The author - Sozinova AV practicing obstetrician-gynecologist. Experience in the specialty since 2001.
Missed abortion or miscarriage frustrated - a condition when the fetus stops developing and dying for up to 28 weeks.
The concept of "missed abortion" comes from the fact that the child was dead, and his expulsion from the uterus has not happened. Missed abortion is one of the variants of miscarriage.
It found a similar condition, sadly realize it, often from 10 to 20% of all (and wanting to give birth, and who wish to abort) pregnancies. And the risk of "fading" of pregnancy increases with the age of the woman.
threatened dates
"Freeze" pregnancy can in any period. But most often it occurs in the first trimester, that is up to 13 weeks. Experts identify the most dangerous stages of pregnancy for "fading" (however, they coincide with the terms of the threat of interruption)
- 3-4 weeks
- 8-11 weeks
- 16-18,
- 22-24,
- 28-30 weeks.
Especially dangerous is the period of 8 weeks of pregnancy.
Attention! Read about ways to interrupt missed abortion in the early stages can be our special article.
Causes of fading
The reasons that lead to a state of "missed abortion" are very numerous. These include:
hormonal imbalance
The lack of the hormone of pregnancy - progesterone - slows down the progression of the pregnancy, which ultimately leads to death of the fetus.
It can also be guilty of androgens, or rather their excess or hyperandrogenism. Accordingly, diseases such as: sklerokistoz ovarian, disease of the thyroid and adrenal glands, and other endocrine pathology can lead to fetal death of the embryo / fetus.
genetic disorders
Chromosomal aberrations fetus or inheritance abnormal gene of a parent leads to the formation karyotype unborn child with which life is impossible. That is the very nature removes defective embryos.
infection
Infection, sexually transmitted diseases (chlamydia, ureaplasmosis, herpes and others), as well as general infectious diseases (rubella, flu, toxoplasmosis, cytomegalovirus infection) In the early stages lead to the death of the fetus, and in later stages to gross malformations. It is for the detection of infections and reduce the fading risk of pregnancy in women are taken three times smears on the flora.
ECO
Often after IVF pregnancy "freezes", that is most likely due to causes which prompted woman refer to the method of getting pregnant.
Age
The older the woman, the higher the likelihood of missed abortion. Particularly high risk of the condition in nulliparous women older than 35 years.
autoimmune conditions
Antiphospholipid syndrome, wherein the amount of antibodies to phospholipids blood increases, leading to thrombosis, including the uterus, so that the fruit does not receive oxygen and nutrients and dies.
immunological factor
Fetus inherits equally genetic material from the father and from the mother, due to any conditions the mother's body perceives the unborn child as a foreign agent, and kills him.
adversity
Malnutrition, Harmful production, climate change and much more are also a cause of missed abortion.
Bad habits
Alcohol, smoking, drug abuse - the reason is not only the deformities of the fetus, but also missed abortion.
abortions
multiple abortions lead to the formation of defective endometrium during the second phase of the menstrual cycle that prevents implantation of the ovum after conception. In that case, if implantation has occurred yet, defective endometrium cavity shell can not satisfy all of the embryo needs for nutrients and oxygen.
Symptoms of non-viable pregnancy
Early stages (I term)
In the early stages of a woman guard missed abortion may be the following symptoms:
- Early toxicosis. The sudden disappearance of all signs of early toxicity (Nausea, intolerance to smells, vomiting, sleepiness) up to 10 weeks indicates missed abortion
- Chest. Chest stopped hurting, no feeling of engorgement.
- Basal temperature. Reduced basal body temperature to 37 degrees and below tells how the threat of interruption, and on the death of the embryo.
- Pregnancy test. Pregnancy test began to show slight positive or negative (decrease hCG).
- Pain. Aching or pulling a constant pain in the abdomen and / or back.
- Minor bleeding from the genital tract, usually dark.
Later date (II-III trimester)
- Absence of fetal movements (main topic);
- Abdominal pain pulling character at the bottom;
- Bleeding from minor to moderate.
Diagnostics
In the first place in the diagnosis of missed abortion plays the role of a pelvic exam.
In the early stages the doctor determines the disparity size of the uterus during pregnancy (specifically for this purpose in the first trimester of every appearance at the reception is carried out vaginal examination).
In the later stages of the abdominal circumference and the height of standing uterus behind the normal, corresponding to a given date. Moreover, not auscultated fetal heartbeat.
The second stage of diagnosis of missed abortion is uterine ultrasound and determination hCG in blood.
In the early stages of an ultrasound fetal heartbeat is not detected, the embryo size does not correspond to normal or diagnosed anembrioniya (fetal membranes are available, and there is no embryo).
Decreases or increases the level of hCG in the blood. In later periods in addition to ultrasound performed cardiotocographyWhich confirms the absence of the fetal heart.
The consequences of non-viable pregnancy
Effects after missed abortion are possible, but the probability of their extremely low.
The risk of complications increases with the number of missed abortion history.
Almost all women after failed abortion in the future and give birth to normal healthy children.
Possible consequences:
infection of a woman
When long-undiagnosed missed abortion or in the case of women not seeking medical attention, the fetus in the uterus starts to decompose and undergo aseptic inflammation. For the time being it does not threaten the health and lives of women, while in aseptic inflammation not associated infection. In this case, the infected dead fetus is a powerful source of bacteria and toxins, which, penetrating into the woman's blood, lead to its contamination and Development sepsis. In addition, the possible development of DICThat is fraught with massive bleeding and nekupiruyuschimsya. And sepsis and DIC may lead to death.
Depression
Any interruption of pregnancy, miscarriage especially frustrated, leading to the breakdown of the emotional and mental strength and can cause long-term depression.
fetal mummification
A similar phenomenon occurs in a multiple pregnancy, when one fetus is developing normally, and the other dies, thus becomes a "mummy" or in paper fruit.
lithopedion
Lithopedion - a petrified fetus that is dead fetus undergoes calcification (deposition of calcium salts). This phenomenon is very rare, only 300 known cases to date. Lithopedion can exist in a woman's body for years, even though the "pregnant" does not know about it.
prevention
In order to prevent missed abortion for pregnancy must be carefully prepared, not only to those women who have this complication has been the place to be, but all the rest:
- cessation of smoking, alcohol and drugs to both sexual partners is not less than 3 months before the planned pregnancy;
- make the necessary vaccinations (rubella, hepatitis B, influenza, etc.) not later than 3 months before the intended pregnancies;
- pass swabs for infections, sexually transmitted infections and, if necessary, pass the appropriate treatment (pregnancy plan 3 months after recovery);
- and to treat chronic Adjusted ekstragenital'nye disease;
- to explore and to normalize hormones, if necessary;
- rejection of abortion;
- adherence to a balanced diet (with the obligatory use of fresh fruits and vegetables);
- Consultation genetics (women older than 35 years and the presence of hereditary diseases);
- Folic acid supplementation for 12 weeks before planned pregnancy (prevention malformations neural tube).
Some studies in pregnancy
- Smears during pregnancy.
- Tests during pregnancy by trimester.
- Ultrasound during pregnancy.
- Urinalysis in pregnancy.
- Coagulation.
- Installing pessary.
- Glucose tolerance test.
- Homocysteine in pregnancy.
- Amniocentesis.
- Anesthesia during childbirth.
- Fetal CTG (cardiotocography)
- Cordocentesis.
- Epidural anesthesia during childbirth.
