The biggest tragedy for a pregnant woman is antenatal fetal death. It occurs during the intrauterine development of the child and is a great shock not only for parents, but also for all relatives.
Pathology of the placenta, fetus and umbilical cord
Many people want to figure out why this happened, find out for themselves what caused the death of an unborn baby. But it is very difficult for doctors to unequivocally answer this difficult question. This is due to the large number of possible causes of antenatal death, as well as their complex nature.
It is very rare that the umbilical cord is entwined around the neck, which prevents nutrients from entering the body. In the case of a prolonged continuation of such a process, suffocation occurs. Another danger associated with the umbilical cord is its positioning over the front of the fetus.
An equally rare cause of antenatal death is a severe congenital pathology of the placenta. The presence of premature crusts, improper placement, falling of the mother, hematomas and other abnormalities negatively affect the transport of nutrients and oxygen. This provokes the appearance of growth disorders and intrauterine death. Premature aging of the placenta reduces its conducting functions. This contributes to the emergence of morphological changes that pose a great threat to the life and development of the unborn child.
Diseases of a pregnant woman and intrauterine death of a child
Possible causes of fetal death often include:
- the appearance of severe late toxicosis;
- various pathologies of the placenta (presentation, premature detachment, malformations);
- diagnosing multiple pregnancies or low water levels;
- incompatibility of Rh factors in the blood of mom and baby.
Not the last place in this list belongs to inflammatory processes in the genitals, syphilis, hepatitis, eczema.
For a more accurate determination, numerous specialized studies are required, which include an autopsy of a stillborn child, genetic testing, etc.
Factors leading to fetal death
Since the causes of fetal death have not yet been studied enough, experts distinguish several of its factors:
- Disruption of the hormonal background of a pregnant woman. This provokes progesterone deficiency, and the fetus does not receive enough nutrients. As a result, antenatal fetal death occurs. This condition is typical for the first trimeter of pregnancy. In addition, early fetal death can provoke thyroid disease and ovarian dysfunction (for example, polycystic).
- Stressful situations, misuse of various medications.
- The presence of bad habits.
- Various external influences (air travel, lifting weights, radiation, prolonged exposure to the sun) and exposure to chemicals.
Immune and autoimmune factors
Recently, the immunological factor has become more and more common. Since the fertilized egg is half composed of the genetic information of the father, the body of the expectant mother can perceive it as a foreign body. This provokes the production of antibodies that interfere with the development of the fetus. In other words, the embryo is rejected by the woman's immune system.
A large number of antibodies to phospholipids in the blood plasma causes the appearance of autoimmune disorders. The first place among them belongs to antiphospholipid syndrome. Almost 5% of cases of fetal freezing occur due to the presence of this pathology. With subsequent pregnancies, this figure rises to 42%. The main reason for the appearance of this syndrome is heredity. Pathology provokes the formation of blood clots and greatly complicates the situation with the course of pregnancy.
Influence of infectious diseases
Acute and chronic forms of infectious diseases are also a great threat to the life of the fetus. The most common cases of fetal freezing are in the presence of herpes, mycoplasmosis, chlamydia, etc. They may appear earlier. But during this period, there is a significant decrease in the woman's immunity, and because of this, any disease during pregnancy manifests itself more intensely.
In the first trimester, cytomegalovirus, which is very often the cause of pregnancy fading, poses a great threat. But at a later date, it provokes the appearance of a variety of developmental defects.
But, unfortunately, it is far from always possible to determine why antenatal fetal death occurred. Its reasons often remain unknown.
The first signs of antenatal death
It is very difficult to independently determine intrauterine fetal death in the early stages. This is due to the individuality of the course of each pregnancy. Someone suffers from toxicosis, while others do not. Therefore, in the first trimester, the first symptom of intrauterine death of a child is the cessation of signs of pregnancy. This applies to those occasions when they were present. With the initially good health of a woman, antenatal fetal death is determined only during a visit to a doctor or an ultrasound scan.
Somewhat later, the main indicator of fading is the absence of movement. Late fetal death is most often accompanied by spontaneous miscarriage. But there are also cases when a pregnant woman walks with a frozen child inside for some time. The death of the fetus and the beginning of the process of its decomposition can be indicated by pulling pains in the abdomen and the presence of bloody discharge.
Maceration
The fetus can be in a woman's uterus from 1-2 days to several months, even years. In this case, maceration, mummification or petrification occurs in the uterine cavity. Approximately 90% of all cases are maceration - the aseptic wet process of tissue necrosis. Very often it is accompanied by autolism of the internal organs of a frozen child, their resorption.
The first time after death, maceration is aseptic in nature. And only after that an infection appears, which very often provokes the development of sepsis in women.
The macerated fruit is characterized by flabbiness, softness, wrinkled skin with exfoliated epidermis in the form of blisters. This explains the reddish color of the skin of the fetus, which turns green when infected.
The head has, as well as the chest and abdomen, a flattened shape, soft, the bones of the skull are separated. There is an impregnation of soft tissues with liquid, the separation of the epophyses from the diaphysis. Bones and cartilage are dirty red or brown in color.
Mummification and petrification of the fetus
Mummification is dry necrosis of the fetus. Most often, it is fixed with multiple pregnancies. In this case, intrauterine death of one of the children occurs. Also, mummification is observed when there is an umbilical cord entanglement of the fetus's neck. As a result of this process, the fetus shrinks and the amniotic fluid is absorbed.
A rarer case is petrification. Most often, it is characteristic of an ectopic pregnancy, when calcium salts are deposited in the tissues of the mummified fetus. That is, the formation of the so-called lithopedion, or fossilized fruit, takes place. Its presence in a woman's body can last for many years. At the same time, there are no symptoms of intrauterine fetal death.
Research supporting the diagnosis
If there are suspicions of intrauterine fetal death, urgent hospitalization of the pregnant woman is necessary. For reliable confirmation of the diagnosis, PCG, ECG are used. Their results can confirm or deny the presence of heartbeats. Ultrasound examination of the fetus, which is also mandatory in this situation, in the early stages of pregnancy will help to see the lack of breathing and heartbeat, as well as vague body contours. A little later, with its help, you can detect the decomposition of the body.
Amnioscopy is one of the methods by which the condition of the water and the fetus is diagnosed. During this procedure, in the first day after the death of the fetus, you can find a green tint of amniotic fluid. Later, they acquire a less intense color and blood impurity appears. The skin of the fetus is the same color. By pressing the amnioscope on the part of the fetus that is presented, you can see the depression. This is due to the lack of tissue turgor.
X-ray examination is rarely used, during which it is possible to observe a violation of the condition of the fetus:
- its value does not correspond to the gestational age;
- flattened vault and vague contours of the skull;
- the arrangement of the bones is tiled;
- sagging lower jaw;
- curved spine;
- atypical nature of the location of the members of the body;
- decalcified skeleton.
Removing a dead fetus from the uterine cavity
If a sudden interrupted pregnancy (fetal death) was established in the first trimester of pregnancy, surgery (curettage) is performed. There are also spontaneous miscarriages.
If this problem occurs in the second trimester and the placenta is prematurely detached, an urgent delivery is performed. The definition of its method depends on the degree of readiness of the birth canal. The likelihood of spontaneous expulsion of the fetus at this time is reduced to zero.
At the end of pregnancy, with intrauterine fetal death, spontaneous childbirth most often occurs. Otherwise, doctors stimulate labor.
Sometimes, in the presence of indications, fruit-destroying operations take place. In the postpartum period, it is imperative to carry out the prevention of endometritis and uterine bleeding.
Death of one fetus in multiple pregnancies
The death rate of one fetus during twin pregnancy is 1: 1000. The causes of death in this case are different:
- fetal pathology during pregnancy;
- improper blood circulation;
- violation of the development of the placenta or umbilical cord;
- the influence of mechanical factors (critical lack of oxygen in the common placenta or fetal sac).
This greatly affects the health of the second child, up to and including death. If one of the children dies in the first trimester of pregnancy, the chance that the second will survive is 90%. If the development of the fetus has stopped before the third week, the frozen embryo is absorbed or softened. This is followed by drying. In this case, a woman may not feel absolutely any symptoms. And only ultrasound helps to identify pathology.
In later lines, the death of one of the twins can provoke fetal pathology during pregnancy, associated with the development of severe lesions of the central nervous system of the second. As a result, various pathologies of internal organs, and even death, can also occur.
Actions of medical workers
What the doctor will do when this problem is detected depends on the period of pregnancy. At a later date, he may decide to carry out an emergency delivery, without taking into account the unpreparedness of the second fetus for birth. This happens when it is safer for a living baby to be born than to be with a dead fetus. And the sooner a living child is removed from the uterus, the less harm he will receive.
In the second trimester, in the absence of the possibility of delivery, you can stop any interconnections between the organisms of babies and transfuse blood to a living fetus.
If this trouble occurs in the last trimester, artificial childbirth is performed. Because the harm from the stay of a dead child inside is inflicted not only on the body of a healthy baby, but also on the female. This condition can provoke the appearance of coagulation disorders.
Ways to prevent intrauterine fetal death
It is very difficult to predict in advance whether intrauterine fetal death will occur. Therefore, before pregnancy, doctors recommend that absolutely all women, regardless of age, undergo a full examination. It consists in carrying out the following activities:
- Ultrasound of the small pelvis;
- taking smears;
- analysis of urine, blood;
- examination of the thyroid gland;
- tests for the presence of infections and hormonal levels.
Additional studies may also be prescribed, based on the individual characteristics of the female body.
Antenatal fetal death is not a death sentence. To prevent problems, parents-to-be should lead a healthy lifestyle, follow the doctor's recommendations, conduct a full examination before planning pregnancy and cure absolutely all existing diseases.
It is extremely important that the woman is then surrounded with special care, so that doctors and midwives, as far as possible, protect her from physical pain and isolate her from other women in labor as well as newborns. How to deal with pain? The death of a child even before his birth is as painful as the loss of an older child or another loved one. Feelings of despair, refusal, anger are quite natural feelings; parents will also pass through a period of mourning. Here are some tips that should help you a little in this extremely difficult time:
- Remember that what happened was not your fault.
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It is important to note that a spontaneous abortion can only be caused by the death of an embryo in the womb, with a gestational age of up to 20 weeks.
Accordingly, fetal death is often viewed in a different light.
However, a pregnant woman whose fetus has died within 20 weeks, with no other signs of miscarriage, may then be considered a woman with the likelihood of a miscarriage.
Attention
There are several hidden symptoms of a missed pregnancy.
The birth of a still child: what happens after and how to cope with it If the child dies in the womb, unfortunately, it will be necessary to go through the whole procedure of natural childbirth.
It is extremely important that the woman is then surrounded with special care, so that doctors and midwives, as far as possible, protect her from physical pain and isolate her from other women in labor as well as newborns.
Antenatal fetal death
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- Antenatal fetal death
What are the symptoms of a missed pregnancy? If this condition continues, then symptoms of a missed pregnancy occur, which may already be felt.
Frozen pregnancy
It is necessary to conduct strict monitoring of pregnant women with the possibility of hospitalization, monitor the main indicators of their body, such as blood pressure, pulse, temperature, the values of which can be recognized as an indicator of the onset of infection, if there are deviations from the norm, as well as the study of fibrinogen, which makes it possible to identify early detection of blood clotting disorders.
Important
If the dead fetus remains in the uterus for a long time, it can cause many complications for the mother, threatening her life, and it is not recommended to wait for the spontaneous expulsion of the fetus.
The expulsion of the fetus from the uterus should be done no later than 2 weeks after its death. Pregnancy should be completed immediately if there are indicators of the onset of infection, such as fever, increased white blood cell count.
Stillbirth (stillbirth)
Changes in the body of the expectant mother associated with the possibility of a very dangerous complication of pregnancy called EPH-gestosis (EPH - gestosis: Eodema, Proteinuria, Hypertensia) and is manifested by high blood pressure, proteinuria and edema are of great danger to the fetus.
Info
Diseases and infections such as tuberculosis, syphilis, hepatitis and emphysema, infections (rubella, measles, influenza, hepatitis and others), as well as other infectious diseases with high fever, carry the same danger.
All types of drugs taken during pregnancy, as well as alcohol and nicotine, have a huge effect on the fetus.
Under the influence of these drugs, narrowing of blood vessels in the placenta and uterus can occur, which does not allow the fetus to receive oxygen and nutrients in the required volume, and a lack of nutrients can cause stillbirth.
Intrauterine fetal death: causes, symptoms, diagnosis, signs
The question of the economic efficiency of some components of this serological screening (Herpes simplex virus) is debatable, and it, apparently, can be resolved with an appropriate history.
- Macroscopic and microscopic pathological examination of the fetus and placenta.
Examination of the mother Blood tests:
- complete blood count;
- staining of a blood smear according to Kleihauer-Betke for the search for fetal maternal transfusion;
- determination of anti-rhesus antibodies;
- a study of the blood coagulation system (see.
The risk of stillbirth with this disease is 15% higher than in the absence of complications.
- maternal diabetes;
- infections such as listeriosis, salmonellosis, or toxoplasmosis;
- diseases of the immune system - for example, antiphospholipid syndrome;
- many children die as a result of birth trauma. The risk is increased with shoulder dystocia, when, after the birth of the head, the shoulders become stuck and cannot emerge.
Also, the risk increases with breech presentation of the fetus.
Problems with the umbilical cord can lead to acute fetal hypoxia, which is often the cause of stillbirth.
One third of all fetal deaths occur during full-term pregnancy.
Multiple pregnancies are at greater risk (1.5-1.6%) than single pregnancies (0.5-0.6%).
What causes children to die in the womb?
Examination of the abdomen may not reveal anything suspicious or identify symptoms of placental abruption or local symptoms of damage in the mother, indicating damage to the uterus. After excluding the most important diagnosis - placenta previa - vaginal examination reveals signs of bleeding or inflammatory discharge.
In this case, it is necessary to take smears for bacteriological examination.
In the UK, after the diagnosis of intrauterine fetal death, most women choose active treatment tactics in order to end their pregnancy. Among those choosing conservative tactics, spontaneous labor begins within 2 weeks from the moment of fetal death in 80% of women. It is necessary to discuss the issue of postmortem examination of the fetus and placenta to establish the cause of intrauterine death before delivery.
Intrauterine fetal death. causes, symptoms and diagnosis
Histological examinations of the embryo that has died are carried out to find out the reason for the fading.
A man and a woman are forced to face a cytogenetic examination.
Tests will show if there were chromosomal abnormalities, infectious pathologies or other factors. When an infection is found, both partners are treated. Timely removal of a dead fetus does not give a negative result for the health of the mother.
Often a woman, after a frozen pregnancy, gives birth to a healthy, normal child, and not even one.
You cannot plan the next pregnancy immediately after the frozen embryo has been removed.
The body is rehabilitated for some time (six months or a year), so that there are no problems with physical and psychological health.
If a child dies in the womb
Spontaneous miscarriages are common. But when this does not happen, the dead embryo is removed as soon as possible, because it is extremely unsafe for a woman to stay in this state. When a dead fetus is found in the uterus, blood poisoning develops for 4-5 weeks, the uterus and its appendages become inflamed. And here we will talk about the infertility of a woman and her inability to become a mother in the future. Vacuum extraction in the hospital or inducing miscarriage with specific drugs is done when the fetus freezes in the early stages of pregnancy.
At a later stage, curettage of the uterus is indispensable, in which a woman is given general anesthesia.
If a spontaneous miscarriage occurs, then scraping is also used to prevent further health problems of the woman, since sometimes some parts of the dead fetus remain in the uterus.
If a child dies in the womb
If the decay was caused by an intrauterine infection, then the mother is also at risk, as this can complicate the complete and proper healing of the postoperative wound.
In this case, the treatment procedure is very difficult, therefore, to avoid septic complications after expulsion of the dead fetus, antibiotic prophylaxis is often administered.
Stillbirth is usually a very difficult process. The fact is that most organs are not fully prepared for childbirth, the cervix is immature, and the fetus could be too small.
In order to activate labor and avoid water accumulation, it is necessary to inject intravenous oxytocin.
If a baby dies in the womb
For diagnosis, specific questions related to the patient's condition and / or pregnancy are useful. Issues specific to pregnancy include:
- history of pain;
- a history of bleeding;
- problems identified during previous ultrasounds;
- possible discharge of amniotic fluid;
- the sequence number of the pregnancy in the account, that is, the sequence of pregnancies, and multiple pregnancies.
In multiple pregnancies, the risk of intrauterine fetal death is higher than in single pregnancies.
In the UK, this risk is 3.5 times higher. Sometimes one twin dies while the others remain alive.
The risk of death for living twins depends on the number of chorions, with monochorionic twins it is much higher.
Many couples dream of trying on the role of young parents. Unfortunately, this desire is not always realized. One of the reasons for this problem is a missed pregnancy. Both the father and the mother can be to blame for this pathology. That is why it is so important at the planning stage to undergo a full examination for both partners. What if early? How to prevent this pathology?
general information
A frozen pregnancy is a condition in which the fetus stops growing and developing, as a result of which it dies. There may be no signs of spontaneous abortion, but the embryo remains in the uterine cavity. That is why this pathology is also called a failed miscarriage. Freezing can happen at any time, but most often it occurs in the first trimester. The 3-4th and 8-10th weeks are considered the most dangerous.
What happens with a frozen pregnancy? The fertilized egg is sent to the uterus, where it is implanted. After a while, the growth of the embryo stops. Another option for a frozen pregnancy is the empty egg syndrome. In this case, the membranes develop, chorionic gonadotropin is synthesized, but the embryo itself is absent. If a pregnancy test is done, the result will be positive. Among the main reasons that affect the occurrence of empty egg syndrome, doctors distinguish various chromosomal pathologies.
How often is a missed pregnancy diagnosed?
According to statistics, every second woman's pregnancy “freezes” and ends in spontaneous abortion. This usually happens before the lady finds out about her interesting position. The risk of developing this pathology after the test shows a positive result is no more than 20%.
How to determine a missed pregnancy in the early stages?
The development and growth of the fetus over the course of nine months depends on many factors. Sometimes a certain set of circumstances can lead to a stop of this process and the death of the embryo. Freezing symptoms are very obvious, and medical diagnosis is usually straightforward. The first in the early stages is the disappearance of the condition, which is characteristic of a woman in a position. In this case, you need to see a doctor. A specialist, based on the results of an ultrasound examination, will be able to determine the presence or absence of pathology. After that, appropriate treatment is prescribed.
Causes of pathology
Why early pregnancy freezes? This is the question asked by women who have already had to face this problem. Doctors identify a number of factors that can affect the formation of a pathological process.
- Chromosomal and genetic abnormalities. This is the most common cause of miscarriage. When an embryo inherits an abnormal gene or an extra chromosome, it develops a variety of defects during development. Most often they are incompatible with life, so the fetus dies inside the womb. The rule of natural selection applies here. Nature itself decides that it is wrong to give birth to an incapacitated baby, therefore it “terminates” the pregnancy. The genetic abnormality can also occur with smoking or drinking alcohol.
- Infections. Infectious diseases play a huge role in the genesis of a frozen pregnancy. These include rubella, toxoplasmosis, herpes infection. Sexual diseases and common colds should not be ignored. Infection is especially dangerous in the first trimester. Infectious agents after penetration through the placenta affect the fetus. They can interfere with normal implantation and nutrition of the embryo. As a result, it turns out that the pregnancy froze at an early stage.
- Hormonal disorders. Deficiency of the main pregnancy hormone progesterone can be one of the reasons for freezing.
- Autoimmune pathologies. With such diseases, antibodies begin to be produced in the mother's body. They fight not with foreign elements, but with their own cells. It is known that the embryo inherits about 50% of the mother's genes. As a result, antibodies begin to kill the cells of the fetus, which leads to its death.
- Teratozoospermia. Sometimes the father himself is to blame for a frozen pregnancy. Teratozoospermia usually causes male infertility. If it is still possible to conceive a child, its development usually stops at the initial stages. Teratozoospermia is a pathology of spermatozoa, which is expressed in their abnormal structure. It can manifest itself in the form of an irregular head, a short tail, or its kink.
- Wrong way of life. The emergence of a frozen pregnancy is influenced by the nutrition of the future woman in labor, her work and rest schedule, and addictions. Do not forget about possible side reactions after using medications. The age of the woman is also significant. The older she is, the higher the likelihood of the appearance of pathology.
The above are only the most common causes of miscarriage. In fact, there are a great many of them. In each case, only a doctor can determine what caused the pregnancy to fade.
Signs of a frozen pregnancy
Many women are concerned about the question of how to recognize a missed pregnancy at an early stage at home? The whole insidiousness of this condition is that it is often asymptomatic. From the moment of death of the fetus to the immediate miscarriage, it can take several days, and sometimes weeks. What signs of a frozen pregnancy in the early stages should you pay special attention to?
First of all, the woman's symptoms that characterize pregnancy disappear: toxicosis, weakness, malaise. Nausea and vomiting, intolerance to some odors disappear. However, if the signs were weak, you should not pay attention to this parameter.
A decrease in basal temperature is also a sign of fetal death. Such changes appear against the background of a decrease in the level of progesterone, since it is this hormone that is responsible for maintaining pregnancy. It is recommended to measure basal temperature in the morning hours in the rectum. Before and immediately during measurements, it is necessary to be motionless for several hours. Basal temperature during a frozen pregnancy in the early stages usually decreases and does not exceed 37 degrees.
Breast softening can also indicate fetal freezing. From the moment of conception of a baby in women, the mammary glands swell almost immediately and become painful. After his death, the chest relaxes, but you should not immediately panic. According to the testimony of many women, during the entire nine months of pregnancy, the breasts can tighten and relax several times. Doctors explain this fact by hormonal changes.
Pulling pain in the lower abdomen and spotting rarely signal this pathology. This is its main difference from a spontaneous miscarriage. In any case, if you experience discharge or discomfort, you should contact your gynecologist.
The listed signs do not always indicate fetal freezing. They can occur in normal pregnancies. If you have the above symptoms of a frozen pregnancy in the early stages, it is recommended to seek the help of a doctor to clarify the diagnosis.
Medical diagnostics
Only a specialist can confirm or deny the diagnosis "missed pregnancy" after an appropriate examination. The first stage is ultrasound examination. With the help of ultrasound, you can check the viability of the embryo and determine its approximate size. Also, the doctor measures the degree of enlargement of the uterus, the thickness of the chorion. If the examination results are doubtful, the specialist will appoint a follow-up visit after 12 days. It should be noted that the quality of the equipment plays an important role in obtaining reliable and most informative data. Sometimes, older ultrasound machines may "fail to notice" the presence of a heartbeat in the fetus, leading to a misdiagnosis.
Then the woman is prescribed a blood test for beta-hCG. With a frozen pregnancy in the early stages, a decrease in this indicator is observed, which indicates that a gradual increase in the content of this hormone in the blood is considered normal.
Treatment for miscarriage
If a woman is suspected, she is hospitalized. If the pregnancy froze at an early stage, all efforts of doctors should be directed not at preserving the fetus, but at restoring the woman's health.
After a full examination (ultrasound, hCG), the evacuation of the ovum is prescribed. If the embryo is dead for less than 14 days, doctors resort to expectant tactics. Another indication is the absence of signs of spontaneous abortion and infection of the uterus. The level of the hormone gradually decreases in the early stages. The uterus begins to contract and expel the ovum.
However, most often, doctors resort to surgery. The fetal egg and its shells are removed by scraping. For a period of up to 7 weeks, a medical option for abortion is usually used. After surgery, hysteroscopy is mandatory. In the postoperative period, women are prescribed antibacterial agents for the prevention of endometritis and chorionamnionitis.
Recovery period
After identifying the cause of the pregnancy fading and the course of treatment, the woman needs to recuperate. This usually takes no more than six months. During this period, you should adhere to a healthy lifestyle and be sure to use contraception. Some women require counseling from a psychologist. The specialist helps to overcome all fears regarding the future planning of pregnancy.
What tests to take after a miscarriage?
Before conceiving a child after pregnancy dies down, doctors recommend passing the following tests:
- vaginal swab for STDs;
- ultrasound examination of the pelvic organs;
- a blood test to assess progesterone and estrogen levels;
- histological examination of the biological material of the uterus.
If a missed pregnancy has already been diagnosed several times, both partners need to undergo genetic compatibility testing. If the test results do not show serious violations, you can think about conceiving.
Prevention of a frozen pregnancy
To prevent a recurrence of such a situation, doctors recommend that certain preventive measures be followed even before the moment of conception. In the presence of infections that are directly transmitted sexually, it is necessary to undergo a course of treatment. If you did not have rubella or chickenpox as a child, you should get all vaccinations before conceiving. This is especially true for those women whose work is related to children.
Symptoms of a frozen pregnancy in the early stages inspire fear in many women. In order not to face the manifestations of this pathology, doctors recommend adhering to a healthy lifestyle and eating rationally. In addition, it is necessary to give up addictions, devote more time to physical activity.
Let's summarize
Any woman can find out that a pregnancy has frozen at an early stage. This pathology does not always indicate pathological disorders in the work of the body, but the examination is still worth it. Based on its results, the doctor can prescribe the necessary treatment and give useful recommendations.
During pregnancy from 1 to 8 weeks, there is an embryo in the womb, and the death of an unborn baby at this time is called. In the literature, you can find a generalized concept of these two states -.
information According to statistics, the fetus dies quite rarely. In the first trimester (up to 12 weeks) - about 5% of all pregnant women, and in the second and third trimesters - about 1%.
Causes
There are many reasons and predisposing factors leading to the intrauterine death of a baby. The main ones:
- infections and inflammatory diseases of the mother, proceeding in a complicated form (rubella, chickenpox, flu, etc.);
- (negative Rh factor in the mother and positive in the child);
- intrauterine fetal hypoxia;
- alcoholism and drug addiction;
- placenta previa;
- toxicosis (), severe course;
- violation of the hormonal function of the woman's body;
- radiation exposure;
- contact with toxins;
- injuries during pregnancy (hitting or falling to the abdomen);
- hard future mom;
- genetically determined fetal malformations that are incompatible with life;
- frequent and uncontrolled intake of medications that are toxic to the developing fetus;
- hypertonic disease;
- rather strong stress of a woman while carrying a child.
Signs of antenatal fetal death
Antenatal fetal death is characterized by classic signs and symptoms:
- cessation of fetal movement;
- lack of heartbeat of an unborn baby;
- severe general weakness;
- heaviness, discomfort in the lower abdomen;
- lack of uterine tone and uterine contractions;
- cessation of the growth of the fetus and uterus;
- reduction of the mammary glands, the disappearance of their engorgement.
In the case of a late diagnosis of such a condition, when 2 weeks or more have passed after the death of the child in the womb, signs of sepsis join:
- (temperature over 38-39 ° С);
- pain in the abdomen;
- headache;
- disturbances of consciousness;
- lethal outcome as the end of an undiagnosed and untreated infection of a woman's blood with the toxins of a dead child.
Diagnostics
After a woman turns to a gynecologist with suspicions of a pregnancy pathology or comes for a routine examination, the doctor directs her to diagnostic procedures that will make it possible to make a final diagnosis and decide on the necessary measures. Among the simplest and most accurate methods for diagnosing antenatal death of a baby, the following are distinguished.
- Ultrasound... Allows you to determine the absence of heartbeat and blood flow, the location of the deceased fetus, its size, the state of the placenta and amniotic fluid.
- ... Allows you to determine the absence of heart impulses in the fetus.
- FCG... By analogy with the ECG, it determines the absence of a heartbeat in the fetus.
Treatment of antenatal fetal death
The treatment of antenatal fetal death is its removal from the uterine cavity within 14 days after the development of this pathology.
- In the first trimester (before), curettage of the uterine cavity is performed (classic abortion).
- In the second trimester, oxytocin stimulation of labor is most often resorted to. In extreme cases, delivery is possible.
- In the third trimester, when the fetus dies, most often, labor occurs independently.
dangerous In cases where the deceased unborn child cannot independently pass through the birth canal of the mother, fruit-destructive operations are performed (decapitation, craniotomy, etc.), and the fetus is taken out of the woman's uterus in parts.
After the baby is removed from the womb, the woman must pass rehabilitation course... Ceftriaxone or its analogues are prescribed within 7-10 days. Within 4-6 months after the incident, all possible causes of fetal death are eliminated:
- treatment of chronic foci of infection;
- nutritional correction;
- taking several courses and minerals;
- observation at the reproduction center and work with a psychologist.
Effects
In the case of timely treatment for medical care, intrauterine death of the fetus does not bear any consequences for the woman. In 99% of cases, repeated pregnancy, which occurred six months or more after artificial childbirth, ends well.
In cases where a woman consulted a doctor late, infectious and bacterial complications may develop, up to sepsis. This is due to the fact that the dead fetus releases a large amount of toxins into the bloodstream, and its decomposition occurs. In extreme cases, death is possible.
Carrying a baby is the most important period in the life of any woman, but the desired pregnancy does not always end with the birth of a baby. At various times, the death of the embryo can occur.
What is antenatal fetal death
This pathology is an interruption in the formation of an embryo in the womb, when the uterus freezes and stops enlarging. It is necessary to classify antenatal fetal death depending on the timing:
- up to 20 weeks - early;
- from 20 to 27 weeks - intermediate;
- from week 28 - late.
Pathology is manifested by severe pulling pain in the lower back or in the lower abdomen, weakness in the extremities and open bleeding (especially with late detection of developmental arrest).
Attention! The death of the embryo is not always accompanied by painful symptoms. A woman may not be aware of the abnormal condition for a long time, so it is important to listen to her own body and immediately notify the doctor about the occurrence of new unfamiliar sensations.
Causes
In 10-11% of cases, fetal-type bleeding associated with an increase in the amount of fetal hemoglobin in a woman's blood is considered a probable cause of fetal death. There are also a number of secondary factors that can provoke a miscarriage:
- infectious diseases - pneumonia, ARVI, influenza, sexually transmitted diseases;
- the presence of an inflammatory process affecting the uterus;
- severe toxicosis;
- bad habits, the use of certain medications;
- congenital anomalies in the development of the cardiovascular system, heart disease, abnormal functioning of the liver and kidneys;
- incompatibility of the Rh factor in the blood of the mother and the child;
- changes in the condition of the umbilical cord or placenta;
- hormonal disruptions, autoimmune processes in a woman's body;
- stress, emotional stress;
- little - or polyhydramnios;
- injuries sustained.
Clinical manifestations
When the development of the embryo stops, the body of the expectant mother independently contributes to the rejection of the fetus and its exit from the uterus. This process is called spontaneous miscarriage. It is accompanied by symptoms such as:
- feeling of heaviness in the abdomen, malaise, weakness throughout the body;
- stopping the increase in the volume of the uterus;
- decreased breast sensitivity;
- decrease in uterine tone, lack of contractions;
- stopping the heartbeat and motor activity of the child.
If these signs are detected, the pregnant woman should be hospitalized immediately. Lack of symptoms and untimely provision of medical care are very dangerous. Long-term presence of a frozen embryo in the uterus is fraught with not only serious complications, but also the development of processes that threaten the mother's life:
- Maceration. Under the influence of amniotic fluid, necrosis and softening of the tissues of the embryo occurs. Usually this phenomenon is not accompanied by suppuration, but the likelihood of the onset of sepsis here, nevertheless, is too high.
- Mummification. It happens with repeated entanglement of the baby's neck with the umbilical cord or with multiple pregnancies.
- Petrification is a rare type of mutation, which is ossification or calcification of the fetus (usually with an ectopic pregnancy).
Diagnostics
Fetal death can be diagnosed using ultrasound, ECG and PCG. These methods make it possible to determine the absence or presence of impulses, palpitations, movements and respiration of the embryo.
An additional way of fixing a pathological condition is amnioscopy - a procedure for detecting changes in the color and composition of amniotic fluid. In the first days after stopping the development of the embryo, they acquire a greenish tint, and later they mix with blood.
To obtain a 100% reliable result, it is advisable to carry out several procedures at once. After confirming the diagnosis, you must immediately resort to surgical intervention.
Therapeutic activities
In this case, therapy involves the removal of a dead fetus from the uterus. It is recommended to carry out the procedure no later than 2 weeks after the death of the child:
- When embryonic death is recorded within a period of up to 12 weeks, an abortion of the classic type is performed - a standard curettage of the inner layer of the uterus.
- With the onset of pathology in the second trimester, contractions are stimulated through the use of special medications.
- In some cases, a caesarean section is required.
- With incorrect presentation, as well as with the threat of rupture of the uterus, it is necessary to carry out a craniotomy - an operation to destroy the structure of the baby's body.
After the evacuation of the embryo, the woman is recommended to undergo rehabilitation, the minimum duration of which is 7 days. During this period, the patient is prescribed to take "Ceftriaxone" or its analogues. Over the next 6 months, it is required to find and eliminate the factors that caused the pathology.
Prophylaxis
If intrauterine death occurred in the first pregnancy, this does not mean that it will occur again (the attempt can be repeated no earlier than six months later). To reduce the likelihood of repeated antenatal death, simple preventive measures should be followed:
Antenatal fetal death in multiple pregnancies
When carrying twins, the death of one of the embryos occurs extremely rarely (about 1 in 1000 cases). The reasons for this phenomenon may be:
- violation of blood flow;
- embryo pathology;
- lack of oxygen in the fetal sac or placenta;
- improper formation of the umbilical cord or placenta.
It is important to remember that the death of one child has a serious negative impact on its twin (up to and including death). If death occurred in the first trimester, then the probability of survival of the second baby is 85-90%. Freezing of the fetus at a later date often leads to the development of various defects.
The obstetricians' actions are adjusted according to the gestational age. In the last weeks, an emergency delivery is performed, which does not take into account the condition of the second baby. The faster the removal of the newborn from the “child's place” is carried out, the less harmful effects a healthy child will be exposed to.
