Histological examination after a missed pregnancy. Examination after a frozen pregnancy

Pregnancy is a complex process and not in all cases it proceeds without complications. Moreover, a number of diseases can lead to fetal death, which in medicine is called missed pregnancy. The most critical in this regard is the first half of pregnancy, or more precisely, the eighth week of bearing a child, when the risk of fetal death is maximum. What causes this pathological process and how is histology performed after a missed pregnancy? We learn from this article.

What threatens frozen pregnancy

Obstetricians say that detecting a missed pregnancy on initial terms bearing is extremely difficult. Future mom does not yet feel the movement of the fetus, she does not have any discharge, which means that the loss of the fetus can only be detected through ultrasound diagnostics. But in time to identify the death of the fetus is extremely important! An undetected frozen pregnancy leads to the decomposition of the fetus in the uterine cavity, and, as a result, to a serious violation of blood clotting (DIC), which can threaten a woman with a fatal outcome.

Histology in case of fetal death

In 100% of cases, after a missed pregnancy, doctors conduct a histological examination. Its purpose is one - to identify the cause of fetal death in order to prevent its recurrence. As a rule, such studies are carried out immediately after scraping, which is necessary in this situation. The method itself involves the study of the tissues of a dead embryo using a microscope. If necessary, doctors can take a thin section of the epithelium from the uterus or from the fallopian tubes for analysis. Such a study helps to identify a possible infectious disease or other developing pathological process in the pelvis of a woman.

With the help of histology, carried out in the case of a missed pregnancy, it is possible to identify the most common causes of miscarriage:

diabetes;
anomalies in the development of the uterus;
sexually transmitted infections;
chronic pathologies internal organs in a pregnant woman;
viral infectious pathologies(hepatitis, rubella).

It should be frankly said that in most cases, the histology performed is only the key to understanding why the death of the fetus occurred. However, it is impossible to talk about the specific causes of a missed pregnancy on the basis of histology alone. This method is the basis for the appointment of additional tests. They must be handed over, because they should help restore the causal relationship that led to such a deplorable result.

Histological examination results

According to the results of the histology, a woman is usually prescribed the following examinations:

testing to check hormone levels thyroid gland, estradiol and progesterone;
detection of TORCH infections (it is imperative that the study be carried out in as soon as possible after scraping, because only in this way can reliable results be obtained);
a number of immunological tests together with a sexual partner, including an immunogram;
Ultrasound of the pelvic organs (must be done twice during menstrual cycle;
donation of sperm for analysis and consultation with a urologist (for men).

In each individual case, the specialist may prescribe additional tests. According to the data received, the doctor makes a conclusion and selects the appropriate course of treatment. Usually in such cases, the therapy process is long and can last up to six months. At the same time, during treatment, doctors do not recommend getting pregnant again, since the likelihood of a recurrence of a missed pregnancy is too high.

As a rule, think about conceiving a child by going through a histology after a missed pregnancy and necessary treatment, follows not earlier than in half a year. Health to you!

Pregnancy does not always end in childbirth. Due to various circumstances in the early stages, a woman may lose a child. This pathology is called the fading of pregnancy. And in these cases, doctors resort to histology. Find out what this procedure is and why it is carried out.

About intrauterine fetal death

Practice shows that a frozen pregnancy is more typical of the first trimester of bearing a child. And the 8th week of the term, when the risk of fetal death is the greatest, is of particular danger. In the early stages, even experienced doctors can find it difficult to detect a missed pregnancy. Indeed, often a woman does not have any discharge, and she still does not feel the baby. Therefore, it is possible to diagnose the fading of pregnancy only with the help of ultrasound. This is how pathology is detected in most cases. Within 6-7 weeks, an undetected frozen pregnancy is very dangerous for women. After all, the fetus decomposing in the uterine cavity causes intoxication. female body. The consequence of untimely detection of pathology can be - severe complication from clotting blood. It can even cause death.

As you can see, the death of a fetus is not only a difficult moral test for a woman, but also a serious threat to her physical condition.

Why do histology

Each failed mother in the above situation wonders why such a misfortune happened to her, what are the reasons for the death of the embryo? Histological examination helps to answer this question.

In practice, this procedure is carried out by specialists immediately after scraping. Its essence is that tissues of a dead embryo are studied under a microscope. This is the main histological procedure. But in rare cases, gynecologists still take a small section of the uterine epithelium for analysis, or fallopian tube. This is necessary to determine the pathologies and infections of the pelvic organs of the patient.

So, a histological examination after a missed pregnancy is an opportunity to identify the cause of the death of the embryo and, on its basis, prescribe an adequate treatment for a woman. Most often, such negative factors are sexually transmitted infections, viral diseases (hepatitis), abnormalities in the development of the uterus, hormonal disruptions in the female body, chronic diseases from the expectant mother.

You should be aware that using the results of histological examination alone after intrauterine death of the fetus, it is not always possible to determine the exact causes. Additional research is needed. Histology in many cases gives only the key to understanding why the death of the unborn baby occurred. Therefore, a woman needs to undergo other diagnostic tests, procedures that a doctor will prescribe.

According to the results of histology, patients can be prescribed the following examinations:

Analysis for TORCH infection. It is very important to take it within a few days after scraping. This is the only way to get accurate and objective results, to identify the causative agents of infectious diseases.
An examination that determines the level of thyroid hormones, as well as estradiol and progesterone.
Ultrasound examination of the pelvic organs. It must be taken twice during the menstrual cycle.
Immunogram and other immunological examinations that both the woman and her partner must undergo.

After a histological examination, the doctor in each individual case may recommend other examinations to the woman. When all their results are received, the attending physician will select an individual course of treatment. It usually lasts three to six months. And during this period, gynecologists recommend women to protect themselves. You can plan a second pregnancy after a frozen one at least six months later. It is worth knowing that the probability of repeating the pathological situation is too high. Therefore, a woman needs to be careful, follow all the prescriptions and recommendations of the doctor. Only in this way the chances of a successful next pregnancy will rise significantly.

Histology - studies the structure of tissues of living organisms. The main research methods are microscopy. With the help of it, they study the usual structure of tissues and their pathology, which causes changes and damage.

Laboratory Frozen Histology
pulling a dress in days
phases on nature clock

Identification of the cause of a missed pregnancy

Now, in order to determine the disease of the female body, histological methods are used. This method is resorted to after a miscarriage, if a missed pregnancy has occurred, when there is a suspicion of an oncological disease and other similar cases.

Essence and stages of the study

IN modern world is an indispensable procedure that can identify even the most complex pathology. Such an analysis is associated with cytology (the study of cells), embryology (the study of the structure of the embryo), thanks to which it is possible to study the exact structure of tissues.

In order to conduct histological studies, a piece of tissue (small) is taken, a smear, print or a small cut from the organ that is being examined is sufficient. The study period usually varies from five to ten days, in rare cases, when urgent results are needed, a rapid test can be done in twenty-four hours.

But such research is not always accurate. Research is carried out in seven stages:

fixation. Tissue fragments are treated with a special composition in order to prevent the breakdown of cells and structures. This is done so that the material does not deteriorate during the study;
wiring. Materials are degreased in order to compact them;
fill. Impregnated with paraffin to prepare a hard cut;
cutting. Using a microtome, the hardened material is cut into thin layers;
staining. These layers are placed on special glasses, stained with a special composition to determine different tissue structures (DNA, RNA, cytoplasm, etc.);
conclusion. Sections on the glasses are covered with another glass on top to preserve the layers;
study. the obtained samples are examined by histologists or pathologists using a light microscope.

They are directly involved in deciphering the results of histology, if a missed pregnancy, miscarriage, etc. occurs. Why .

In gynecology, histology is prescribed to study the fetus. Such a pregnancy is the same miscarriage that has not yet occurred. After determining the death of the fetus, a purge is prescribed so that suppuration does not begin in the woman's body.

The material is cut directly from the uterus. During the day you can not have sexual intercourse. Everything is done under sterile conditions, local anesthesia is done, a piece of flesh is taken for analysis. The material is sent to the pathomorphology laboratory and examined there. If anomalies are found, treatment is prescribed.

What the results say

The results after histological studies carried out after a missed pregnancy are very important. Determine the causes of the disease, malignant or benign tumor process. And detect the early stages of diseases.

Can determine the origin of the disease

The extracted matter (placenta) is always sent for histology. Histology is carried out along with tests for infections, hormones, and so on. This allows you to accurately determine the cause of what happened. This is necessary to avoid a repetition of the situation.

Gynecologists prescribe histology for inflammatory processes on the uterine cavity, neoplasms on it, after curettage, with a missed pregnancy. If multiple ovarian cysts are present.

It also helps to identify oncological diseases on initial stage. Another histology is prescribed:

with prolonged bleeding;
pain in the lower abdomen that appears for no particular reason;
leukoplakia;
uneven surface of the body;
painful menstruation;
with infertility;
irregular periods;
neoplasms on organs, etc.

The cost of such an analysis

Analyzes for histology, carried out after a frozen pregnancy, there are several types: with an urgent examination and a planned one. The diagnosis depends on:

the quality of the material being examined;
the quality of equipment for diagnostics and the qualifications of laboratory staff;
qualifications and experience of pathologists.

The price of histological analysis is from 2 to 3 thousand rubles

The cost of such a procedure is from two to three thousand rubles. Decoding and description of about five hundred rubles. Re-examination of glass costs about two thousand rubles. Immunohistochemistry costs about three to five thousand rubles.

After you have received the results of the histology, which was carried out after a frozen pregnancy, each woman must undergo certain examinations:

reveal TORCH infections, it is necessary to undergo an examination a few days after scraping (not later), otherwise there will be no accurate result;
undergo an examination to determine the level of hormones - progesterone, estradiol, thyroid hormone;
undergo a pelvic ultrasound, several times in one menstrual cycle;
make an immunogram, immunological examinations, yourself and do the same to your spouse (partner);
it is necessary to undergo a study on biocenosis, sowing on the flora of the discharge from the genital organs. Determine the sensitivity to the main spectra of antibiotics, bacteriophages;
identify infections that can be sexually transmitted;
identify indicators of hemostasis Fibrinogen, Prothrombin, Thrombin time, APTT, Antithrombin 3, Lupus anticoagulant;
reveal genetic risks, with repeated pregnancy;
determine blood clotting.

Of course, an accurate examination is prescribed by the attending physician. It takes into account the specifics of your particular case and assigns a course that you need to take. This is usually three to six months. You should not plan pregnancy for this period.

Unfortunately, sometimes a number of negative processes occur in a woman's body that lead to the death of the fetus. This process is usually early term. The study showed that the eighth week of pregnancy is the most dangerous, because it is during this period that the fetus can most often freeze.

It should be noted that fixing a missed pregnancy with short term It's hard enough. This process may not be accompanied by secretions. It is possible only to fix the absence of movement, and also to notice the pathology on ultrasound. It should be noted that such a result can only be recorded through such a study.

Doctors warn that if a missed pregnancy is not detected within six to seven weeks, then this situation becomes quite dangerous for a woman's health and can even threaten her life. The fetus that remains in the uterine cavity for for a long time, begins to decompose gradually, which can cause significant complications. First of all, this process can cause problems with blood clotting, such as DIC. Quite often, such a disease can lead to death.

Histology in missed pregnancy to determine the cause of the pathology

In order to determine the causes of fetal fading, you should carefully analyze the transcript of the study. Histology after a frozen pregnancy is prescribed by a doctor immediately after the scraping procedure. As a result of this process, the state of the tissues of the embryo is analyzed, which is performed using a microscope. IN special case, to obtain a more accurate interpretation, it may be necessary to analyze a thin section of the epithelium of the fallopian tube or even the uterus itself. These tests must be analyzed in order to clearly determine the cause of the pathology, as well as the possible presence of any infections of the woman's small pelvis.

Histology will help not only to determine the cause of fetal death, but also to prescribe the correct treatment package that will completely eliminate the cause of this pathology.

Experts identify a certain list of the main reasons that lead to miscarriage before the end of the term:

You should also take into account the fact that in almost any of these options, which will be determined through histological studies, it will be necessary to pass additional tests that can confirm or refute one or another reason for a miscarriage. Indeed, without a detailed analysis of all factors, it is difficult to one hundred percent name the main cause of miscarriage.

Histology during pregnancy is necessary in order to only get the first clue that can be used in the future to eliminate the problems that exist in the woman's body. After the result is received, the doctor will need to determine a list of additional tests. These studies should be done in without fail, as soon as on their basis it is possible to correctly determine the course of further treatment.

Histological results after a missed pregnancy

After the results of histological studies are obtained, the woman must undergo an additional list of activities:

Analyze the presence of TORCH infection in the woman's body. IN this case it is mandatory to pass all the necessary tests for this within a few days after curettage. Only in such a period it will be possible to say that the conclusions will be drawn correctly.
Donating blood for analysis to determine the levels of hormones such as progesterone, estradiol, as well as the correct functioning of the thyroid gland.
It is necessary to undergo an ultrasound of the pelvic organs twice during the menstrual cycle, which is necessary to detect pathologies.
A man should also visit a urologist, as well as, if necessary, take sperm for analysis.

At the same time, for each individual of these options, it may be necessary to prescribe additional analyzes that will help determine true reason occurrence of a particular pathology.

Recovery after a frozen pregnancy

Only after a detailed analysis of the results obtained, it will be possible to determine the correct course of treatment that will eliminate the cause of these ailments. In this case, these activities can stretch for a period of three to six months. IN given period you should not plan the next pregnancy, as there is a fairly high probability of a subsequent miscarriage.

Frozen pregnancy is a tragedy for any woman. This can lead to depression and the collapse of hopes. However, do not despair, but first of all you should think about your health.

Don't forget to think about your physical condition, because you are further interested in the birth healthy baby. Doctors recommend drinking vitamins that are designed to restore immunity. Don't forget about proper nutrition. A month after surgery, you can proceed to perform minor physical activity.

All modern obstetrics is based on prenatal screening. This is a set of studies that allows you to identify abnormalities in the development of the fetus. Early detection of abnormalities allows you to timely resolve the issue of prolonging or terminating a pregnancy, receiving antenatal therapy, or being psychologically prepared for the appearance of a child with an anomaly. Prenatal diagnosis includes obligatory ultrasound fetus, additional study of AFP and blood hCG mother. In some cases, it is necessary to use invasive studies.

Classification of methods

The methods of invasive diagnostics include: chorionobiopsy (chorionic biopsy), placentobiopsy (placentocentesis, placenta biopsy), amniocentesis, fetal tissue biopsy, cordocentesis.

The chorion is the germinal outer shell that surrounds the embryo. It has numerous small villi that grow into the endometrium and form the placenta. Chorionic biopsy is the receipt of chorion cells, which is carried out before the 14th week of pregnancy.

The placenta is an organ that develops in the uterus during pregnancy. Placentobiopsy is the receipt of placental cells, which is carried out at 15-20 weeks of gestation.

Amnion - the inner shell of the embryo. The amnion cavity is filled with amniotic (amniotic) fluid, which protects the embryo from drying out and mechanical damage. Amniocentesis is a puncture amniotic sac, suggesting a fence amniotic fluid. The procedure is carried out at 15-19 weeks of pregnancy.

Cordocentesis - obtaining umbilical cord blood of the fetus, is carried out from the 20th week of pregnancy.

A biopsy of fetal tissues is the most traumatic of all the methods listed. At the same time, under the control of ultrasound, a direct sampling of the skin or muscle tissues of the fetus is carried out. The method is used to clarify the diagnosis in case of especially severe intrauterine anomalies. The method is used extremely rarely, in the most uncompromising cases.

Indications for carrying out

Primarily invasive. prenatal diagnosis indicated for early detection of chromosomal and monogenic diseases. In addition, with its help, it is possible to determine paternity, the sex of the unborn child and the Rh conflict on early stage. Usually this study is offered to pregnant women at risk:

Age over 35;

Poor genetic history (the presence of the birth of children with a chromosomal or monogenic anomaly);

Burdened history in the family (family carrier of a gene mutation or chromosomal abnormality)

Already long time women at risk undergo non-invasive prenatal screening. IN Lately such screening studies are recommended for all pregnant women, as they help to identify chromosomal diseases in the fetus without risk to the course of pregnancy.

Contraindications for carrying out

All of them are only relative, and even if there are positive ultrasound markers, it may be necessary to conduct histological studies. Among such relative contraindications are a clear threat of abortion, serious malformations of the uterus, progressive infectious diseases of the mother, cervical incompetence, skin infection on the anterior abdominal wall, adhesions in the pelvic area, etc.

There is only one absolute contraindication - the active refusal of the pregnant woman herself to undergo any invasive diagnostics. The final decision to conduct any research is made by the family, and the doctor only provides reliable information about the risk of a baby with chromosomal or monogenic diseases.

Complications

Serious complications that can threaten the patient's life do not occur during invasive diagnostic methods. The main risk is associated with the possibility of terminating the pregnancy. At the same time, the overall risk of abortion after histological examinations is very low. After chorionobiopsy and placentobiopsy, the risk is about 1% - this is the usual risk of abortion during the first trimester. After amniocentesis, this risk is even less - 0.2%. Most high risk for the course of pregnancy was noted during cordocentesis - about 3.3%.