The term "frozen pregnancy" in obstetrics is usually used to refer to the complication of the gestation process, in which fetal death occurs. Pathology develops early, up to 20 weeks, but in some cases, the disorder is possible in the 2nd and 3rd trimesters. An unavoidable consequence of the disorder is spontaneous abortion.
Why does pregnancy stop?
Doctors can not give an unambiguous answer to the question, why the fetus stops. There can be many factors capable of provoking this pathology. Often, doctors say at the same time about several reasons that caused the fading of pregnancy, because it is impossible to determine what exactly triggered the impetus. Among the frequent causes of pathology, physicians distinguish:
- viral and infectious processes in the body;
- incompatibility of the Rh factor of the fetus and the mother;
- violation of the process of blood clotting in the body of a future mother;
- presence of pathologies of the uterus;
- presence in the anamnesis of abortions;
- bad habits (alcohol, nicotine);
- frequent stressful situations;
- carrying out IVF .
Pregnant pregnancy at an early stage - reasons
In most cases, pathology develops in the early stages of intrauterine development of the embryo. In this case, the main provocative factor doctors call infectious diseases of the mother:
- flu;
- herpes;
- chlamydia;
- mycoplasmosis;
- toxoplasmosis;
- ureaplasmosis.
Explaining why the fetus fades in the early stages of pregnancy, doctors at one of the first places put forward and genetic disorders in the fetus. Often they affect the processes of intrauterine development of organs and systems. As a result, the vices of the cardiovascular and respiratory systems develop, which are incompatible with life. The baby dies, and the pregnancy stops.
Fetal pregnancy in the second trimester - reasons
Frozen pregnancy in the second trimester is infrequent. Her development is often associated with the behavior of the pregnant women themselves. Non-compliance with the established regime, neglect of medical appointments, frequent experiences and stresses negatively affect the general well-being of the woman and the process of pregnancy. As a result of such conditions, often exacerbation of chronic pathologies occurs. Among the violations that can provoke the fading of pregnancy:
- disturbance of the cardiovascular system;
- kidney disease;
- failures in the endocrine system;
- diabetes.
Pregnant pregnancy in the third trimester - reasons
When a frozen pregnancy develops in the third trimester, its causes are often associated with a sudden change in the health of the mother. Often, pathology occurs in women who have chronic inflammatory processes in the body. To lead to the fading of pregnancy at a later date, disruptions to the endocrine system are also possible: diabetes mellitus, dysfunction of the thyroid gland - are often considered as the main causes of the disorder. However, we can not completely exclude the indirect causes of fading:
- abdominal trauma;
- alcoholism;
- severe stress;
- addiction.
How to understand that the fetus is frozen?
A feature of the pathology is the absence of symptoms in the early stages. The first signs of a frozen pregnancy can appear in a few days, and after two weeks. In order to diagnose the violation in time, the pregnant woman should be attentive to her state of health, to know the symptoms of a frozen pregnancy. At the first, even implicit suspicions it is necessary to address to the attending physician.
Frozen pregnancy - signs in the first trimester
In most cases, a frozen pregnancy is accompanied by the appearance of specific symptoms that help to suspect the wrong. Signs of a frozen pregnancy in the early stages have no special features, so the mothers themselves can take them for temporary occurrences. The first signs of a stagnant pregnancy at a short term appear as follows:
- A sudden cessation of toxicosis - persistent vomiting and nausea, which tormented the pregnant couple for several days, are lost.
- The appearance of sharp cramping pains in the lower abdomen, which are unstable, are of low intensity and can be intensified.
- The disappearance of swelling of the mammary glands and a decrease in their volume - the breast becomes the same size, the sensitivity of the nipples decreases.
- Bloody discharge from the vagina - are associated with the rejection of the fetal egg.
- Gradual decrease in basal temperature - with the onset of pregnancy, this indicator is set at 37 degrees, but with fading is reduced to 36.7-36.8.
- Increased body temperature, chills, weakness are caused by the destruction of the membranes of the fetus.
Frozen pregnancy in the second trimester - signs
If the fetus has died in the 2nd trimester, the symptoms of the woman are almost the same as those listed above. At the same time, such signs as sudden termination of fetal movements are added to them. If previously the expectant mother observed frequent tremors and fetal flips in the abdomen, then in the development of pathology they are absent. In order to diagnose the violation in time and take action, doctors advise to contact the medical institution if the fetus does not make itself felt for more than 12 hours in a row.
Frozen pregnancy in the third trimester
To avoid complications, every future mother should imagine how the pathology manifests itself in later terms and what symptoms if the fetus is frozen. On a long term, the baby is no longer so active, commits fewer movements, so a woman's frozen pregnancy can be mistaken for a normal physiological phenomenon. However, in most cases, absent moves are joined by:
- bloody issues;
- cramping pains in the lower abdomen;
- severe vomiting;
- increased body temperature;
- deterioration of general well-being;
- lowering blood pressure;
- increased heart rate;
- fainting condition (with severe bleeding).
Frozen pregnancy - diagnosis
In most cases, it's up to the woman to determine whether the fetus is frozen, the woman can not. A pregnant woman can only assume the development of a pathology, for the diagnosis of which it is necessary to consult a doctor. When a frozen pregnancy develops at a later date, its gynecologist can also determine during a routine examination. To confirm his assumptions, the doctor assigns the following diagnostic measures:
- blood test for hCG - with fetal fading, the concentration of this hormone in the pregnant woman's blood is lower than the norms that are set by the term of pregnancy;
- inconsistency of the size of the uterus for a period;
- absence of palpitation of the fetus during an auscultation through the anterior abdominal wall.
Frozen pregnancy - ultrasound
This hardware examination allows you to diagnose pathology at the very beginning of gestation. A premature pregnancy at an early stage can be detected already at 6-7 weeks of pregnancy. During the examination of the uterine cavity, the doctor makes a final diagnosis on the basis of the ultrasound findings. A frozen pregnancy is said if:
- the fetal egg has a diameter of 20 mm or more, but there is no embryo (anembrionia) in it;
- there are no cardiac contractions in a fetus larger than 5 mm (transvaginal ultrasound) or 9 mm (with transabdominal examination).
Frozen pregnancy - tests
The main laboratory study for a stunted pregnancy is a blood test for hCG. Its concentration on small terms is constantly growing. However, hCG in the deadened pregnancy decreases, and in some cases, the dynamics of its increase in the blood can not be traced. To finally make a diagnosis, the pregnant woman is assigned several repeated tests, with an interval of 1 day, and ultrasound is performed.
Analysis of the dead fetus
The histology of the fetus after a frozen pregnancy involves microscopy of a sample of the tissues of the fetal membranes of the embryo. This study is aimed at establishing the cause that caused the pathology. Based on the results of the analysis, a woman can be assigned additional studies to confirm them. Among them:
- analysis for TORCH infection - is performed a few days after scraping;
- determination of the level of sex hormones - progesterone, estradiol, thyroxine;
- an immunogram;
- smears on the microflora;
- determination of the main indicators of the blood coagulation system - fibrinogen, prothrombin , antithrombin.
Cleaning of a stiff pregnancy
Surgical intervention is not the only way to treat a frozen pregnancy. At a very short time, the removal of the deceased fetal egg can be carried out by taking medications that expel it. Cleaning after a frozen pregnancy is indicated if a pathology is found at the time of 7 weeks or later. This surgical intervention is performed in a hospital using general or local anesthesia.
During the operation, the doctor removes the frozen fetus, simultaneously scraping the uterine endometrium. The tissue particles of the embryo are placed in a sterile container and sent to the laboratory for histology. At the end of the scraping procedure, a woman is administered oxytocin, which causes uterine contractions. During the recovery period, the patient takes antibiotics to avoid the risk of infectious complications.
It is worth noting that after scraping all women fix their vaginal discharge. Normally they should be of a sacrificial nature and last no more than 1 week. The appearance of blood, even a small amount of bloody discharge, which can be accompanied by pain in the lower abdomen often, should be the reason for going to the doctor. This symptomatology is typical for uterine bleeding, which requires urgent medical attention.
Pregnancy after a stiff pregnancy
It takes time to restore the body's reproductive system, so doctors do not advise planning pregnancy for 6 months. The hormonal system in this period gradually returns to its former state. Ovulation does not always happen, therefore, and monthly after a stagnated pregnancy do not have constancy. All this complicates the process of pregnancy planning, so doctors recommend starting a course of preparatory therapy before it starts, which includes:
- Exclusion of the factor that led to the fading of pregnancy ;
- taking drugs aimed at eliminating existing chronic diseases of the reproductive system;
- course of vitamin therapy and physiotherapy.