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Pregnancy after missed abortion: planning and testing

Pregnancy does not always end in childbirth. Sometimes the development of the embryo in the fetal egg stops, and it dies, causing miscarriage. According to statistics, most often missed abortion is diagnosed for a period of 6-8 weeks.

A woman has either a natural miscarriage, or is sent to an artificial interruption of pregnancy, if the fertilized egg that regresses in development still remains in the uterus.

Most often, the expectant mother does not notice the moment of death of the embryo and may still notice signs of pregnancy in her: pain and heaviness of the mammary glands, toxemia, drowsiness. This is due to the fact that the hormone hCG is still present in the blood, although it is already in a much smaller quantity.


Identification of causes and risks

Pregnancy after missed abortion

Many women planning a pregnancy after a frozen pregnancy are concerned about the question - how likely is the embryo to die the next time? To assess the risks you need to know the factors that led to the regression of the development of the ovum. Professionals need to investigate aborted material and establish the reasons for which it died:

  • Genetic disorders of the fetus. Scientists have found that about 80% of pregnancies that fade at up to 8 weeks have chromosomal abnormalities. The number of chromosomes is either altered or their structure is disturbed.
  • Hormonal disorders. About 20% of pregnancies freeze due to an excess of testosterone, either prolactin, or due to a lack of progesterone, or as a result of a combination of these factors. The vast majority of pregnancies, frozen due to hormonal imbalance, die because of the insufficiency of the luteal phase of the menstrual cycle in the mother.
  • Immune causes. Pregnancy may die due to the incompatibility of the spouses, as well as due to the presence of antibodies in the mother’s blood, causing either thrombosis in the placental circulation, or the occurrence of inflammation in the chorion.
  • Infectious factors. The most common cause of death of the embryo due to infections is infection in the early stages of gestation. This provokes abnormal measurements in the circulatory system between the mother and the fetus.
  • Insufficient blood supply to the placenta. It is a common cause of spontaneous fetal death in 2 and 3 trimesters. Disruption of blood flow can occur for two reasons: due to abnormalities in the structure of the vascular system of the placenta, or due to the formation of blood clots in it, which is caused by genetic factors (for example, thrombophilia in the mother).

A study of aborted material during a non-developing pregnancy will determine what caused the death of the embryo and the attending physician will either prescribe treatment to the woman or continue research on her body to see if it is possible to prevent a missed abortion in the future.

Examination after missed abortion

Examination after missed abortion

If the aborted material was not examined, then before planning the next child, a woman needs to undergo a series of examinations to determine whether the embryo's death was due to a spontaneous genetic failure or it was a result of pathological processes in the body of the future mother.

If in the first case no treatment is required, then in the second doctors will have to think not only about the scheme for correcting pathological disorders in a woman, but also about what kind of drug therapy to be carried out in case of a new pregnancy.

Genetic examinations involve a visit to a geneticist who will take the necessary blood tests and determine whether hereditary genetic mutations are present in the couple that is preparing to conceive a child.

The study of hormonal background - involves taking blood on certain days of the cycle to study the concentration of hormones in a woman's body. Estrogens, prolactin, FSH, LH and testosterone are given on days 3–5 of the menstrual cycle. 17-OH progesterone, DEA sulfate, SHBG - from 8 to 10 day of the cycle. Progesterone - on day 7 after ovulation took place.

Studies of autoimmune disorders include a visit to a gynecologist-immunologist, tests to determine the compatibility of spouses, the presence of antisperm antibodies in a woman, and pathological changes in the functioning of the immune system. The main study will be to analyze the exclusion of antiphospholipid syndrome (APS), contributing to the rejection of the embryo.

Standard planning examinations: ultrasound examination of the uterus and appendages, STD analysis, spermogram , gynecological examination, a picture of a Turkish saddle, a visit to a therapist.

A complete list of the necessary tests to bring problematic - each specialist, examining the clinical picture of missed abortion, can appoint examinations that are necessary only in a particular case.

Planning after missed abortion

You can start planning a child only after the complete restoration of the reproductive system after a frozen pregnancy. The gynecologist will determine the readiness of the body to conceive, based on several factors:

  1. Normalization of the menstrual cycle;
  2. Healing of the uterus after curettage;
  3. Normalization of hormonal levels ;
  4. Lack of STDs, or the presence of some of them in inactive phases;
  5. The usefulness of the luteal phase of the menstrual cycle.

The physician may advise you to drink a course of vitamins and folic acid before planning a pregnancy.

Despite the fact that a visit to a geneticist and a gynecologist-immunologist is recommended only after several missed pregnancies, it must be understood that the embryo never stops developing unreasonably. Therefore, it is not necessary to wait for the child’s death to repeat and to start planning the next pregnancy only when the doctors carry out the necessary research.

Perhaps, during the planning and for the first weeks after conception, they will prescribe a drug therapy, which will help the child to avoid the threat from the maternal organism and allow him to develop properly and at a normal pace.

How long to wait for the next planning?

After losing the desired pregnancy, a woman can be in a depressed state for a long time, and her only desire will be to drown out the pain of losing by conceiving another baby. Therefore, the reception at the gynecologist invariably raises the question: when can one become pregnant after a missed abortion? Doctors advise you to start planning no earlier than six months after curettage or miscarriage.

This period is not determined by chance:

  • Surveys that need to be taken will take a lot of time. Therefore, a woman will have to wait several months before finding out the cause of the death of the embryo.
  • After curettage of the fetal membranes of a frozen pregnancy, the uterus should heal, and the endometrium to fully restore its structure. If this does not happen - the next pregnancy will also be in danger of regression, only now because of the lack of functioning of the endometrium.
  • A woman's body needs to be sated with folic acid in order to reduce the possibility of abnormal development of the child during subsequent pregnancy. For full saturation will take several months.
  • If the cause of the lost pregnancy was the improper functioning of the organs of the endocrine system, then it would take time to correct the concentration of hormones in the blood to the limits of the norm.

Of course, pregnancy after missed abortion may occur in 1 - 3 months. But in this case, the life of the baby will be at constant risk not only of repeated cases of regression in development, but also of miscarriage due to uterine loosening after curettage.

How to get pregnant and carry the child after a missed abortion?

How to get pregnant after missed abortion

Depending on what caused the death of the fetus, treatment regimens will be determined that, firstly, will help to conceive a child without genetic disorders, and secondly, will help the pregnancy to develop properly.

Genetic factor - if the analysis of abortive material showed that the embryo died due to genetic pathologies that are likely to reappear in subsequent pregnancies - the conception of a genetically healthy baby becomes most likely only in IVF, where preimplantation genetic diagnosis will be performed before the embryo transfer to the uterus ( PGD).

It is dangerous to get pregnant in the usual way, with the hereditary genetic factor of missed abortion - the risk of having an unhealthy baby is too great or, most likely, the risk of recurring missed abortion.

If the analysis of abortive material showed that the genetic mutation was spontaneous and the genetic set of the chromosomes of the father and mother allows them to have healthy offspring, it is possible to become pregnant after removing a non-developing pregnancy naturally.

The hormonal factor - assumes that from the first days of the beginning of the next pregnancy, regular monitoring of indicators of concentration in the blood of the future mother of hormones, which caused the death of the embryo last time, will be conducted. The frequency of checks is determined by the doctor.

At the slightest deviations from the normal values, an emergency hormonal correction is carried out to stabilize the functioning of the reproductive system and maintain fetal life.

In addition, menstruation after a frozen pregnancy, due to hormonal factors, can be irregular for about six months. Therefore, a new pregnancy will be possible only after the correction of the endocrine system.

Autoimmune factor - the next pregnancy after a frozen one should be under the control of an immunologist. If possible, he will prescribe a treatment regimen that, firstly, will allow a woman to conceive a child, and secondly, temporarily weaken the immune system of a woman in order to increase the chances of survival of the embryo.

Preliminary medical therapy before conception, with autoimmune factor is very important, since pathological changes in homeostasis occur soon after the implantation of the ovum into the uterine wall.

Infectious factor - suggests that a new pregnancy should be planned only when it is possible to cure the infection that led to the death of the previous embryo. The main barrier to the pathogenic flora in the female body becomes the cervical canal.

If it is affected by chronic diseases, the infection is much easier to penetrate into the uterus and cause pathological changes in the structure of the fertilized egg. Therefore, before a new pregnancy, attention should be paid to the state of the cervix.

Pregnancy pregnancy is not a verdict - it signals that there are certain problems in the mother’s or father’s body that have prevented fetal embryos. In most cases, with the proper level of treatment, these problems can be overcome and the next pregnancy a woman can endure safely.


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