What is done if the fetal egg is empty during pregnancy? Fetal egg on ultrasound: sizes by weeks of pregnancy.

At non-developing pregnancy there is such a thing as empty fertilized egg. Symptoms in this case can be completely different and quite often women cannot associate the pathology with certain disorders in the body.

Ultrasound examination, which is carried out with a delay menstrual cycle may detect pregnancy, but early stages the absence of an embryo in an egg is quite difficult to diagnose.

Empty fertilized egg. Causes of the anomaly

There are quite a few reasons that can cause such a pathology, among them:

• genetic disorders;
• Infectious diseases;
• Toxicological effects;
• Unfavorable ecological situation;
• Lack of vitamins, trace elements and much more.

Thus, to reveal the exact reason why an empty fetal egg developed in specific case, almost impossible. Pay attention to the fact that it is possible to minimize the risk of anomalies only in the case of a planned pregnancy, when even before the conception of a baby, future parents refrain from stress, bad habits and lead healthy lifestyle life. Otherwise, when an unplanned pregnancy occurs, the risk of an empty ovum can be reduced to nothing by adhering to the recommendations of the attending physician and regularly taking folic acid, so necessary for the body of the mother and fetus.

When pregnancy occurs, an empty ovum can be diagnosed as early as the fifth to sixth week if the precise, high-tech equipment that is equipped with modern centers reproductive medicine. Otherwise, the first "alarm bells" may ring much later, when spotting and gradual rejection of the fetus begin. If we talk about statistics, now, in the conditions of the current environmental situation, one out of eight pregnancies is accompanied by an empty fetal egg, the reasons for this are very different depending on the characteristics of the body. However, if this is not the first time this has happened to you, then you need to urgently go through additional genetic research to identify the cause of the disease and its further elimination.

How to diagnose an empty fetal egg: hCG and its effectiveness

When there is an empty fetal egg, the hCG analysis will not be able to diagnose this. When pregnancy occurs, for the first time even the body itself does not suspect the presence of a violation and fading of the fetus, the symptoms are the same as in the normal course of child development:

• Fast fatiguability;
• Nausea, dizziness;
• Delayed menstrual cycle;
• Increasing the sensitivity of the breast and so on.

Of course, an empty fetal egg cannot be left and brought to the birth of a child, so it is necessary to clean the uterus by scraping it under general anesthesia. Of course, this is a complex medical operation, which previously quite often ended in heavy blood loss and infections. However, now medicine has stepped forward, so such manipulations should not cause concern.

After the operation, a second ultrasound is done, corresponding analyzes of the removed tissue are taken, which allow to identify the actual cause of the pathology. Pregnancy after an empty fetal egg should be planned no earlier than 6-12 months later, this period is enough for the body to rehabilitate, and future parents have enough time to prepare and plan the birth of the baby properly.

Symptoms of an empty ovum

The anomaly of anembryonia or an empty fetal egg, the causes of which are still not fully understood, is accompanied by symptoms similar to the course of a normal uterine pregnancy. Already later, when a frozen pregnancy goes into the last stage spontaneous interruption, may occur first minor, and then severe bleeding.

This phenomenon suggests that the body arbitrarily decided to get rid of the pregnancy, and the empty fetal egg is rejected. In this case, it is necessary to urgently contact a specialist, but one should not panic, because it is much better if the woman's body itself rejects an empty body than if it had to be stimulated to this medically or surgically. However, what actions should be taken by a woman who suspects an empty fetal egg? HCG, ultrasound and going to the doctor to find out the reasons and pass all the necessary tests - that's how to do it.

Pregnant women should be especially sensitive to their body and, in case of the slightest suspicion, immediately contact competent and experienced doctors who will provide individual, comprehensive treatment. This is the only way to expect a normal pregnancy after an empty fetal egg in the future.

Every fifth pregnant woman is faced with such a diagnosis as an empty fetal egg, the causes of which are almost impossible to find out. You can only minimize the risks if you lead a healthy lifestyle before planning a pregnancy and consume folic acid a couple of months before conception.

Causes

What does an empty ovum mean? This means that pregnancy does not develop, it stops at the stage when the cells begin to form an embryo. Such an anomaly can be triggered by some changes in the woman's body. If a woman was diagnosed with anembryony, she should immediately take all necessary measures, because the death of the fetus is not inevitable.

Why can a fertilized egg be empty:

1. genetic abnormalities;
2. infectious diseases;
3. environmental ecology;
4. avitaminosis;
5. malnutrition, etc.

It becomes clear that it is impossible to identify the causes of an empty fetal egg in a certain situation. most main reason The fact that an empty egg was formed during pregnancy is the incorrect division of the first cells, which entails the genetic errors of all subsequent ones.

This provokes the formation of the creation of extra chromosomes (trisomy), sometimes the set of chromosomes is not complete. In such situations, the fertilized egg does not turn into an embryo. After the body has realized that this is a frozen pregnancy, it begins to reject the amniotic egg.

Manifestations

An empty pregnancy is a state of the female body that does not show itself at first. Even with internal gynecological examination it is impossible to identify signs of an empty fetal egg. They can become visible when the extreme stage already sets in - spontaneous abortion begins: brown discharge appears and Strong smell from the vagina.

Does hCG grow with an empty ovum? HCG indicator increase, but much less than in the normal course of gestation. Seeing the growth of hCG in dynamics is perhaps the only way to recognize an empty fetal egg during pregnancy. If there are problems with the development of pregnancy, the indicators are slowly growing or standing still.

The symptoms of an empty fetal egg are identical to those that appear with successful fertilization: nausea, dizziness, permanent state fatigue, delayed menstruation.

An empty fetal egg can be very difficult to determine in the early stages, because the embryo for the first week of pregnancy is very small size and it can easily be overlooked. But at week 5, it becomes possible to detect the absence of a fetus.

With an embryo - the norm

Empty fertilized egg photo

An empty fetal egg at week 6 can be diagnosed during an ultrasound examination. At this stage of gestation ultrasonography is carried out in order to determine the location of the fetus: in the uterus or outside it. Future mother you should be attentive to your health in the early stages of pregnancy, because the first trimester is considered the most dangerous due to frequent miscarriages.

Preventive actions

As you know, it is better to prevent a problem from occurring than to deal with the consequences. If, upon the onset of pregnancy, an empty egg is found, nothing can help.

But it is quite possible to help reduce the likelihood of such an anomaly. To do this, you will need to follow some recommendations during pregnancy planning.

You can minimize the risks of an empty fetal egg if:

• undergo a full examination for both partners (take tests, do an ultrasound scan, consult a gynecologist, therapist to exclude the presence of chronic diseases);
• start taking folic acid two to three months before the intended conception;
• lead a healthy lifestyle: give up bad habits, drinking alcohol. You will need to review your diet and replenish it with vitamins and macronutrients and useful substances.

It is important to choose an obstetrician-gynecologist in a timely manner, who will manage the pregnancy from A to Z, and the sooner this happens, the better. Most importantly, if the pregnancy stopped once, this does not mean that any of the partners has problems with reproductive health. You should not be upset and after half a year, again take up the continuation of the family. And be sure the long-awaited two stripes appear on the test.

This kind of problem, though rare, does happen. According to statistics, this happens to every fifteen women. Seeing the long-awaited two stripes on the test, the woman is delighted, but soon she is severely disappointed, because on the ultrasound the doctor discovers a fetal egg without an embryo. The diagnosis in this case sounds like an embryonic pregnancy.

A non-developing anembryonic pregnancy is a type of missed pregnancy. This syndrome is also called empty gestational sac syndrome. That is, pregnancy has come, the fetal membranes are formed, and the embryo is absent. This saves all external signs pregnancy - lack of menstruation, enlarged breasts, fatigue, hCG levels in anembryos continue to rise.

Diagnosis is based on ultrasound of the embryo. It is necessary to conduct a study no earlier than 6-7 weeks, since at earlier periods this study is not indicative, the embryo is not visualized, and the doctor simply may not see its presence or absence. An erroneous diagnosis in the early stages may be due to the fact that the fetus is located near the wall itself and is not visible, or the fetus has a short amniotic leg.

Sometimes diagnostic errors occur if the gestational age is set inaccurately. That is, at the time of the examination, the embryo may be so small that the sensors of the ultrasound machine will not be able to detect its presence. Be that as it may, having heard such a diagnosis, do not panic - insist on an additional check at some interval.

If you have been diagnosed with an anembryonic pregnancy, you need to undergo an additional examination by another specialist with an interval of 5-7 days. And only after confirming the sad phenomenon, go to terminate the pregnancy (in the common people - purge).

Anembryonic pregnancy is eliminated by curettage of the uterine cavity (curettage) under general anesthesia. After the operation, a second examination of the uterine cavity is performed. Sometimes a doctor may prescribe special hormonal drugs to improve a woman's health.

Reasons for pregnancy without an embryo

To the question - why is there no embryo implantation? - Doctors can not give an exact answer. Most probable causes development of an egg without an embryo are considered genetic disorders, infectious diseases, features hormonal background.

The cause of the appearance of anembryony can be:

• acute viral or bacterial infection at an early stage of pregnancy, which either affects the embryo or leads to a significant increase in the temperature of the woman, due to which the development of the embryo is disrupted;
• the influence of toxic substances or radiation at the stage of fetal laying;
• hormonal failure in the female body;
• bad habits: smoking, alcoholism, drug use.

You can learn more about the factors that influenced pregnancy by conducting histological studies during surgery. materials. To avoid a recurrence of an anembryonic pregnancy, both partners need to be tested for infections, undergo karyotype studies (genetic studies), and submit material for spermogram.

Sometimes such a pregnancy develops completely healthy parents. In this case, the prognosis of future pregnancies is very positive, that is, with a high degree of probability repeated pregnancy without an embryo you are not in danger. You just need to give the body a little rest from the resulting stress (about six months), gain strength and try to get pregnant again.

Approximately 15% of expectant mothers at the next appointment with a gynecologist hear a terrible diagnosis - anembryony. Many women experience this hard, because it is very painful when you just get used to the idea that a baby lives inside, but it turns out that it doesn’t exist at all. The problem is especially worrisome for women who have had difficulty getting pregnant. According to statistics, anembryony threatens every fifth of the fair sex.

Re-pregnancy Syndrome Examination
doctor examining the calf
difficulties during pregnancy

If you have been diagnosed with anembryonia, you should not ask your doctor how long you can walk with it. You need to take immediate action, because inside you is a fetal egg without an embryo. Usually, the examination is carried out either at 5 or 7 weeks after conception using an ultrasound machine. By this time, the fetus is already dying.

Sometimes at the 7th week of pregnancy, the doctor may put misdiagnosis, and actually there is no anembryony. This is because the fetus is still so small that the ultrasound machine cannot see it. Don't get upset right away, just come back in a couple of weeks for a re-examination. If you confirm the diagnosis, then you will need to carry out gynecological curettage and begin treatment.

The second name for this pathology is “syndrome of an empty fetal egg”

Anembryonic pregnancy is not dangerous for physical condition women. Rather, she inflicts psychological trauma. However, pregnancy some time after anembryony is quite possible.

The main causes of the disease

Doctors explain the fact of anembryony with a genetic pathology. When the fetus is very weak, it has an incorrect chromosomal combination or set of genes, the female body itself gets rid of it. In this case, anembryony develops. Other factors are also the cause:

• sudden change in hormonal levels;
• stressful situations that can easily provoke an undeveloped pregnancy, various tragic events, constant conflicts at home, problems at work can affect the health of the expectant mother and the development of her child;
• bad habits of a woman: narcotic drugs, regular alcohol abuse and tobacco smoking are very detrimental to the development of the fetus, mothers need to carefully monitor their behavior and lead the most correct lifestyle;
• viral pathologies: elevated temperature has an extremely negative effect on the embryo;
• there are cases when, during the fetal laying, a woman is under the influence of radioactive and toxic substances, in this case the risk of destruction of the embryo is high;
• pathology is often diagnosed in women who regularly play sports, serious physical exercise contraindicated in the early and late stages of bearing a child (you can do special exercises for expectant mothers, this is even welcome, but intensive training is prohibited, it is best to direct your energies to sports after the birth of the baby).

Sometimes even experienced doctors do not understand real reasons the onset of anembryony. Pregnancy can freeze in absolutely healthy girls. In this case, it is worth examining and paying attention to lifestyle. Also find out.

Symptoms of the development of pathology

Usually, anembryony does not have any symptoms, so it is very difficult to recognize it. The woman continues to suffer from toxicosis, her breasts begin to increase in size. In a word, pregnancy develops according to its standard scenario.

1. With anembryony, the growth of hCG continues, as the fetal egg continues to increase.
2. The uterus is enlarged.
3. A woman suffers from toxicosis.
4. The chest swells.

The examination must be carried out several times to eliminate the possibility of error.

Signs of anembryonic development can only be tracked by the pregnancy hormone. Although it grows, but not in enough. Usually a competent doctor immediately draws attention to this. The growth of hCG is extremely small during anembryony, because there is no embryo, but the fetal membrane produces a hormone, since there is a female egg in the body. sometimes happens miscarriage.

This condition can be diagnosed only through an ultrasound examination. At the same time, it should be carried out no earlier than at 5-6 weeks of gestation, counting from the 1st day of the last menstruation.

When the fetus develops normally, the embryo begins to visualize, and the ultrasound shows a photo that shows that there is no anembryony.

When the doctor made a preliminary diagnosis for a period of 5-6 weeks, you should not despair. Go through the diagnostics again to be sure of the result. At the same time, the doctor will monitor the growth of hCG for some time to determine for sure that you have anembryony. At the next ultrasound, the specialist will already be able to see an empty fetal egg.

Treatment and prevention of missed pregnancy

• medical abortion;
• curettage of the uterine cavity;
• medical treatment.

Medical termination of pregnancy with anembryony is performed if the period is very short. In this case, the doctor prescribes special pills that provoke a miscarriage. It is forbidden to take them on your own, because the doctor must keep the process under control.

When the period is already long, scraping is performed. If it is suspected that a woman has an undeveloped pregnancy, and the doctor determines that she is of the type of anembryony, Duphaston is prescribed to the patient. The same medication is prescribed after the elimination of the dead embryo in order to normalize the tone of the uterus.

Anembryonia is treated with antibacterial and immunomodulatory agents. They do not allow the development of inflammatory processes and increase the tone of the body. Pregnancy after anembryony is possible at least six months later. During this time, the hormonal background and the uterus should fully recover. Be sure to analyze your lifestyle, undergo a complete examination to prevent the re-development of a missed pregnancy.

Always consult with your doctor, because only he should tell you about how long after the discovery of anembryony, you can become pregnant again. You may have to undergo an additional course of treatment, pass any tests.

What happened often causes severe psychological trauma, the woman feels very depressed. Yes, for many this is a real grief, but there is no need to despair. In most cases next pregnancy proceeds quite well. In any case, anembryony is not a sentence. It's just that some women will have to go through this difficult test in order to then give birth to a healthy baby.

Frozen pregnancy is not a reason to give up. It is necessary to draw appropriate conclusions and carry out prevention of the development of pathology. One of the basic rules is regular visits to the gynecologist, strict implementation of all his recommendations. Give up serious physical exertion, because a healthy child is more important than the next sports achievements. Lead the right lifestyle: take vitamins, completely eliminate alcoholic beverages.

Expecting a baby is one of the most beautiful periods in a woman's life, but, unfortunately, it does not always go without problems. There are times when the diagnosis of doctors is disappointing - "a fetal egg without an embryo." Why does this happen and how can you determine that the pregnancy has stopped?

What does "egg without embryo" mean?

Anembryonic, or frozen, pregnancy is a diagnosis confirming that the fetal egg develops without an embryo. As a rule, this fact is detected during the ultrasound procedure at 5-6 weeks after conception. By this time, it becomes obvious that there was no germ in the egg at all, or that, having turned out to be unviable, he had already died.

Important! If the gestational age was set erroneously, the diagnosis may be false. To confirm or refute anembryony, the examination is repeated after 2 weeks, since the ultrasound machine simply does not see the tiny future baby.

A frozen pregnancy is not a threat to a woman's health and in most cases does not have serious consequences. If the diagnosis is confirmed, gestation is interrupted, and young parents are advised to undergo a course of special treatment. Of course, anembryony is a lot of stress, but you should not get depressed. Subject to all the prescriptions of the doctor, the next pregnancy may well be successful.

Possible reasons

Most often, such a phenomenon as a fetal egg without an early embryo is due to genetic changes in the fetus at initial stage its formation. However, there are other reasons:

• frequent stress, conflicts with loved ones or tragic events in the life of a pregnant woman;
• hormonal imbalance;
• smoking, drinking alcohol, stimulants or drugs;
• viral diseases accompanied by high fever;
• exposure to poisons or aggressive chemical substances on the body of the expectant mother;
• high loads in early pregnancy.

Quite often, female athletes who regularly train and test their body for strength are diagnosed with an ultrasound scan of a fetal egg without an embryo. The reasons for this are clear: high physical activity is contraindicated for any woman throughout pregnancy, and neglect of this rule is fraught with her breakdown.

Diagnosis of anembryony

It is very difficult to detect signs of a frozen pregnancy on your own. As a rule, it proceeds in the same way as normal. A woman has no menstruation, the mammary glands increase in size and hurt, symptoms of toxicosis appear.

Important! The only indicator of an embryonic pregnancy that can be seen in the early stages is a low level of the hCG hormone.

Many women are concerned about whether a fertilized egg can grow without an embryo and why they feel "totally pregnant." This pathology does not exclude the fact that an empty fetal egg will increase in size, but such a pregnancy must be interrupted in any case.

In some cases female body he himself understands that the embryo is absent in the egg, and launches natural process his rejection. This is usually accompanied by sharp or aching pain in the pelvic area and

Obstetric pathology is an important aspect modern medicine. And among all diseases special place belongs to miscarriage. For women hoping for safe conception and the further development of the child, it becomes a heavy blow. Similar situation can occur at an early stage, when an undeveloped anembryonic pregnancy occurs, which indicates the absence of an embryo in the fetal egg. Why this happens and what actions should be taken are questions that the doctor will answer. A woman should follow his recommendations.

Causes and mechanisms

The causes of non-developing pregnancy are diverse and complex. It is difficult to single out any one factor that has the greatest impact on a woman's body before and after conception. More often we are talking about the association of several causes. Of them importance have the following:

• Infections (viral-bacterial, chlamydial, fungal).
• Chromosomal abnormalities (trisomy, monosomy, tri- and tetraploidy).
• endocrine diseases ( diabetes, hypothyroidism, adrenogenital syndrome).
• Autoimmune disorders (antiphospholipid syndrome).
• Intoxication with chemicals.
• Heavy physical activity.
• Radiation exposure.
• Taking certain medications.

The sensitivity of the embryo to external adverse factors is greatest in the early period. Exist critical periods during pregnancy, when the risk of pathology is significantly higher. This is mainly observed on the 7-12th day after conception, with the implantation of the fetal egg into the uterine mucosa, and from 3 to 8 weeks of gestation, which is associated with active processes embryogenesis.

Among the mechanisms of development of anembryony, the main role belongs to the disruption of the life support processes of the embryo, which leads to its death. This occurs against the background of the cessation of chorionic blood flow, involution of the villous membrane and exudative-fibrous reaction of the endometrium. The latter, instead of decidual transformation, acquires signs of glandular cystic hyperplasia. If the pregnancy is not rejected, then a fetal egg without an embryo may still long time persist in the uterus, increasing the risk of complications.

Anembryony is a type of non-developing pregnancy. And its causes include external and internal factors that have an adverse effect on the fetus in the early stages of gestation.

Symptoms

A fetal egg without an embryo does not have bright symptoms. But despite this, in the clinical picture, certain features can be distinguished that make it possible to suspect obstetric pathology. As a rule, we are talking about such manifestations:

1. The size of the uterus does not correspond to the gestational age.
2. The signs of pregnancy gradually disappear.
3. Uterine tone is reduced.
4. There is scanty bloody discharge from the vagina.

During a dynamic gynecological examination, the size of the uterus does not grow, as it should be in the norm, but, on the contrary, decrease. Cyanosis of the mucous membrane of the cervix and vagina disappears. Rectal temperature also decreases.

If a non-developing embryo lingers in the uterine cavity for a long time, then there is a possibility of complications. First of all, we are talking about a violation of blood coagulation (coagulopathy or DIC). In this case, there is increased bleeding from various sites body and internal organs that is hard to stop. The second danger is the infection of the mummified fetal egg and the development of endometritis.

Additional diagnostics

Crucial in the diagnosis of anembryony belongs to additional methods. And the main role in this is played by ultrasound examination of the uterus. According to its results, the following signs of pathology are determined:

• The absence of an embryo is an “empty” fetal egg.
• Areas of detachment of the chorion.
• Discontinuity of the decidua.
• Expanded fetal bladder.
• Fuzzy visualization of the embryo.
• Deformation of the fetal egg, uneven structure.
• Absence of heartbeat.

If the doctor said that the woman does not have an embryo on ultrasound, and clinically the pregnancy is normal, then the study should be repeated after 7 days. In the absence of pathological changes, the fetus will grow, and it will not only be seen, but also heard (at week 8, the heartbeat should already be). Therefore, do not rush to conclusions and focus only on the results of a single procedure.

According to ultrasound data, two types of anembryonia are distinguished. The first is characterized by the fact that the diameter of the fetal egg does not exceed 25 mm, the size of the uterus corresponds to the 5-7th week of pregnancy, but lags behind the real term. In the second type, the egg grows at a normal rate and reaches 50 mm by 2.5 months, but the villous chorion is not visualized.

In addition to instrumental research, diagnostics includes the determination of the hormonal spectrum and biochemical parameters of the blood. The following indicators may indicate anembryony:

1. Low level chorionic gonadotropin(hCG), the absence of its peak concentration at 10-11 weeks.
2. Decrease in prolactin, progesterone, estradiol, cortisol.
3. A drop in the level of trophoblastic β1-globulin.
4. Decreased concentration of placentospecific α1-microglobulin.

It must be said that the increased hCG, as well as other biochemical markers, indicate the normal course of pregnancy. And even if the embryo is not yet visible on ultrasound - this happens up to 6-7 weeks - then the woman should not worry. Perhaps this is due to its individual characteristics or the imperfection of the apparatus.

To find out why a fetal egg may be absent, a study is assigned immune status(immunoglobulins, lupus anticoagulant, cardilipin and antiphospholipid antibodies), is carried out genetic analysis(karyotyping). For early detection of complications, analysis of the coagulogram (clotting time, prothrombin index, fibrinogen) is necessary.

It is possible to confirm anembryony only by instrumental and laboratory methods. But even their results should be considered in the context of the clinical picture and individual characteristics organism.

Treatment

If a fetal egg without an embryo lingers in the uterine cavity, then there is a real threat to the woman's health and her life. Therefore, pathology requires active treatment tactics. After the diagnosis of non-developing pregnancy is established, it is interrupted in one of the following ways:

• Vacuum aspiration.
• Curettage (curettage).
• Medical abortion.

After the fetal egg is eliminated, the woman is shown anti-inflammatory therapy, immunostimulating and restorative drugs. If a complication has developed in the form of bleeding, then hemostatics and plasma substitutes are used. Endocrine disorders require appropriate hormone therapy, and autoimmune disorders require the use of glucocorticoids. Sedatives are shown to normalize the psychophysiological state.

Subsequent pregnancy is recommended only after the elimination of all factors involved in the development of pathology. A woman is shown medical genetic counseling and a careful approach to planning conception. It does not hurt to lead a healthy lifestyle and emotionally tune in to the favorable bearing of a child.

Anembryony is quite common. obstetric pathology, which becomes known by the results of ultrasound. Of no small importance in the diagnosis are also laboratory methods to identify systemic disorders and suggest whether a subsequent pregnancy can end safely. And for the implementation of a positive scenario, it is necessary to adhere to medical recommendations in everything.

This kind of problem, though rare, does happen. According to statistics, this happens to every fifteen women. Seeing the long-awaited two stripes on the test, the woman is delighted, but soon she is severely disappointed, because on the ultrasound the doctor discovers a fetal egg without an embryo. The diagnosis in this case sounds like an embryonic pregnancy.

A non-developing anembryonic pregnancy is a type of missed pregnancy. This syndrome is also called empty gestational sac syndrome. That is, pregnancy has come, the fetal membranes are formed, and the embryo is absent. At the same time, all external signs of pregnancy remain - the absence of menstruation, enlarged breasts, fatigue, the level of hCG during anembryony continues to grow.

Diagnosis is based on ultrasound of the embryo. It is necessary to conduct a study no earlier than 6-7 weeks, since at earlier periods this study is not indicative, the embryo is not visualized, and the doctor simply may not see its presence or absence. An erroneous diagnosis in the early stages may be due to the fact that the fetus is located near the wall itself and is not visible, or the fetus has a short amniotic leg.

Sometimes diagnostic errors occur if the gestational age is set inaccurately. That is, at the time of the examination, the embryo may be so small that the sensors of the ultrasound machine will not be able to detect its presence. Be that as it may, having heard such a diagnosis, do not panic - insist on an additional check at some interval.

If you have been diagnosed with an anembryonic pregnancy, you need to undergo an additional examination by another specialist with an interval of 5-7 days. And only after confirming the sad phenomenon, go to terminate the pregnancy (in the common people - purge).

Anembryonic pregnancy is eliminated by curettage of the uterine cavity (curettage) under general anesthesia. After the operation, a second examination of the uterine cavity is performed. Sometimes a doctor may prescribe special hormonal drugs to improve a woman's health.

Reasons for pregnancy without an embryo

To the question - why is there no embryo implantation? - Doctors can not give an exact answer. The most likely causes of the development of an egg without an embryo are genetic disorders, infectious diseases, and hormonal characteristics.

The cause of the appearance of anembryony can be:

• an acute viral or bacterial infection in the early stages of pregnancy that either affects the embryo or leads to a significant increase in the temperature of the woman, due to which the development of the embryo is disrupted;
• the influence of toxic substances or radiation at the stage of fetal laying;
• hormonal disbalance in the female body;
• bad habits: smoking, alcoholism, drug use.

You can learn more about the factors that influenced pregnancy by conducting histological studies during surgery. materials. To avoid a recurrence of an anembryonic pregnancy, both partners need to be tested for infections, undergo karyotype studies (genetic studies), and submit material for spermogram.

Sometimes such a pregnancy develops in completely healthy parents. In this case, the prognosis of future pregnancies is very positive, that is, with a high degree of probability, a second pregnancy without an embryo does not threaten you. You just need to give the body a little rest from the resulting stress (about six months), gain strength and try to get pregnant again.

The article talks about what a woman should do if she has a missed pregnancy. The methods of treatment for anembryonia are explained.

A woman waiting for the birth of a baby is absorbed in thoughts about the upcoming joyful chores. The diagnosis of anembryonia, which is usually made during an ultrasound examination, becomes a bitter sobering pill. It is especially difficult when the pregnancy did not occur for a long time, and the chances of giving birth were approaching zero.

Unfortunately, in 15% of women, doctors are forced to confirm the threat of anembryonic pregnancy (missed miscarriage). Inconsolable tears after hearing the diagnosis lead to a complete misunderstanding of what happened. Let's try to figure out what causes anembryony and how hopeless the situation is.

The main signs of anembryony. Why does anembryony occur?

A whole bunch of pathological symptoms leads to a frozen pregnancy or anembryony. This includes intrauterine death of the embryo, and inertia of the myometrium, and violations of the hemostasis system. Everything in the complex leads to a halt in the development of the fetus in the early stages. The fertilized egg is empty, without an embryo

The formation of the fetus with a failed miscarriage stops no later than the third semester of pregnancy. Until the fifth week, the embryo does not reach a size sufficient for examination by ultrasound. In other words, the device simply does not detect the presence of the embryo. Therefore, the diagnosis may be erroneous.

What to do after you have been diagnosed with anembryonia? Do not panic and do not fall into despair! By waiting a few weeks and insisting on additional tests, a misdiagnosis can be ruled out.

After confirming the diagnosis, the woman will undergo a gynecological curettage. You will also need treatment. But frozen pregnancy does not put an end to motherhood.

Psychological trauma after a failed miscarriage does not threaten a woman's health. Having become pregnant again, the woman will be able to carry the baby safely. Anembryony does not affect its development.

How to find out about a non-developing pregnancy?

The fact that the embryo has stopped developing, the woman learns during an ultrasound examination or after testing for the level of hCG (using the test, pregnancy is confirmed or various abnormalities are detected in its course). She may not feel any changes in the body or discomfort.

• Some of the cells that began dividing after fertilization form the embryo, some form the placenta and the fetal membrane. But with anembryony, fetal cells stop dividing
• The fertilized egg continues to grow. Hormones that cause toxicosis are produced. But there is no embryo inside the fetal egg. Menses are absent. The uterus grows in size
• At this stage, spontaneous miscarriage may occur. A woman has spotting, pain in the lower abdomen

Why does anembryony occur?

The female body is able to get rid of a weak, non-viable embryo on its own. The same applies to a fetus with an incorrect chromosomal combination. But among the causes of the genetic pathology of the embryo, there are others.

What causes fetal death?

• genetic disorders (laying the wrong chromosome set, getting a defective sperm into the egg, or pathological changes in the egg, the coincidence of several wrong combinations at once)
• infections carried by a woman in the first trimester of pregnancy, if they were accompanied by an increase in body temperature (has a devastating effect on the embryo)
• toxic substances that enter the body of a pregnant woman in the early stages;
• decreased secretion of hormones necessary for the normal development of the fetus;
• bad habits (alcohol abuse, smoking, drugs)
• the reasons can also be hidden in the stressful state of the pregnant woman, conflicts, tragedies in the family, which do not pass without consequences for the woman and the fetus;
• excessive physical activity can cause an empty amniotic egg (this applies to athletes). Therefore, care for a beautiful and fit figure must be postponed until the baby is born.

But even when modern development medicine, not everything is known about the causes of a missed pregnancy. Absolutely healthy women may face the problem of pathological pregnancy.

When does anembryony occur?

The development of anembryony is exposed to a pregnant woman up to the 13th week of pregnancy. But even at later dates (up to 28 weeks) there is a threat of fetal fading

Anembryonic symptoms

It is impossible to independently determine in the early stages of pregnancy that the fetus has stopped developing. A feature of the course of the pathology is asymptomatic. Absence subjective signs pregnancy (toxicosis, if it was before), the appearance of spotting may indicate the onset of rejection of dead cells. Followed by a miscarriage

Video: anembryony

Characteristic features of anembryony

• a decrease in the size of the mammary glands (the breast becomes less dense on palpation) manifests itself on the 6th day of fetal death in early pregnancy
• at 25 weeks, the breast swells when the embryo dies and colostrum is released
• in late pregnancy, there is a cessation of fetal movements, if they have already been observed
• a sharp increase in temperature, weakness, headache (poor health is caused by a delay in a non-developing embryo inside the female body);
• the appearance of cramping pains in the lower abdomen

Is it possible to get pregnant after anembryony

• If the genes of future parents are normal, then a woman after primary anembryony has every chance to see two stripes on the test again and safely give birth to a healthy baby
• But with "bad heredity", genetic incompatibility will have to be fought. Getting pregnant on your own in this case is tantamount to "Russian roulette"
• Re-diagnosis is not ruled out. At natural pregnancy a woman risks losing a baby even after he is born

After anembryony, it is important not only to become pregnant, but also to exclude all kinds of risks and malformations of the fetus. by the most in a safe way getting pregnant is in vitro fertilization (IVF).

• Thanks to the IVF procedure, only healthy viable sperm will take part in fertilization. Thus, the possibility of "replanting" the embryo with genetic abnormalities is excluded.
• Reproductive technologies make it possible to exclude not only anembryony, but also the development of congenital genetic diseases compatible with life. Remember: now you want to become parents and give birth to a healthy child
• Soon your children will want the same. What they pass on to your grandchildren must be taken care of by you! A good genetic heritage of the genus will help you preserve medicine

Consequences of anebryonia

90% of women who have been diagnosed with anembryony successfully become pregnant and bear healthy children. After the experience, it will take some time to recover.

A frozen pregnancy is always a heavy physical burden on a woman's health and her mental state. But in some, the pathology of pregnancy may recur. Therefore, in the future it is necessary to be examined and eliminate the cause of a missed pregnancy.

After a frozen pregnancy, a woman physically remains healthy if the frozen fetus is identified and removed in a timely manner

Anembryony: how long can you walk with it?

Once a woman is diagnosed with anembryony, the most suitable method to remove a dead fetus

In the early stages (up to 8 weeks) it can be:

• medical method (performed to provoke an abortion) - pills are prescribed;
• vacuum aspiration (the fetus is removed from the uterus by suction with an extractor)

At a later date:

• curettage (carried out under anesthesia);
• artificial labor is induced, followed by cleaning of the uterus

Doctors do not always resort to immediate surgery. Sometimes a waiting tactic is preferred. The condition of the woman is monitored until the body independently rejects the frozen fetus.

Treatment of anembryonia

• A patient with a confirmed diagnosis of anembryonia is prescribed Duphaston. The drug is also necessary after cleansing to normalize the tone of the uterus
• Further treatment consists in prescribing antibacterial and immunomodulatory drugs that prevent the development of sepsis and inflammation.
• At least six months later, the woman's body will fully recover for a new pregnancy. Repeated consultation with the doctor and examination are mandatory, because you may need additional treatment

Anembryonic cleansing, pros and cons

Scraping does not relieve a woman from spotting, cramping pains (occur during uterine contractions). They continue for another week.

After the discharge has passed, it is necessary to visit a gynecologist to exclude inflammatory processes in the uterus and appendages. Curettage is performed with an incomplete miscarriage. In the event that a woman has a complete miscarriage, curettage is not done. In any case, an ultrasound is mandatory before the procedure.

Video: pregnancy after scraping

What to do if anembryony recurs?

If in a newly pregnant woman, after repeated ultrasound, the fetus is not located inside the fetal egg, there is no heartbeat, then curettage is performed. With repeated repetition of anembryony, a full examination of both spouses is shown.

Nadezhda, 42 years old: “With anembryony, the level of hCG decreases. Once every three days, you can take an hCG test to once again don’t worry, because a woman sometimes doesn’t suspect a frozen pregnancy: she feels normal, and there are no other signs that the child is no longer there ”

Olga, 35 years old: “After a missed pregnancy is discovered in a woman for the first time, there is no need to try to find the cause. It is likely that there was a genetic failure. In my case, everything is different: the pregnancy ends with the fading of the fetus for the fourth time in a row! It is important not to give up. Check several times. Examine and listen to the advice of doctors. It is believed that a frozen fetus in a woman happens only once. But that's not my case."

Larisa, 29 years old:“The gynecologist put the gestational age at 6-7 weeks. But when examined by ultrasound, it turned out that the period was 3 weeks. The size of the fetal egg is 4 mm. But there is no fruit in it. Preliminary diagnosis of anembryony was made and sent for a second ultrasound in a week. It is also necessary to pass tests for hCG "

Svetlana Yurievna, obstetrician-gynecologist:“After cleaning, the patient developed nausea, her temperature rose. She decided to take a pregnancy test, which came back positive. This indicates the development of trophoblastic disease, in which hospital treatment is indicated.

Every fifth pregnant woman is faced with such a diagnosis as an empty fetal egg, the causes of which are almost impossible to find out. You can only minimize the risks if you lead a healthy lifestyle before planning a pregnancy and consume folic acid a couple of months before conception.

Causes

What does an empty ovum mean? This means that pregnancy does not develop, it stops at the stage when the cells begin to form an embryo. Such an anomaly can be triggered by some changes in the woman's body. If a woman was diagnosed with anembryony, she should immediately take all necessary measures, because the death of the fetus is not inevitable.

Why can a fertilized egg be empty:

1. genetic abnormalities;
2. infectious diseases;
3. environmental ecology;
4. avitaminosis;
5. malnutrition, etc.

It becomes clear that it is impossible to identify the causes of an empty fetal egg in a certain situation. The most important reason that an empty egg was formed during pregnancy is the incorrect division of the first cells, which entails the genetic errors of all subsequent ones.

This provokes the formation of the creation of extra chromosomes (trisomy), sometimes the set of chromosomes is not complete. In such situations, the fertilized egg does not turn into an embryo. After the body has realized that this is a frozen pregnancy, it begins to reject the amniotic egg.

Manifestations

An empty pregnancy is a state of the female body that does not show itself at first. Even with an internal gynecological examination, it is impossible to identify signs of an empty fetal egg. They can become visible when the extreme stage has already begun - spontaneous abortion begins: brown discharge and a pungent odor from the vagina appear.

Does hCG grow with an empty ovum? The hCG index increases, but significantly less than during the normal course of gestation. Seeing the growth of hCG in dynamics is perhaps the only way to recognize an empty fetal egg during pregnancy. If there are problems with the development of pregnancy, the indicators are slowly growing or standing still.

The symptoms of an empty fetal egg are identical to those that appear with successful fertilization: nausea, dizziness, a constant state of fatigue, a delay in the monthly cycle.

An empty fetal egg can be very difficult to determine in the early stages, because the embryo for the first week of pregnancy is very small and can easily be overlooked. But at week 5, it becomes possible to detect the absence of a fetus.

With an embryo - the norm

Empty fertilized egg photo

An empty fetal egg at week 6 can be diagnosed during an ultrasound examination. At this stage of gestation, an ultrasound examination is performed to determine the location of the fetus: in the uterus or outside it. The expectant mother should be attentive to her health in the early stages of pregnancy, because the first trimester is considered the most dangerous due to frequent miscarriages.

Preventive actions

As you know, it is better to prevent a problem from occurring than to deal with the consequences. If at the onset of pregnancy, it is found empty egg- you won't be able to help.

But it is quite possible to help reduce the likelihood of such an anomaly. To do this, you will need to follow some recommendations during pregnancy planning.

You can minimize the risks of an empty fetal egg if:

• undergo a full examination for both partners (take tests, do an ultrasound scan, consult a gynecologist, therapist to exclude the presence of chronic diseases);
• start taking folic acid two to three months before the intended conception;
• lead a healthy lifestyle: give up bad habits, drinking alcohol. You will need to review your diet and replenish it with vitamins and macronutrients and useful substances.

It is important to choose an obstetrician-gynecologist in a timely manner, who will manage the pregnancy from A to Z, and the sooner this happens, the better. Most importantly, if the pregnancy stopped once, this does not mean that any of the partners has problems with reproductive health. You should not be upset and after half a year, again take up the continuation of the family. And be sure the long-awaited two stripes appear on the test.

Now women often have to deal with problems during pregnancy. And a fertilized egg without an embryo is one of such terrible problems. Such a diagnosis - an empty fetal egg - must certainly be subjected to intervention by doctors, since the child will not be born, and an empty fetal egg inside the uterus will aggravate the situation.

Cause and effect

The diagnosis of "anembryony" is made by doctors quite often. According to statistics: out of 1000 women who become pregnant, 100 do not have an embryo - only an empty fetal face. This diagnosis is also called anembryony.

It is placed in a woman if the fetal egg develops and grows, but there is no embryo in it. This is due to the cessation of cell division, as a result, the embryo stops growing. In this case, the doctor announces the diagnosis to the woman: an empty fetal egg without an embryo.

There is also another case when a pregnant woman can be diagnosed with anembryony, in which case the embryo not only stopped developing, but its absence is generally observed. There is still one pathology associated with this diagnosis: when the embryo grows, but the fetal egg does not, and in the case of this pathology, anembryonic pregnancy can also be diagnosed.

In this case, the doctor may advise you to terminate the pregnancy, since later the pregnancy may become frozen and the embryo will stop developing, but the development of the fetal egg may even out, and the pregnancy will continue calmly, not being called frozen, and the embryo will grow. This situation is very uncertain, and you should not rely on the opinion of one specialist.

Signs of complications

Another pregnancy is called frozen if the fetus does not continue to develop and dies. An empty fetal egg can also be called a frozen pregnancy. A frozen pregnancy can become in the first 12 weeks, while the fetus is growing.

It is also worth clarifying about another complication - ectopic pregnancy or false.

This occurs when a fertilized egg attaches outside the uterine cavity, or rather, attachment occurs inside the fallopian tube. A diagnosis that speaks of WB (inside the tube) is dangerous for the health of a woman, a child and requires urgent medical intervention, otherwise this complication can be fatal if the tube ruptures without treatment. Percentage of the frequency of manifestation ectopic pregnancy accounts for only 2%, but almost all of them develop an embryo inside the fallopian tube. The reasons may be:

• Hormonal failures or lack of any hormones;
• Tumors of the uterus or its appendages;
• The genital organs do not develop properly;
• Surgical operations that take place in the abdominal cavity;
• Violations in the transport function of the fallopian tube.

The first signs of fetal development inside the ectopic tube: drowsiness, nausea, weakness, pain in the lower abdomen, spotting.

The definition of the development of an ectopic pregnancy occurs before 4-6 weeks of the term, otherwise it can lead to a bad end.

To eliminate this complication, the WB performs an operation in which the fetal egg located inside the ectopic tube is eliminated, and if the tube ruptures, then it is removed. A false fetal egg in the uterus can serve as an indirect sign of an ectopic pregnancy, this is clearly visible if the so-called false fetal egg in size less than normal. A false fetal egg in the uterus simulates uterine pregnancy while another fertilized egg may begin to develop inside the fallopian tube or inside the cervix, contributing to an ectopic pregnancy. A false fetal egg is an accumulation of blood inside the uterus or an accumulation of the secretion of tubular glands.

Signs of pathology

Now let's figure out what can cause the development of anembryony. The causes of anembryony are not completely known: pregnancy without an embryo or a fetal egg without an embryo, but there are some conditions that can lead to the death of an embryo in its early stages of development.

For example, bad habits lead to anembryony: nicotine addiction, too frequent use alcohol, drug addiction and substance abuse. Harmful substances enter the fetus and have a detrimental effect on it, as a result of which the embryo may stop growing.

Genetic abnormalities can also serve as the cause of this pathology: initial violations during fertilization affect the development of the embryo in the initial stages.

Also, the cause of this pathology can be the fertilization of the egg by the sperm of a blood relative. Another reason is hormonal disorders: there is a lack or, conversely, an excess of any hormones in a woman.

Diagnosis "absence of an embryo in the fetal egg": signs of pathology. The absence of an embryo inside the fetal egg may in no way affect the external and internal sensations of a woman either in the first week or in subsequent ones. A woman may experience nausea, desire to eat something special, and other signs of pregnancy without feeling any discomfort. Therefore, a woman may be completely unaware of the diagnosis of anembryonia, without feeling. But some of the fair sex may feel unwell, excluding signs of pregnancy: pain in the lower abdomen, red discharge or discharge may be observed, which indicates anembryony. This happens because the body begins to reject an empty fetal egg or an egg with an embryo, which will not be able to develop and live in the future.

If a woman is concerned about the above symptoms, then you need to see a doctor and explain everything to him. An ultrasound examination is performed, in which the doctor observes the absence of the embryo or the suspension of its development. And in the absence of symptoms in a woman, she learns about anembryony at the next examination. ultrasonic device when the doctor notices a discrepancy between the development of the fetal egg and the embryo.

Methods of treatment

With such a pathology: pregnancy without an embryo - anembryony, medical intervention is necessary. There are two ways to treat this pathology:

• Medication treatment. This pathology treatment can be offered if the woman is in position for no more than 6 weeks. This method is a medical abortion and happens like this: for this you need to drink the necessary medicine under the supervision of a doctor and wait until the contents of the uterus begin to be rejected and come out. After that, the woman will have to stay under the supervision of a doctor in the hospital for several days, until the bleeding finally ends. To complete the treatment, the doctor conducts an ultrasound examination and determines the purity of the uterine cavity;
• Surgical intervention. This method is chosen by doctors more often, since it allows you to thoroughly clean the uterus from an empty fetus, without giving rise to the development of any complications, and the operation can be performed at any week of pregnancy. At the time of this operation, the woman is put into a state of deep sleep and does not feel any pain. The operation itself can last for 5-20 minutes. The operation is as follows: an empty fetal egg is cleaned from the uterine cavity by a gynecologist using special tools. In this case, the woman does not need to stay in the hospital, and after a few hours she can leave it. After the operation, the woman will be disturbed only by small spotting, after which she needs to visit an ultrasound room and make sure that there are no remnants of the fetal egg in the uterine cavity.

To find out the causes of this pathology, the doctor sends the material obtained after the operation for histological examination. During the course of the study, they find out such questions: was the embryo in the fetal egg or at what time did it stop developing, and what was the reason.

For recovery, a woman is prescribed anti-inflammatory and antibacterial drugs. Reception is also required sedatives, because the loss of a child, despite the term, is always the strongest stress for any woman. If a woman wants to try to get pregnant again, then it is recommended to do this no earlier than six months after the operation, and it is necessary to eliminate the causes that caused the development of the embryo to stop.

In this position, you should be attentive to your lifestyle, habits and especially well-being. You need to find out about all the possible causes of ah that can lead to this pathology or to any other pathology in order to prevent the development of false, ectopic and other types of pregnancy. And in case of any discomfort, contact a specialist.

Expecting a baby is one of the most beautiful periods in a woman's life, but, unfortunately, it does not always go without problems. There are times when the diagnosis of doctors is disappointing - "a fetal egg without an embryo." Why does this happen and how can you determine that the pregnancy has stopped?

What does "egg without embryo" mean?

Anembryonic, or frozen, pregnancy is a diagnosis confirming that the fetal egg develops without an embryo. As a rule, this fact is detected during the ultrasound procedure at 5-6 weeks after conception. By this time, it becomes obvious that there was no germ in the egg at all, or that, having turned out to be unviable, he had already died.

Important! If the gestational age was set erroneously, the diagnosis may be false. To confirm or refute anembryony, the examination is repeated after 2 weeks, since the ultrasound machine simply does not see the tiny future baby.

A frozen pregnancy is not a threat to a woman's health and in most cases does not have serious consequences. If the diagnosis is confirmed, gestation is interrupted, and young parents are advised to undergo a course of special treatment. Of course, anembryony is a lot of stress, but you should not get depressed. Subject to all the prescriptions of the doctor, the next pregnancy may well be successful.

Possible reasons

Most often, such a phenomenon as a fetal egg without an early embryo is due to genetic changes in the fetus at the initial stage of its formation. However, there are other reasons:

• frequent stress, conflicts with loved ones or tragic events in the life of a pregnant woman;
• hormonal imbalance;
• smoking, drinking alcohol, stimulants or drugs;
• viral diseases accompanied by high fever;
• exposure to poisons or aggressive chemicals on the body of the expectant mother;
• high loads in early pregnancy.

Quite often, female athletes who regularly train and test their body for strength are diagnosed with an ultrasound scan of a fetal egg without an embryo. The reasons for this are clear: high physical activity is contraindicated for any woman throughout pregnancy, and neglect of this rule is fraught with her breakdown.

Diagnosis of anembryony

It is very difficult to detect signs of a frozen pregnancy on your own. As a rule, it proceeds in the same way as normal. A woman has no menstruation, the mammary glands increase in size and hurt, symptoms of toxicosis appear.

Important! The only indicator of anembryonic pregnancy that can be seen in the early stages is low level hCG hormone.

Many women are concerned about whether a fertilized egg can grow without an embryo and why they feel "totally pregnant." This pathology does not exclude the fact that an empty fetal egg will increase in size, but such a pregnancy must be interrupted in any case.

In some cases, the female body itself understands that the embryo is absent in the egg, and starts the natural process of its rejection. This is usually accompanied by sharp or aching pain in the pelvic area and odorless bloody discharge.

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In the presence of similar symptoms you should immediately consult a doctor - only he can confirm or refute the diagnosis. It can be reliably established that there is no embryo in the fetal egg, it is possible only after examination on the gynecologist's chair and an ultrasound procedure.

Treatment Methods

There are two methods to correct the pathology.

• Medical abortion. Under the supervision of the attending physician, the woman takes a special medicine, after which the contents of the uterus are rejected, and it comes out. You need to be under the supervision of a doctor for several days until the bleeding process is completely completed.
• Abortion surgically. This method is preferable in most cases, as it allows you to completely remove the top layer of uterine tissue along with an empty ovum. The procedure is performed under anesthesia, and as soon as the woman's health stabilizes, she is allowed to go home.

4-5 days after the termination of pregnancy, it is necessary to undergo an examination by a gynecologist and ultrasound to make sure that no particles of the pathological fetal egg remain in the uterine cavity.

If anembryony is diagnosed in a woman for the first time, there is no reason for undue concern. Statistics confirm that due to spontaneous chromosomal mutations occurring in the process of fusion of the sperm with the egg, every eighth pregnancy freezes. And this is absolutely not the fault of future parents.

Unfortunately, not all pregnancies end in childbearing. Reproductive losses in this case can be due to various reasons. And one of them is a non-developing or missed pregnancy. According to medical statistics, this pathology accounts for up to 15-20% of reproductive losses.

Currently, there are 2 options for a missed pregnancy: embryonic death and anembryony. It is important to understand that differential diagnosis between them does not affect the subsequent treatment tactics, but is taken into account when assessing the prognosis. Anembryony is more often determined, and this condition in many cases is not accompanied by spontaneous abortion and therefore requires artificial interruption frozen pregnancy.

Anembryony - what is it and why does it develop?

Anembryony is the absence of an embryo in a developing fetal egg. This condition is also called the empty gestational sac syndrome. This is by no means a rare pathology that can be diagnosed in primigravida and in women who already have healthy children.

There are currently quite a few possible causes anembryonia. These include:

• Genetic anomalies, which are noted in almost 80% of the pathological condition. They are usually associated with gross and/or multiple chromosomal abnormalities. Moreover, with anembryony, such anomalies are of a qualitative nature, and with the death of the embryo and its abortion, they are predominantly quantitative. Unviable combinations of parental genes or mutations in key areas responsible for the early stages of embryogenesis and the synthesis of the main structural proteins of cell membranes are also possible.
• Some acute viral and bacterial diseases occurring in the early stages of gestation and leading to damage to embryonic tissues or trophoblast. The most dangerous in this regard, although other pathogens can be embryotropic.
• Persistent viral and bacterial infections of the reproductive system, leading to development. And in most cases, such a pathology occurs without obvious clinical symptoms and is detected after a frozen pregnancy.
• Radiation exposure to the developing embryo.
• Exogenous intoxications: taking drugs with an embryotoxic effect, drug addiction, exposure to certain industrial and agricultural poisons (toxins).
• Endocrine disorders in a pregnant woman. And the most critical is the deficiency of progesterone and disorders of its metabolism, which is the main cause of the pathology of endometrial decidualization and abnormal implantation of the fetal egg.

In general, the causes of pathology in most cases remain undiagnosed. Usually it is possible to determine only a presumptive etiology.

Genetic diagnostics of aborted tissues can reveal obvious anomalies of hereditary material. But such a study, unfortunately, is carried out in a very small percentage of cases. It is mainly indicated for aggravated obstetric history in a woman, when in the past she already had frozen or spontaneously interrupted in the early stages of gestation. But even such diagnostics is not always informative enough, which is associated with the limited capabilities of modern genetics and high probability influence of other etiological factors.

Pathogenesis

Anembryony is a consequence of the cessation of reproduction and differentiation of the embryoblast or inner cell mass - a group of cells that normally give rise to fetal tissues. And this happens at the earliest stages of pregnancy (usually at 2-4 weeks of gestation), and without disturbing the development of the fetal membranes from the trophoblast. As a result, a so-called empty fetal egg is formed, which continues to grow even in the absence of an embryo in it.

The pathogenetically important factors in the development of the disease include:

• Inherited or acquired chromosomal aberrations and other genetic abnormalities. They can lead to a gross desynchronization of the development of embryonic tissues, critical changes in the structure of collagen and other proteins, disruption of the induction of differentiation and migration of dividing cells. The most common autosomal trisomy, monosomy, triploidy, tetraploidy.
• Excess formation in the body of a woman of circulating immune complexes. Their deposition in the walls small vessels leads to thromboembolism and other critical microcirculation disorders in the area of ​​the implanting egg. Antiphospholipid antibodies are of the greatest clinical importance.
• Excessive activation of T-helper cells with an increase in the concentration and aggression of the cytokines secreted by them. These substances are able to have a direct and indirect damaging effect on embryonic tissues with a violation of their proliferation and differentiation. In fact, the fetal egg in this case acts as a target for the cellular link of immunity. The reason for such an abnormal immune response of a woman's body may be a chronic infection of the endometrium, hormonal abnormalities, and some other endogenous factors.

It is important to understand that with anembryony, a woman's body produces substances that help prolong pregnancy. Therefore, in a significant proportion of cases, spontaneous abortion does not occur. The patient develops and maintains signs of pregnancy, there is an increase in hCG in the blood serum. Therefore, the basal temperature during anembryony usually does not have characteristic features. And the fact of successful implantation of the fetal egg in the uterine cavity is confirmed. After all, pregnancy does occur, but it develops without a key component - the embryo.

Subsequently, rejection of the abnormal fetal egg is possible. In this case, the threat of termination of pregnancy (including with the formation of exfoliating retrochorial hematomas) or spontaneous abortion (miscarriage) can be diagnosed. But often anembryony is diagnosed only during a routine examination, in which case the diagnosis is absolutely unexpected and shocking news. Such a pregnancy requires an artificial interruption.

How does it manifest itself?

Anembryony does not have its own clinical symptoms, all emerging violations are usually associated with the threat of interruption of such abnormal pregnancy. And the warning signs include the presence of clinical manifestations of relative progesterone deficiency, which creates the prerequisites for spontaneous abortion. Therefore, pain in the lower abdomen and bloody discharge can become a reason for contacting a doctor; with anembryony, they can appear at almost any time during the 1st trimester.

But often a woman learns about the existing pathology only when conducting a screening ultrasound for a period of 10-14 weeks.

Diagnostics

Like other forms of missed pregnancy, anembryonia is detected in the first trimester of gestation. And it is the main diagnostic tool, because it is this study that allows you to visualize the existing deviations.

At the same time, symptoms can be reliably detected only after the 8th week of gestation. At earlier stages, visualization is often insufficient due to the too small size of the ovum, so that an erroneous diagnosis is not ruled out. Therefore, if a missed pregnancy and anembryony are suspected, it is recommended to conduct an examination several times, repeating the procedure on expert-class equipment with an interval of 6-8 days. At the same time, the initial diagnosis of an empty fetal egg can be removed if, on subsequent ultrasound scans, it is possible to visualize the embryo with signs of a heartbeat and sufficient developmental dynamics.

The main echographic features:

• absence yolk sac with a diameter of the fetal egg 8-25mm;
• the absence of an embryo in a fetal egg with a diameter of more than 25 mm.

TO additional features include the irregular shape of the fetal egg, insufficient increase in its diameter in dynamics, weak severity of the decidual reaction, the absence of a heartbeat at a gestational age of 7 or more weeks. And signs of the threat of its interruption are a change in the tone of the uterus and the appearance of areas of chorion detachment with the appearance of subchorial hematomas.

Anembryony can also be suspected with a dynamic assessment of the level of hCG in the blood. An increase in the level of this hormone along the lower limit of the norm should be the basis for further examination of a woman with an ultrasound scan. It is important to understand that hCG is also produced in the syndrome of an empty ovum. Moreover, its level in this pathology will be almost normal, in contrast to a frozen pregnancy with the death of a normally developing embryo. Therefore tracking indirect signs pregnancy and the growth of hCG during anembryony cannot be attributed to reliable methods diagnostics.

Varieties

There are several options for the syndrome of an empty fetal egg:

• Anembryonic type I. The embryo and its remains are not visualized, the size of the fetal egg and uterus do not correspond to the expected gestational age. The diameter of the egg is usually no more than 2.5 mm, and the uterus is enlarged only up to 5-7 weeks of gestation.
• Anembryony type II. There is no embryo, but the fetal egg and uterus correspond to the gestational age.
• Resorption of one or more embryos at. At the same time, normally developing and regressing fetal eggs are visualized. According to this type, anembryony often occurs after IVF, if several embryos were implanted in a woman.

All these varieties are determined only with the help of ultrasound, they do not have characteristic clinical features.

What to do?

Confirmed anembryony is an indication for artificial termination of pregnancy. This does not take into account the gestational age, the woman's well-being and the presence of signs of a possible spontaneous abortion. An exception is the situation when anembryony of the second fetal egg is diagnosed during multiple pregnancy. In this case, a wait-and-see strategy is taken, evaluating the dynamics of the development of the preserved embryo.

Termination of a missed pregnancy is carried out only in a hospital. After the procedure for the evacuation of the fetal egg, the woman should be under medical supervision. In many cases, after it, additional medication and sometimes physiotherapy are prescribed, aimed at normalizing the hormonal background, preventing inflammatory and hemorrhagic complications, and eliminating the detected infection.

To conduct a medical abortion in this pathology, it is possible to use several methods, the choice depends on the technical equipment of the medical institution and the gestational age. Can be used:

• medical abortion - termination of pregnancy with the help of hormonal drugs that provoke rejection of the endometrium along with an implanted fetal egg;
• vacuum aspiration of the contents of the uterine cavity;
• curettage is an operation involving the mechanical removal of the ovum and endometrium with a special instrument (curette) after the forced expansion of the cervical canal with bougie.

Medical abortion with anembryony is possible only for a period of 6-8 weeks. In later periods of gestation, preference is given to mechanical methods, which requires the use of general anesthesia. The choice of the method of artificial abortion depends on whether the stomach hurts after an abortion, the length of the rehabilitation period, the likelihood of early and late complications.

Examination after induced abortion necessarily includes ultrasound control. This allows you to confirm the complete evacuation of the membranes and endometrium, to exclude undesirable consequences of abortion in the form, perforation, etc.

Forecast

Can anembryony recur? Can I still have children? These questions concern all patients who have undergone this pathology. Fortunately, in most cases, the condition does not recur, the woman subsequently manages to safely become pregnant and bear the child. But at the same time, she is classified as a risk group for the possible development of complications of pregnancy and childbirth. Therefore, in the first trimester, she is usually assigned dynamic ultrasound control of the development of the fetal egg, determination of the hormonal profile and assessment of the state of the hemostasis system.

Pregnancy after anembryony is theoretically possible already in the next ovarian-menstrual cycle. But it is desirable to allow the body to recover. Therefore, planning for re-conception is recommended to start no earlier than 3 months after the induced abortion. If it proceeded with complications, the rehabilitation period, while maintaining reproductive rest, is extended for up to six months. If a woman has chronic endometritis and various infections, 2 months after the completion of treatment, a control examination is carried out and only then is determined possible dates re-conception.

To prevent pregnancy, preference is given to the barrier method and hormonal contraception. The choice of means is carried out individually. Intrauterine devices immediately after a frozen pregnancy are not used in order to avoid the development of endometritis.

Prevention

Primary prevention of anembryonia includes careful planning of pregnancy with a comprehensive examination. If deviations are found, they are corrected. Of course, such preparation does not allow 100% to exclude the possibility of pathology, but reduces the risk of its development.

Secondary prevention is carried out if a woman has a history of spontaneous abortion and anembryony. The first pregnancy with empty ovum syndrome is a reason for a subsequent examination of a woman for infections and hemostasis disorders. When the situation repeats, a genetic examination of the spouses is also shown to exclude anomalies in their hereditary material. In some cases, subsequent conception is preferably carried out using IVF, which will allow the use of preimplantation diagnosis to detect chromosomal abnormalities in embryos.

Anembryony is diagnosed quite often. And, unfortunately, at present it is not yet possible to completely exclude such a pathology already at the stage of pregnancy planning. After all, it can develop even in completely healthy and examined patients. At the same time, a missed missed pregnancy does not mean the impossibility of a repeated successful conception; most women after anembryony manage to safely give birth to a healthy child.