- Types of an undescended pregnancy
- At what stages does the pregnancy most often freeze
- Causes of a faltering pregnancy
- Why else can a pregnancy freeze
- Infections resulting in fetal death
- Symptoms of a frozen pregnancy
- Signs of fetal cessation
- What else to pay attention to
- Diagnosis of a frozen pregnancy
- Fetus arrested: a risk group
- How to treat a frozen pregnancy
- Prevention of Miscarriage
A long-awaited pregnancy may not always last the nine months and end with the birth of a child. Unfortunately, a pregnancy that has stopped working is not the only variant of events after conception. According to statistics, planned and desired pregnancies in about 15% of cases “freeze” and stop developing for one reason or another.
Such a situation is dangerous to the health and even life of the expectant mother. Therefore, the sooner such a condition is diagnosed and adequate treatment begins, the less losses for the pregnant woman can come out of this situation. At a minimum, it is important not to miss routine examinations at the gynecologist, who will be able to diagnose in time and reliably establish the presence of a woman’s faltering pregnancy.
Types of an undescended pregnancy
There are two types of failed pregnancies. This is directly an undescended pregnancy, when the fertilized egg enters the uterus, attaches to its wall and begins to develop. And suddenly, for unknown reasons, the process stops suddenly, resulting in the death of the fetus. There is no miscarriage, the uterine muscles are in an inactive state. There are no abortive manifestations, the dead embryo is not rejected and remains in the uterine cavity. Such a frozen pregnancy is classified as a failed miscarriage.
The second type of such pathology is the so-called “empty fetal egg”. In this case, when fertilization occurs, the introduction of the fetus egg in the uterine endometrium formation of the embryo does not occur. In this pathology, called anembryony, only the fetal membranes are formed, but the embryo itself is not inside them.
At what stages does the pregnancy most often freeze
Often women are concerned about the critical timing of a possible pregnancy faltering. In theory, the fetus can stop developing at any gestational age. But there are certain time periods that are specific to a faltering pregnancy. These include:
- Day 7-12 after fertilization – implantation of the fetus;
- 3-8 weeks after conception – the period of fetal formation;
- up to the 12th week from the beginning of pregnancy – placental formation stage.
The regularity of the occurrence of a frozen pregnancy in the first trimester is explained by specialists as being insufficiently protected by the embryo at this time. By the eighth week, the most important organs of the embryo are laid, so this milestone is considered crucial to the risk of termination of its development. Pregnancy can stop progressing at different stages, even shortly before delivery. However, it most often occurs before 28 weeks.
Causes of a faltering pregnancy
The causes of a frozen pregnancy can be a variety of abnormalities:
- Genetic – these causes most often provoke the termination of embryo development. These include the presence of an extra chromosome in the embryo or abnormal genes lead to the development of many defects incompatible with life, resulting in abortion. Genetic abnormalities are the most common cause of pregnancy termination in the eighth to tenth weeks.
- Hormonal – the balance of hormones is critical to normal pregnancy. Therefore, an excess of male hormones (androgens) or a lack of progesterone significantly increases the risk of not carrying the baby. This is why, if a woman has hormonal malfunctions, it is recommended to treat them even before fertilization to avoid a frozen pregnancy.
Why else can a pregnancy freeze
Provoke the occurrence of a frozen pregnancy can also teratozoospermia. This factor of termination of fetal development is associated with pathological changes in the seminal fluid of the man. They consist in the fact that the spermatozoa in such an ejaculate have an irregular structure, and fertilization with such a cell causes abnormal development of the embryo.
Can lead to fetal death and antiphospholipid syndrome. Its presence can lead to a decrease in the formation of placental vessels, or blockage, which prevents the embryo needed nutrition. Bad habits, as well as an unhealthy lifestyle during the planning period and while pregnant – smoking, drinking alcohol, stress, work-related risk factors, daily routines, a sedentary lifestyle, and an unbalanced diet can all be negative factors that lead to fetal death.
Infections resulting in fetal death
Fetal death is often provoked by infectious diseases that are diagnosed in the expectant mother. This is due to the fact that there is a fairly serious decline in immune defense during pregnancy. Exceptionally dangerous at this time are considered TORCH infections, which include toxoplasmosis, rubella, cytomegalovirus, herpes. Therefore, screening for all these types of infections is mandatory when registering for pregnancy.
The cause of pathology, especially when the fetus is still forming vital organs, can be even such seemingly familiar and simple ailments as acute respiratory infections or the flu.
Infection can affect the fetus directly and cause all kinds of anomalies. Or it can affect the fetal membranes, resulting in a significant lack of nutrients or oxygen to the fetus.
Symptoms of a frozen pregnancy
As a rule, a woman carrying a baby has no idea that the fetus inside her has already died, because a frozen pregnancy in the early term does not have the striking symptoms that usually characterize spontaneous miscarriage. The woman continues to feel pregnant, because with this pathology the placenta continues to produce hormones.
An indirect sign of a frozen pregnancy in some cases can be that the woman has disappeared such manifestations of the first months of pregnancy, such as fatigue, increased breast sensitivity, nausea. If the fetus is frozen on later terms, when there was already a stirring, you can understand that there was a problem, the absence of its movement in the uterus.
Signs of fetal cessation
Before visiting a gynecologist and laboratory detection of fetal death a woman may notice the symptoms of a frozen pregnancy, which should be a reason for an immediate, even unscheduled visit to the gynecologist. A harbinger of a terminated pregnancy is a smear of bloody discharge from the vagina and bleeding that increases over time. These symptoms are usually accompanied by painful cramps in the lumbar region and lower abdomen. The appearance of such symptoms is a reason to call an ambulance immediately and to call the doctor in charge of the pregnancy.
Although the bloody discharge is not always a hundred percent sign of a frozen pregnancy, it is a mistake to wait and see. An important indicator of a frozen fetus is the basal body temperature, which a woman measures through her rectum. Usually the temperature is above 37 degrees if the fetus is alive and developing.
What else to pay attention to
The expectant mother must carefully monitor changes in her condition. If her previously suffered from toxicosis suddenly ceased to appear – this is a cause for concern. Of course, with increasing gestation symptoms of toxicity is gradually disappearing, reducing the daily reaction of nausea to external stimuli. Its sudden and abrupt cessation – reason to make an unscheduled visit to the gynecologist. At the same time, it is worth monitoring the condition of the mammary glands.
During pregnancy, they are enlarged, swollen, and a little painful. With a frozen pregnancy painful breasts disappear, it does not feel saturated.
An ordinary pregnancy test can help resolve any doubts that may arise. The test is not one hundred percent reliable, but sometimes it can detect fetal stiffness. In the test, instead of the previously obvious two stripes is one due to a decrease in hCG levels.
Diagnosis of a frozen pregnancy
Reliably confirm the presence of pathology can only be diagnosed in a medical facility. In addition to emergency cases, it is important to attend all routine examinations recommended by a gynecologist. During the gynecological examinations, the specialist will definitely determine whether there is a pregnancy that is not developing by the lack of growth of uterus size, its inconsistency with the current term. Low uterine fundus position is also a serious factor forcing to resort to additional examinations.
In this situation, the doctor prescribes a referral to take a blood test for hCG and hormones, as well as an ultrasound to determine the fetal heartbeat. And the ultrasound is performed twice. At later terms, the embryo’s heart is listened to with an obstetric stethoscope. To confirm the diagnosis of “frozen pregnancy” is a cardiotocography – recording uterine tone and fetal heartbeat.
Fetus arrested: a risk group
Unfortunately, almost every woman can “freeze” the fetus. However, experts identify groups of women in whom the risk of a frozen pregnancy is much higher. These include women who are pregnant:
- who have already had a history of a frozen embryo, if there have been more than two cases, they talk about habitual uncompleted pregnancy – this is a category of increased risk, which requires the most careful attention;
- Under the age of 18 and over 40, in the latter case, the reproductive function begins to wane during this period and the probability of genetic abnormalities increases.
The risk of fetal death also increases in case of diseases of the ovaries, including polycystic ovary syndrome. Abortions also have a negative influence on the development of pregnancy – the risk of a frozen pregnancy increases in proportion to the number of abortions. Kidney disease, arterial hypertension, and fungal infections can lead to pathology.
How to treat a frozen pregnancy
After the fact of fetal death is unequivocally established, the question of whether and how to treat a frozen pregnancy arises. In some cases in the early stages, doctors expect spontaneous rejection of the embryo, but not more than 2 weeks. The treatment is usually surgical and is done by:
- Aspiration – a procedure to siphon off the remains of the fetal egg, performed in the early term up to 5 weeks;
- Curettage – cleaning with a complete curettage of the uterus cavity at five weeks;
- Artificial birth.
The aspiration and curettage procedures are performed under general anesthesia. Both operations take about half an hour each. During the rehabilitation period a course of antibiotic therapy is necessary. After that the patient sees a doctor every week. If no complications appear during this time, and the causes of pathology are eliminated, the woman can return to her normal routine.
Prevention of Miscarriage
To prevent the recurrence of a frozen pregnancy in the future, experts recommend that the next conception be planned no earlier than 6-8 months after the failed attempt. Ideal is a situation where a year or even a year and a half has passed since the abortion or miscarriage. This period of time is sufficient for both parents to have the necessary examinations and treatment. The woman is usually referred for an ultrasound scan, urine tests, blood tests, and smear tests. She consults with a geneticist, gynecologist, and endocrinologist.
When planning further conception, the patient is prescribed an increased dose of folic acid, potassium iodide. In addition, the body of the expectant mother gets the time necessary to recover, becomes physically ready to carry the baby. Do not get discouraged if you have a history of an undeveloped pregnancy. Following your doctor’s recommendations will help you realize your dream of motherhood.