Non-viable or non-developing pregnancy - Causes, Symptoms and Treatment .MF .
stilled or developing pregnancy - is to stop the development of the fetus and its destruction.More often than not pregnant zhenshina faced with a similar problem in the first trimester (14 weeks).Much more rarely missed abortion occurs at a later date.
developing pregnancy - is a type of pregnancy loss, just like a miscarriage.
How freezes pregnancy?
Initially, as in a normal pregnancy, embryo implantation occurs in the uterus.But for some reason, fetal development is stopped and the fetus dies.But, despite this, the interruption of pregnancy does not occur, as in conventional abortion, that is, the fertilized egg does not flake and does not leave the womb.Therefore, the uterus continues to grow, the woman still feels like a "pregnant" and the level of HCG (human chorionic gonadotropin human) - the hormone of pregnancy - is not growing, but slowly decreases.But sooner or later there is placental abruption and fetal eggs and only if symptoms of missed abortion.
Because of what may be developing pregn
Firstly, due to hormonal imbalance, or rather the lack of progesterone or due to excess androgens, particularly testosterone.
second possible cause of missed abortion - a genetic abnormality of the fetus incompatible with life.According to most researchers, nature thus carries natural selection, timely eliminating nonviable fetus.
third most common reason - this infection.During pregnancy, the immune system weakens, which serves as a favorable backdrop for acute infectious diseases.The most dangerous are sexual infections (gonorrhea, chlamydia, and ureaplasmosis mycoplasmosis) and TORCH infections (toxoplasmosis, rubella, herpes, cytomegalovirus infection).
Increasingly cause of developing pregnancy and abortion becomes the presence of a pregnant APS.
Other precipitating factors include pregnancy after in vitro fertilization;
stress and sharp change of climate - long-distance flights;
smoking and alcohol intake,
age of the pregnant over 35 years.
missed abortion Symptoms Symptoms
missed abortion is almost no different from abortion symptoms.When detachment of the ovum appear cramping abdominal pain, bleeding from the genital tract.
woman can draw attention to the disappearance of the symptoms of pregnancy: toxicosis (unless, of course, it was), breast tenderness, and so on.
If you missed abortion occurred at a later date, one of the terrible signal the occurrence of disease is the absence of fetal movements.
However, even with these symptoms whether frozen pregnancy say for sure whether or not there is difficult, therefore, for any described symptoms should consult a gynecologist.If there is blood discharge and the absence of fetal movements medical consultation is needed urgently.
Diagnosis of missed abortion
survey includes gynecological examination, pelvic ultrasound and a blood test for HCG in dynamics.Based on these studies can be reliably diagnosed missed abortion.
When viewed on a chair in all pregnant women with non-developing pregnancy is detected mismatch size of the uterus in pregnancy that is the uterus is smaller than it should be.
According ultrasound fetal size is smaller than the due date of pregnancy.Heartbeat he is absent.Ultrasound can also detect anembrioniyu - a kind of developing pregnancy, when the fertilized egg is empty, without embryos.
hCG level, as has been said, with missed abortion is not growing and is far behind the figure of hCG in normal pregnancies.To better appreciate the dynamics of fluctuations hCG in the blood, it is advisable to be tested twice with an interval of 48 hours.
Interruption missed abortion
Unfortunately, you can not save the stood pregnancy and pregnancy is interrupted in any way.Tactics doctor in this case will depend on the individual case.
In most cases, start with expectant taktiki.To there after the fetus dies, HCG levels fall, the uterus contracts, and there is a spontaneous miscarriage, t.e.plodnoe egg comes out of the uterus independently.
second method - a medication abortion drugs.This method is used if the gestational age of less than 8 nedel.Dlya medical termination of progesterone antagonists are used (or Mifepristone Mifegin) with analogues of prostaglandin E2 (Misoprostol Cytotec).After a few hours under the influence of drugs and the fight there is a spontaneous miscarriage.
also used surgical treatment, which is scraping the uterine cavity with the removal of the ovum.The resulting scraping is sent for histological and cytogenetic study of tissues of the ovum.After scraping intravenous hormone that reduces the uterus (Oxytocin) and prescribe antibiotics to prevent infection.
A week or two after curettage make reference pelvic ultrasound, to see whether the ovum in the uterus remains.
All women who have been diagnosed with developing pregnancy, after treatment, that is, after an abortion or curettage, gynecological examination is recommended to determine the cause of missed abortion, otherwise, and subsequent pregnancies may also be undeveloped.
The complex survey after missed abortion include:
- cytogenetic and histological examination of fetal tissue, which is carried out after scraping and with this result, the woman should contact your gynecologist;
- PCR diagnostics for urogenital infections;
- Smear on the flora;
- blood test for TORCH-infection;
- blood test for hormones influence the conception and child bearing (LH, FSH, prolactin, estradiol, progesterone, androgens, testosterone and DHEA, 17-hydroxyprogesterone, kortizol.Pri need to examine the thyroid hormones (TSH, T4, T3);
- pelvic ultrasound;
- blood coagulation;..
- a blood test for antibodies to phospholipids and chorionic gonadotropin
on the basis of these results the doctor prescribes medication after developing pregnancy is recommended prevents pregnancy for 3 to 6 months for the survey,treatment and recovery of the body. As a rule, protection prescribed oral contraceptives (Jeanine, Jess, and so on Yarina).
In most cases, developing pregnancy is not a sentence, and then a woman can safely become pregnant and give birth.
Complications of missed
pregnancy Possible complications developing pregnancy are associated with long-term presence of the deceased fetus in the uterus.This can lead to chorioamnionitis, ie the infection of membranes and endometritis, an inflammation of the mucous membrane of the uterus.If you missed abortion occurred at a later date, there is a risk of fetal maceration, ie the decomposition of dead fetus, which can lead to serious complications such as peritonitis or sepsis.
Prevention missed abortion:
- a healthy lifestyle, avoiding harmful habits, regular exercise;
- examined by a gynecologist before planning pregnancy and early treatment of infections and hormonal disorders;
- folic acid and vitamin E during pregnancy planning and in the first trimester to 12-14 weeks of pregnancy.
1. When will the month after scraping over missed abortion?
After 25 to 60 days after curettage should come monthly.
2. month ago I made a scraping.The gynecologist has appointed 6 months of oral contraceptives, but I do not want them pit.Chto advise?
Oral kontratsevtivy have a healing effect, so they are most often prescribed.Temporarily you can and use barrier contraception, but in any case it is decided by your doctor on the basis of analyzes.
3. How many days after curettage may be vaginal bleeding?
to 10-14 days.
4. What are my chances of pregnancy normally make if it was previously missed abortion?
Same as in healthy women was missed abortion if only once.
5. I drink oral contraceptives.Can I be tested for hormones?
can not.It makes no sense.
6. At what stage of pregnancy accurately seen the heartbeat of the fetus by ultrasound?
At 6 weeks pregnant.
7. Can develop developing pregnancy, if you often do ultrasound?
No, I can not.
8. Which ultrasound is better to do on a short term, if there is a suspicion of missed abortion?
In the early stages is more informative with vaginal ultrasound probe.
9. I HCG sootvetvuet deadline, and on US say that pregnancy not developing.Whom to believe?
Watching how long pregnancy.Up to 6 weeks of pregnancy, the heartbeat is not always visible on an ultrasound.But it so happens that pregnancy, "it freezes", as can be seen on ultrasound after 6 weeks and HCG is not yet time to fall.
Obstetrician-gynecologist, Ph.D.Christina Frambos