How to determine that a pregnancy is developing. Why does pregnancy freeze? Why pregnancy freezes

Many pregnant women begin to feel their connection with the unborn child only after they feel the movements of the fetus - at first subtle, and then more insistent. How to decipher these signals, we asked the expert.

About what the baby is doing in the womb, says the head of the Moscow Center for Perinatal Diagnostics at the maternity hospital No. 27, obstetrician-gynecologist Elena Vladimirovna Yudina.

The laws of intrauterine life are not fully understood ...

Moves or it seemed?

The fetus begins to move in the mother's womb while still an embryo, almost from the moment of conception. He rolls over and somersaults almost continuously, but the expectant mother does not feel movement until his muscles are thin and weak. When their size and strength increase, a woman begins to feel a barely audible and gentle thrill inside herself. For the first time, the fetus makes itself felt at various stages of pregnancy. It depends on the condition and physiological characteristics of the expectant mother. Women who are expecting their first child may feel fetal movements in 20-22 weeks pregnant. Those who have already given birth can feel it earlier - from 16 weeks. The muscles of the uterus are more strongly stretched, and the movements of the fetus are heard more clearly.

Baby, how are you?

Studies have shown that in utero, the baby reacts to external sounds and the brightness of light. Their strength affects the intensity of his movements. It is also known that his activity is affected by both the mental and physical state of the mother. The state of wakefulness and rest can change in the fetus during each hour. This happens in accordance with the physiological rhythms of its intrauterine development, which are different for everyone. Some children may be more mobile in their mother's belly, others may behave more calmly. Their intrauterine life follows its own laws, which have not yet been fully studied.

Babies, even in their mother's womb, have days of special activity and periods when they want to relax and behave calmly. Sometimes fetal movements can be caused by the touch of the body on the inner wall of the fetal membrane, from which it moves away. Perhaps not enough oxygen is supplied to him with blood through the umbilical cord. When he moves, her position changes, blood flow increases and oxygen supply increases.

The fetus makes respiratory movements, sighs, sometimes hiccups. At times, the expectant mother feels stomach cramps from his hiccups. In the fetus, as in a newborn child, this does not cause any particular inconvenience. With some babies, this happens daily, or even several times a day, while others do not hiccup at all.

The number of fetal movements with the development of pregnancy becomes more and more. Rhythmic beats in some cases become regular and are repeated at a constant interval, while in others the fetus pushes spontaneously and in various ways. The great activity of the fetus in the mother's womb does not at all mean that after birth it will be more restless than those babies whose movements were less intense.

Test D. Pearson "Count to ten"

On a special map, the number of fetal movements is noted daily from 28 weeks. The count starts at 9:00 and ends at 21:00. A small number of movements (less than 10 per day) may indicate fetal oxygen deficiency and is a reason to see a doctor.

Periods of special activity

If a pregnant woman leads an active lifestyle, the child calms down with the rhythm of her movements and she does not feel his jolts. As soon as she lies down to rest, the baby begins to kick and push. Therefore, some expectant mothers hear the baby's movements more often at night than during the day.
Sometimes the strength of the pushes increases after the mother eats. The food she eats adds energy to the fetus.
The intensity of stirring also increases from the release of hormones into the blood when the expectant mother gets nervous.

After 28 weeks Pregnancy fetal movements are already well distinguishable. It develops, grows and grows stronger, and its movements become more and more tangible. You can already clearly understand when he is resting and when he is awake. As long as the baby is spacious enough in the uterus, he is constantly spinning and kicking. Sometimes it hurts a pregnant woman.

In order for the child to calm down, it is sometimes enough for her to change the position of her body or take a few deep breaths.

By 34 weeks During pregnancy, the fetus in the uterus takes the final position from which it will be born. He has already grown so much that it becomes cramped there - it is already difficult to roll over and spin. In women who have given birth, the fetus sometimes changes its position even after this period. The activity of the fetus before childbirth decreases slightly, but even then it does not stop its movements. In late pregnancy, the fetus often sleeps at the same time as the mother.

All the feelings of a future mother who listens to the movement of her child are very subjective, and you should not attach importance to the observations of other pregnant women and compare them with your own. Each fetus in the mother's womb, like any person, has its own individuality, temperament and develops in its own way. If something worries you, consult with the doctor who is leading the pregnancy!

Prepared according to the materials of the journal.

Text: Nadezhda Smirnova

A frequent fear that haunts expectant mothers in the early stages of pregnancy is that they are afraid to detect the death of an embryo during one of their ultrasound trips. Sometimes this anxiety becomes so obsessive that the expectant mother is ready to literally live next to the ultrasound machine and be constantly confident in the successful development of the child.

But a missed pregnancy has certain symptoms that can be noticed if you carefully monitor the general condition of your body.

It is conditionally possible to divide these signs into 2 groups: the first includes those that a pregnant woman can observe on her own, and the second - those observed with the help of special studies and not visible to the naked eye.

Symptoms of a missed pregnancy in the first trimester

It is possible to determine that the fetal egg has died by observing the nature of the discharge from the genital tract, general well-being, toxicosis, and also the behavior of the basal temperature graph. These will be only indirect symptoms of a missed pregnancy in the early stages, but their presence will serve as a signal to see a doctor and conduct more thorough research.

Allocations

Despite the fact that the embryo dies, for some time the fetal egg is in the uterus. If the miscarriage did not occur in the first hours, then the body will get rid of the fetus gradually.

In the first 1-2 days after the onset of regression in the development of the fetus, the discharge has the usual whitish color and the usual consistency.
Over the next few days, the embryo begins to decompose. These processes affect the fetal egg, which begins to gradually exfoliate from the wall of the uterus, where it was previously implanted. Reddish streaks may appear in the discharge.
After 2 weeks from the moment of the death of the embryo, the detachment of the fetal egg is more obvious. The discharge becomes bloody, acquires a red-brown color.

As a rule, when blood appears, a woman turns to a gynecologist who diagnoses a lost pregnancy. But this symptom does not necessarily mean that the embryo has stopped developing. Perhaps he is alive, and the detachment began for completely different reasons.

Toxicosis

If nausea began from the first weeks of pregnancy, then by changing its frequency and intensity, one can judge that not everything is in order with the embryo. begins to appear after the implantation of a fertilized egg in the uterus, so an increase in the concentration of the hCG hormone in the blood causes nausea and vomiting to increase.

On the first day after the embryo died, nausea can manifest itself in the same way as while the pregnancy was developing.
Over the next day, the level of hCG begins to decrease, so if the expectant mother had vomiting, then it can turn into a slight feeling of nausea.
After 4-5 days, toxicosis disappears.
Another option for changing the manifestations of intoxication may be the sudden cessation of vomiting and nausea.

It must be remembered that a decrease in the number of vomiting may be a sign of the natural cessation of toxicosis due to the mother's body getting used to the presence of pregnancy.

General well-being

A decaying fetal egg that has not left the uterus will contribute to a deterioration in overall health over time. However, this symptom appears when the deceased pregnancy is in the mother's body for a long time.

Weakness, dizziness and pulling sensations in the lower abdomen appear about 3 weeks after the embryo dies.
Sharp pains in the uterus and a slight increase to 37.7 appear 4 weeks after the death of the embryo.
High fever and cramping pain in the uterus, accompanied by general weakness and loss of consciousness are observed 5 weeks after the death of the embryo.

A long stay of a decaying fetal egg in a woman's body is fraught with severe inflammation, which can develop into sepsis. Therefore, special attention should be paid to other signs of a missed pregnancy in the early stages of pregnancy in order to carry out curettage of the uterine cavity in time.

Changes in the BT schedule

Many women continue to monitor their basal temperature daily even after pregnancy. This will be another opportunity to notice the first signs of fetal death in time, moreover, the temperature will react faster than all other symptoms.

In two days, the BT line on the chart will start moving down. Normally, the thermometer should show a temperature of at least 37 degrees. However, approximately 48 hours after the termination of the life of the embryo, it will drop to values of 36.9 - 36.8.
After 4 days, the temperature will drop to 36.7 degrees and will stay at this value for several more days.
Further, the process of decomposition of the fetal egg will enter a more active phase, and BT will react to the occurrence of an inflammatory process in the organs of the small pelvis with a sharp rise.

However, in some cases, the cessation of embryo development is not reflected in the indicators of basal temperature. Then the pregnant woman should rely on a number of the above symptoms.

Signs of a missed pregnancy in the early stages (I trimester)

The signs of fetal death are determined by the doctor, based on the results of the studies. As a rule, a woman seeks help in the presence of pain and spotting scanty (or profuse) spotting, or a dead pregnancy is discovered by chance during an ultrasound scan. In addition to the hardware study, the pregnant woman will have to take a blood test to determine the concentration of hCG.

Ultrasound indicators

The heartbeat of the embryo is not determined. Normally, it is noticeable on ultrasound, starting from the 5th week of pregnancy.
The fertilized egg does not have a diameter of such dimensions that the gestational age suggests.
The size of the embryo in the fetal egg does not correspond to the gestational age.
If the period is up to 4 weeks, then a sign of the death of the fetal egg is deformation.
The embryo is not visualized for a period of 6-7 weeks.

HCG indicators

The concentration of hCG is below the gestational age, set on ultrasound or during a gynecological examination.
For several days, there is a persistent decrease in the hormone hCG in the blood.
The level of hCG rises, but very weakly and far behind the norm, determined by the gestational age.

In order to accurately establish the presence of a frozen pregnancy in the first trimester, the signs found on ultrasound and according to the results of hCG are considered in conjunction with each other.

Symptoms of a missed pregnancy in the II and III trimesters

With an increase in the gestational age, the child makes itself felt more and more clearly, therefore, in the event of his death in the second trimester, the signs of a missed pregnancy will be equally noticeable both at 16 weeks and at 18 weeks. The same can be said about the third trimester.

Since the symptoms of fetal death in both trimesters have much in common, you can combine them into a single list:

Sudden cessation of movement for several days.
The appearance of pulling pains in the lower back.
The appearance of bleeding.
Isolation from the genital tract of amniotic fluid that has an unpleasant odor.

Unlike the first trimester, in the long term of pregnancy, the woman's body independently gets rid of an undeveloped pregnancy rather quickly - within a few days.

Factors that provoke the death of the embryo

Frozen pregnancy is not unreasonable. It can occur due to genetic failure, hormonal disorders, infectious diseases, or due to autoimmune problems. Doctors identify two factors that cause the development of the embryo to stop:

Factors that contribute to the development of a potentially defective embryo (genetic mutation).
Factors that create conditions that are unfavorable for the development of the embryo (hormonal disorders, infections, autoimmune problems)

The vast majority of pregnancies that fail before 8 weeks die due to the genetic mutation factor. They may be spontaneous or may be hereditary.

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

The actions of a woman should depend on how the non-developing pregnancy was established. It happens that doctors make mistakes in the diagnosis, so before you go for curettage, you need to double-check the conclusions of doctors.

Diagnosis during gynecological examination

The size of the uterus may not match the gestational age, which the doctor calculated based on the date of the start of the most recent menstruation. If at the same time bloody spotting comes from the genital tract, then the specialist can conclude that the embryo has regressed in development and the fetal egg has begun to decompose.

It often happens that the period determined by the gynecologist differs from the actual gestational age by 2, and sometimes by 3 weeks. Bloody discharge can go for completely different reasons, for example, the fetal egg began to exfoliate with a live embryo.

Therefore, if a frozen pregnancy is diagnosed only with the help of a gynecological examination, then it is better to double-check the doctor's conclusions by visiting an ultrasound room.

Diagnosis with ultrasound

Signs of a missed pregnancy, for example, at 8 or 10 weeks, are clearly defined during the first ultrasound procedure. But if the period is still small, and does not exceed 5 weeks, then even hardware diagnostics can make a mistake: do not visualize the embryo or not notice its heartbeat.

Therefore, in the short term, when determining a lost pregnancy, ultrasound cannot be completely trusted. In this case, you should come back in a week and make a new attempt to identify the presence of the vital activity of the embryo.

Diagnosis with HCG

The results of the blood test may not coincide with the expected gestational age. But if the blood sampling for hCG was single, then in determining the death of the fetus, it is not informative.

Only a second test, made a few days after the first, is able to answer the question about the viability of the fetal egg. There will be even more accuracy if the results of hCG are correlated with the results of ultrasound.

What to do if a missed pregnancy is detected?

If the child was desired, then his death at any stage of pregnancy will be a tragedy for the mother. But from the moment the doctors suspect the death of the fetus, a certain scheme of actions must be followed:

You need to make sure that the pregnancy is really dead. To do this, you need to follow the results of the analysis of hCG in dynamics.
If the embryo died recently, then you can apply expectant tactics - perhaps the body itself will reject the fetal egg. But this should be done only after consulting a doctor who will carefully assess all the risks.
If the embryo died a long time ago, the doctor will prescribe a curettage of the uterus, which is performed in a hospital under general anesthesia.

It is necessary to get rid of a frozen pregnancy only under the supervision of medical specialists. In no case should you self-medicate and try to induce uterine contractions at home with the help of herbal preparations.

Firstly, you can miss the time and the fetal egg decomposing in the uterine cavity will cause serious harm to the woman's body.

And secondly, inept actions create the risk of a partial exit of the embryo from the uterus. The remains of the membranes may still be in the body of a woman, contributing to the onset of the inflammatory process.

In addition, self-treatment of a missed pregnancy can provoke severe bleeding, to stop which you will have to go to the hospital.

” №8/2014 02.06.16

Of course, all expectant mothers are looking forward to the first movements of the fetus. Many women from this moment are truly aware of the fact of their pregnancy. At this stage, many questions arise regarding the activity of the fetus in the mother's tummy. We will answer the most popular ones.

1. The baby starts to move before you feel it.

The fetus begins to make the first movements early, already at 7-8 weeks of pregnancy. It was at this time that his first muscles and rudiments were formed. nervous system. From about 10 weeks of pregnancy, the baby begins to move more actively in the uterus, sometimes bumping into its walls. However, it is still very small, and these blows are very weak, so the expectant mother cannot yet feel them.

2. “Like a fish swam”: during the first pregnancy, fetal movements are felt later

The first movements of the fetus will be soft and as if tickling - as if a fish swam. The expectant mother will be able to feel tangible shocks a little later. If the pregnancy is the first, the first movements of the fetus can be noticed at a period of 18-20 weeks, and with a second pregnancy - at 16-18 weeks (the woman is already familiar with this feeling, she more accurately and earlier determines the movement of the fetus).

In general, the manifestation of the first movements of the fetus is very individual and depends on how sensitive the expectant mother is, as well as on her physique. For example, thin women may feel fetal movements earlier - even at 15-16 weeks, and larger mothers - sometimes after 20 weeks.

Women who lead an active lifestyle, work a lot, usually feel the movements of the fetus later, since with high employment they usually listen less to their inner feelings.

3. From the 24th week, the fetus already “communicates” with the mother with the help of movements

Fetal movements are an indicator of a normal pregnancy, good growth, development and well-being of the baby. At first, when the expectant mother only felt the first movements of the fetus (18–20 weeks), movements may not even be felt every day. From 24 weeks of pregnancy, the expectant mother already feels how the fetus changes position, moves its arms and legs. The motor activity of the fetus increases gradually, and its peak falls on the period from the 24th to the 32nd week of pregnancy. At this time, she becomes one of the indicators of the normal development of the baby, the child begins to "communicate" with his mother with the help of movements, respond to the sounds of her voice and emotional state. From the moment of “his growing up”, when the baby began to actively move, he “talks” to his mother, thereby informing her about his anxiety, joy, pleasure or his well-being.

In turn, the fetus is very sensitive to changes in the emotional state of the expectant mother. For example, when she is excited, worried about something or rejoices, the baby may move more actively or, conversely, calm down for a while. Fetal movements can vary in number and intensity even during the day. And this is normal.

4. If there is no movement, the baby can just sleep

Starting from the 24th week of pregnancy, the baby should move on average 10-15 times per hour. If the baby does not make itself felt within 3-4 hours, it is possible that he is just sleeping. In this case, the expectant mother needs to eat something sweet and lie down on her left side for half an hour. If these simple steps do not help, it is worth repeating them again after 2-3 hours. If the baby still does not make itself felt, this is an occasion to consult a doctor.

After 32 weeks of pregnancy, the number of fetal movements gradually decreases due to the fact that the baby is growing up, and he simply does not have enough free space. But their intensity and strength remain the same or increase. This becomes especially noticeable at the time of childbirth.

Seek immediate medical attention if:

there is no motor activity of the fetus for 12 hours or more,
the fetus was overly active for several days, and then abruptly subsided,
you notice only rare and weak fetal movements (this may be caused by a lack of oxygen - fetal hypoxia).

5. How to count fetal movements? 2 special tests

It is recommended that every expectant mother count the number of fetal movements, especially in the third trimester of pregnancy (after the 28th week) - there should be at least ten of them during the day. There are 2 fetal movement tests to assess fetal activity

"Count to ten". On a special card (you can get it from your doctor or he will tell you how to make it), the number of fetal movements is noted daily, usually from 28 weeks of pregnancy. The essence of the test of fetal movements is that the expectant mother counts the movements of the fetus for 12 hours, for example, from 9 am to 9 pm. If the fetus makes less than 10 movements per period, this is a reason to consult a doctor for an examination.

There is another way to count fetal movements - Sadowski technique. They spend it like this: in the evening after dinner, the woman lies on her left side and counts the movements of the fetus. In this case, it is necessary to take into account all, even the smallest movements of the fetus. If 10 or more fetal movements are noted within an hour, this indicates that the baby feels good. If the fetus moved less than 10 times in an hour, then its movements are counted for the next hour. Evening time for this assessment method was not chosen by chance. It is in the evening, especially after dinner and the associated increase in glucose, that the greatest activity of the fetus is noted. If the number of fetal movements is less than 10 times in 2 hours, this should be considered as a sign of a violation of his condition and additional studies should be carried out.

6. Fetal movements can be a little painful.

Sometimes the movements of the baby cause pain to the expectant mother. In this case, she needs to change the position of the body (lie down on the other side, walk, etc.). After that, the discomfort should pass. If for a long time, for several hours, fetal movements remain painful, the expectant mother should definitely inform the doctor about this, as this may be a sign of problems during pregnancy (for example, with oligohydramnios). In addition, most expectant mothers note some soreness in the hypochondrium, especially in the third trimester of pregnancy - and this is not a deviation from the norm, since the uterus has risen high enough for the baby to “get” already in these areas.

7. Nimble baby: why are the fetal movements too active?

The baby can move too actively, as already mentioned, when the emotional state of the future mother changes, in addition, he can react to external noise in this way (from about the 20th week of pregnancy, when the hearing aid was formed and the bones in it began to ossify in order to conduct sound ). Therefore, if the expectant mother comes to an apartment that is being renovated, or watches a movie with strong sound effects in a cinema, she will most likely feel quite frequent tremors in her tummy.

8. What is the oxygen starvation of the fetus?

There is a widespread belief that the increased activity of the fetus is a sign of its oxygen starvation, but this is not always the case. Indeed, in the initial stages of fetal hypoxia, the baby's restless behavior is noted, which consists in the increase and intensification of his movements. However, with a prolonged or increasing lack of oxygen, the movements of the little man weaken, and may even stop altogether. Therefore, rare (less than 10 per day), weak fetal movements (especially after 30 weeks) or increased activity after a “calm period” should cause alarm, which requires urgent consultation with a doctor. If the doctor suspects something is wrong, he will send the expectant mother for an ultrasound or CTG (cardiotocography), with which you can figure out why the baby is behaving this way. And if necessary, the doctor will prescribe treatment to normalize the condition of the fetus.

It is very important to listen to the sensations in your tummy and notice how often and intensively the baby moves. Then you can feel the changes in the nature of his movements and consult a doctor in time to make sure that everything is in order with the baby.

9. The little "cosmonaut" is always on the move

At the 20th week of pregnancy, the fetus makes about 200 movements per day, and between the 28th and 32nd weeks their daily number reaches 600. Naturally, the expectant mother does not feel all the movements of the baby, but only a small part of them. So, after 28 weeks, the frequency of fetal movement, according to the sensations of a woman, is usually 4 to 8 times per hour, with the exception of periods of his sleep (3-4 hours in a row). In the third trimester, a pregnant woman may notice that the baby has certain sleep and wake cycles. Children are usually most active from 19:00 to 4:00 in the morning, and the "rest" period occurs more often from 4 to 9:00 in the morning.

Pregnancy is a unique, planned and organized process by nature itself. In just 9 months, a new life is born and fully formed in a woman’s tummy, a little man is born.

Let's see how life is born, what dangers can lie in wait for it at the very beginning of the journey, and how they can be overcome.

Early pregnancy

Well-being of the expectant mother

Every woman can experience pregnancy differently. Usually there is fatigue, drowsiness, even apathy to everything that happens. Possible intestinal upset (both constipation and diarrhea), toxicosis, swelling of the mammary glands. Due to hormonal changes, there may also be frequent mood swings. The main thing is not to give in! Relax, spend more time in the fresh air, try not to be nervous - all the unpleasant companions of the first trimester of pregnancy will soon pass, and you will have the opportunity to truly enjoy the new position!

Fetal development in early pregnancy

The first month is very important in the life of both a woman and a future baby, because they are adapting from now on to live together, there is a colossal load. During this period, you need to take care of yourself more than ever!

After fertilization, the egg moves for some time to the uterus, where the process of implantation of the fetal egg takes place. Only after it has attached to the wall of the uterus, we can talk about the onset of pregnancy!

At the beginning of pregnancy, the fetal egg is a round or oval body of small size - only a few millimeters. Depending on its size, which the specialist will install on the ultrasound, you can determine the gestational age.

By the sixth week, the fertilized egg grows to an average of 2.5 cm, at this time you can already see the embryo! And although its outlines are incomprehensible, you can already hear the heartbeat! Heart rate can reach up to 230 beats per minute.

By the end of the seventh week, the embryo separates from the fetal egg and takes the shape of the letter C. At this time, you can already see the rudiments of arms, legs, a head, and even a formed umbilical cord.

During the first month, the embryo is actively developing, and by the beginning of the second month it has already formed the brain and spinal cord, there are rudiments of internal organs. In the second month, they are actively developing, individual facial features appear.

By the end of the third month, the unborn baby can reach 9 cm in length, and weigh about 45 grams! Already at a period of 9-12 weeks, with a good set of circumstances, it will be possible to see the gender of the unborn child!

Irregular shape of the fetal egg

As mentioned above, the normal shape of the fetal egg should be round or oval. In some cases, it may be flattened and resemble a bean - this may indicate the tone of the uterus. As a rule, in such cases, bed rest is indicated, and it is also possible to prescribe medications to relieve tone and bring the fetal egg back to normal. As a rule, if a woman is not worried about anything, then there is nothing terrible, but a doctor's supervision is still necessary. Otherwise (pain, bloody discharge), urgent hospitalization is necessary!

Empty fertilized egg

When conducting an ultrasound of the fetus in early pregnancy, only the fetal egg is visualized at first - the embryo is simply not visible until 5 weeks of pregnancy. If the embryo is not visible even after 5 weeks, an additional ultrasound should be performed after 2 weeks. If even now it is absent and there is no heartbeat, then the fetal egg turned out to be empty! Then the woman urgently needs cleaning!

As a rule, the main reason for this phenomenon is considered to be a failure at the genetic level, or the intake of certain medications that are strictly prohibited during pregnancy!

After cleaning, the next pregnancy is usually recommended to plan no earlier than 6 months later.

Detachment of the fetal egg

In fact, the detachment of the ovum is a spontaneous abortion. There is a rejection of the fetal egg from the walls of the uterus. Such a phenomenon may be accompanied by a pulling pain in the lower abdomen, brown or dark red discharge, pain in the lower back. If you recognize what is happening in time and seek competent medical help, you can save the pregnancy! While waiting for an ambulance, it is necessary to provide a pregnant woman with complete rest - it is advisable to lie down and raise her legs above her body.

In each case, the reasons that caused the detachment of the fetal egg are purely individual. Among the main ones are:

Hormonal failure, namely, the lack of progesterone - the hormone responsible for the pregnancy of a woman.
Stress.
Excessive loads.
Diseases in gynecology.
Fetal pathologies.
Rhesus conflict.
Tumors.
Viruses and infections.
Conducting abortions in the past.
Use of drugs, alcohol and so on.

So, the main thing is to recognize the detachment of the fetal egg in time and take appropriate measures! After all, it is very dangerous and can lead to an abortion or missed pregnancy!

Fading early pregnancy

A frozen pregnancy is understood as the condition of a pregnant woman in whom the development of the fetus in the womb has stopped and it has died.

Experts say that the fetus is vulnerable precisely in the early stages of pregnancy, almost the entire first trimester, so you need to carefully monitor your health during this period.

Causes of fetal fading in the early stages

Pathology of the fetus in the early stages. In this case, nature does the so-called natural selection - “the fittest survives”, it does not allow the birth of a baby with congenital deformities.
The presence of infections in a woman, such as rubella, herpes, toxoplasmosis, chlamydia, and so on.
Another reason is Rh-conflict pregnancy, as well as hormonal disorders and severe stress in the expectant mother.
All sorts of bad habits - smoking, drinking alcohol and drugs.

Symptoms of a missed pregnancy

Unfortunately, it is not always possible to recognize such a condition! There are certain symptoms, but they can easily be attributed to anything.

Sudden cessation of toxicosis. Nausea and vomiting have passed, there is no more fatigue and former drowsiness.
A decrease in basal body temperature due to a decrease in the level of the hormone progesterone. It must be measured in the rectum in the morning after sleep - it is advisable to lie down for at least 6 hours before measuring. With a frozen pregnancy, it decreases and does not exceed 37 degrees.
Softening of the breast. From the first days of pregnancy, as a rule, breast engorgement occurs. If the breast suddenly becomes soft, then this may indicate a fading pregnancy.
Pulling pain in the lower abdomen and bloody discharge can rarely indicate this pathology, this is how it differs from spontaneous miscarriage. However, this may be the case, in any case, if such a symptom is detected, it is necessary to urgently consult a doctor.

As you can see from the above list, the symptoms are quite general and easy to attribute to anything. Toxicosis and a general tired state can constantly change, the chest can also swell or soften. And the basal temperature needs to be measured every day to notice any deviations.

Medical diagnosis of missed pregnancy

A frozen fetus in the early stages of pregnancy can only be diagnosed by a doctor with the help of special studies.

First of all, an ultrasound is performed, on which the fetal heartbeat is heard in the early stages, its viability is determined. In addition, the size of the uterus and the thickness of the chorion are measured. It is also necessary to donate blood for hCG - during a normal pregnancy, its constant increase is observed. In the case of a fading pregnancy, its indicators fall.

Treatment of missed pregnancy

In this situation, we are talking only about the treatment of women. Saving the fetus in this case is useless.

So there are two tactics:

Expectant. Under the total control of doctors, they are waiting for a spontaneous miscarriage, which can be stimulated with special drugs.
Without waiting, the woman is sent for cleaning.

The fact is that a long stay of a dead fetus in the womb of a woman provokes severe inflammatory processes that can lead to terrible consequences, even death!

After the procedure, as a rule, pregnancy is recommended to be planned at least six months later. And ideally within a year! During this time, it is necessary for both partners to undergo examinations in order to establish the causes of missed pregnancy and prevent such a condition in the future.

How to keep an early pregnancy

Let's start with the fact that competent pregnancy planning is necessary: a preliminary passage of all the necessary specialists and the delivery of blood and urine tests.

If there are any infections, you must first cure them, make all the necessary vaccinations, and only then make the first attempts to conceive a baby!

If the pregnancy came unplanned, without any preliminary tests, you must immediately register and, again, go through all the specialists!

Under the supervision of a competent doctor, many of the dangers that await a woman and her unborn child can be prevented!

At the same time, do not forget about your own common sense. You need to walk more, be less nervous with or without reason, give up all bad habits, eat only healthy foods etc.

This approach will help save you from adverse consequences, and you will give birth to a wonderful healthy baby!

Video "1-9 weeks of pregnancy"

When a baby is born with a lot of weight, many are happy and consider this a sign of the health of mom and baby. Being pregnant, women, on the contrary, are afraid of this, since a large fetus is associated with many dangers, in particular, it can significantly complicate the course of childbirth.

In fact, a golden mean is needed: this is not a pathology and a very serious problem, but this fact cannot be taken lightly. This is just a risk factor, and if you fall into this group, you should find out all the nuances, pitfalls and features of delivery when the child is too large.

Many people mistakenly believe that a baby is born with a lot of weight due to the fact that the parents are not small, that is, the heredity factor is triggered. In fact, the features of the skeleton and the general type of figure, transmitted to a person from a mother or father, begin to appear at a much later age, but not immediately after birth.

There are special causes of a large fetus during pregnancy, and if you know about them in advance, you may not be at risk. Among them, the most common are:

maternal malnutrition: eating a large amount of carbohydrates (flour, confectionery, sweets), overweight up to obesity;
number of children: each subsequent child, according to statistics, is born larger than the previous one; so that all subsequent ones, most likely, can be complicated by the large size of the fetus;
sedentary lifestyle;
a woman has a metabolic disorder due to hypothyroidism or diabetes- accordingly, it enters the blood of the child in the womb a large number of glucose, which leads to an increase in his body weight; so if at some point in pregnancy a large fetus is diagnosed at the same time, the mother is sent to be tested for sugar;
long-term use of certain medications: a version not confirmed by research, but doctors consider it as one of the causes of a large fetus, especially if during pregnancy the expectant mother took Actovegin and other drugs that improve uteroplacental blood flow;
a thickened placenta provides intensive intrauterine nutrition, which leads to the formation of a large fetus;
active intake nutrients may occur due to the fact that the placenta is attached to the back wall of the uterus;
postmature pregnancy is also one of the causes of a large fetus, and it can also be diagnosed at 40 weeks if, in addition to being overweight, the child has a number of other signs of postmaturity: he has dry wrinkled skin, there is no original lubrication, long nails and hair are observed, too hard cranial bones, already closing fontanelles;
there is a theory that the fetus can be large if the mother took multivitamin complexes during pregnancy, but she does not find scientific confirmation.

Usually, if a doctor suspects a large fetus, he tries to establish the cause of this feature of pregnancy. Sometimes this allows you to identify diseases in the mother (, for example), or placenta previa, or put in order the nutrition and lifestyle of a woman even before childbirth. Sometimes there is enough time for the mass of the child to return to normal - then the course of childbirth is not complicated by anything. However, another question arises here: how to understand whether the fruit is large or not, is it worth sounding the alarm or not worrying about this?

We replenish vocabulary. The birth of a large child in obstetrics is called macrosomia.

signs

Doctors rarely make mistakes in such a diagnosis: there are certain signs of a large fetus that can be detected even during pregnancy. It should be noted right away that these include not only the weight of the baby: other factors matter here.

A large child is called a child whose birth will be difficult due to its size and weight. When a woman in labor, for example, even a 3.5-kilogram baby can be considered large.

Dimensions

In the course of research (ultrasound), all kinds of measurements of the fetus are made, as a result of which it is concluded whether it is large or not. With a full-term pregnancy at 40 weeks, these figures should not exceed the following norms.

Fetal parameters:

BDP (biparietal, i.e. between opposite bones of the crown, skull size) ≈ 93.9 mm;
LTE (fronto-parietal, i.e., the gap between the forehead and the crown, the size of the skull) ≈ 120 mm;
DB (this is the length of a small thigh) ≈ 75.8 mm;
SDGK (stands for the average diameter of the child's chest) ≈ 99.9 mm;
SDJ (as the average diameter of the abdomen is indicated) ≈ 108.2 mm;

Mother parameters:

weekly in the absence of edema and symptoms of preeclampsia ≈ 500 gr;
Coolant (this is the circumference of the abdomen) ≈ 100 cm;
VDM (designation for the height of the fundus of the uterus) ≈ 40 cm.

Having studied all these indicators, one can understand which fetus is considered large: if these indicators exceed the indicated values, the mother is at risk. In addition, doctors have an interesting formula by which you can calculate the approximate weight of a baby still in the womb: WDM is multiplied by coolant.

Symptoms

If the baby is overweight, it takes up a lot of space. Accordingly, the various organs of his mother, located nearby, are subjected to severe infringement and compression, experiencing an enormous load. Therefore, a pregnant woman in such cases may notice the following symptoms during the last 2-3 weeks before childbirth, which will indicate a large fetus:

frequent urination;
constipation;
fainting in the supine position, as the enlarged uterus puts strong pressure on the lower vein;
pain in the legs, ribs, spine, lower back due to the increased load on the musculoskeletal system;
development or exacerbation of varicose veins;
stretch marks on the abdomen;
increased tone of the uterus.

All these symptoms and signs need to be thought about already a few weeks before the birth and draw the attention of doctors to them. If for some reason you have to give birth ahead of schedule and you know this for sure, consult your doctor which fetus is considered large at week 38 (or at the time when your baby appears). As a rule, for such a calculation, 5-6 units must be subtracted from the above parameters (the size of the mother and child). For example, coolant should be ≈ 94-95 cm.

Keep in mind! Many people mistakenly consider too large a belly in a pregnant woman to be the first and surest sign of a large fetus. This is not at all the case: it can also indicate polyhydramnios or multiple pregnancy. Even a small belly and a large fetus are possible.

What to do?

If 2-3 weeks before the birth, at the next examination, the gynecologist reported that you have a large fetus, you should not panic and immediately start talking about caesarean section. You still have time to correct this risk factor, so consult a doctor who will tell you what to do in this situation. You will need:

undergo medical examinations to exclude multiple pregnancy and polyhydramnios;
conduct a glucose tolerance test and visit an endocrinologist to make sure that there is no diabetes mellitus;
find out the estimated weight of the fetus;
daily exercise therapy;
adjust nutrition: avoid sweet and starchy foods, i.e., easily digestible carbohydrates and refractory fats;
cancel or limit (in accordance with medical recommendations) the use of anabolic steroids.

If you follow these tips, by week 40 the situation may well improve and the doctor will be happy to inform you that the baby's weight is now within the normal range. In this case, you do not have to resort to: they are waiting for you natural childbirth with a successful outcome, without any complications associated with the large size of the child.

But what if it's too late or the correction failed? Then you will have to intensively prepare for surprises, and maybe for operative delivery.

The most helpful advice. Very often, young mothers, having heard that they have a large fetus, begin to worry so much and exhaust themselves with all kinds of diets that they only worsen the situation. As a result, they are on the delivery table ahead of schedule, and the baby is born restless and nervous. So the most important thing is not to panic, calm down and rely on the experience and professionalism of doctors in everything.

Possible Complications

Why, when a large fetus is detected during pregnancy, the question is often raised: caesarean or natural childbirth? It's all about the complications that the independent birth of a large child is fraught with. They can affect not only the health, but also the life of the baby. And the mother will have a very difficult time. Among the consequences, the following are considered the most dangerous.

narrow pelvis

This pathology is diagnosed if the baby has a large skull that does not correspond to the size of the pelvis in a woman (by the way, they can meet the standards) even with full opening of the cervix of the uterus. Strong, good contractions do not save the situation. If a woman in labor has a narrow pelvis and a large fetus, in most cases she is advised to have a caesarean section.

Premature discharge of water

Due to its large size, the fetal head cannot press against the pelvic bones, and it occurs early. This is fraught with the fact that the loop of the umbilical cord and even the arm or leg of the baby may fall out, the uterine pharynx opens much more slowly, childbirth is delayed and exhausts the woman. Without amniotic fluid, the child will last no more than 12 hours: then intrauterine infection may occur.

Anomalies of labor activity

A large fetus delays childbirth, which depletes the strength of the woman in labor. Diagnose, in which the intensity and frequency of contractions is significantly reduced. This can lead to intrauterine hypoxia. The way out of this situation is the stimulation of childbirth, which, however, does not affect the fetus in the best way.

breaks

Due to the large size of the fetal head, the lower uterine segment is overstretched, which leads to numerous ruptures in the uterus. Often the pubic joint is also damaged - the ligaments are torn, the pubic bones diverge. All this will have to be corrected after childbirth surgically.

Fistulas

If the head of the fetus, due to its large size, presses too long on the bones of the pelvis, neck, vagina, bladder, the anus is under enormous load. Among the consequences - circulatory disorders in soft tissues, ischemia, necrosis, in the future - rectovaginal fistulas.

Birth trauma in a child

Due to its large size, the fetus cannot pass through the birth canal on its own without injury. The bones of the skull (and with them the brain) are damaged, fractures of the shoulders, collarbone, and neck are diagnosed. The child may remain disabled for life or die. For the same reason, cerebral hemorrhage can occur.

Given all these complications, a woman, together with a doctor, needs to make the right decision on how to give birth: or by caesarean section. If the risk of complications is not so great, the size of the fetus only slightly exceeds the norm and they can be corrected, and the parameters of the pelvis of the woman in labor allow him to be born on his own, you should not insist on surgical intervention. But if the situation is critical and the doctors advise the CS, there is no need to resist: at stake is the life and health of the unborn baby.

Facts, facts. If doctors suggest that you have a large fetus, get ready to go to the hospital ahead of time: at 37-38 weeks of pregnancy.

Indications for caesarean section

Proper management of childbirth with a large fetus reduces the risk of complications by 80%. An experienced doctor who knows his business, even if it was decided to give birth naturally, will always keep a team of doctors and the necessary equipment for carrying out at the ready. Indeed, at any stage of labor, unforeseen circumstances may arise that threaten the life of the mother or child.

As a rule, a caesarean section for a large fetus is prescribed for the following indications:

age up to 18 and after 30 years;
breech presentation;
a large fetus detected on ultrasound and - in this case, a CS is necessarily prescribed, because such a baby cannot be born on its own;
delayed pregnancy;
anatomically narrow pelvis;
third births, if both previous ones were complicated by a very large fetus;
myomatous nodes and any other pathology of the uterus;
contraindications for attempts: problems with the heart and blood vessels, myopia;
poor obstetric history: if there was a stillbirth, prematurity, infertility, etc.

Polyhydramnios or moderate oligohydramnios with a large fetus are not considered absolute medical indications for caesarean section. In these cases, the baby is not in danger, and in the absence of other pathologies, he is quite capable of being born on his own.

Statistics. According to the latest data, 75% of cases with a large fetus end in a caesarean section.

Features of childbirth

Doctors know all the features of a caesarean section with a large fetus, which require them to have high professional skills and a certain amount of experience. Beginners do not trust such operations. Physicians take into account the following nuances:

caesarean section is carried out under monitor control;
a partogram is being drawn up - drawing up a schedule indicating the time of the period of childbirth, parameters of the opening of the pharynx, indicators of the intensity of contractions;
re-measurement of all dimensions is carried out;
anesthesia is done, antispasmodics are used;
reducing agents are used for preventive purposes;
a narrow pelvis should be diagnosed in a timely manner;
bleeding is prevented.

If doctors diagnosed a large fetus during pregnancy, do not be afraid of such news. You need to know all the risks associated with this fact and how to avoid them. A doctor's consultation is essential here.

Do not rush to insist on a caesarean section, fearing ruptures: for a baby, this will not be the best option for the development of events. Perhaps its size is not so colossal as to seriously harm you during childbirth. Listen to the recommendations of doctors - and complications can be avoided.