Pregnancy freezing is one of the worst pathologies of pregnancy - fetal death in the womb.
For those who have waited a long time and wanted to conceive a baby - this is a big tragedy. However, the situation is far from hopeless, and the chances of conceiving and carrying out a healthy child are very high. In addition, it is also a significant reason to revise your lifestyle, be examined and responsibly treat pregnancy planning.
What is missed abortion
Pregnancy freezing is the arrest of the development of an embryo or fetus that occurred at up to 28 weeks of gestation. Another option is possible: the egg was fertilized, but an embryo did not begin to form in it.
The most dangerous weeks in which the development of pregnancy most often occurs:
Deserves special attention 8 week. Since this is the time when the “laying” of all vital organs of the embryo takes place, and it is exposed to the greatest impact of negative factors.
Frozen pregnancy: early symptoms
If the pregnancy stops for up to 16 weeks, then it is characterized by the following signs.
The sharp disappearance of symptoms of toxemia: nausea and vomiting occur, the mammary glands lose their pain and return to normal volume, become soft.
Lower abdominal pain: often have a weak pulling character. However, pain during missed abnormalities are not always present.
Also observed spottingbloody or brownish.
Basal temperature during missed abortion falls to a level characteristic of lack of pregnancy.
If a woman did not notice a missed abortion on time, and the dead fetus is in the uterus for a rather long time, intoxication can begin, for her characters:
- sharp pain in the groin and lumbar region,
- temperature rise,
- pale skin
All this is fraught with the development of infection of the blood and tissues - sepsis, since the decay products of the deceased ovum enter the bloodstream of the woman.
It is worth noting that the manifestation of symptoms is extremely individual, and in some cases the woman does not know that the pregnancy has stopped developing, right up to the next examination. If a woman observes them in her room, she needs to see a doctor, but do not panic right away and commit rash acts. It is advisable to get advice from several specialists, at least two.
There are real cases when a woman was diagnosed in one woman’s consultation - a missed abortion, and in another they said that everything was in order, and as a result this pregnancy was resolved by successful delivery.
Frozen pregnancy: late symptoms
Recognize a stalled pregnancy, stopped in the development in the second trimester (up to 28 weeks), is primarily possible due to the lack of fetal activity - a child stops moving in the belly of a woman.
As you know, the first movements of the baby fall on a period of 17 to 20 weeks. Here everything is individual - there are kids that are active and not very good, but if the child does not move within 4-6 hours - this is a reason to see a doctor. You should not wait any longer, at this time the fetus may suffer from hypoxia, which ultimately can also lead to its death.
Another symptom of missed second trimester pregnancy is change in the state of the mammary glands. It is noteworthy that if the fetus stops developing for a period of up to 25 weeks, the breast also returns to a “pregenerative” state, however, if the pathology develops later than 25_th week, it is possible that the mammary glands swell even more, colostrum will start to stand out from them.
Pain in the inguinal region or lower back, general deterioration of health, nausea - are also symptoms of stunted in late pregnancy, and appear a few days after the death of the fetus.
Freezing early pregnancy: causes
- chromosomal abnormalities in the fetus, in particular, they can be caused by blood relationship between the mother and father,
- rhesus-conflict in mother and child, and in most cases negative rhesus in mother,
- teratogenic effects, i.e. effects on the developing body of medications that a pregnant woman takes for a period of 1 to 10 weeks. Later, the child is already protected by the placenta, and earlier it is still not sufficiently connected with the mother's body to perceive all the factors. However, some medications accumulate in the body and have an effect on it for a long time after use,
- infectious diseases, including diseases transmitted by sexual contact (influenza, rubella, cytomegalovirus, mycoplasmosis, syphilis, gonorrhea, chlamydia, etc.),
- antiphospholipid syndrome, an autoimmune disease expressed in the body's production of antibodies to its own phospholipids (components of cell walls). In pregnant women, the disease manifests itself in the form of the formation of blood clots in the vessels of the placental tissue, which prevent the normal provision of the fetus with nutrition and oxygen. It is noteworthy that almost half of the women suffering from this disease had 2 missed pregnancies in a row. However, this diagnosis is not a sentence, and it is quite possible to make and give birth to a healthy child - with timely detection and treatment,
- disturbed hormones, as a rule, lack of progesterone. Women who already have missed abortions, miscarriages, menstrual irregularities and other manifestations of hormonal imbalance should be alerted in advance.
- severe psychological stress and exercise,
- unfavorable ecological situation and bad habits of one or both parents: smoking, drinking, drug addiction,
- physiological features and abnormalities of the structure of the uterus of a pregnant woman,
In addition, in some cases, it is not possible to find out why a frozen pregnancy occurs.
Losing pregnancy at a later date: causes
- infectious diseases, including diseases transmitted by sexual contact (influenza, rubella, cytomegalovirus, mycoplasmosis, syphilis, gonorrhea, chlamydia, etc.),
- hormonal disorders,
- diseases of the kidneys and cardiovascular system of a pregnant woman,
- genetic and other abnormalities of the fetus are incompatible with life.
Diagnosis of missed abortion
The most accurate way to determine a frozen pregnancy, both in the early stages and in the later periods, is an ultrasound scan, during which the specialist will check:
- The mismatch of the size of the uterus during pregnancy,
- Lack of heartbeat and respiratory movements,
- Incorrect position, deformation and contour around the body of the fetus in the later periods, indicating the decomposition of tissues,
- Lack of visualization and growth of the embryo in early pregnancy. It is very rare, but it also happens that the fertilized egg grows for some time, and the embryo does not form in it or has stopped developing.
This also causes occasional problems with the determination of missed abortion as a result of the analysis of hCG - the second method for diagnosing pathology. It happens so that the stop of pregnancy development is determined on ultrasound, and the level of hCG in the blood continues to grow, as it is produced by the shell of the ovum, or it is kept at a high level several more days after the fetal death. As you see and pregnancy test may show a positive result, because and its action is based on the detection of hCG in the urine.
Although, as a rule, the level of hCG with a frozen pregnancy decreases sharply or is equal to zero. Read more about the hCG level during pregnancy>
Consequences and termination of missed abortion
As a result of missed abortion, there are two possible scenarios:
- Spontaneous miscarriage in the early stages, when the uterus rejects the dead embryo and removes it from the body,
- Medical intervention. If it is not carried out on time, then in later periods the decomposing fetus will poison the mother's body with decay products, which will lead to serious consequences for her health.
So, if a frozen pregnancy is diagnosed, then its interruption is currently possible in several ways.
1. Medication. This is a way to interrupt a missed abortion in the early stages. Women are prescribed medications that trigger uterine contractions, and as a result, miscarriage.
2. Curettage, or curettage (brushing) during a frozen pregnancy. A rather popular, though not the most desirable, procedure, since during it the tissues are injured and the likelihood of complications is high.
The operation is performed under general anesthesia and is a mechanical cleaning of the uterine cavity, removal of its upper mucous layer, with a special tool that is inserted into the cervical canal, having previously provided access there through the installation of dilators.
After surgery, bleeding or inflammation can develop, so a woman should stay in the hospital for several days, where she will be monitored.
3. Vacuum aspiration. The operation, carried out under anesthesia or local anesthesia, is that a woman cleans the uterus with a vacuum suction. It looks like this: the tip of the vacuum apparatus is inserted into the cervical canal (without expansion).
After the procedure, a woman should be under the supervision of a doctor for about two hours. Of course, this method of interrupting a frozen pregnancy is more benign than curettage. In addition, a woman will not have to stay in hospital for a long time.
4. Childbirth. In the later periods, the interruption of a missed pregnancy is much harder, mainly from a psychological point of view. The fact is that a non-developing pregnancy is a contraindication for cesarean section (the contents of the uterus may be infected), so only one way out is artificial stimulation of labor. That is, a woman cannot simply disconnect from the process, for example, under general anesthesia, she herself should give birth to the dead fetus on an emergency basis.
It is also worth noting that in the early stages, doctors sometimes do not make any attempts to interrupt a missed abortion, waiting for the uterus to reject the fetus itself.
Treatment and recovery after missed abortion
After missed abortion prescribed examination to determine the cause of the pathology. If it is possible to establish one, it is recommended to undergo a course of appropriate treatment.
Usually post-pregnancy tests include:
- a blood test for hormone levels
- smear and examination of the vaginal microflora for the presence of genital infections,
- histology after missed abortion - study of the uterus epithelium. For analysis, a thin section of the upper layer of the uterus or tube is taken, or the material obtained during curettage is used.
As for the restoration of the uterus after surgery, usually prescribed a course of antibiotics, hemostatic agents, as well as abstinence from subsequent pregnancy for a certain time (depending on the associated factors).
In the case of identified genetic abnormalities of the fetus, after missed abortion, genetic counseling will be required to determine the compatibility of partners.
Pregnancy after missed abortion
How much time it will be undesirable for a woman to get pregnant is determined by the doctors in each particular case, at least it will be six months. Until then, a woman needs to use contraception and not worry about the fact that she no longer succeeds in conceiving a child. These fears are completely in vain.
Pregnancy pregnancy is, as a rule, a special case, which in no way indicates violations in the reproductive system of a woman.
However, remember, in order not to survive this blow again - a woman should undergo a thorough examination, adhere to a healthy lifestyle and wisely approach planning for the next pregnancy. In addition, it is very important that not only the future mother was engaged in her health, but also the future father supported her in this. And the matter is not only in moral support: it has been established that miscarriage in some cases is caused by factors emanating from the man.
Of course, it is very difficult to survive a frozen pregnancy, and in the later stages it is simply impossible to betray the depth of this tragedy. But instead of falling into despair, a woman needs to focus all her attention on taking care of her health, and soon she will know the joy of motherhood.
Frozen pregnancy: treatment and pregnancy planning | My Gynecologist Search this site
Treatment of missed abortion
Immobilized pregnancy in the early stages ends sooner or later with spontaneous abortion. However, it may take several weeks from the moment of death of the embryo to its rejection from the uterus. During this time, inflammation, bleeding and other unpleasant complications may develop. That is why most doctors do not recommend waiting until a miscarriage occurs, but prefer to make a curettage of the uterus and remove the dead embryo immediately after the diagnosis of missed abortion has been finally confirmed.
Scraping (brushing) when pregnancy stopped is performed under general anesthesia, and the whole procedure lasts no more than 30-40 minutes. Sometimes vacuum aspiration is used to remove a dead embryo. Do not confuse cleaning after a missed abortion with an abortion, even if the methods are the same. Abortion is the interruption of a normal pregnancy with a viable embryo. With missed abortion, there is nothing to interrupt, since the death of the embryo has already occurred. You should not blame yourself for the fact that you had an abortion during a missed abortion, since it was not an abortion, but a treatment after the tragedy that had already happened.
After curettage, the gynecologist directs the resulting material to a special histological examination. Histology with missed pregnancy helps to understand the causes of the incident.
What will happen after cleaning with missed abortion?
Recovery after curettage during missed abortion may take a few weeks.
In the first days after scraping:
If you are okay, you will be discharged from the hospital on the same day. The doctor will prescribe antibiotics for the prevention of inflammation and pain medication, as the pain after cleansing can be quite intense.
After returning home, keep bed rest for a day. Intense physical exertion in the first days after curettage can lead to bleeding.
Pain in the lower abdomen after curettage during missed abortion may persist for several days. No need to endure the pain, if it is expressed. You can take pain medication. Usually, Ibuprofen helps to deal with these pains.
The discharge after curettage during missed abortion can be quite intense and last from several days to 2 weeks. For the time of these secretions, use gaskets, but not tampons. Using tampons in this situation can cause dangerous inflammation.
In the first weeks after scraping:
Gynecologists recommend to abstain from sex for at least 2 weeks after scraping. If, after this time, you still have bleeding, you should wait for their complete cessation. Depending on your situation, the doctor may give other recommendations.
If you resume sex life, then take care of contraceptive methods. Pregnancy after curettage of a missed pregnancy may occur in the first weeks, so you should not practice unprotected sex until your doctor tells you that you can start planning your pregnancy again.
The following menstruation after missed abortion may come in 2-6 weeks after curettage.
Immediately consult a gynecologist if, after curettage:
- Body temperature rises to 38 ° C and higher
- The bleeding has increased and you have to change the gasket every hour or more.
- Spotting ("monthly") continues for more than 2 weeks in a row
- Severe pain in the abdomen does not go away while taking painkillers
- Vaginal discharge has an unpleasant smell
Recovering from a missed pregnancy: tips that help overcome fear
The signs of fetal death differ depending on the state of health of the mother, the term of gestation, the reasons that led to such sad consequences. However, in any case, after a missed abortion and its extraction (cleansing), long recovery and qualified rehabilitation will be required.
How to quickly recover?
The rate of recovery of the body partly depends on the period at which the baby stopped developing.
So, if we talk about early spontaneous miscarriages (up to 7 weeks), the woman’s body has not yet adapted to hormonal changes, the uterus has not increased, no dramatic changes have occurred in appearance either.
Recovery at this stage depends, rather, on the emotional state of the woman, rather than on body reserves.
But, the situation is completely different in the case of late fading, especially in the period from 20 to 26 weeks. There are already many more problems concerning both moral rehabilitation (psychological help) and restoration of the normal functional activity of the organism, which was preparing for motherhood. The duration of recovery in this context can last for half a year or a couple of years.
Correctness of action
When the irreparable happened - the woman lost the child, then it is worth understanding that not only the patient’s future health, but also her ability to realize herself as a mother after treatment depends on the correctness of the chosen rehabilitation tactics.
Actions after missed abortion:
- To establish the cause of fetal death. This is necessary, above all, for the implementation of motherhood in the future. It should be understood that a viral infection, a chronic disease or abnormal development of the uterus does not resolve itself, it is necessary to identify the cause and eliminate it.
- Get tested for infectious diseases. Some doctors, recommending just to accept this state of affairs, doom a woman to repeat the situation. It is important to pass all studies on the infection: HIV, pyelonephritis, toxoplasmosis, herpes, rubella, chickenpox.
- Investigate the state of hormonal background. Often, exaggerated male testosterone levels cause abnormal fetal development.
- Check compatibility with sexual partner. Rhesus conflict can cause excessive activity of antibodies in the mother's body, which, in turn, provokes a miscarriage.
The primary task for abnormal pregnancy is to determine the causes. Without special medical research, it is impossible to determine the pathology. Therefore, a comprehensive medical examination includes:
- hormone analysis: testosterone, prolactin, progesterone,
- examination of the thyroid and adrenal glands,
- examination of the thickness of the endometrium of the uterus, its growth,
- control of the ovulation cycle
- histology of fetal remains,
- genetic research of pathological heredity.
Recovery of the menstrual cycle
When diagnosing a non-developing fetus, doctors clean the uterus. This procedure is traumatic, but mandatory. Immediately after the curettage, the woman is given lochia, which lasts 3-4 weeks.
Restoration of the menstrual cycle depends largely on the hormonal balance. If the reason for the interruption of development is an infection, inflammation or hormonal imbalance, then the rehabilitation process will be protracted. In all other situations, the first menstruation occurs not later than one and a half months after the termination of the pregnancy.
The emotional state of a woman after identifying fetal fading is extremely unstable. It will require not only professional psychological help, but also the support of relatives and friends. Tips to remember:
- It is not necessary to "hush up" the problem, to behave as if nothing happened.
- It is impossible to visit children's playgrounds for the first time, communication with families with small children is limited in the first 2-3 months of rehabilitation.
- It is important to speak out, cry out and, if necessary, shout out.
- You should not blame anyone, there are no guilty in this situation, there may be provocative factors, risky moments, but if the development of the fetus and its vital organs is normal, then no problems can provoke pathology.
- Pay attention to self-development, try to find a hobby, a new hobby.
In each individual case, apply personal effective methods to alleviate emotional pain. But, obviously, one thing: silencing the problem and putting it into a “long box” will only aggravate the situation. It is necessary to go through all the stages of moral and psychological recovery. Only a psychologically healthy body can give birth to a strong baby in the future.
Recommendations for future pregnancy
Depending on the degree of difficulty of the rehabilitation after miscarriage, we can talk about the planning of subsequent pregnancies. Unsuccessful gestation in the past without generic permission is the same difficult work for an organism, as well as childbirth. Rehabilitation is a long, difficult emotional state.
After the pathology, doctors recommend to drink away the contraceptive drugs. These pills contain the right amount of hormones that are produced in a healthy body. The minimum term of hormone replacement therapy is 4 months.
Fetal dying in the development of intrauterine - a pathology that happens quite rarely: only every 200-thousandth pregnancy ends in miscarriage in the early stages, 300-thousand - in miscarriage in the later terms. However, those women who survived such a tragedy once, do not want to find themselves again in the “happy” 200th position. Therefore, they are concerned about the main question: how can the fetus fade further be prevented?
First of all, you should follow the elementary rules:
- to refuse from bad habits,
- to undergo a course of psychological assistance
- include seafood rich in folic acid, vitamins and minerals,
- eliminate alcohol
- do all the necessary research before fertilization.
No one can be insured against the pathology of pregnancy, and even the healthiest woman can be among those who have lost a child. However, the right approach to recovery, qualified assistance and round-the-clock support of loved ones work wonders, and most importantly, the new pregnancy will not take long
How to recover from a frozen pregnancy?
For almost every woman, missed abortion is a huge stress. But despite this, a woman has a chance to conceive and endure a long-awaited child without any problems. Planning for the next pregnancy should be approached responsibly, going through the stages of physical and psychological recovery.
What kind of examination you need to pass?
Many women who are faced with this problem are interested in the question of which examination should be performed after a missed abortion. In fact, there is no clear examination algorithm, since in each case an individual approach is required.
Careful diagnosis is assigned only to those couples whose fetal death has occurred several times in a row. Even a healthy couple can face a similar problem. In such situations, the chances for the next successful pregnancy are high.
After missed abortion, doctors prescribe a series of tests to determine the cause of this phenomenon. It is strongly recommended to take them if the death of the embryo happened more than once.
How to restore physiological health?
Usually, when a woman stands still, she is scraping the uterus. Sometimes it all ends in a spontaneous miscarriage. In either case, the female body is under tremendous stress. Physical health is restored faster with the second option to solve the problem. Surgical curettage causes damage to the cervix and uterine cavity.
The period of normalization of the reproductive organs in women will depend on the method of getting rid of the frozen fetus:
- if there was a spontaneous miscarriage, then the next attempt to get pregnant can begin after three months,
- After cleaning the uterus, pregnancy can be planned at least six months. After this period of time, the endometrium is fully restored.
With regard to the menstrual cycle, it is restored in about two months, so the pregnancy may occur earlier than six months. This pregnancy may be accompanied by such a phenomenon as miscarriage.
If two months later the menstrual cycle has not recovered, then the woman is prescribed hormonal preparations. After the cycle is fully normalized, the next pregnancy can be planned.
Normalization of the psychological state
- For successful conception, it is important that a woman has a normal mental health.
- You need to accept the situation as it is, that is, you should get rid of the feeling of guilt.
- It is better to enlist the support of loved ones. It is hard to worry about the problem alone.
- It is recommended as soon as possible to return to the former life, to do what you love, which will help to distract.
- Escape help out walking with friends.
- No need to rush to the next pregnancy. It is necessary to get rid of obsessive thoughts to conceive a child again, this also applies to fear and apprehension.
Successful conception and childbearing to a greater extent depends on the moral attitude of the woman, subject to a satisfactory state of physical health.
Planning to conceive a baby after a missed abortion
A woman should understand that missed abortion is not a sentence. There is always a chance to restore your health and again try to endure the child. In such situations, it is appropriate to properly plan a new pregnancy with the delivery of all tests and the examination. No need to rush things, it is better to be patient and do everything that the attending physician says.
Many women who have previously survived a missed abortion are interested in when to proceed to the next conception? Gynecologists advise to wait at least three months, ideally it should take six months. During this period of time, a woman regains her physical health, normalizes hormonal status and improves her psychological state.
Your doctor may recommend taking oral contraceptives, which prevent untimely pregnancy. This is necessary so that the ovaries can "rest" for some time. Studies show that the chances of successful conception increase after discontinuation of taking such drugs.
After a three-month course of recovery of the ovaries, the woman is prescribed folic acid. This vitamin remedy affects the early development of the embryo, helping it to better consolidate and survive.
There are cases when women become pregnant one month after missed abortion, and successfully bear a child. Nevertheless, the risk of failure is still there, so it is better to adhere to the recommendations of the doctor.
In each case, an expert consultation is required. You may need to undergo treatment or more thorough examination. All these measures are aimed at reducing the risk of missed abortion in the early period of embryo development.
Rehabilitation after missed abortion
Fetal dying is one of the reasons for not carrying a pregnancy in women, regardless of their socio-economic level and lifestyle. The danger is that it appears only after the death of the ovum.
A sudden spontaneous interruption of the development of pregnancy is a stress for the body, a psychological trauma for a woman and her family members. Hope for the future is the planning of a new conception, the success of which determines the quality treatment and rehabilitation after a frozen pregnancy.
It is impossible to reanimate the dead fertilized egg. It gradually decomposes, over time, an infection starts to develop in it, which causes intoxication and may end in sepsis.
Therefore, treatment is aimed at removing the fetus from the uterus without a residue, and restoring the woman's body after that. The choice of method depends on its state of health, duration and development of pregnancy until the moment of fading.
The following removal methods are used:
- Spontaneous miscarriage.
- Vacuum aspiration (mini abortion).
- Medical (tableted, pharmaceutical) abortion.
- Scraping (cleaning) the uterus.
Most often prescribed method of abortion, scraping, mini-abortion, less often - miscarriage. When the fetus dies in late periods, artificial births are performed.
Use of spontaneous miscarriage and vacuum aspiration
The fading of pregnancy is accompanied by a decrease in the concentration of a specific hormone - human chorionic gonadotropin in a woman's body. The uterus reacts to this by contractions, rejection of the deceased fetus and pushing it through the slightly open neck. The method is prescribed in the absence of symptoms of inflammation in a woman.
A complete miscarriage without complications confirms the study of ultrasound. If fetal remains are found in the uterus, vacuum or scraping is performed.
The first week after a spontaneous miscarriage may be accompanied by slight pain in the lower abdomen and discharge with a small amount of blood. After a few weeks, the woman's body is restored, and a month later, periods begin. The method is used in the absence of signs of inflammation and intoxication in the body of a woman.
If the fetus is frozen for a period of 5 to 6 weeks, vacuum aspiration of the contents from the uterine cavity with the help of an inserted catheter is prescribed. This removes only the top layer of the mucous and removes the embryo. Conduct control ultrasound.
The found fetus remains in the uterus are sucked off repeatedly by vacuum, or mechanical curettage is performed. 2 weeks after the mini abortion, the woman's body is restored, the menstruation appears on the 35-40 day.
Medical abortion - rehabilitation
Tableted removal of a frozen fetus is performed during embryonic development - no later than 7 weeks of gestation.
A woman in two stages of the scheme takes drugs that block the action of progesterone - Mifepristone, Mifegin. Their properties are enhanced by misoprostol. Under the influence of drugs, the uterus actively contracts, rejects and pushes the embryo with bleeding. After its release, the blood secretion gradually stops, but smears for a few more weeks.
On the first day, a woman feels pain in the lower abdomen, which is relieved by an antispasmodic - No-shpy. Pain medication is taken only on prescription. Uncontrolled use of such drugs significantly weakens the immune system.
Counting of the menstrual cycle comes from the onset of bleeding after taking pills. Within 2 - 3 months it is normalized. The first menstruation lasts up to 2 weeks.
2 weeks after the abortion on the ultrasound scan the remains of the fetus in the uterus. During this time, it must be cleaned completely. If this does not happen, vacuum aspiration or scraping is performed.
Rehabilitation after a medical abortion is reduced to the implementation of a number of doctor's recommendations that help restore the woman's body. He reviews the patient's diet, helps to balance it, include vegetables and fruits in the menu.
To strengthen the immune system, the doctor prescribes a vitamin complex. Also recommends following simple rules:
- avoid emotional stress, learn to manage them,
- eliminate any physical activity
- include rest mode, walk in fresh air,
- give up smoking, alcohol, strong coffee,
- eliminate the use of water procedures in baths, saunas, bathrooms, swimming in pools, ponds,
- monitor the recovery of the monthly cycle, the nature of vaginal discharge after an abortion,
- Sexual life begins after the end of the first menstruation,
- it is necessary to protect from pregnancy for the first 6 months, contraception should be coordinated with your doctor.
Every woman after an abortion is thinking about how to quickly recover and conceive a child again. This should not be allowed to complete the rehabilitation of the body. This can negatively affect pregnancy.
The pharmabort method is the easiest and most accessible; it is easily tolerated by women. But should be used only as prescribed by a doctor and under his control.
Mechanical cleaning, restoration
Scraping the uterus is prescribed in cases of fetal death for 7 - 8 weeks of pregnancy and later. Before surgery, a woman is examined and given special training. Cleaning is performed in the hospital, under general anesthesia or local anesthesia, with dilation of the cervix.
Scrape up a special tool (curette). They clean the top layer of the mucous membrane and remove it with the entire contents of the uterus. Cleaning materials are sent for histological examination to determine the cause of fetal death.
Treatment after missed abortion and curettage begin during surgery - inject drugs to quickly reduce the uterus (Oxytocin, Pituitrin).
The complex of medical and recovery measures after the surgical removal of a frozen fetus include:
- antibacterial drugs that prevent the development of infection in the uterus (Ceftriaxone, Metronidazole, Gentamicin),
- contraceptive hormonal drugs that protect against pregnancy and restore hormones in a woman’s body (Regulon, Marvelon),
- vitamin complexes to support immunity,
- proper nutrition with the inclusion of meat, vegetables, fruits, lactic acid products, juices in the menu,
- control ultrasound to detect fetal debris in the uterus.
Incomplete scraping is an indication for re-cleaning. If you experience severe pain after surgery, the doctor may prescribe painkillers.
Sexual life is recommended to start no earlier than one month after cleaning. За этот период восстанавливается эндометрий, и значительно снижается вероятность проникновения и развития инфекции в слизистой матки.
Месячные начинаются через 2 — 8 недель после операции. Если не восстанавливается менструальный цикл, назначают гормональные лекарства — аналоги прогестерона (Дюфастон, Утрожестан).
The next pregnancy can be planned no earlier than 6 months from the day of the curettage. The favorable period is 9 to 12 months after surgery. During this time, the recovery after curettage of a missed abortion has been completed, its causes have been established.
At the first fading of pregnancy, the doctor most often finds them in a woman's health disorders in the first trimester. Additional studies are not conducted.
The histology of scraping materials provides an answer to the reasons for re-fading of the fetus. In some cases, the doctor prescribes a comprehensive examination of both spouses. After that, if necessary, perform the treatment.
Woman's psychological recovery
Suddenly missed abortion is a psychological trauma for a woman and develops into depression. She blames herself for the death of the fetus. Therefore, the gynecologist directs each patient to a psychologist for professional help.
It is important for her relatives, especially her husband, to surround her with care and attention, to be patient. A woman is depressed, loses interest in life, is indifferent to everything, cries. She must be convinced that motherhood will be, but for this it is necessary to recover.
It is more correct to speak this topic, and not regret a woman. During this period, it is better to protect from contact with young children and pregnant women.
Communication with family and friends, practicing your favorite hobbies, meditation, walks will help to find peace of mind and confidence in future motherhood. It takes 1 - 2 months. Prolonged depression can last up to 6 months.
In this case, women are attracted to a psychiatrist who is prescribing medication with antidepressants and tranquilizers to recover. Mental pain subsides, life goes on, and the family re-plans a pregnancy.
The success of the second conception depends on the fulfillment of all prescriptions and recommendations of the attending physician, and on meeting the recovery time after cleaning. A healthy lifestyle, a good family climate, harmony of family relationships and observation by a gynecologist will help you safely endure the next pregnancy.
Examination after missed abortion
Many couples ask themselves the question “what to do after a frozen pregnancy, do we need to be examined?” There is no single answer to this question, since everything is individual.
In most cases, missed abortion occurs due to "random" errors in the early stages of embryo development, so gynecologists usually do not prescribe a thorough examination after the first missed abortion.
This makes no sense, since there is simply no “guilt” on the part of a woman or her partner.
A frozen pregnancy can happen in an absolutely healthy couple, and in this case the chances of a successful pregnancy in the future are very high.
Tests after a missed abortion are usually prescribed if this has not happened for the first time. Most gynecologists recommend screening after the second missed abortion, and in Western countries, tests are often prescribed only after the third missed abortion.
So, what tests you need to take after a frozen pregnancy? It all depends on how long it took, what histology data were obtained after scraping, what reason your attending physician suspects. The most common tests after missed abortion are:
Also, after a missed abortion, you may need to consult a geneticist, an endocrinologist and an immunologist.
The consequences of missed abortion
Pregnancy pregnancy very rarely causes complications or consequences if it was detected and eliminated in time.
The risk of developing a second missed pregnancy depends on how many missed pregnancies have already happened in a woman’s life:
- If this is the first missed abortion, then after it the risk of re-fetal death is about 20-25%.
- If this is the second missed abortion, then the risk of recurrence is 25-35%.
- If this is the third missed abortion, the risk of recurrent fetal death exceeds 40%.
Planning for pregnancy after missed abortion
You have every chance of becoming pregnant and having a healthy baby after a missed abortion. You just need to be patient and listen to the recommendations of the attending physician.
When can you get pregnant after a frozen pregnancy? Most gynecologists recommend waiting at least 3 months before proceeding with re-planning of pregnancy. This time is necessary so that hormones “return to normal” after a frozen pregnancy, so that the body has time to recover from the stress.
Sometimes the doctor recommends that a woman take birth control pills (OC): they prevent an untimely pregnancy and give the ovaries a little “rest.” It is noted that after the abolition of birth control pills, the chances of pregnancy are somewhat increased. This is a good bonus to the above benefits of taking OK after a missed abortion.
In the 3-month recovery period after missed abstinence, begin taking folic acid. This vitamin is extremely important in the early stages of embryo development. On our site there is a separate article on this topic: Folic acid.
If the pregnancy occurred earlier (for example, one month after the missed abortion), then the chances for its successful pregnancy will be quite high. However, you need to consult a gynecologist: the doctor may recommend special treatment to reduce the risk of re-frozen pregnancy or miscarriage in the early period.
How to avoid missed abortion?
The following gynecological advice will help reduce the risk of missed abortion:
- When planning a pregnancy, consult a doctor and pass all necessary tests (smear on the flora, analysis for TORCH infection, ultrasound of the pelvic organs). If all the tests are in order and the gynecologist resolves the pregnancy, then the risk of its interruption will be lower, since you are healthy in terms of the main “gynecological parameters”.
- When planning a pregnancy, start taking folic acid. Gynecologists recommend doing it at least 1 month before conception (and even better for 3 months). Taking folic acid several times reduces the risk of abnormal development of the central nervous system, which can cause missed abortion in the early stages.
- Stop smoking and drinking alcohol at the planning stage of your pregnancy, or as soon as you know that you are pregnant. See Alcohol during pregnancy.
- Start eating right. Limit the use of caffeine, which is contained in coffee, tea, some carbonated drinks. On our site there is a separate article devoted to this topic: On nutrition during pregnancy.
- Remember that some medications may increase the risk of missed abortion. For example, during pregnancy it is not recommended to take aspirin and drugs containing it. In order to bring down the heat or ease the headache, Paracetamol can be taken.
These tips will help reduce the risk of missed abortion, but do not guarantee that you will never again encounter this problem. Most cases of missed abortion remain beyond our control. However, do not lose hope. Even after several missed pregnancies in a row, a woman still has a big chance for a successful pregnancy and childbirth.
Consequences of a fading pregnancy
Pregnancy closure is an interruption of fetal development. Often an abnormal phenomenon occurs in the first trimester. The most dangerous period when fading occurs is considered to be 6–8 weeks.
During this period, important organs of the fetus are formed. There are episodes of fading of the fetus and a longer period of pregnancy.
Until the 22nd week, an independent rejection of the fetus usually occurs and is considered a “spontaneous abortion”. In later periods, though fortunately they occur rarely - by “premature birth”.
If the rejection has not occurred, the intervention of physicians and forced curettage are required.
For a woman who has experienced such a rejection, this is primarily a big blow and psychological stress. She is most worried about the question “is it really planning a baby after a frozen pregnancy?” Will the sad experience not happen again?
In physiological terms, the rejection of the fetus is fraught with inflammation due to incomplete removal of particles from the uterus. Therefore, we need a timely examination by a gynecologist and, if necessary, an ultrasound examination.
Treatment before a new pregnancy
The consequences of fetal death do not lead to serious conditions and exclude the occurrence of infertility on this background. Most women who have gone through this tragedy have a chance of a successful pregnancy. But in order to restore health, the possibility of planning a pregnancy after a fading pregnancy is recommended:
- eliminate physically loads for up to six weeks,
- conduct antibiotic therapy to eliminate infectious complications,
- sedatives with strong psycho-emotional reactions,
- carefully plan pregnancy after frozen, and to restore hormonal levels for at least 3 months to drink hormonal contraceptives,
- periodic consultations with your gynecologist.
More serious treatment is needed when detecting any abnormalities or diseases that caused the interruption. After pregnancy subsides, baby planning is allowed after the full course of treatment.
Important! Some drugs are excreted from the body for up to two months. This period is contraindicated for conception.
Compliance with simple recommendations makes it possible to successfully conceive soon. But, if the situation with the fetus is not worn out again and again, a thorough examination is necessary, identifying the causes and treatment of specialized specialists.
How to prepare for pregnancy after a missed abortion
The woman's body must be physiologically prepared for the new bearing of the fetus. Therefore, the first month after the interruption, it is necessary to exclude sex life, since sexual relations can adversely affect her health.
Further sexual life after the cessation of discharge is possible only with the use of contraceptives. Unwanted pregnancies during this period can also end miserably due to the uterus being unprepared for carrying.
The period after frozen pregnancies prior to pregnancy planning is dedicated to improving health with the help of:
- balanced nutrition
- vitamin complexes,
- walks in the air and positive emotions
- small physical exertion.
Of great importance is the psychological state. No talk with psychologists and sedative pills will not replace the home understanding and participation.
Surveys and analyzes in planning after ST
For a successful outcome of a subsequent pregnancy, it is necessary to find the causes of fading, to undergo the necessary examinations.
The first examination takes place immediately after curettage. The study of fetal tissues with the help of histological research helps to identify mutations, genetic abnormalities, hormonal abnormalities, infectious and chronic diseases of women. To confirm the preliminary diagnoses prescribe additional studies:
Control of new pregnancy after frozen
You can start conceiving after the natural restoration of the woman's body. Your gynecologist will be able to assess the condition of the uterus and hormones that are suitable for carrying a fetus.
But even if the conception happened before the planned dates, the chances of successful pregnancy are satisfied are great. In any case, timely consultation with a gynecologist who will recommend means to reduce the risk of another miscarriage is necessary.
Recommendations of doctors in the planning of pregnancy after missed abortion
Adhering to the recommendations of gynecologists, it is possible to exclude the likelihood of unwanted abortion:
- Planning conception, act only in tandem with a doctor. Examination, testing and resolution of a gynecologist for pregnancy will reduce the risk of her fading.
- Take folic acid for three months before conception - it will reduce the risk of fetal abnormalities that cause fading.
- Eliminate bad habits. Negative effect on conception and fetus alcohol, smoking.
- Adjust the power. Prefer healthy foods and give up on convenience foods and caffeine-containing beverages.
- Be serious about taking medications. Some of them are dangerous for the fetus and the course of pregnancy.
No one can guarantee that the process will be successful. But balanced pregnancy planning after a missed abortion and a sensible approach greatly reduce the risk of miscarriage. Even a few unsuccessful attempts allow a chance for a safe pregnancy.
Nutrition in preparation for pregnancy
Planning the sex of the child for ovulation
Hormone tests for pregnancy planning
Folic acid when planning
Diet for conception
Caution Vitamin E When Planning Pregnancy
What is conception?
Ovulation discharge if conception has occurred
Planning the sex of the child for ovulation
How can I recover from a frozen pregnancy? - Home treatment
Histology after pregnancy, frozen, is carried out immediately after surgery, it helps to identify the pathology that led to the death of the fetus. The question of how to recover from a frozen pregnancy becomes relevant for women in such an unpredictable situation.
This condition causes shock and depression. On the physiological side, the body experiences a strong hormonal shake. The result may be a serious hormonal failure, which will increase the psychological problems. To recover, a woman will need time. In addition, during this period, the support of family and loved ones will play an important role.
Features of physiological rehabilitation
The term "missed abortion" means the death of the fetus in the period up to 20 weeks of its development. It can result in spontaneous miscarriage or minor surgery (curettage of the uterus). Any of these situations has a negative impact on the health of a woman.
It should be noted that it is a miscarriage, or, as it is also called, a miscarriage, is the best option.
In fact, the mother's body alone or with the help of medicines saves a dead or non-viable fetus. Scraping is a small operation, albeit a small one.
During its holding, the cervix and uterus will be traumatized. Therefore, a woman's body needs more time to recover.
This is reflected in the rehabilitation period recommended by gynecologists. For example, after a spontaneous abortion recovery after pregnancy, the frozen will take at least 3 months. And in the case of curettage, a woman can become pregnant without harming her health and the health of the unborn child no earlier than six months later, but most often this period is extended to one year.
What is the reason? In the latter case, the uterus is actually injured twice:
- fetal death,
- surgical intervention (scraping).
Upon completion of the entire process, it has the appearance of a solid surface that is bleeding. Only to restore a normally functioning endometrium will take up to 6 months.
In addition, cervical erosion may be an undesirable consequence of such an operation. Therefore, regular visits to the gynecologist will be mandatory for the entire period of rehabilitation.
Only he will be able to correctly assess the results of recovery and, if possible postoperative complications appear, prescribe timely treatment.
Back to the menstrual cycle
The problem may be the difficulty of restoring the monthly cycle, that is, menstrual and ovulatory. Cases of settling normal periods of menstruation in the first two months also occur. However, often a hormonal failure, which is caused by abortion, leads to a delayed menstruation.
Gynecologists warn their patients that this delay for up to 45 days is almost not considered pathology, therefore, does not require medical correction.
Thus, the female body is trying to recover on its own. If the delay period is lengthened, then perhaps a medical correction of the hormonal background of the body is necessary.
But the decision on the appointment of hormonal drugs takes the attending physician.
The next cause of menstrual irregularities after a spontaneous abortion can be an inflammatory process or the presence of fetal remnants in the uterus. To avoid this, a week after surgery, an ultrasound scan is prescribed.
Back to the screening need more tests?
This question worries many families who are faced with the problem of pregnancy, which has stopped. But in this case there is only an individual approach. Everything is decided by the attending physician. Очень часто причиной данной патологии становится проблема со здоровьем матери или плода, которая возникла в первом триместре беременности. Но и у абсолютно здоровой пары такой результат возможен.
Чаще всего специалисты придерживаются такой тактики. После впервые регистрируется такой проблемы серьезных исследований не проводят. But in situations where the next pregnancy with a married couple ends in spontaneous abortion, various diagnostic methods are required.
As a rule, a laboratory plan begins with a histological examination. Both fetal tissues and thin sections from epithelial tissue of the fallopian tubes and uterus are taken for examination. That is, at the same time it will be possible to answer the question of whether there is a pathology in the development of the fetus or a fading problem associated with the health of the mother.
When conducting this study, you can identify the following pathological processes:
- venereal diseases,
- pathological processes and malformations of the fetus that are caused by viruses, such as rubella or herpes,
- female genital pathology
- hormonal disruptions of the maternal organism,
- genetically determined abnormalities of the fetus.
However, only one histological study is not able to give a complete answer about the factors that caused the missed abortion. For this you need to conduct additional laboratory tests.
Studies of histology after curettage may indicate the exact cause of the pathology of gestation.
Based on this research, it is possible to identify the direction of further searches, as well as pre-appoint drug therapy.
Return to sexual health is allowed sex life?
This question is often asked by women after discharge from the department. It all depends on how it was decided miscarriage:
The first time sexual intercourse can be painful, which is natural. The next pregnancy can begin to plan no earlier than 6 months and after a preliminary examination.
Back to the picture. Do you plan your next pregnancy?
Pregnancy is not a reason to panic. A woman should know that she has a great chance to get pregnant and have a healthy baby. Only for this you need to give some time to your body for recovery.
The minimum period is at least 3 months for spontaneous or medical abortion, and in the case of curettage, it is extended to six months. Yes, and the frozen histology should confirm the absence of a serious pathology.
Most often during this period, the gynecologist recommends taking medical contraceptives.
Their main goal is to prevent unplanned pregnancies, to provide a hormonal timeout for the ovaries. In addition, experts noted an increase in the chance of getting pregnant from a woman immediately after the abolition of the contraceptive drug.
Additionally, during this period, the intake of vitamins, especially folic acid. It improves the exchange processes and helps the female body recover quickly.
Back to zm_stuProfіlaktika froze
If the woman’s first pregnancy has ended unfavorably, then, in order to prevent further freezing, the expectant mother must adhere to such preventive measures:
By observing preventive measures and carefully considering their health, every woman will be able to bear and give birth to a healthy baby.
The actions of doctors in fetal death
To abort a failed pregnancy, the following methods are used:
- Waiting When detecting a frozen pregnancy in the early stages, it is better to give the body a chance to get rid of the dead embryo on its own. The doctor must monitor the condition with an ultrasound. If the fetus is not separated within 7-10 days, additional measures are required.
- Medical abortion. The essence of this procedure is to induce processes in the body, similar to those that occur during a spontaneous abortion. A woman is given a drug to drink that causes rejection of the ovum, which is then expelled with blood to the outside. Some agents are inserted into the vagina. Use of these potent drugs is only allowed under the supervision of a physician or qualified nurse.
- Scraping. This method has to be resorted to when the dead embryo is too firmly fixed to the uterine wall and is not separated, despite the accepted preparations. Scraping method is also used to clean the uterus from the remnants of the ovum and chorion with their incomplete rejection in the process of miscarriage.
- Artificial labor pains. If pregnancy subsides in the second or third trimester, when the fetus is large and the placenta is formed, the woman is given medication to stimulate the onset of labor. They cause contractions followed by disclosure of the cervix and the birth of a dead fetus.
- Cesarean section. This method is used as a last resort, when attempts to cause artificial childbirth have failed or the condition of the woman does not allow the fetus to be removed by other means.
Women with missed abortion have lower resistance to infections and a high risk of inflammation in the uterus after the expulsion of the fetus. In this regard, they must prescribe a prophylactic course of antibiotics. In some cases, repeated removal and curetting are carried out to remove the altered endometrium and inflamed tissues.
Another negative consequence of missed abortion is the detrimental effect of the deceased fetus on blood clotting and the increased risk of bleeding. Careful medical monitoring of hemostasis at all stages of medical procedures helps to prevent this complication.
Examinations and Treatment
Full recovery after missed abortion is impossible without a thorough examination. Diagnosis has two goals:
- establish the cause of missed abortion
- to assess the state of the reproductive system and the readiness of the organism for the future conception.
The survey consists of several stages:
- gynecological examination (for detection of infection, inflammation and other disorders),
- diagnostic ultrasound (visual examination of the uterus, tubes and ovaries),
- vaginal smear analysis,
- blood test for hemoglobin, hormones, antiviral antibodies,
- additional studies (assessment of thyroid function, genetic examination, etc.).
Based on the results, the patient is prescribed treatment. For fever and abdominal pain after missed abortion, additional cleaning with the subsequent prescription of antibiotics is indicated. With hormonal disorders and failure of the menstrual cycle, it is necessary to take drugs containing different combinations of estrogen and progesterone. Complications such as depression require the help of a psychotherapist, as well as the administration of antidepressants and sedatives.
How to prepare for the next pregnancy?
Statistics state that missed abortion rarely affects the future ability to have children. More than 85% of women become pregnant safely, and they have healthy babies. However, doctors recommend to postpone the attempts of the new conception. Why is it harmful to get pregnant quickly and what is the minimum time needed to restore health?
The inner surface of the uterus after rejection of the fetus should be restored. This is especially true for women who have undergone a cleansing procedure during a missed pregnancy. Their endometrium needs time to bounce back and be ready to accept a new fertilized egg.
If fetal death has occurred over long periods, then the uterus must not only increase the endometrium, but also shrink. The recovery period at the same time takes about the same time as the rehabilitation after childbirth (45-60 days). During this time, sexual intercourse, exercise, exercise, swimming in the bath and swimming in the pool are prohibited.
Conditions under which a new pregnancy is possible:
- good physical and mental well-being of women
- lack of fever, abdominal pain, vaginal discharge,
- recovery of the regular menstrual cycle.
If there are complications in the form of pain and temperature, a longer period is required for recovery. All this time you need to be protected with the help of designated contraceptives by a doctor. Usually gynecologists prescribe oral contraceptives, which in the first weeks after the termination of pregnancy should be combined with barrier means (condom).
Increase the chance of a full pregnancy by using the following measures:
- treatment and prevention of urinary infections (thrush, cystitis, STDs),
- a diet rich in vitamins, the use of healthy nutritional supplements,
- control of existing chronic diseases,
- treatment of hidden foci of infection, such as carious teeth,
- elimination of stress and achievement of psychological comfort with the help of auto-training, yoga and other practices,
- general strengthening procedures (physical education, nature walks).
About planning your next pregnancy
When a missed abortion was desired for a woman, she experiences severe stress. And then events develop in two ways. Some representatives of the weaker sex immediately ask when the offensive of the next is possible and how to prepare for it, while others cannot even think about a second pregnancy. Both ways of thinking are normal. But the desire as soon as possible to conceive a child is unreasonable. Yes, the woman has already got used to the image of the future mother, made plans, thought out the name of the boy or girl. But in any case, the rapid onset of the next pregnancy again threatens with serious pathologies, a repetition of the tragic scenario.
The first thing to do is find out the cause of the miscarriage. If fetal fading was caused by bad habits, infections, hormonal disorders, then the chances of re-pathological development of the fetus are great. Two or three frozen pregnancies in the past adjust the body to habitual miscarriage. This is a pretty serious diagnosis. It is difficult to treat even after the elimination of risk factors. The female uterus out of habit will reject the embryo at the same gestation period. This is precisely what subconsciously feared women who do not hasten with the next pregnancy.
The first priority should be a comprehensive examination, physiological and psychological recovery.
As for the next pregnancy, this, according to gynecologists, should occur no earlier than 6 months.
Treatment and contraceptives after missed abortion
Experts strongly recommend to refrain from sexual intercourse for at least 2 weeks, if the period was short, and it all ended in miscarriage. After it, bleeding lasts an average of 14 days. If there was a scraping, it is necessary to refrain from sex for a month so that the cervix closes and its inner surface heals. After this time, doctors often prescribe hormonal contraceptives to their patients - they help the body cope with hormonal disruption. These are usually combined oral contraceptives with low doses of estrogen and progestogen, in particular Yarin, Regulon, Jes plus, Zhannin, Novinet. They all suppress ovulation, alter the cervical mucus so that it becomes impermeable to sperm. Oral contraceptives have a number of contraindications. These include thrombosis, stroke, angina pectoris, diabetes mellitus, epilepsy, hepatitis, migraines, liver failure, severe depression, and venous embolism. You can not take them with cholelithiasis, smoking, breast tumors, over the age of 35 years. You also need to know about the side effects of such drugs. These are mood swings, nausea, migraine, weight gain, thromboembolism, allergic reactions.
Often, physicians prescribe Duphaston or Utrozhestan for patients — these drugs also restore hormonal balance.
The World Health Organization (WHO) recommends that women abstain from a new pregnancy after a miscarriage for six months. Although many researchers claim that there is no danger in its earlier occurrence, for example, in 3-4 months. And yet you should listen to the recommendations of WHO. For six months, it is very important to lead a healthy lifestyle, control your diet every day, taking care of proper intake of vitamins, weight loss, if necessary, daily stays in the fresh air, positive emotions. Be sure to take vitamins C, E, B6.
If a woman has experienced a miscarriage very emotionally and painfully, then it is advisable to contact a psychologist, a psychotherapist.
The subconscious fear of repeating the past scenario can be an obstacle to even getting pregnant. Therefore, it is important to leave the negative in the past, to believe that bad will not happen. According to statistics, 80-90% of women after a frozen pregnancy and following medical recommendations are bearing and giving birth to healthy babies.
Rehabilitation after a miscarriage is a complex event, which consists of:
- medical examination
- recovery of reproductive function
- normalization of the menstrual cycle
- emotional mood
- healthy lifestyle.
Recovering from a frozen pregnancy! Hi,
Hello! I also had ST after 2 weeks as cleaning was under anesthesia cleaning was for 12 weeks the reason for the ultrasound when looked could not say everything was good just the child's heart stopped saying the doctor that the tablet may not help the term is not small. attributed candles for 10 days to insert terzhinan began to hurt a little to pull the stomach and discharge pink doctors on the chair looked more than once everything said well I do not know if this is the norm or not that the discharge goes? (they are going to end but not much) cleaning was January 9, 2017, but this is not my first. The first was in February 2016 a period of 5-6 weeks, and the second in January 2017. While my doctor has a suspicion of thick blood a month later, we’ll say we’ll find out the reason for ST. Now I do not know when it will all end (selection) and the mes will begin. Who can help? And now I'm afraid to become pregnant suddenly again it will be. Just the first time everything went without the intervention of the doctor and the second time everything was under anesthesia, it is very scary and psychologically very hard. because I have never done this.
Alexandra, I also had an ST. On a period of 6-7 weeks, the fetus died after an ultrasound scan, which showed that everything was fine, found the ST at 8-9 weeks. They did the cleaning. Not good. Did the cleaning a second time in a week. It was hell. The pain is unbearable.
You have a good doctor that did not immediately barbaric cleaning. I regret that I agreed. Abroad in such cases they do not cleanse, but let nature do their work, naturally under the supervision of a physician. And we have doctors barbarians.
After cleansing, my uterus inflamed, the microflora got lost for a long time, although there had never been such problems before.
Histology showed that there was no inflammation. Anaza for infection - did not find anything.
I was told not to get pregnant for half a year.
I wonder why you can not also half a year?
The girlfriend had a ZB, too, after an early ultrasound, she could not be cleaned. It all entered. I went to the control ultrasound, everything is OK.
In the next cycle, she became pregnant, now she has a pretty daughter.
Do not worry! my kuma had a miscarriage at 11 weeks. And pills. Now their daughter is already 2 years and 7 months old. So everything will be fine with you)))
An unpleasant procedure in the life of a woman
When doctors accurately determined using ultrasound that the fetus in the uterus of a woman does not have vital signs, a manipulation called scrape or brushing is prescribed. It represents the removal of a frozen embryo and its membranes using special surgical instruments under general anesthesia. Cleaning a missed abortion is a surgical procedure that requires the written consent of the pregnant woman.
Scraping with missed abortion is carried out strictly in sterile conditions after a preliminary examination of the woman. First, it is examined by a gynecologist, excludes the presence of contraindications for the operation and prescribes the necessary laboratory tests (general and biochemical blood test, blood for HIV and syphilis).
How is scraping done
Currently, cleaning after missed abortion is a fairly common operation, which is owned by all obstetrician-gynecologists. Весь процесс удаления погибшего плода безболезнен для женщины и занимает около 30 минут.
Операция проводится на гинекологическом кресле после начала действия внутривенного общего наркоза. The gynecologist treats the female genitals with an antiseptic and begins the procedure for expanding the cervical canal. After the cervix has been opened, it is fixed and the uterus is scraped with special tools (curettes). At the end of the manipulation, endometrial contraction medications are administered, and the woman is sent to the ward. A subsequent pregnancy after curettage of a missed pregnancy should be planned more carefully.
Life after curettage during missed abortion
Rehabilitation activities after this operation play an important role. The woman is primarily concerned about discharge after cleansing a missed abortion. Under normal circumstances, they should not be strong for several days. Their color and smell correspond to the usual menstruation. To prevent infection in the cavity of the injured uterus, it is necessary to change the gasket and flush the external genitals.
The temperature after cleaning a frozen pregnancy can be subfebrile (37-37.5 degrees) for three days. It should be measured in the morning and evening, but there is no need to take any antipyretic drugs. Doctors usually prescribe a course of antibiotic therapy so that the inflammatory process in the uterus does not develop.
Two weeks after cleaning a missed pregnancy, a woman must visit a gynecologist and undergo an ultrasound examination of the pelvic organs. In some cases, the doctor additionally prescribes a course of hormone therapy, which normalizes the "female" background.
Sometimes there are complications.
Still, any surgical intervention is associated with certain risks and cleaning after missed abortion is no exception. The heaviest of them are:
This damage to the uterine wall is extremely rare and is associated with the presence of structural features or deformation of the uterus cavity.
Complication can develop at the time of the operation itself or after some time. The amount of discharge after curettage of a missed pregnancy is monitored by a doctor throughout the entire period of the woman being under observation in the hospital. The cause of occurrence may be poor coagulability of the blood of a pregnant woman, the absence of a proper contraction of the uterus or the remains of the ovum.
The uterine cavity after surgery is a continuous bleeding surface, subject to the accession of any infection. The task of the woman is to closely monitor their state of health after the procedure. If the discharge after curettage of a frozen pregnancy has acquired an unpleasant odor or color, then you should consult a doctor without delay.
Doctors remove the dead embryo blindly, so it is possible that in the uterus may remain parts of its ovum. The temperature after curettage of a missed pregnancy, incessant bleeding, an enlarged uterus are clear signs of such a complication. It is very important that the woman undergo an ultrasound scan in time to eliminate the presence of residues.
- • Formation of adhesive processes.
Complication makes itself felt after a large amount of time and sometimes leads to the development of female infertility.
Planning a baby after scraping
A woman who has lost a long-awaited child, immediately asks the doctor about when you can plan a pregnancy again after scraping a frozen pregnancy. Experts in such situations recommend to abstain from conception for at least six months, and it is best to suffer a year to restore the hormonal processes in the body.
Tell friends: 1 comment on this entry.
Thank you very much, very good article !! It helped me, today I was scraped ... I hope there will be no complications, and everything will be fine!
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- When to start a new life?
In the days of our parents' youth, only a few couples were engaged in purposeful planning of pregnancy. Today, most parents are aware of all the responsibility that will fall on their shoulders with the birth of a child, so they take the issue of increasing the family very seriously. Nevertheless, at this stage they often have to face many difficulties.
It happens when the expectant mother comes to the doctor for consultation before the onset of pregnancy; she has a pathology of the internal genital organs. Sometimes an already occurring pregnancy proceeds in a completely different way, as desired. And both of these situations lead to one sad result: curettage of the walls of the uterus. Further planning of the child rests on very important questions: when should pregnancy begin after curettage? Can I get pregnant after this manipulation? Will this intervention have a negative impact on the development of the future baby? In order to answer them, it is necessary to penetrate a little into the very essence of this surgical technique.
When should the uterus be cleaned?
Scraping is the removal of a functional layer from the walls of the uterus, which is usually rejected on its own during menstruation. Carrying it out is indicated both for the purpose of diagnosis and for the removal of the ovum (during a missed abortion or during an abortion).
During this manipulation, which is usually carried out under short-term general anesthesia, special tools are introduced into the cavity of the uterus - curettes, with which the entire mucous membrane is carefully scraped off. It is restored during one menstrual cycle, therefore this manipulation should not cause any harm to the woman’s body. However, doctors reluctantly resort to this intervention, since in practice it is accompanied by various unpleasant consequences:
1. During the insertion of instruments into the cavity, the mucous membrane and sometimes the muscular layer of the cervix is damaged, and true erosion is formed. This can cause the development of chronic pseudo-erosion, failure of the cervix and subsequent infection of the uterus after curettage.
2. The walls of the uterine cavity suffer most during and after curettage. The fact is that the doctor performing this procedure in order to make sure that the mucous layer is removed completely, especially during curettage of a missed pregnancy and medical abortion, continues the procedure until the appearance of the so-called “first snow crunch” - the characteristic sound that occurs when the curette moves along the muscular layer of the uterus. That is, in practice, not only the functional layer is removed, but also partly muscular. This means that the recovery will be much longer, and in some cases scars will remain on the uterus. These scars can cause a violation of the process of attachment of the ovum.
3. The healing of the uterus after curettage does not always occur normally, sometimes the postoperative period is accompanied by complications that permanently deprive the woman of work capacity.
Considering all the potential problems, doctors try to use instead of diagnostic curettage another manipulation - hysteroscopy. This is an examination of the uterine cavity with the help of special endoscopic equipment, the probe of which is inserted through the cervix inside it. During hysteroscopy, the doctor can not only carefully examine the walls, but also takes a piece of suspicious tissue for laboratory testing if necessary. After hysteroscopy, the woman does not need a long recovery period, especially if during the study a picture of the physiological state of the uterine cavity was revealed. In some cases, after hysteroscopy, the same complications arise as after curettage, but the probability of their occurrence is extremely low.
In order what problems may arise at the stage of healing of the uterine cavity after curettage, it is necessary to get an idea of its physiological course.
Postoperative period: norm and pathology
The physiological course of the postoperative period is aimed at natural cleansing of the uterus from the remaining fragments of the mucosa, vascular thrombosis and healing of the wound surface. If the pregnant uterus was scraped (during a medical abortion or in order to remove a missed pregnancy), then after this manipulation, it is reduced to its natural size, and hormones gradually normalize in the woman's body. Outwardly, these processes are manifested as follows:
1. In the first few days after curettage, the woman feels pain in the lower abdomen, behind the bosom. They can be pulling, aching or cramping. Pain will be worse if a woman receives treatment with uterine-reducing drugs (in particular, oxytocin). So the uterus returns to its former size. Pain in the first hours, immediately after the manipulation - this is also a consequence of damage to the uterine walls.
2. From the vagina appear bloody discharge. After curetting, the discharge may be very dark, with clots, or scarlet. Then, as the vessels heal, the discharge after curettage becomes more and more brown, and after about a week - mucous or disappear altogether. Longer and more intense discharge after diagnostic curettage, conducted to remove uterine polyp. Discharge after an abortion more scarce, brighten faster, since the entire mucous membrane is already removed.
3. In the first days after the surgical intervention, the body temperature may slightly rise (in subfebrile limits, that is, up to 37.5 ° C). This is a natural reaction of the body to the presence in it of an extensive wound surface, which is the uterine cavity. But even a low temperature after 3-4 days is an alarming symptom indicating inflammation.
The general state of health of the woman after a scraping usually does not suffer. Immediately after curettage, insignificant weakness or decrease in blood pressure is possible, which is explained by the hemorrhage suffered.
When does the process go wrong?
If recovery after the transferred manipulation deviates from its normal course, the woman can feel or see the following changes:
1. Completely absent after curettage, sometimes they disappear immediately after surgery. This may be a sign of the development of hematometers - accumulations of blood in the uterus due to spasm of the cervical canal or flaccidity of the uterus. If you do not take action in time, after a few days the body temperature rises - the infectious process joins. The treatment of hematometers consists in removing blood residues from the cavity with a vacuum aspirator.
2. Severe pain after curettage, which appeared after a few days, localized in the lower abdomen. On their background, the body temperature rises. So manifests itself inflammation of the body of the uterus - endometritis. Treatment - conservative, includes antibacterial drugs and anti-inflammatory drugs.
3. Bleeding in the postoperative period. It can be the result of damage to a large vessel, reduction in blood clotting or resolution of hematometers. Hemostatic and uterine-reducing agents are prescribed.
Therefore, observing your own well-being after curettage is a way to avoid very serious complications.
When to start a new life?
You can get pregnant after curettage in the next menstrual cycle. But this should not be done categorically: the mother's body is not at all ready to accept and develop the future baby. Considering how serious the intervention occurred in the internal genital organs and what the complications can be, you should not rush to conceive.
If the recovery after curettage is normal, then the doctors are allowed only after 6 months to plan the onset of a new pregnancy.
During the recovery period, they recommend taking combined oral contraceptives that help restore hormonal levels. In addition, these six months can be spent with maximum benefit, how to prepare for the emergence of the unborn child inside. This is especially important if the scraping was carried out on the termination of a frozen pregnancy.
1. First, it is necessary to undergo a thorough examination of all organs and systems in order to, in the presence of somatic pathology, take measures to eliminate it or select an effective supportive treatment. It is especially important when suffering a frozen pregnancy to be examined by an endocrinologist, since it is hormonal pathology that can stop the development of the baby.
2. Secondly, and most importantly, you need to consult a qualified gynecologist to identify possible gynecological causes of missed abortion. These may be hidden infections (cytomegalovirus, ureaplasma, etc.). They need to be treated before the onset of a new pregnancy in order to avoid a sad outcome, since treatment after conception will harm the baby. To consult a gynecologist at the planning stage of pregnancy is also necessary if the scraping was carried out for another purpose. The doctor will examine the genitals, make sure that there is no inflammation in the uterus and ovaries. Then you can not be afraid of getting pregnant, knowing that the body is ready to meet the baby.
3. Thirdly, it is necessary to strengthen your body, to pay attention to proper nutrition, healthy lifestyle, sport. Often, after curettage of a missed pregnancy, the woman sinks into a depressive mood. This is easy to understand. However, in this case we should think not about the lost child, but about the future: he needs a strong, vigorous, healthy mother who can bear him and give birth to a healthy one.
Sometimes after curettage of a missed pregnancy, doctors recommend that you go to the genetic center before you get pregnant again. This is explained by the fact that genetic pathology can be one of the reasons for stopping the development of the fetus. Geneticists will calculate her risk and, if a woman becomes pregnant again, they will observe her before the onset of labor.
What is cleaning and how does it go
Medical cleaning is carried out in order to remove the dead embryo from the uterus. If this is not done, the decomposition of the tissues of the deceased fetus will cause a local inflammatory reaction, and also provoke a general intoxication of the body. Depending on the period at which the development freeze occurred, physicians may choose one of the removal methods.
With the help of a special tool, the cervix is opened slightly, the extractor is introduced into the organ and its contents are sucked off. The operation is performed under local or general anesthesia. The uterine epithelium during the procedure is minimally damaged, and the bleeding after such an intervention does not last long (1-3 days). Vacuum aspiration is done with fading for up to 8 weeks.
Therapeutic curettage is performed under local or general anesthesia (the type of anesthesia is determined by the doctor after clinical laboratory tests in preparation for the operation). Uterine endometrium is cleaned with special tools.
This surgery, even carefully conducted by an experienced doctor, is traumatic for the female reproductive system. The recovery process after it will take a long time, and the bleeding from this type of treatment can last 2-3 weeks.
For a period of 18-28 weeks with the help of drugs artificially stimulate the generic activity, and after the dead fruit comes out, carry out scraping, as described above.
The deceased embryo, after being removed from the uterus, is sent for histological examination in order to identify the causes of the arrest of development.
After removal of the stalled fetus, the woman must undergo a control ultrasound.
Despite the fact that the surgical treatment is carried out in a hospital and in compliance with all the rules of asepsis and antisepsis, after removing a frozen embryo from a woman, the following complications can arise:
- Endometritis (acute inflammatory process of the damaged uterus mucosa).
- Uterine cervix rupture. Such breaks heal independently for a long time, they can suppurate. To prevent the accession of a secondary infection, immediate repair of such traumatic neck cracks is necessary.
- Incomplete removal of pieces of the ovum that begin to reject the female immune system, causing hyperthermia and severe pain. In severe cases, with the late treatment of medical care, the development of sepsis.
In order to notice the signs of developing complications in time, in the first days after surgical treatment it is necessary to carefully control such moments.
The presence of even a small hyperthermia, even if there are signs of a cold, should serve as a reason for additional examination.
Воспалительный процесс может начаться в репродуктивной системе, а простуда возникнет уже из-за ослабленного воспалением иммунитета.
В норме выделения будут скудными и кровянистыми, напоминающими менструальную «мазню». The presence of strong bleeding or discharge with an unpleasant odor and with additional admixtures to the blood will indicate the presence of a pathological process.
In the first 2 days after extraction of the embryo, due to instrumental intervention, slight pain in the lower abdomen is possible.
But a long or intense pain syndrome is a sign of the development of postoperative gynecological pathology.
Any deviation from the normal course of the recovery period should be immediately examined and treated. Timely treatment will help reduce the effects of complications, such as the development of chronic diseases or even infertility.
To recover from a frozen pregnancy and the subsequent retrieval of a dead embryo, the female body will need about 3 months. During this time, normal menstrual flow will be established, the cycle will be normalized, hCG (pregnant hormone) will be eliminated from the body. Despite the fact that 3 months is enough for recovery, doctors recommend planning a pregnancy after curettage of a frozen pregnancy no earlier than after 6-12 months to reduce the risk of recurrence of this pathology.
In order to minimize the risk of embryo death during subsequent pregnancies, the following treatment is prescribed after cleansing.
As prevention of secondary infection after curettage, especially if fetal freezing was not immediately detected, broad-spectrum antibiotics are prescribed.
If the patient has purulent discharge or discharge with an unpleasant odor, her drugs are selected individually, taking into account data from clinical and laboratory studies. During this period, it is better to avoid sexual intercourse or use barrier contraceptives (condoms).
For the female psyche, which is already set for the upcoming motherhood, the loss of an unborn child is a great deal of stress. Sometimes women need the help of a psychologist to stop feeling guilty about what happened and get rid of the fear of subsequent failures. In severe cases, at the initial stage of psychological treatment, antidepressants or tranquilizers are prescribed in combination with hormonal and antibacterial therapy.
Risk of pathology recurrence
The probability that the fetus will die in the womb is at each conception. But even if this happened, the risk of recurrence of this situation is small. To make and give birth to a healthy child, you must:
- Plan a pregnancy no earlier than six months after the previous unsuccessful attempt.
- During the recovery period to pay attention to their own health, because, as a rule, a healthy child is born in a healthy mother. It is possible that the organism was weakened due to a chronic disease and was unable to provide the embryo with the substances necessary for development.
- Psychologically tune in and believe that this time everything goes well, and enjoy the feeling of upcoming motherhood. Do not plan to conceive, if the fear of losing the child.
Freezing pregnancy is not a sentence, and the risk of a recurrence of a repeated situation is minimal. It is necessary only during the recovery period after cleansing to pay careful attention to your health and psychological attitude, and then there will be good chances to give birth to a healthy child.
Bulgakova Olga Viktorovna
Doctor obstetrician-gynecologist, Stavropol, Graduated from the Stavropol Medical Academy with honors. Residency in obstetrics and gynecology. Advanced training for the treatment of infertility.