Anembryony
The content of the article:
- Causes of anembryonia and risk factors
- Symptoms of anembryonia
- Diagnostics
- Treatment
- Potential consequences and complications
- Forecast
- Prevention
Anembryonia is a pathological pregnancy in which there is no embryo in the cavity of the ovum. This means that the woman has become pregnant and the fertilized egg is implanted into the lining of the uterus. However, under the influence of certain factors, the embryo stopped its development, and the ovum continued to increase in size. Therefore, this pathology is also called the empty egg syndrome.
Anembryonia on ultrasound
Anembryonia is a common complication of pregnancy, seen in about 15% of pregnant women in the first trimester. The disease has a strong negative effect on the psycho-emotional state of a woman, especially if the pregnancy was not only desired, but also long-awaited. In such cases, patients often develop a depressed mood, sleep worsens, and in severe cases, the transferred stress can cause depression.
Causes of anembryonia and risk factors
Currently, the exact causes of anembryonia are not known. It is believed that genetic factors play the main role in the death of an embryo in the early stages of development, that is, an incorrect set of chromosomes in the fetus can lead to anembryony. If a full-fledged egg is fertilized by a pathologically altered sperm or vice versa, a pathologically altered egg by a healthy sperm, the embryo turns out to be defective, weak, possibly unviable, and the female body gets rid of it.
Risk factors that significantly increase the risk of developing anembryonia are:
- alcohol abuse during the planning stage and during pregnancy;
- smoking;
- drug addiction and substance abuse;
- a state of chronic stress caused by conflict situations in everyday life or at work;
- a state of severe acute stress (death of a loved one, disaster, etc.), experienced in the first weeks of pregnancy;
- significant pathological fluctuations in hormonal levels;
- exposure of a woman to ionizing radiation, toxic substances at the earliest stages of pregnancy;
- acute infectious diseases caused by viruses (flu, rubella, chicken pox) or bacteria (pyelonephritis, cystitis, pneumonia).
Smoking, alcohol consumption, drug addiction can become the causes of anembryonia
Excessive physical activity performed by a woman in the early stages of pregnancy can also become the cause of anembryonia. That is why this complication is often observed in professional athletes who do not stop their strenuous training after pregnancy.
Symptoms of anembryonia
The absence of an embryo in the ovum is asymptomatic, that is, the signs of anembryony are similar to those of a normal early pregnancy:
- cessation of menstrual function (physiological amenorrhea);
- engorgement and enlargement of the mammary glands;
- in re-pregnant women, colostrum may be excreted;
- an increase in the level of chorionic gonadotropin (hCG);
- nausea, vomiting, drooling and other manifestations of early toxicosis in pregnant women;
- an increase in the size of the uterus.
Symptoms of anembryonia do not differ from early pregnancy signs
In undiagnosed cases, the first sign of anembryonia may be spontaneous abortion, i.e., miscarriage. This condition is characterized by the appearance of bloody discharge from the genital tract, which can be of varying intensity, ranging from minor smearing and ending with abundant, requiring immediate specialized medical care. In some cases, the appearance of bloody discharge is accompanied by pain in the pelvic area.
Diagnostics
The doctor can suggest anembryonic disease in a pregnant woman by the following signs:
- discrepancy between the size of the uterus and the expected period of pregnancy (lag in size);
- a slow increase in the concentration of chorionic gonadotropin, which does not correspond to the expected period of gestation.
Anembryonia can be detected on ultrasound starting from the 7th week of pregnancy
It is possible to confirm the diagnosis of anembryonia only by the results of an ultrasound examination of the uterine cavity. On the echogram, the ovum is determined, in which the yolk sac and the embryo are absent. Given the likelihood of a diagnostic error, the woman is recommended to repeat the ultrasound examination after 7-10 days. Only if in the course of this study the embryo is not found, is the final diagnosis of anembryonic disease made.
Treatment
Treatment of anembryonia consists in artificial termination of pregnancy. Sometimes, in rather rare cases, doctors resort to expectant tactics, that is, they wait for the woman's body to reject the defective ovum itself and a spontaneous abortion will occur.
For the artificial termination of pregnancy, medical and surgical methods are used. Most specialists give preference to medical abortion as the most gentle method. A woman is prescribed drugs that significantly increase the tone of the muscles of the uterus and thereby contribute to the expulsion of an empty ovum from her cavity.
Surgical termination of pregnancy by instrumental curettage of the uterine cavity is most often used in cases where the patient has had an incomplete spontaneous miscarriage, accompanied by profuse bleeding.
Medical abortion is the most gentle method of terminating pregnancy in case of anembryonic disease
Abortion material is sent for histological examination. In some cases, it is possible to carry out its genetic study, but for this it is necessary to comply with a number of conditions, which are not always feasible (for genetic research, not dead, but dividing cells are needed).
After termination of pregnancy, antibiotic therapy is carried out, drugs are prescribed that improve the functions of the immune system.
If the patient develops a depressive state, it may be advisable to prescribe antidepressants, tranquilizers. Consultation with a psychotherapist is recommended.
Potential consequences and complications
By itself, anembryonia does not have a negative effect on the physical health of a woman, but it can cause mental disorders (insomnia, depression, indifference to the environment, depression), family conflicts.
Artificial termination of pregnancy can be accompanied by the following complications:
- uterine bleeding;
- damage to the cervix;
- rupture of the uterus;
- violation of blood clotting (development of DIC syndrome, coagulopathy);
- Rh sensitization;
- incomplete extraction of the ovum;
- secondary infertility;
- perforation of the body of the uterus.
One of the most dangerous complications of artificial termination of pregnancy is acute endometritis, which can, in turn, cause sepsis, toxic-infectious shock and death of the patient.
According to statistics, the mortality rate for induced medical abortion is less than 0.05 per 100,000 interventions performed and depends on the method of abortion, as well as the period during which the termination of pregnancy was performed.
Forecast
In general, the prognosis for life and fertility is favorable. The next pregnancy should be planned no earlier than six months after the transferred anembryony. This time is necessary to restore the woman's body. In most cases, repeated pregnancies are normal and end on time.
In cases where one or both parents suffer from any genetic diseases, a woman may experience repeated cases of non-developing (frozen) pregnancy, in particular anembryonia.
Prevention
Specific prevention of anembryonia has not been developed. To prevent the development of this pathology, a married couple is recommended to take a responsible attitude to the stage of pregnancy planning. Spouses should undergo a medical examination, cure all identified diseases. It is very important to lead a healthy lifestyle (rejection of bad habits, proper nutrition, moderate physical activity, adherence to work and rest). From the first days of pregnancy, a woman should be under regular supervision of an obstetrician-gynecologist and refrain from excessive physical exertion.
For subsequent pregnancies, a genetic consultation is recommended for a married couple.
If the cause of anembryonia is sperm pathology, artificial insemination with donor sperm or ICSI is recommended, for which the embryologist selects the most motile sperm with normal morphological structure under a microscope. Then, using a special microneedle, one of the selected spermatozoa is injected into the cavity of an egg previously obtained from a woman. Subsequently, the fertilized egg is transferred to the uterine cavity, where it is implanted.
In cases where the cause of anembryony lies in the pathology of the eggs or the presence of genetic mutations in a woman, in vitro fertilization (IVF) using a donor egg may be recommended for a married couple. Another solution to this situation may be surrogacy.
YouTube video related to the article:
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
