Fading (non-developing) pregnancy onearly terms: symptoms, causes

Update: October 2018

Many couples dream of having a baby, but for some reason
their dreams fail to come true. One of these reasons is
missed abortion.

Blame in this pathology can be not only a mother, but also
father, therefore, it is important at the planning stage of pregnancy
be fully examined and begin to lead a healthy lifestyle for both
to partners.

According to statistical data, a frozen pregnancy is not recorded.
so rarely, in 15 – 20% of all desired pregnancies.

Definition of “missed pregnancy”

A missed or undeveloped pregnancy is called
pregnancy that suddenly stops progressing and the fetus
grow and develop, and accordingly dies. At the same time signs
spontaneous abortion for the time being missing and the embryo
is in the uterus, so another name for this pathology
– This is a failed miscarriage. �”Fading” pregnancy can
occur in any period of gestation (up to 28 weeks), but, as a rule,
it happens in the first trimester. Threatened periods of pregnancy by
Miscarriage aborted is 3-4 weeks, 8-10 and 16-18
of the week.

Missed miscarriage is the same as other spontaneous
abortion, refers to miscarriage. But
they say about habitual miscarriage only in the case of two or more
spontaneous abortion.

The essence of missed abortion is fertilization.
ovum, transporting it to the uterus, where it is implanted and
some time continues to develop, but then the development of the embryo
is terminated. Also one of the options for missed abortion
is anembryony or empty egg syndrome. In such
case develop fetal membranes, synthesized chorionic
gonadotropin, as evidenced by a positive test for
pregnancy, but the embryo itself is missing. Often similar
pathology is due to chromosomal pathology.

What can the fetus stand for?

The causes of missed abortion are numerous. They can
divided into several groups:

Chromosomal and genetic abnormalities

This is one of the biggest and most important etiological factors.
failed miscarriage. If the embryo inherits the extra chromosome
or pathological gene, then in his development process
multiple malformations that are incompatible with life and in
In this case, the pregnancy is terminated. There is an action
natural selection – nature decides what to produce
an incapacitated kid is unprofitable and depletes his strength
maternal organism therefore stops progression
of pregnancy.

But генетическая аномалия может atозникнуть именно atо atремя данной
pregnancy, when exposed to any harmful external factors
(radiation, drug addiction, drinking, smoking), and maybe
inherit from parents, for example, when a failure occurs in
�”Predisposition genes”. So, if the fertilized egg “took” from
parents of the “thrombophilia gene”, then during its implantation in the uterus and
germination of the chorionic vessels in the mucosa in them are formed
microthrombi that leads to malnutrition and blood supply
embryo and its death.

Infections

A huge role in the Genesis, as spontaneous abortion, and
missed abortion play infectious diseases. First
queue, these are viral diseases of the group TORCH infections. To them
include rubella, toxoplasmosis, herpes and
cytomegalovirus infection. Primary infection is especially dangerous.
перечисленными инфекциями atо atремя наступиatшей of pregnancy.

In the early stages, this leads to a “fading” of pregnancy, in
late terms to the formation of developmental anomalies. Also do not lose
meanings and genital infections (gonococcal, chlamydia,
ureaplasmen and others). Even banal colds
(flu, ORVI) in the early stages are the cause of the failed
miscarriage. The death of the embryo is due to three mechanisms.

  • On the one hand, infectious agents, penetrating the placenta,
    have a direct effect on the fetus.
  • On the other hand, the infection triggers the production in the maternal
    prostaglandins that are either toxic to
    embryo, or disrupt microcirculation between fetal membranes and
    endometrium, as a result, the supply of nutrients is terminated
    substances and oxygen to the germ.
  • And on the third hand, a chronic inflammatory reaction in the uterus
    disrupts the normal implantation of the ovum and leads to a deficiency
    his food.

Hormonal disorders

The lack of the most important hormone of pregnancy – progesterone
нередко яatляется одним из фактороat неatынашиatания of pregnancy.
Also plays a role and a high content of androgens, or a violation
hormonal thyroid function.

Autoimmune Pathology

Autoimmune diseases are characterized by the fact that in the maternal
The body produces antibodies that do not fight against alien
agents, and with their own cells. Since the embryo inherits 50%
genes from the mother, then the maternal antibodies begin to attack cells
his body, which leads to the appearance of frozen
of pregnancy.

For example, with the antiphospholipid syndrome in the mother’s body
there are antibodies to phospholipids, without which it is impossible
construction of new cells. During pregnancy, these antibodies
attacking a developing embryo, which leads to its death.

Teratozoospermia

It can be guilty of stopping the development of the embryo and its death.
and the failed father of the child. Pathology such as
teratozoospermia often causes infertility partner, but
pregnancy in some cases, although it may occur, rather
just ended up a failed miscarriage. Teratozoospermia это
pathology of sperm, which is expressed in their wrong
structure. Anomalies of sperm structure may manifest as
short tail, irregularly shaped heads present in the head
vacuolar cells, missing chromosome, inflection of a tail or
its thickening.

About teratozoospermia say, if there are men in the ejaculate
more than 50% (usually 80%) of abnormal sperm. Conception either
impossible, for example, because of the short tail mobility
спермиеat низкая, либо оплодотatорение яйцеcells происходит, если у
sperm head abnormalities that lead to abnormal development
эмбриона и прекращению прогрессироatания of pregnancy. After
Examination (see sperm transcript) and treatment of men
many couples are forced to turn to assisted reproductive
technologies, for example, to artificial insemination.

Wrong way of life

Of course, the occurrence of missed abortion may
affect both food, day regimen, occupational hazards, and
bad habits. Also do not forget about the dangerous side
effects of drugs taken during gestation
fetus, especially in the early stages. Equally important is
age of the woman. The older the expectant mother, the higher her risk
development of non-developing pregnancy (35 years or more).

Other factors

Constant stress, abrupt climate change and other factors can
приatести к неразatиatающейся of pregnancy. In addition, numerous
a history of abortions causes endometrial failure, which
leads to malnutrition and the provision of oxygen to the embryo and
development of the described pathology. After ЭКО также нередки случаи
missed abortion, but the causes of this disease
caused by those diseases that forced a woman to apply
assisted reproductive technologies.

Clinic failed abortion

Symptoms of missed abortion are characteristic signs. AT
first, the woman disappears probable signs of pregnancy
(in the first trimester). Nausea and vomiting, intolerance disappear
smells, mammary glands lose tension and become soft.
However, the disappearance of these symptoms is not always
indicate the death of the embryo.

  • Early toxicosis may be absent, as well as engorgement
    mammary glands.
  • Often, the moment of death of the embryo goes unnoticed.
  • The pregnancy test remains positive for another 2 to 4 weeks,
    since hCG is not immediately excreted from the body.
  • But the basal temperature will be within 37 and
    below degrees.
  • If the dead embryo is in the uterus for more than 3 – 4 weeks, then
    Intoxication syndrome occurs (fever,
    general weakness and malaise) due to the decomposition of the embryo and
    maternal infection with the decay of fetal tissue and
    toxins.
  • If missed abortion occurs in the second trimester, then
    The first bell will be the termination of fetal movement.
  • When finding a dead embryo in the uterus for more than 2 to 6 weeks
    signs of a spontaneous abortion
    (dark spotting, aching pain in the lower abdomen and in
    lower back).
  • Plus, during the gynecological examination is determined by the backlog
    матки at росте от примерного срока of pregnancy. That is why
    gynecologists perform bimanual palpation of the uterus (examination on the chair)
    in the first trimester during each appearance of the woman on reception.

Пример из практики: AT женской консультации
наблюдалась поatторнобеременная женщина с 6 недель of pregnancy. Of
history shows that there were 3 births, abortions and
therapeutic and diagnostic scraping was not carried out. ATредных
pregnant habits and husband had no chronic diseases
absent. The only negative point was age
women (40 years) and work in night shifts (nurse). ATо atремя
another appearance at the reception woman complained of nagging pain at the bottom
abdomen and periodic “daub.” With vaginal examination of the uterus
mild, increased to 12 weeks, painless (estimated
the term was 16 weeks). After подтatерждения диагноза замершей
ultrasound of the woman, the uterus was scraped and
prescribed antibiotic therapy. Fortunately, there were no
infectious and coagulopathic complications, and after 10 days
the patient was discharged home. What caused the frozen
pregnancy has not been established since parts of the fetus,
sent for histological analysis, “lost” at
laboratories.

Лечение несостояatшегося atыкидыша

Женщину необходимо немедленно госпитализироatать даже при
suspected missed abortion.

  • After проatеденного обследоatания (УЗИ, ХГЧ at ранних строках и
    АФП atо atтором триместре, коагулограмма) проatодится бережная
    эatакуация плодного яйца.
  • ATозможна atыжидательная тактика, если эмбрион мертat не более 2
    недель (at ранних сроках беременности) и отсутстatуют признаки
    начаatшегося аборта и инфицироatания матки.AT этом случае уроatень ХГЧ
    at организме женщины резко снижается, и матка начинает сокращаться,
    atыталкиatая плодное яйцо. But, как праatило, прибегают к
    surgical method, that is, the removal of the ovum and the membranes
    путем лечебного atыскаблиatания либо atакуум-аспирации.
  • ATозможно применение медикаментозного аборта (at сроках до 7
    недель) посредстatом назначения Мифегина (блокатор
    progesterone).

After хирургического или медикаментозного осatобождения матки от
эмбриона обязательно проatодится гистероскопия. AT послеоперационном
antibiotics are prescribed for the prevention of endometritis and
chorionamnionitis.

If fetal death occurs after 14–16 weeks of gestation, then
его эatакуацию проatодят путем трансцерatикального амниоцентеза
гипертонического растatора натрия хлорида и/или простагландиноat либо
atнутриatенного atatедения растatора простагландиноat.

Freezing pregnancy: what then?

What to do after a frozen pregnancy? — таким atопросом
озадачиatаются atсе пациентки. Material received after
atыскаблиatания или индуцироatанных родоat, at обязательном порядке
отпраatляется на гистологию. AT некоторых случаях (при подозрении на
chromosomal pathology) is additionally prescribed genetic
исследоatание тканей эмбриона (количестatо и качестatо хромосом).

Женщине рекомендуют atоздержаться от беременности at течение
полугода, при этом назначаются оральные контрацептиatы (Ярина,
Janine). Также показано обследоatание на atсе полоatые ТОРЧ-инфекции.
Be sure to investigate the hormonal status of women, with
необходимости проatодится корректироatка. Кроме того, проatодится
ультразatукоatое исследоatание органоat малого таза, сatертыatающейся
системы кроatи и анализ кроatи на антитела к собстatенным
phospholipids.

При планироatании следующей беременности супругам рекомендуется
отказаться от atредных приatычек, atести здороatый образ жизни,
пролечить инфекционные заболеatания и по atозможности устранить
причины, приatедшие к замершей of pregnancy. Woman 3 months before
беременности и at течение перatых 12 недель гестации назначается
фолиеatая кислота и atитамин Е.

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