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Non-developing pregnancy(intrauterine fetal death, miscarriage) - the death of an embryo or fetus without obvious signs of termination of pregnancy. Unfortunately, this can happen to every woman and at any gestational age, but this does not mean that subsequent pregnancies will be complicated (unless this is a repeated case).

information Pregnancy fading in the early stages of development occurs most often. Critical timing for non-developing pregnancy (NB) is most often up to 8 weeks of gestation. It is at this time that all organs and tissues are being laid, so any pathological factor can disrupt the development of the fetus and lead to its death.

The consequences of NB in ​​the early stages, both for the woman's body and for her psychological state, are less than if this happened during the period when the mother already felt a stir. In any case, you should not dwell on what happened and be afraid of a subsequent pregnancy. Try to treat this as a natural selection of nature.

The reasons

Unfortunately, even modern medicine is not always able to answer why the death of a child occurred in utero. There are many reasons, but it is not always possible to get to the truth. Moreover, at an early stage, the law is in effect: “all or nothing”. This means that under the influence of adverse factors, the embryo either transfers them and develops further correctly, or dies.

  • genetic factor

Most often, a frozen pregnancy at an early stage occurs due to a genetic breakdown of the embryo itself, which occurred at one stage or another of its development. The fetus is simply not viable, so it is rejected. This is a kind of natural selection.

  • infectious factor

Another common cause of NB is infection. Most often it is the herpes simplex virus and various respiratory diseases, sexually transmitted infections (chlamydia, mycoplasmas, gonococci) and others. Under the action of these pathogens in the early stages of development, a violation of cell division can occur, damage to the genetic material of the embryo, which will cause its death.

  • immune factor

Maternal immunological disease (antiphospholipid syndrome, systemic lupus erythematosus and others), immunological incompatibility of spouses can also cause fetal death, and more often this occurs before 12 weeks of pregnancy.

  • Endocrinological factor

Inadequate synthesis of progesterone (a hormone that maintains pregnancy), thyroid disease, excessive synthesis of male sex hormones and prolactin can interfere with the normal development of the fetus.

  • Other factors

We should not forget about the lifestyle of future parents. Bad habits, contact with chemicals, living in a zone of high radiation, stress can affect the favorable course of pregnancy, especially in the very early stages.

Symptoms

important The main signs of abortion at different times are pain in the lower abdomen,. The difficulty with NB is that all these symptoms do not bother the woman. She may not know for several weeks that the fetus has died.

The main signs of an early miscarriage are a decrease in subjective sensations that are characteristic of many women in the position:

  • engorgement of the mammary glands;
  • sensitivity to smells;
  • unusual food preferences;
  • nausea, vomiting;
  • drowsiness.

Of course, not every pregnant woman will be wary of such symptoms, and often these signs disappear with the progression of pregnancy (gestation). That is why fetal fading is often not diagnosed immediately, but after a few weeks. Often, spotting from the genital tract can join, which indicates the beginning of pregnancy rejection.

Ultrasound signs of missed pregnancy

The main ultrasound signs of stopping the development of the embryo at the shortest time are the deformation of the fetal egg, uneven contours, and its location in the lower part of the uterus. It is characterized by a discrepancy between the gestational age according to ultrasound and monthly, the absence of a fetal heartbeat (usually from 5-6 weeks it can already be determined).

additionally However, the gestational age and menstrual period do not always coincide. This can happen for various reasons (irregular periods, hormonal disorders, stress, ovarian cysts, and others), and the difference can be up to four weeks.

Therefore, in some cases (for example, for a monthly gestation period of 7-8 weeks, and ultrasound shows only a fetal egg characteristic of 4 weeks), in order not to make a mistake with the diagnosis, it is worth repeating the study after 5-7 days. If during this time the fetal egg does not grow up, the embryo is not visualized, then the fetus freezes.

Signs of NB during gynecological examination

At a gynecological examination, the doctor evaluates the size of the uterus, its compliance with the expected gestational age, and the condition of the cervix. If the uterus is judged to be smaller, an ultrasound should be performed to confirm or refute the suspicion. Some women have physiological features (initially smaller internal genital organs) or there may be a difference in terms for menstruation and for the embryo, so it is important to make sure that the delay in uterine growth is really caused by pregnancy fading.

Determination of human chorionic gonadotropin (hCG)

Determining the concentration of human chorionic gonadotropin helps in making a diagnosis, especially in the very early stages. So, when it is still impossible to see the fetal heartbeat using ultrasound, but there are doubts about its viability, you can donate blood to the level of hCG. It is important to observe the dynamics here, since with a normally developing embryo, the level of the hormone almost doubles every day.

Measurement of basal temperature in case of suspected NB

It should be said right away that this method is only additional and indicative, since it is inaccurate and its results may vary under the influence of many factors. Basal temperature is measured in the rectum, without getting out of bed, at the same time after a night's sleep. Under the influence of the hormone progesterone (preserves pregnancy), this temperature rises by 0.3-0.5 degrees Celsius and is 37.2-37.5. When the embryo freezes, the level of progesterone decreases, and as a result, the basal temperature also decreases.

Treatment

When confirming intrauterine fetal death, a woman must be hospitalized in a gynecological hospital. In the early stages, the main treatment for non-developing pregnancy is the simultaneous removal of the embryo or fetus and its membranes. If the gestational age allows, it is better to do this by vacuum aspiration. This method is more gentle. At a later date, curettage of the uterine cavity is performed (like an abortion). Before the operation, it is worth preparing the cervix, especially in nulliparous women. To do this, use kelp (algae sticks), catheters. This is done to gently and gradually dilate the cervix. Vacuum aspiration of the fetal egg and curettage of the uterine cavity is performed under general anesthesia.

Also, for short periods, expectant management and medical abortion are increasingly used. These methods will allow pregnancy to be terminated more gently (but always under the supervision of doctors).

Rehabilitation

important It is very important to rehabilitate a woman after an undeveloped pregnancy. It includes taking oral contraceptives (at least 3 months), treatment of diseases of the genital organs (infections) and hormonal disorders.

Also, do not forget about the psychological aspect. It's good to change the situation, get positive emotions. Try to avoid conflicts. It is important to feel supported by others.

Effects

The consequences for the reproductive health of a woman are reduced to zero if the removal of the embryo with its membranes is carefully performed, and rehabilitation is also carried out.

Prognosis for next pregnancy

In 90% of cases, women who have suffered early fetal death are able to become pregnant and bear a healthy child. However, if a non-developing pregnancy recurs, it is necessary to undergo a full examination to identify the cause, since violations can be at the hormonal and immune levels.

Planning a pregnancy is not earlier than 6 months. During this time, the body will be able to recover in order to become capable of bearing a healthy child. It is very important during this period to undergo an examination and preparation for a subsequent pregnancy.

The main thing is to believe in the good and not let your fears prevent you from becoming happy parents.

A frozen or developed pregnancy is an intrauterine death of the fetus, which does not show clear signs of termination of pregnancy. The pathological condition occurs up to 28 weeks of gestation. Most often, the fading of pregnancy occurs in the early stages in the first trimester before the 16th week of the child's development. The period before is especially dangerous, when the organs and systems of the embryo are being laid, and the placenta has not yet been formed. After diagnosing a missed pregnancy, the embryo is removed from the woman's uterus. In some cases, spontaneous abortion occurs.

Symptoms of a missed pregnancy in the early stages

The danger of an undeveloped pregnancy in the early stages of development is that the pathology can proceed without clinical manifestations. The delay of a dead embryo in the uterus leads to the gradual decomposition of its tissues. Toxic decomposition products are absorbed into the blood of a woman, causing poisoning of the body and the development of severe complications.

Obvious clinical signs may occur 6-7 weeks after the death of the fetus, which indicate a violation in the work of the woman's body. A late pregnancy in the 2nd trimester is detected faster - the fetal movement stops, which should alert the woman. Doctors warn that a scheduled visit to a gynecologist can eliminate not only the development of intoxication and other undesirable consequences in a pregnant woman, but also in some cases prevent fetal death.

Clinical signs of non-developing pregnancy, if they appear, are rather weak. A woman may not attach any importance to this. It is necessary to know the symptoms of intrauterine fetal death in the early stages in order to respond in a timely manner and visit the doctor of the antenatal clinic, where the pregnant woman is registered with the dispensary.

Symptoms of a missed pregnancy:

In the event of complications associated with poisoning of the body with toxic decomposition products of fetal tissues, obvious clinical signs occur.

  1. Fever up to 40 degrees.
  2. Chills, increased sweating.
  3. Headache.
  4. Intense pain in the lower abdomen.
  5. Constant nausea, repeated.
  6. Uterine, epistaxis, internal bleeding.

Prolonged intoxication can lead to the development of sepsis (bacteremia, general infection of the body) and DIC (impaired blood clotting, massive bleeding).

Signs of a missed pregnancy in the early stages

A gynecologist can diagnose a non-developing pregnancy by specific signs that are characteristic of intrauterine fetal death. The specialist also prescribes additional examination methods that confirm the disappointing verdict. Only after contacting the antenatal clinic will it be possible to say with certainty that the embryo died, and the pregnancy stopped development. Before visiting a specialist, one should not draw premature conclusions.

You can suspect a frozen pregnancy at home by changing. To do this, you need to measure the temperature in the rectum with a thermometer in the morning after sleep, without getting out of bed. The female sex hormone is responsible for maintaining pregnancy, which causes an increase of 0.3-0.5 degrees.

The normal course of intrauterine life corresponds to the temperature in the rectum at the level of 37.2-37.5 degrees. A decrease in this indicator indicates a violation of the course of pregnancy and possible death of the fetus. It must be remembered that a low rate is not an absolute sign of a missed pregnancy. If a basal symptom is detected, it is necessary to seek advice from a gynecologist.

At the appointment, the doctor collects the woman's complaints, conducts an examination, including on the gynecological chair, prescribes laboratory and instrumental methods of examination. In the early stages of gestation, the most informative is ultrasound diagnostics of the embryo and laboratory analysis to detect concentrations (human chorionic gonadotropin) in peripheral blood.

Causes of missed pregnancy

In most cases, it is possible to identify the cause of a non-developing pregnancy and, with further planning of conception, undergo a course of preventive treatment. Sometimes doctors cannot determine the cause of intrauterine fetal death. This does not cause concern in the case when such a pathology occurs once. Repeated miscarriage indicates a severe pathology in the body of a woman, which requires a thorough examination and adequate therapy. According to statistics, intrauterine fetal death is rare and does not have a habitual character - for 200 normally occurring pregnancies, there is one case of embryo death in the womb.

Causes of missed pregnancy.


Habitual miscarriage often causes a combination of several adverse factors. Identification of the cause of the pathology is an important link in planning pregnancy and the birth of a healthy child.

What diagnosis of a missed pregnancy will be the most accurate?

Non-developing pregnancy in the early stages is detected using laboratory and instrumental diagnostic methods. Before the appointment of the examination, a gynecological examination of the pregnant woman is carried out.

  1. Examination on a gynecological chair - allows you to determine the condition of the cervix, the compliance of the size of the uterus with the gestational age. If a discrepancy or pathological changes are detected, ultrasound diagnostics is prescribed.
  2. Ultrasound examination of the uterus and fetus is the most accurate method for detecting intrauterine fetal death in the early stages of development. Signs of a missed pregnancy: uneven contours and deformation of the fetal egg, localization of the embryo in the lower parts of the uterine cavity. In case of a doubtful result, a second ultrasound examination is performed after 5-7 days. Stopping the growth of the fetal egg or poor visualization of the embryo is evidence in favor of a non-developing pregnancy.
  3. A blood test for maintenance is an effective method for diagnosing intrauterine fetal death at the earliest stages of pregnancy (up to 8-10 weeks), when an ultrasound examination is not informative. In the first weeks of pregnancy, the level of the hormone doubles every 24-48 hours. The absence of an increase in the blood or a decrease to 5 mIU / ml (typical for non-pregnant women and men) speaks in favor of intrauterine fetal death. In some cases, the membranes of the fetal egg are formed and synthesized, and the embryo does not develop - hormone indicators will give a false negative result and the diagnosis becomes ineffective.

The appointment of a method for diagnosing a missed pregnancy and the interpretation of the results of the examination is carried out by a gynecologist. The specialist will correctly assess the risk of pregnancy pathology and determine the tactics of treatment.

What to do if a missed pregnancy is detected?

After confirmation of a missed pregnancy, a dead embryo is removed from the uterine cavity. In some cases, the body independently rejects the fetus in the process of spontaneous abortion. In case of a failed miscarriage, a pregnant woman is prescribed medical procedures and surgical interventions that are aimed at removing the embryo and its membranes.

Methods for terminating an undeveloped pregnancy.

  1. Medication - intravenous administration of drugs that increase the tone of the uterus and cause contractions. The embryo leaves the uterine cavity naturally through the cervix and vagina.
  2. Curettage - cleaning the uterine cavity with special surgical instruments. It is carried out under anesthesia. The cervix is ​​dilated, then instruments are inserted into the organ cavity. The embryo and the inner lining of the uterus are scraped out. The technique is dangerous for the development of complications: bleeding, inflammation, infertility. This method cannot be considered sparing in early pregnancy and is prescribed if other methods are contraindicated.
  3. Vacuum aspiration is a gentle surgical procedure by means of vacuum suction. Used for abortion in early pregnancy. The tip of the vacuum apparatus is inserted into the cervix without the use of dilators and the contents of the organ are sucked under pressure, removing the embryo and mucous membrane.

After the termination of a frozen pregnancy, a woman should be under the supervision of a gynecologist. Carry out outpatient or inpatient treatment, depending on the type of permission from the burden, the general condition of the woman, the risk of complications. The therapy includes broad-spectrum antibiotics, hemostatic agents, vitamins. It is recommended to refrain from planning conception for six months.

To identify the cause of intrauterine fetal death, the uterine mucosa (endometrium) and embryonic tissues are taken for histological examination. When chromosomal abnormalities are detected, genetic counseling of parents is prescribed to establish compatibility. It is obligatory to study the woman's blood for the state of the hormonal background, the analysis of the smear for the flora and the presence of genital infections. Identification of the cause of a missed pregnancy helps prevent intrauterine fetal death during further planning of motherhood.

A frozen pregnancy is a tragic event in a woman's life, but not a sentence. If the cause of the pathology is identified, it is possible to prevent the death of the embryo, preserve the vital activity of the fetus throughout the entire period of development, and give birth to a healthy child.

For every woman, pregnancy is a great happiness, future parents are looking forward to the birth of a baby. But sometimes unforeseen circumstances happen, and the joy of motherhood comes to naught. This is due to a number of reasons, one of them is. This is a pathological condition in which the fetus stops developing, growing and subsequently dies. Usually such a pregnancy is interrupted long before the appointed time.

It is extremely difficult to determine the fading at the beginning of pregnancy with your own hands, the symptoms are practically not traced. But women who are attentive to themselves and their feelings, as a rule, always feel something is wrong. Usually the diagnosis is made by the doctor based on the results of the planned.

First signs

The most dangerous week of gestation is the eighth, at which time the small organism is susceptible to any effect. In the first trimester, there are much more risks of hearing this diagnosis, especially since the signs of a missed pregnancy are not particularly visible.

Common symptoms of a missed pregnancy include:

  • cessation of toxicosis;
  • bloody vaginal discharge;
  • temperature rise;
  • return of the mammary glands to their previous state;
  • pain in the lower abdomen, resembling contractions.

If one or more of the above symptoms appear, you should immediately see your doctor!

How to detect early

In the early stages of the “interesting position”, fading is very difficult to recognize. Among the frequently encountered signs, uncharacteristic ones (with blood or pus) are noted, a decrease in basal and an increase in general temperature, malaise, pain in the abdomen, etc. In the early stages, an accurate diagnosis can only be made based on the results of ultrasound and hCG analyzes.

Ultrasound in this case will indicate:

  1. lack of fetal heartbeat, which can be traced as early as 5 weeks of pregnancy;
  2. the size of the baby does not correspond to the gestation period;
  3. fetal deformity (determined up to 4 weeks of pregnancy);
  4. at a period of 5-6 weeks, the embryo is not visible in the uterus.

HCG analysis will show:

  1. the concentration of hCG is lower than that which should correspond to the gestational age according to an ultrasound scan or a doctor's examination;
  2. decrease in the hCG hormone;
  3. lagging behind the norm for a given gestational age.

Symptoms after IVF

The death of the fetus after in vitro fertilization is evidenced by such symptoms as:

  1. drawing pains in the lumbar region;
  2. the appearance of contractions in the lower abdomen;
  3. increase in body temperature;
  4. from the vagina with blood blotches;
  5. if there was toxicosis, then its abrupt cessation;
  6. the swelling of the mammary glands has stopped;
  7. reduction in the volume of the abdomen;
  8. decrease .

Symptoms in the first trimester

As already noted, it is quite difficult to establish the fading of pregnancy at first.

This usually happens after an ultrasound.

However, the woman shows some symptoms that deserve special attention.

Abdominal pain

Painful sensations usually affect the lower abdomen and appear in almost every woman with a similar diagnosis. This is due to the fact that the body itself is trying to expel the fetal egg in order to avoid serious consequences. The cause of the pain is the cessation of the production of certain hormones. The uterus becomes sensitive, tries to contract.

In a woman, this process is accompanied by pulling or cramping pain. However, such symptoms sometimes indicate a possible miscarriage. To avoid this tragedy, it is urgent to see a doctor.

Allocations

One of the symptoms of pathology is discharge, which differs from normal. Branches of white, cream or milky color are considered natural.

If they contain pus or blood, then there is a pathology in the development of the fetus.

Blood in the discharge indicates rejection of the fetal egg. Pus speaks of a neglected state of a frozen pregnancy, when inflammation has already begun.

For the first two days, a woman has white discharge of a normal consistency.

  • Then the embryo decomposes, which leads to the release of streaks of blood
  • 14 days after the death of the fetus, the discharge becomes bloody

Any woman knows that spotting during pregnancy is no longer the norm.

Such discharges do not always indicate the death of a child, sometimes these signs signal other reasons for which the fetus retains its viability.

Feelings in the chest

When the fetus fades, the area of ​​\u200b\u200bthe mammary glands becomes less sensitive and painless. The fact is that in the body of the expectant mother at the beginning of her “interesting position”, changes occur that affect the mammary glands. At first they become larger and more sensitive. Sometimes painful. These signs usually go away after 16 weeks. If the breast has sharply become the same as before pregnancy, then there is a threat to the life of the fetus.

Toxicosis

Usually, a pregnant woman in the first trimester is worried about nausea and even vomiting. An abrupt cessation of toxicosis may indicate fetal fading.

However, this factor is not an accurate confirmation. Toxicosis can be interrupted by itself, without obvious reasons. Only a doctor can confirm the diagnosis, and then only after a thorough examination.

  • In the first days after the death of the fetus, nausea may persist
  • After two days, the level of hCG decreases, which leads to a gradual decrease in the symptoms of toxicosis.
  • After a week it disappears completely.

Basal body temperature

Another symptom may be a sharp decrease in basal temperature. If a woman is attentive to herself, she will definitely notice this change. After fertilization, the basal temperature is kept at 37 °. With a sudden drop to 36.7 °, you need to sound the alarm.

  • After 2 days, the basal temperature will begin to decrease to the level of 36.8 °
  • In 4 days it will reach 36.7°
  • Then there is a sharp rise in temperature, as the fetus begins to decompose, and an inflammatory process develops in the small pelvis

Not always frozen pregnancy leads to a decrease in basal temperature

Fever

Another symptom of the death of a baby is an increase in body temperature. Everything happens due to the decomposition of the fetus in the uterus and the long process of its being there. This can lead to unpleasant and dangerous consequences for the life and health of a woman, such as inflammation of the internal organs of the small pelvis, sepsis, etc.

  • A woman develops dizziness, pain in the lower abdomen, general weakness
  • After 4 weeks, there is pain in the uterus and an increase in body temperature
  • After 5 weeks, the temperature becomes even higher and can reach 40 degrees, there is pain in the uterus, resembling contractions

How to determine at home?

If you are extremely attentive to the gestation process, then any deviations from the norm will not go unnoticed. During pregnancy, the female body is rebuilt, so it is difficult to separate the normal state from the bad.

Based on the fact that the decomposition of the fetal egg occurs slowly, accordingly, the symptoms will be progressive. It is important to pay attention to them and save the life of at least the mother. Moreover, the early diagnosis of a missed pregnancy does not exclude the possibility of further motherhood.

The first signal of a frozen pregnancy should be malaise. Severe headaches, weakness, apathy. These symptoms appear as early as 4 weeks after freezing. In a pregnant woman, toxicosis disappears sharply, bloody or purulent discharge from the vagina appears.

You can also take a pregnancy test. With an increased hCG hormone, it shows a positive result, and with a reduced one, it shows a negative result. The second option is typical for a frozen pregnancy.

The basal temperature is also measured, its decrease indicates an unfavorable course of the process. It's good when a woman measures it every day. This makes it easier to notice a malfunction in the body.

Short term prevention

Frozen pregnancy indicates a pathology in the human body. Therefore, it is important to take preventive measures to avoid its recurrence. The most important thing is to find the cause of the tragedy.

After the deceased embryo is taken out, its tissues are sent to the laboratory, where they are studied. Thus, you can find out the cause of pregnancy fading, as well as determine the number of embryo chromosomes.

If a woman subsequently decides to become pregnant, it is best to plan ahead. First you need to undergo a comprehensive examination, to study the hormonal background of a woman. Any pathologies should be identified and eliminated before pregnancy.

A mandatory event is the examination of not only the patient, but also her spouse. Since the cause of pregnancy fading may be a partner whose spermatozoa have an irregular shape, a short tail or other changes.

If the partners have failures in genetics or the structure of chromosomes, which cannot be eliminated, then subsequent pregnancies will not bring the desired result. In this case, it is better to consider alternative motherhood options.