Early fetal rejection symptoms. Detachment of the fertilized egg

Unfortunately, the sad outcome of pregnancy does not always depend on the woman. As a rule, the primary role is played by the reaction of her body to the “new resident”. This is how experts most often explain detachment ovum. Currently, many representatives of the fair half have to hear such a diagnosis. Not to be confused this definition with the so-called low-attached fertilized egg. The thing is that these are two completely different concepts. It is important to note that the latter diagnosis still suggests a greater chance of survival for the baby inside the mother’s womb.

general information

Treatment usually lasts at least one week. However, even after discharge future mom must be under constant medical supervision. At this time it is better to limit physical activity, observe bed rest, try to rest more.

Consequences

According to experts, timely and competent treatment makes it possible to give birth to a healthy baby. Unfortunately, most often miscarriage and detachment of the ovum become inseparable concepts, since the baby in the womb does not have normal, constant nutrition, and as a result, placental insufficiency develops. In this kind of situation, the woman, together with the doctor, decides on further pregnancy. There can only be two options here - either save the fruit or clean it.

Conclusion

According to available statistics, in Lately Detachment of the ovum, ultrasound photos of which can be found in medical journals and books on gynecology, is becoming quite common. Some explain this fact poor environment, frequent stress, unhealthy diet. Others see the reasons in the abnormal structure of the uterus. In any case, every woman should understand that the successful outcome of her pregnancy depends on a number of factors that only she can influence.

One of the most reliable signs of pregnancy is the fertilized egg. In the ultrasound image 2 weeks after the missed period, you can see the formation, according to appearance which can determine the timing of pregnancy, the nature of its course and identify possible pathological development processes. The normal shape of the ovum is round; deformation of the ovum is a cause for serious concern; this pathology requires additional examination and careful observation.

Structure of the fertilized egg

In the first weeks of pregnancy, the fertilized egg is a group of cells that, on the way to the uterus through the fallopian tube, continue their division in the form of an embryo and embryonic membranes. The outer layer of the egg is covered with the chorion, the top layer that provides nutrition and oxygen exchange to the embryo.

The so-called children's place", or placenta, is formed from the upper layer of the fertilized egg, which is covered with villi. By destroying a small fragment of the uterine mucosa and the walls of blood vessels at the site of attachment, filling them with blood, the villi are immersed in the prepared place, where implantation occurs.

The structure of the fertilized egg in the last trimester of pregnancy represents the fetus, amniotic fluid, membranes, umbilical cord and placenta. The egg occupies the entire uterus and weighs about 5 kg.

Visualization of the embryo and ovum by ultrasound begins 6-7 weeks after the delay of menstruation. Already at this stage, it is possible to consider possible pathologies, such as: empty ovum, deformation of the ovum, detachment of the ovum, hematoma of the ovum, etc.

Due to the fact that the risk of spontaneous abortion, rejection and other pathologies is highest in the first trimester, an ultrasound scan must be done in a timely manner, which will increase the chances of successfully correcting the situation.

Growth of the fertilized egg

When conducting an ultrasound examination, an assessment is made of the internal diameter of the ovum - SVD of the ovum. To determine the gestational age, indicators are used coccyx-parietal size fetus (CTF).

The growth of the ovum until the 15-16th week of pregnancy averages 1 mm per day, then from 2 to 2.5 mm per day.

For example, a fertilized egg of 3 mm corresponds, as a rule, to three weeks of pregnancy, a fertilized egg of 6.5 mm corresponds to five weeks.

When can you consider a fertilized egg after IVF?

Many women who have undergone IVF (in vitro fertilization) (as a rule, these are women who have had problems conceiving for a long time naturally), with special trepidation they are waiting for the first ultrasound examination, which will help make sure that they managed to get pregnant. An ultrasound, which these patients are recommended to do no earlier than 3 weeks after the procedure, will determine the presence, location and number of fertilized eggs, which will confirm pregnancy.

Rejection of the fertilized egg

The initial stage of spontaneous abortion due to any developmental anomalies is the rejection of the fertilized egg. When the egg is detached from the chorion due to damage to the vessels, a wound surface is formed, behind the fetal membrane an accumulation of blood occurs, which is called “retrochorial hematoma of the fetal egg,” an increase in which leads to miscarriage.

It is necessary to understand that a hematoma of the ovum is not a threat of termination of pregnancy, but the result of detachment. If the embryo remains alive, the accumulation of blood does not harm the health of the woman and the fetus. Continued detachment and an increase in the size of the hematoma have a negative impact on the course of pregnancy.

Detachment of the fertilized egg due to a hematoma is not a hopeless process. With timely diagnosis, this process can be stopped, preventing the death of the embryo.

The following factors can cause spontaneous abortion:

prolonged stress;
bad habits (smoking, drinking alcohol);
history of induced abortions;
viral, infectious diseases;
diseases of the reproductive system;
pathology of the uterus;
fetal development abnormalities;
Rh conflict (mother and fetus), etc.

Unfortunately, not a single pregnant woman is immune from the occurrence of such a pathology as detachment of the ovum. By treating yourself carefully and listening to your body, you can diagnose this in time. pathological process, stopping its further progression.

Signs of abruption of the ovum (the first symptoms) may be nagging pain in the lower abdomen, accompanied by bloody discharge Brown. Discharge of this type indicates the process of resorption of the hematoma, however, in order to avoid repeated tearing, the woman should urgently contact a gynecologist who will make a final diagnosis.

Recurrence of detachment of the ovum can occur repeatedly, which does not pose a danger to a full-fledged fetus, which subsequently has a chance to reliably attach and continue normal development. Without undergoing treatment, while being kept in a hospital setting, the likelihood of a miscarriage is very high.

Complete rest of the woman is one of the main methods of treatment. To ensure complete relaxation of the abdominal wall, the patient must strictly adhere to bed rest, getting up only when absolutely necessary. The slightest movements can increase intra-abdominal pressure, increase the tone of the uterus, accelerating the process of rejection of the fertilized egg. In order to ensure the outflow of blood from the pelvic area, while in a horizontal position, it is recommended to place a small pillow under the buttocks.

You should monitor normal bowel movements, preventing stool retention, which keeps the intestines tense, eating a proper diet, excluding foods that disrupt normal stool and cause flatulence.

It is very important to provide a calm psychological environment, without stress and emotional turmoil. It is also recommended to limit sex life for a while.

Along with these simple requirements, which a woman is able to fulfill on her own, there is medication treatment prescribed strictly by a doctor.

If detachment of the ovum has been diagnosed, drugs with a hemostatic effect (etamzilat), antispasmodic action (no-spa, Magne B6, papaverine), sedative action (valerian extract, novopassit), hormonal drugs (utrogestan, duphaston) and vitamins (folic acid and vitamin E).

Even if a woman has her own prejudices towards drug treatment, she must set her priorities correctly, understanding that without medicines maintaining pregnancy is impossible.

The course of treatment usually lasts two weeks; if necessary, it can be increased. The more demanding a woman is of herself, responsibly following the doctor’s prescriptions, the faster the positive outcome will come.

After completing the course of treatment, strict supervision by the attending physician is necessary until the end of pregnancy. It should be taken into account that until the process of complete formation of the placenta is complete, in a woman who has suffered detachment of the ovum, the risk of repeated rejection remains quite high.

The fertilized egg is the membrane surrounding the embryo and amniotic fluid. This structure is normally attached to the wall of the uterus, a vascular network is formed between them, thanks to which the vital activity of the embryo is supported.

Detachment of the fertilized egg early stages pregnancy – dangerous complication, which is the first step towards. If the fertilized egg is not completely separated from the uterine wall, there is a chance to continue the pregnancy. But when the detachment is complete, the supply of blood containing oxygen and nutrients to the embryo stops. This condition causes the death of the embryo.

Causes of detachment of the ovum

About 80% of cases of first-time abruption of the ovum are due to chromosomal abnormalities in the fetus. So female body independently gets rid of a non-viable embryo.

Often, detachment of the ovum occurs due to progesterone deficiency. This hormone is synthesized in the corpus luteum and performs the function of maintaining pregnancy. Progesterone nourishes the embryo, so if its quantity is insufficient, the embryo dies.

Detachment of the ovum in early pregnancy can develop due to a history of abortion or curettage. These procedures damage the inner epithelial layer in the uterus. Because of this, the fertilized egg either cannot attach to the wall of the uterus at all, or it is not able to stay on it for a long time.

More rare causes of detachment of the ovum include:

Heavy physical activity.
Emotional stress.
Rhesus conflict.
Viral and bacterial inflammatory infections.
Tumor diseases.
Bad habits during pregnancy: smoking, alcoholism, drug addiction.
Common somatic concomitant diseases.

Signs of detachment of the ovum

Detachment of the ovum is divided into complete and incomplete; both of these types have a specific clinical picture.

Incomplete or partial detachment of the ovum manifests itself as nagging pain in the lower abdomen and is accompanied by brownish or scarlet discharge from the vagina. Very rarely, detachment of the ovum occurs without discharge, when the area of separation of the embryo and fetal membranes from the uterine wall is very small.

In case of incomplete detachment of the ovum, an ultrasound can show a hematoma - a bruise at the site of damaged vessels of the chorionic villi. In the case of a significant area of detachment, this pathology can be seen during an ultrasound examination. During a vaginal examination, the cervix is closed or slightly open, the size of the uterus corresponds to the gestational week.

Symptoms of complete detachment of the ovum:

severe pain in the lower abdomen, cramping in nature;
abdominal wall hardness;
scarlet vaginal discharge.

Complete detachment of the ovum- this is a condition in which the embryo with the membranes is not connected to the uterus in any way and is located in its cavity, which can be seen on an ultrasound. On ultrasound examination a hematoma is also detected. During vaginal examination, the cervix is dilated and softened. The size of the uterus either corresponds to the duration of pregnancy or is reduced.

Treatment of ovum abruption

Nowadays, thanks to the development of medicine, incomplete detachment of the ovum is a treatable condition. A pregnant woman is prescribed bed rest, since the slightest physical activity can provoke the further development of spontaneous miscarriage. It is not recommended to even sit, much less walk, to avoid straining the abdominal muscles.

basis drug treatment are gestagens (synthesized analogues of progesterone) - Dydrogesterone (Duphaston) and Micronized progesterone, which help maintain pregnancy. This therapy is usually used up to 20 full weeks pregnancy. Vitamin E is used as an additional treatment.

Pain in the lower abdomen and bloody discharge due to detachment of the ovum are the main symptoms of this pathology, in the presence of which you should immediately consult a doctor.

To improve blood supply in the non-exfoliated areas of the ovum, antiplatelet agents are used, in particular the drug Curantil. To reduce uterine tone, a tocolytic drug, Magnesium sulfate, is used. If there is an underlying disease (pelvic inflammatory disease, bacterial infection), its therapy is carried out.

If a miscarriage occurs, a thorough examination of the uterine cavity is required to identify any remaining fertilized egg. If they are detected, the uterus should be curetted to avoid the development of necrosis and decomposition, which can cause sepsis.

Prevention

Detachment of the ovum is a dangerous complication of pregnancy, which is easier to prevent than to cure. To prevent this pathology you should:

give up bad habits during pregnancy;
avoid heavy physical activity and emotional stress;
take careful precautions to avoid unwanted pregnancy, which will require an abortion;
plan a pregnancy, namely: cure diseases of the genital organs and urogenital infections, normalize hormonal status, and prevent Rh conflict, if it may arise.

Detachment of the ovum is a fairly common pathology that occurs mainly at the end of the first and beginning of the second trimester of pregnancy. As a result of detachment from the chorion of the fertilized egg, a hematoma is formed - a cavity with an accumulation of blood. It is the hematoma that is diagnosed using ultrasound, and on the basis of it a diagnosis of “threatened miscarriage” is made.

Symptoms of detachment of the ovum are always present in the case of a large detachment area. These are bloody discharge from the genital tract and spasmodic pain. If the hematoma is very small, a few millimeters, it can only be diagnosed using ultrasound and is an accidental finding, while the woman considers herself absolutely healthy.

Many expectant mothers are interested in the causes of detachment of the ovum in order to try to prevent the development of this pathology. However, there is no one specific reason. There are a lot of them. This is a raise blood pressure, and, possibly, a lack of progesterone, and characteristics of the chorionic vessels, etc. Therefore, it is better not to study unnecessarily what abruption of the ovum is, but to register for pregnancy in a timely manner and undergo all recommended examinations on time, plus follow correct mode work and rest, eat right.

What consequences a detachment of the ovum can have for the mother and fetus depends on its size. As a rule, when the detachment exceeds 40 percent (compared to the fertilized egg), a miscarriage occurs. With a small detachment with a tendency to reduce the hematoma, there is no threat to the development of the fetus. This diagnosis may sound like this - partial detachment of the ovum with the formation of a hematoma. With this diagnosis, the woman is admitted to the hospital and the size of the hematoma is monitored by ultrasound. They should decrease. Brown discharge during the recovery process is considered a positive diagnostic criterion - this is “old” blood coming out, the hematoma is emptied. If, on the contrary, the hematoma becomes larger, partial detachment of the ovum may become complete, and a miscarriage will occur.

As for treatment, it is mostly symptomatic. If there is uterine tone, it is relieved with the help of tocolytic drugs. With abundant bloody discharge hemostatic drugs are prescribed. It also makes sense to prescribe progesterone drugs, preferably Utrozhestan, in order to prevent a possible lack of progesterone and save the fertilized egg with the embryo.

The expectant mother herself is required to adhere to bed rest and cease sexual activity for at least several weeks. Only such a detachment of the ovum in the early stages of pregnancy requires treatment, according to modern doctors. The main thing is to do everything so that nothing interferes with the emptying of the hematoma and its reduction in size.

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