Frozen pregnancy

Contents

What is a frozen pregnancy
Signs of a frozen pregnancy
- Frozen early pregnancy
Causes of a frozen pregnancy
What to do with a frozen pregnancy
Features of menstruation during this period
Popular questions and answers

“You have a frozen pregnancy.” Any woman who dreams of becoming a mother is afraid to hear these words. Why is this happening? Will it be possible to give birth to a healthy baby after a frozen pregnancy? These questions are haunting, and only doctors can answer them

Frozen pregnancy is one of the main problems in obstetrics and gynecology. Unfortunately, any woman can face such a pathology. What to do in this case and when you can plan a pregnancy again, we deal with obstetrician-gynecologist Marina Eremina.

What is a frozen pregnancy

There are several terms that describe the same condition: miscarriage, non-developing pregnancy and miscarriage. They all mean the same thing – the baby in the womb suddenly stopped growing (1). If this happened for up to 9 weeks, they talk about the death of the embryo, for up to 22 weeks – the fetus. In this case, a miscarriage does not occur, the fetus remains in the uterine cavity.

Most doctors agree that 10-20 percent of all pregnancies die in the first weeks. At the same time, women who have found a non-developing pregnancy often carry a child without problems in the future. However, there are situations when two or more pregnancies in a row freeze. Then doctors talk about habitual miscarriage, and such a diagnosis already requires observation and treatment.

Signs of a frozen pregnancy

A woman is hardly able to recognize herself whether her pregnancy has stopped or not. Abundant bloody discharge, as in a miscarriage, is not here, there is no pain. Often the patient feels great, and the more painful it is for her to hear the doctor’s diagnosis.

Sometimes you can still suspect a problem. The following symptoms should be alert:

cessation of nausea;
cessation of breast engorgement;
improvement of the general condition; sometimes the appearance of bloody daub.

– Unfortunately, there are no typical signs of a missed pregnancy, and only ultrasound can make an accurate diagnosis. These symptoms are very subjective. obstetrician-gynecologist Marina Eremina.

With these signs, doctors advise to do an ultrasound, only during an ultrasound can you determine whether the embryo is frozen or not. Sometimes outdated equipment or a not very competent specialist can make a mistake, so doctors advise either to undergo an ultrasound scan in two places better with a difference of 3-5-7 days), or immediately choose a clinic with modern technology and highly qualified doctors.

An ultrasound specialist diagnoses a missed pregnancy by the following signs:

lack of growth of the fetal egg within 1-2 weeks;
the absence of an embryo with a fetal egg size of at least 25 mm;
if the coccyx-parietal size of the embryo is 7 mm or more, and there is no heartbeat.

Sometimes you need to take several blood tests for hCG to check if the level of this hormone is changing. With a normal pregnancy, it should increase.

Frozen early pregnancy

The risk of missed pregnancy is especially high in the first trimester.

“Most often, missed pregnancies occur in the early stages, at 6-8 weeks, in rare cases after 12 weeks of pregnancy,” says the obstetrician-gynecologist.

The next dangerous milestone after the first trimester is 16-18 weeks of pregnancy. Very rarely, the development of the embryo stops at a later date.

Causes of a frozen pregnancy

A woman who hears such a diagnosis may think that something is wrong with her. However, doctors assure that 80-90 percent of missed pregnancies are due to the embryo itself, or rather, due to its genetic abnormalities. As it turned out, the embryo turned out to be unviable. The grosser the pathology, the sooner the pregnancy will die. As a rule, the abnormal embryo dies for up to 6-7 weeks.

Other causes of miscarriage concern only 20 percent of cases (2). These reasons are already connected with the mother, and not with the child.

What could be the cause of the miscarriage.

1. Violations of the blood coagulation system, various thromboses, as well as antiphospholipid syndrome, in which the blood coagulates too actively. Because of this, the placenta may not be able to cope with its functions of nourishing the fetus, and in the future the baby may die.

2. Hormonal failures. Any kind of imbalance, whether it is a lack of progesterone or an excess of male hormones, can adversely affect the development of the embryo.

3. Infectious diseases, mainly sexually transmitted diseases, cytomegalovirus, rubella, influenza and others. It is especially dangerous to catch them in the first trimester, when all the organs and systems of the unborn baby are laid.

4. Balanced chromosomal translocations in parents. It sounds complicated, but the essence is this – the germ cells of the parents contain a pathological set of chromosomes.

An important role is played by the lifestyle of a woman, as well as her age. The risk of non-developing pregnancy increases in late reproductive age. If at 20–30 years old it is on average 10%, then at 35 years old it is already 20%, at 40 years old it is 40%, and over 40 it reaches 80%.

Other possible causes of missed pregnancy:

coffee abuse (4-5 cups a day);
smoking;
taking certain medicines;
folic acid deficiency;
systematic stress;
alcohol.

There are a number of factors that are mistakenly considered to be the causes of a missed pregnancy. But it’s not! Can’t be the cause:

air travel;
the use of contraceptives before pregnancy (hormonal contraceptives, spirals);
physical activity (provided that the woman went in for sports in the same mode before pregnancy);
sex;
abortions.

What to do with a frozen pregnancy

If you are under 35 years old and this is your first miscarriage, doctors advise not to get upset or panic. Most often this is an accident, and your next attempt to become a mother will end in the birth of a healthy baby. Now the first thing to do is to get rid of the fetal egg surgically or medically.

At this time, a woman needs the support of loved ones. So do not keep your feelings in yourself, talk about feelings with your husband, mother, girlfriend.

For your own peace of mind, it will not be superfluous to be tested for standard infections – both those that are sexually transmitted, and the flu and other ailments. If nothing is found, you can get pregnant again.

Another thing is if this is a second or more missed pregnancy, then you need to find out the causes of the problem and eliminate them.

Pregnancy after a frozen pregnancy

A frozen pregnancy 一 is always a cause for grief. But, some time later, the woman recovers and begins to plan a new attempt to bear the baby. You can get pregnant again after 4-6 months (3). During this period, it is necessary to recover not only physically, but also mentally. After all, the woman felt pregnant, and her hormonal background changed.

Recommended:

give up smoking and alcohol;
do not abuse products containing caffeine;
do not eat fatty and spicy foods;
do sport;
walk more often.

It also takes time for the endometrium to be ready to accept a new fetal egg.

Before planning a new pregnancy, it is necessary to undergo a number of examinations:

Assess the presence of exposure to harmful factors: medication, environment, diseases, etc.
To study the heredity of relatives. Whether there were cases of pregnancy loss, thrombosis, heart attacks or strokes at a young age.
Get tested for STDs, hormones and blood clotting.
Consult with a geneticist.
Make an ultrasound of the pelvic organs.
Assess the compatibility of partners.

Most often, treatment is not required, since a miscarriage is usually the result of a genetic error. However, if this does not happen for the first time, a doctor’s consultation and the appointment of special therapy are required.

Getting pregnant earlier than 4 months after a missed pregnancy is highly discouraged, despite the fact that it is possible. The body must fully recover in order to exclude a repeated case of miscarriage. Therefore, reliable methods of contraception must be used. If pregnancy does occur, you must definitely visit a doctor and follow all his recommendations.

Required examinations

If you have lost two or more babies, you need to carefully examine. Most often, doctors recommend the following list of tests and procedures:

karyotyping of parents is the main analysis that will show if the spouses themselves have genetic abnormalities; – analysis of the blood coagulation system: coagulogram (APTT, PTT, fibrinogen, prothrombin time, antithrombin lll), D-dimer, platelet aggregation or thrombodynamics, homocysteine, detection of mutations in the genes of the coagulation system;
HLA-typing – a blood test for histocompatibility, which is taken by both parents; – TORCH-complex, which detects antibodies to herpes, cytomegalovirus, rubella and toxoplasma;
examination for sexually transmitted infections; – blood tests for hormones: androstenediol, SHBG (sex hormone binding globulin), DHEA sulfate, prolactin, total and free testosterone, FSH (follicle-stimulating hormone), estradiol, and thyroid hormones: TSH (thyroid stimulating hormone), T4 (thyroxine), T3 (triiodothyronine), thyroglobulin.

If the analysis shows a problem with coagulation, you may need to consult a hemostasiologist, if with genetics – a geneticist, if with hormones – a gynecologist and endocrinologist.

Perhaps the partner will have to visit an andrologist and pass a series of tests.

– Oddly enough, the cause of a missed pregnancy is often a male factor. This is due not only to bad habits, such as alcohol and smoking, but also to malnutrition, for example, the use of low-quality products, a sedentary lifestyle, and many other reasons, clarifies obstetrician-gynecologist Marina Eremina.

A man will most likely be advised to make an extended spermogram and, if teratozoospermia is present in the analysis, then undergo an additional examination for DNA fragmentation in spermatozoa or an electron microscopic examination of spermatozoa – EMIS.

Almost all of these procedures are paid. In order not to go broke, handing them all over, listen to the doctor’s recommendations. Based on your medical history, the specialist will determine which tests are a priority.

Unfortunately, there are still situations where doctors are unable to find the cause of the problem.

What is the cleaning process for?

If the pregnancy stops developing and there is no miscarriage, the doctor should refer the patient for cleaning. The presence of the fetus for more than 3-4 weeks in the uterus is very dangerous, it can lead to heavy bleeding, inflammation and other problems. Doctors agree that you should not wait for a spontaneous abortion, it is better to carry out curettage as soon as possible.

This can be vacuum aspiration or abortion with medications that will allow the embryo to be expelled without surgery.

“The choice of method is individual, depending on the period when the pregnancy stopped developing, on the presence of contraindications to one or the other method, the presence of pregnancy and childbirth in history, and, of course, the wish of the woman herself is taken into account,” explains obstetrician-gynecologist Marina Eremina.

So, medical abortion, for example, is not suitable for women with adrenal insufficiency, acute or chronic renal failure, uterine fibroids, anemia, inflammatory diseases of the female reproductive system.

The recommended surgical method for artificial termination of pregnancy up to 12 weeks in Our Country is vacuum aspiration, when the fetal egg is removed using suction and a catheter. The procedure takes 2-5 minutes and is performed under local or full anesthesia.

Curettage is a less preferred method and should be used only in special situations, for example, if there is tissue remaining in the uterine cavity after vacuum aspiration.

After cleaning, the contents of the uterus are sent for histological examination. This analysis will allow you to understand the causes of a missed pregnancy and avoid a recurrence of the situation in the future.

Further, the woman is recommended to undergo a course of recovery. It includes anti-inflammatory therapy, taking painkillers, vitamins, exclusion of physical activity and good rest.

If you first heard the diagnosis of “missed pregnancy” from a doctor, it is likely that the next attempt to have a baby will be successful. Most often it was a one-time accident, a genetic error. But even women, for whom this is already the second or third missed pregnancy, have every chance of becoming a mother.

The main thing is to find the cause of the problem, and then – examinations, treatment, rest and rehabilitation. When this path has been passed, you should do an ultrasound of the pelvic organs and make sure that the endometrium grows in accordance with the cycle, there are no polyps, fibroids or inflammation in the uterine cavity, visit a therapist and treat existing chronic diseases. In parallel, you need to lead a healthy lifestyle, take folic acid and eat a balanced diet, all this will increase your chances of getting pregnant in the future and giving birth to a healthy baby.

Features of menstruation during this period

After the termination of pregnancy, menstruation will return to the woman. Most often, it comes 2-6 weeks after the procedure. It is easy to calculate the arrival time of critical days. The day of abortion is taken as the first day, and the term is counted from it. For example, if a woman had a vacuum aspiration on November 1, and her cycle is 28 days, her period should come on November 29. The delay can be triggered by hormonal failure. Menstruation after the vacuum procedure will be poorer than usual, since the mucous membrane will not have time to recover completely.

If a woman was “curettage”, then the uterus may be more traumatized, so menstruation may be absent for two or more months.

At this time, a woman needs to be especially careful and protect herself, because the body is not yet ready for a second pregnancy.

If you notice that your period after cleaning is longer than expected and looks more like bleeding, be sure to consult a doctor, this may be a sign of inflammation.