it may seem, the fading of the fetus does not cause serious harm to the woman's body, but negatively affects her consciousness and the desire to have children in the future. However, one should not be afraid and put up a cross: the prognosis after recovery from an uncomplicated, frozen pregnancy is favorable.
At first, parents must undergo a multidisciplinary examination to prevent a repeat of the scenario that has already been traced on the next attempt to have a child. For this, the couple donates blood for the analysis of hormones of the genital area and the study of thyroid hormones. During the examination, various chronic hidden infections can be detected. Here is a list of the main procedures that the spouses must undergo after an intrauterine pathology:
- Cytogenetic analysis.
- Histological examination of the tissues of the uterine cavity.
- Study of bacterial flora.
- Collection of blood to detect possible hidden infections, including mycoplasmosis, herpes, chlamydia, and others.
- Collection of blood for the study of the level of hormones.
- Study of karyotype features.
- Spermogram( for a man).
For each specific pair, a set of studies can be shortened or supplemented with other procedures, depending on the specific pathology that caused pregnancy fading in the past.
The intended treatment is focused, first of all, on strengthening of the general immunity of the woman and her partner. Particular attention is paid to the normalization of metabolic processes and menstrual cycle in women. It is also taken into account that the collision with the phenomenon of frozen pregnancy is a very serious test for the psyche of the mother who failed. Perhaps the most true act of a woman will be her appeal for the professional support of a psychologist who will correct her positive attitude and confidence in subsequent attempts to become pregnant.
To prevent the development of complications after a stagnant pregnancy, responsible contraception, the intake of vitamins and the rich diet rich in nutrients are important. In fact, to recover after the event the body will be quite a long time, the logical conclusion of this process will occur after the birth of a full-fledged strong karapuza.