The impact of anxiety for the child during pregnancy

• Gallery
• News
• Reviews
• Vacancies
• Licenses
• Insurance partners
• Controlling organizations
• Schedule for receiving citizens for personal requests
• What you need to know about coronavirus infection?
• Rules for patients
• Important! Visiting a clinic during self-isolation
• Online consultation with a doctor
• to corporative clients
• Documentation

A miscarriage is always associated with serious consequences for a woman’s entire body and for her reproductive organs in particular; it also affects the family situation and disrupts a woman’s work schedule. An unfavorable pregnancy outcome requires great mental and physical costs on the part of parents. Therefore, turning to doctors to find out the causes of the problem is the very first and correct step on the path to having a child.

Any competent gynecologist will tell you that the problem of miscarriage can be solved. With proper preparation for pregnancy and its management, next time you will have a successful completion of pregnancy. Most girls after a miscarriage go to extremes: they try to get pregnant again as soon as possible. And if this succeeds, then the miscarriage very often recurs. But you need to give the body a rest for 2-3 months, then identify and eliminate the cause. And only then try.

Causes of miscarriage

Many are convinced that miscarriage occurs due to a fall, bruise or some other physical shock. Any woman who has had a miscarriage can remember that not long before she either fell or lifted something heavy. And I am sure that I lost my unborn child precisely because of this. However, those women whose pregnancy was normal also fall and lift heavy things. This is not why most sudden miscarriages occur. The reason is due to problems with pregnancy itself. About half of miscarriages occur due to abnormal genetic development of the fetus, which can be hereditary or accidental. Merciful nature, following in all respects the principles of natural selection, destroys an inferior and non-viable fetus. But there is no need to be afraid of this. The fact that one embryo has a defect does not mean that all the others will be the same.

In the other half of miscarriages, the woman's body is almost always to blame. They are caused by various known and unknown factors, such as: acute infectious diseases suffered in the first trimester of pregnancy, poor environment or difficult working conditions, excessive psychological or physical stress, abnormal development of the uterus, radiation, alcohol, smoking and certain types of drugs.

The causes of miscarriage in early and later stages may vary, although they may coincide. The most important thing is to find out and eliminate or compensate for your own cause of miscarriage. Having discovered the cause, the gynecologist will tell you how to avoid another loss.

Frozen pregnancy

Miscarriage statistics also include “frozen pregnancy.” Sometimes it happens that the embryo dies and is retained in the uterine cavity. Most often this fact is revealed by ultrasound. A dead fetus may begin to decompose, and this will thereby lead to poisoning of the mother’s body.

Doctors resort to surgical curettage, which is associated with the risk of inflammation and complications. With such a miscarriage, the next pregnancy is planned after the body has fully recovered - not earlier than a year. During this year, we will have to find out the cause of the frozen pregnancy and carry out treatment.

Miscarriage before 6 weeks

The main causes of miscarriage on this line are malformations of the embryo itself. Statistics say that 70-90% of embryos had chromosomal abnormalities: they are random and will not occur in other pregnancies. You may have been sick, taken medication, or been exposed to other harmful factors. Fate saved you from a child with developmental defects.

The human body is perfect and finds a way to correct the situation by miscarriage. Today is a tragedy for you. A real tragedy would be the preservation and birth of a sick, non-viable child. So don’t cry and understand: everything is for the best, tears won’t help your grief... And after three months, try again - it will almost certainly be successful.

It should also be noted that the fact of a miscarriage does not mean that you have lost something. So, at a period of 7-8 weeks, the absence of an embryo in the fertilized egg is detected - “anembryony”. It is believed that in 80-90% of cases, miscarriages are undiagnosed undeveloped pregnancies.

Causes of frozen pregnancy

Deviations from the norm often occur in the 8th week, when the active formation of the internal organs of the fetus begins. It is this process that can provoke the manifestation of genetic abnormalities that negatively affect the viability of the embryo. At 16-18 weeks, fading is a controversial issue. Experts in this case believe that the main reason is an incorrectly formed placenta.

The main factors for the development of frozen pregnancy include:

• Genetic, chromosomal disorders

Mutations trigger the process of natural selection, where a weak organism does not survive. Pathology in this case develops at 2-8 weeks. The appearance of anomalies is provoked by accidents, heredity, and natural deviations. Preliminary examinations of both parents during pregnancy planning will help reduce the risk of miscarriage.

• Infections

Viruses, bacteria, parasitic manifestations, sexually transmitted infections can cause fetal death. Unfavorable conditions negatively affect the development of the embryo and its normal formation.

• Hormonal imbalances

Low levels of progesterone and high levels of androgens are the cause of missed abortion. In some cases, the structure of the endometrium, which was previously damaged during aspiration, does not allow the fertilized egg to attach to the uterine walls. Correctly selected hormone therapy can solve the problem.

• Anembryony

“False pregnancy” is a condition in which there is no fetus inside the egg, but the hormone hCG is produced, indicating pregnancy. The resulting fetal sac spontaneously leaves the woman’s body at a certain period.

• Wrong lifestyle, bad habits

Smoking, alcoholism, and drug addiction increase the risk of embryo death.

• Weight

Overweight and underweight often cause pregnancy to stop progressing.

Also, a frozen pregnancy becomes a consequence of pathologies of the structure of the uterus, neoplasms, and intoxication with chemicals.

Fetal death can be caused by taking certain medications, chronic diseases of the cardiovascular and hematopoietic systems, and kidney diseases. When carrying multiple embryos, the risk of developing a frozen pregnancy is much higher. Very often, the fetus dies during artificial in vitro fertilization. In some cases, freezing has an unknown etiology.

Diabetes mellitus, stress, nervous strain, and heavy physical activity can provoke pathology. According to doctors, the 8th week is the most dangerous. At this stage, the embryo reacts sensitively to various teratogenic influences.

Frozen pregnancy in the early stages

According to statistics, a frozen pregnancy occurs in every second pregnant woman. Often, freezing and spontaneous miscarriage occur before the woman finds out about her “interesting situation.”

At the time when pregnancy is determined, the risk of fading is 20%. It is quite easy to determine pathology in a medical setting, so at the first suspicious symptoms it is recommended to immediately consult a doctor.

The causes of frozen pregnancy in the early stages can be:

• Chromosomal, genetic abnormalities that lead to the development of various defects that are incompatible with life.
• Infection. These could be STIs, rubella, herpes, toxoplasmosis, and colds. In the first trimester, infection poses a particular danger to the fetus. Viruses, penetrating the placenta, interfere with the normal nutrition of the embryo and prevent normal implantation.
• Hormonal disorders. Progesterone deficiency leads to freezing.
• Autoimmune diseases. Pathologies lead to the production of antibodies, which begin to fight against their own cells, and since the fetus inherits 50% of the gene from the mother, they kill it.
• Teratozoospermia. The father, who suffers from infertility, may be to blame for the freezing. When conceived in this state, the embryo does not survive and stops developing in the early stages.

Also, sudden spontaneous termination of pregnancy is influenced by bad habits, poor lifestyle, and uncontrolled use of certain medications.

Make an appointment and free consultation by calling +7(495) 256-49-52 or filling out the online form

Answers to frequently asked questions:

• How to get tested for gynecological diseases?
• What diseases does a gynecologist treat?
• What tests can be done by a gynecologist?
• How to prepare for an appointment with a gynecologist?
• Where to go with a gynecological problem?
• What symptoms should you consult a gynecologist for?
• How often should you visit a gynecologist?
• What diagnostics can a gynecologist perform in your clinic?
• What gynecological equipment do you have in your clinic?
• Gynecological care in the clinic
• Gynecological care at home
• How to call a gynecologist at home?
• How to make an appointment with a gynecologist?

Miscarriage at 6 to 12 weeks

A miscarriage in this period is also considered early. Its most common causes are:

Endocrine disorders

Endocrine disorders, when the ovaries do not synthesize enough hormones to keep the fetus in the womb, or the amount of male sex hormones is increased, is one of the most common causes of miscarriage and miscarriage.

An imbalance of hormones in a woman’s body can most likely lead to early termination of pregnancy. With a lack of the main hormone progesterone produced by the ovaries, this happens most often. Another hormonal problem is an increase in uterine tone, which provokes expulsion of the fetus.

Progesterone ensures the preparation of the uterine mucosa for implantation, and is the hormone that maintains pregnancy in the first months. If conception occurs, the embryo cannot properly attach to the uterus. As a result, the fertilized egg is rejected. But pregnancy can be saved with the help of progesterone drugs if this problem is detected early.

Also, the cause of early miscarriage may be an excess of male sex hormones that suppress the production of estrogen and progesterone. Often, the cause of repeated miscarriages is androgens, which affect the formation and development of pregnancy; as well as thyroid and adrenal hormones. Consequently, changes in the function of these glands can lead to miscarriage.

Untreated sexually transmitted infections

This problem must be solved even before conception. Often the cause of miscarriage is sexually transmitted infections: syphilis, trichomoniasis, toxoplasmosis, chlamydia, cytomegalovirus and herpetic infections. Their effect on the fetus and the course of pregnancy is different for each woman and depends on the timing of infection, the activity of the microorganism, the degree of immune protection and the presence of other unfavorable factors. Depending on the situation, they can lead to the formation of fetal malformations, intrauterine infection, feto-placental insufficiency, early miscarriage or premature birth. Infection of the fetus and damage to the fetal membrane leads to miscarriage. To avoid this, treatment of infections should be carried out before pregnancy. The use of therapy is also possible during pregnancy as prescribed by a doctor.

Viral infections and other diseases

Any disease accompanied by intoxication and a temperature rise above 38°C can lead to miscarriage. Rubella, influenza and viral hepatitis occupy a leading position on this list. At 4-10 weeks of pregnancy, a simple sore throat can also become tragic; pneumonia carries a more serious risk. Pyelonephritis and appendicitis can cause early labor. When planning a pregnancy, you must undergo a medical examination to identify and treat foci of infections.

Rubella is extremely dangerous during pregnancy - it leads to severe malformations of the fetus, so infection with it during pregnancy is an indication for medical abortion.

Any disease during pregnancy can lead to the non-viability of the embryo. And the body, through miscarriage, insures you against unwanted offspring. With such a miscarriage, the next pregnancy has every chance of going well.

Immune causes of miscarriage

Sometimes antibodies that are hostile to the fetus are formed in the blood of a pregnant woman. This reason can be predicted and eliminated in advance. Most often, a conflict arises when an embryo inherits the father’s positive Rh factor, and the mother’s negative Rh factor rejects the embryo’s tissues that are foreign to it. Constant monitoring of antibody titers and the administration of anti-Rhesus immunoglobulins allows you to support and maintain pregnancy. In case of immune conflict, progesterone preparations are also used to prevent miscarriage, which in this case has an immunomodulatory effect.

Reduced immunity

Reduced immunity of a pregnant woman also refers to immune causes. The body is simply unable to grow new life within itself. You need to take care of yourself and recover before your next pregnancy.

Anatomical causes of miscarriage

Anatomical causes of miscarriage are the most difficult to resolve. Malformations of the uterus are a serious reason for miscarriage. Sometimes you just have to deal with it.

Frozen pregnancy in late stages

Late fetal fading occurs between 13 and 36 weeks. During this period, the fetus begins to fully form, acquiring the outlines and characteristics of a person. The death of an embryo in the second or third trimester occurs for a number of reasons, one of them being a lack of the hormone progesterone.

The interruption of the baby’s development during this period is not affected by hypothalamic-pituitary disorders, but by serious diseases that are in acute or chronic form: diabetes mellitus, diseases of the thyroid gland, and the cardiovascular system.

If a woman is initially at risk, then it is necessary to take care of her health at the stage of pregnancy planning. Before conception, it is recommended to undergo serious examination and therapy. It is important to exclude sexually transmitted infections, genetic, and psychiatric disorders.

Miscarriage between 12 and 22 weeks

Such a miscarriage is considered late. Its causes coincide with the causes of early miscarriages (anatomical, immune, infectious, endocrine).

At this time, miscarriage also occurs due to isthmic-cervical insufficiency - the weak cervix cannot hold the fetus and dilates. For this reason, miscarriage can occur in the 2-3 trimester. Isthmic-cervical insufficiency is observed in 15.0-42.7% of women suffering from miscarriage. Careful monitoring of the pregnant woman allows you to identify the problem in time and perform surgical correction of the cervix before the onset of labor.

For isthmic-cervical insufficiency, there is only one treatment method - mechanical narrowing of the cervical canal. To do this, the neck is either sewn up or a special ring is put on it. However, the latter method is less effective, because the ring can easily slide off the neck, then it will no longer hinder the process of its opening.

After suturing, if necessary, it is possible to use antibiotics and drugs that normalize the vaginal microflora. Treatment of the vagina and monitoring of the condition of the sutures is carried out daily for 5 days. Sutures are removed at 37-38 weeks and in case of premature onset of labor.

Isthmic-cervical insufficiency can be primary (for no apparent reason), or can be a consequence of abortion or hormonal disorders (increased levels of androgens - male sex hormones or their precursors).

Miscarriage after 22 weeks

Such a loss is difficult to forget. Obstetricians talk about premature birth after the 28th week of pregnancy. Traditionally, a child born after this period is considered viable. But medicine knows of many cases where it was possible to save the lives of earlier children.

We recommend that you be thoroughly examined for miscarriage, check the above factors. In addition to them, the cause of miscarriage can be antiphospholipid syndrome, while the woman’s body perceives the child as something foreign and rejects it. This disease, like the others listed, can be corrected, i.e. You have a very real chance of bearing a child.

Miscarriages due to hemostasis disorders

All of the above reasons account for only 30-40%. Up to 70% of miscarriages are caused by disorders in the blood clotting system (hemostasis).

Disorders of the blood coagulation system that lead to pregnancy loss can be divided into thrombophilic (increased coagulation) and hemorrhagic (tendency to bleeding). Both of these extremes are dangerous for the fetus. Various disorders leading to the formation of small blood clots lead to the fact that the fetus loses sufficient blood supply, development is disrupted and the fetus is rejected.

Major hemorrhagic changes can appear in childhood in the form of increased bleeding during cuts, tooth extraction, and the onset of menstruation. But sometimes they manifest themselves only during pregnancy and cause miscarriage. Early bleeding and chorionic detachment are difficult to stop.

You may not realize it, but strange headaches, weakness, fatigue, and a temporary decrease in sense of smell or hearing may be symptoms of disorders in the blood coagulation system.

When planning a pregnancy, you need to undergo a genetic examination and, if necessary, begin treatment.

It is advisable to be examined for hidden hemostasis defects even for those who consider themselves healthy. This will make it possible to predict the occurrence of complications and prevent loss. Early therapy can prevent miscarriage in 98% of cases. If hemostasis defects are discovered already during pregnancy, it can be difficult to maintain it.

What to do after a miscarriage?

Find out the reason! The ideal option is for future parents to be examined: it is much wiser to postpone conception and spend two to three months identifying the reasons than to risk getting pregnant again, spend two months waiting, and then lose everything again and still go to the doctors.

Until you understand the reason, it will not evaporate. In most cases, the answers lie on the surface. Take care of your health and your future baby.

Make an appointment with an obstetrician-gynecologist by calling +7(495)150-60-01

Tyan Oksana Aleksandrovna Head of department, obstetrician-gynecologist Doctor of the highest category Work experience: 25 years

Maksimova Tamara Anatolyevna Obstetrician-gynecologist Work experience: 6 years

Zabolotnova Olga Valentinovna Obstetrician-gynecologist Doctor of the first category Work experience: 24 years

Moiseeva Alla Vitalievna Obstetrician-gynecologist, ultrasound diagnostics doctor First category doctor Work experience: 36 years

Volkova Polina Dmitrievna Obstetrician-gynecologist, ultrasound diagnostics doctor Doctor of the highest category Work experience: 34 years

Postnikova Nadezhda Anatolyevna Obstetrician-gynecologist, ultrasound diagnostics doctor Work experience: 34 years

Shchelokova Elena Nikolaevna Obstetrician-gynecologist Doctor of the highest category Work experience: 37 years

Risk group

Women at risk of developing a frozen pregnancy are those who:

• had abortions;
• have crossed the threshold of 35 years;
• suffered an ectopic pregnancy;
• differ in the anatomical features of the structure of the reproductive system;
• abuse alcohol, smoke, have drug addiction;
• suffer from certain diseases: diseases of the heart, circulatory system, kidneys, liver, diabetes mellitus, gynecological pathologies, infections and of various origins.

Freezing also often occurs in patients with menstrual irregularities and hormonal imbalances. With the right approach and timely treatment, in most cases the prognosis can be favorable.

The main thing at the pregnancy planning stage is to contact a qualified specialist in time.

Principles of treatment

If we know the reason or reasons for pregnancy failure and correct them in a timely and correct manner, this will significantly increase the chance of a successful pregnancy and birth of a healthy baby.

Doctors at the expert center for women's health at the REMEDI Institute of Reproductive Medicine use an individual approach in diagnosing and treating miscarriage in Moscow.

1. First of all, a consultation on miscarriage is carried out. In the process of collecting anamnesis, the doctor assesses risk factors and makes recommendations for examination and preparation for pregnancy. A comprehensive diagnosis is prescribed, which includes laboratory, cytological, instrumental and other necessary methods.
2. The next stage is treatment before stopping contraception:

• Improving partner's sperm counts;
• Anti-inflammatory treatment, including antibiotic therapy;
• Normalization of endometrial growth (hormone therapy, physiotherapy);
• Correction of genetic and acquired thrombophilia factors, immunoglobulin therapy.

When treating, doctors at our clinic use only the principles of evidence-based medicine. When developing a treatment program, the characteristics of each patient’s body are taken into account. The treatment plan is drawn up individually depending on the results of the couple’s examination.

Which doctor and how does he determine a frozen pregnancy?

If there is a suspicion of a frozen pregnancy, the woman is recommended to consult a gynecologist who will conduct an objective examination of the patient, prescribe a blood test for hCG, and determine the reduction of the uterus.

In addition to laboratory examinations, an ultrasound examination is prescribed, which will show the arrest of fetal development and the absence of heartbeat and motor activity.

Methods for diagnosing gynecological diseases:

• Calling a gynecologist to your home
• Diagnosis of gynecological diseases
• Diagnosis of sexually transmitted infections in women
• Colposcopy
• HCG tests
• Ultrasound during pregnancy
• Pelvic ultrasound
• Diagnosis of sexually transmitted diseases
• Fetal ultrasound
• Ultrasound of the mammary glands
• Ultrasound during pregnancy
• Transvaginal ultrasound
• Ultrasound of the ovaries
• Ultrasound of the uterus
• Cervical smear
• Vaginal smear
• Hormone tests
• Tests for sexually transmitted infections

How to terminate a frozen pregnancy

The death of the fetus requires immediate medical intervention, since after a short period of time after death the embryo begins to decompose, which can lead to an abscess, blood poisoning and other negative consequences, including death.

First of all, it is necessary to remove the fetus from the uterine cavity.

In the first trimester, aspiration is carried out using special abortive medications that cause contractions, and the body independently gets rid of the fertilized egg.

In early and late stages, surgical intervention is also used, which consists of curettage or vacuum aspiration. During a mini-abortion, the fertilized egg is sucked out using a special device. When pregnancy falters in the second trimester, the dead embryo is removed by inducing artificial labor.

Prevention of frozen pregnancy

In order to reduce the risk of developing a frozen pregnancy, you must:

• lead a healthy lifestyle;
• before planning to conceive a child, undergo a full examination and, if pathologies are detected, carry out the therapy prescribed by the doctor;
• be examined with your partner for the presence of genetic abnormalities;
• check your hormonal levels.

While carrying a baby, it is important to visit a doctor regularly, follow all his instructions, give up bad habits, and eliminate any stress or nervous strain.

Prevention of miscarriage

Management of patients with miscarriage is a whole range of measures to reduce possible risks. If there is a threat of miscarriage or a miscarriage, you must contact a specialist.

An important role in the prevention of miscarriage is played by:

• full examination of the couple before a planned pregnancy;
• risk group assessment;
• eliminating the risks of ICN;
• rational psychological support;
• general preparation for pregnancy (pre-pregnancy);
• management of pregnancy by obstetrician-gynecologists specializing in the immunological aspects of reproduction, having a certificate in hemostasiology in obstetrics and gynecology.

At all stages of preparation for pregnancy, our doctors are ready to provide psychological support and are always in touch with the patient.

Diagnosis of frozen pregnancy

A frozen pregnancy is diagnosed using:

• Personal examination by a gynecologist

The doctor collects anamnesis, studies the absence of symptoms such as toxicosis, breast swelling, enlarged uterus, and inquires about the patient’s condition.

• Analysis for hCG

The absence of the “pregnancy hormone” in the blood may indicate that the fetus has died and urgent medical attention is needed.

• Ultrasonography

This is one of the important methods for diagnosing fading. Ultrasound allows you to determine the cessation of fetal activity by the absence of heartbeat, movements and cessation of development.

The gynecologist needs not only to identify the pathology, but also to determine the cause, which will help select the correct treatment after aspiration.

Symptoms

Anxiety of varying severity occurs in almost 40% of women during normal pregnancy. In addition, we must not forget about the possible sharpening of individual character traits. Only a doctor can identify signs of an emerging disorder in a timely manner, which is why it is so important to regularly appear for examinations with your obstetrician-gynecologist, honestly reporting even minor (at first glance) experiences.

For formal diagnosis, the disease criteria specified in ICD-10 (International Classification of Diseases) are used. Possible violations are indicated by the appearance of the following symptoms:

• anxiety regarding the course of pregnancy, one’s own life;
• expressed fear of complicated childbirth, loss of a child;
• thoughts about one's own death;
• apathy;
• severe irritability;
• appetite ranges from acute hunger to complete absence and aversion to food;
• a woman stops enjoying activities that previously brought her joy;
• persistently increased fatigue not related to physical condition;
• mood is depressed most of the time, which does not depend on others or personal circumstances;
• emotional alienation from a partner, indifference to the growing fetus;
• suicidal behavior;
• obsessive ideas of harming the child;
• sleep problems;
• staying in solitude - a person does not want to see even the closest people;
• low self-esteem;
• obsessive feelings of guilt, shame, worthlessness.

Characters have emotional “outbursts” like a sharp jump in mood, but a temporary improvement in condition does not indicate the absence of a disorder. The pregnant woman delves into endless worries about the fate of the child and changes in her own life. Some patients, on the contrary, go into “denial”, reacting negatively to the development of the fetus.

Somatic symptoms of depression are difficult to distinguish from possible toxicosis, gestosis, or exacerbation of chronic pathology. Patients often lack criticism of their condition. People around you begin to notice changes in behavior, personality, and mood.

Where to go with a frozen pregnancy

Our clinic offers gynecological care, which is provided at the patient’s home and in an inpatient setting. The medical center is distinguished by modern equipment, an individual approach, and highly qualified staff.

We have created all the conditions, including providing professional psychological assistance at all stages of the procedure from diagnosing a frozen pregnancy to rehabilitation after the removal of a dead ovum.

Excellent service, correct attitude, rich diagnostic base, cozy atmosphere - all this will help to quickly diagnose the problem and remove the embryo with minimal risk of complications and negative, dangerous consequences.

Useful information on the topic:

• Calling a gynecologist to your home
• Consultation with a gynecologist
• HCG tests
• Ultrasound during pregnancy
• Diagnosis of sexually transmitted diseases
• Fetal ultrasound
• Pelvic ultrasound
• Ultrasound during pregnancy
• Transvaginal ultrasound
• Discharge in women

Stress during pregnancy consequences

A pregnant woman reacts to crisis situations in any case. Worries about the child, about loved ones, about future births and much more - all this accumulates and at some point she cannot stand it. The consequences depend on the strength of the mother’s emotional and physical reaction to all these factors. The nervous and immune systems are affected first, then all the others.

Trembling in the limbs, lethargy and apathy appear, and sleep is disturbed. Stress during pregnancy has quite serious consequences. In addition to the threat of miscarriage, this also threatens to affect the development of the child’s nervous system. Such children are born with low Apgar scores, they may also have problems adapting to society, are hyperactive and give in to fears, resulting in enuresis.

What tests show a frozen pregnancy?

The main laboratory test that can determine the fading and death of the fetus is human chorionic gonadotropin or “pregnant hormone hCG.” This hormone is responsible for regulating hormonal processes during pregnancy.

The element is produced by the syncytiotrophoblast, which is a component of the fertilized egg. After the fertilized egg has attached to the uterine wall, hCG begins to stimulate the formation of the placenta.

In some cases, the analysis is performed to determine cancer. By comparing hormone levels at different stages, a specialist can diagnose an ectopic pregnancy or fetal death.

The test is taken in the morning on an empty stomach or during the day, taking into account that the last meal was taken at least five hours before the procedure. The patient should be warned about taking medications. Results can be obtained the next day after donating blood from a vein.

Ultrasound for frozen pregnancy

An earlier ultrasound examination is prescribed if pregnancy is suspected to be fading. This diagnostic method is highly informative and helps to promptly identify or confirm suspicions of embryo death in the womb.

Each gestation period has certain parameters for fetal development. Based on these indicators, the doctor examines the image obtained through the sensor and draws his own conclusions about the condition of the fetal egg and its viability. Any discrepancies indicate deviations from the norm and pathology.

In the early stages of pregnancy, the volume of the uterus, which is smaller than it should be during the established period of gestation, can tell about TB. In some cases, a frozen embryo is not clearly displayed on the monitor, while a deformed fertilized egg has blurred contours and adhesions and bridges are visible in the picture. Signs of fading also include oligohydramnios and uncharacteristic changes in the structure of the placenta.

In the 2-3 trimester, the fetus is almost formed. The death of the embryo during this period is confirmed by ultrasound due to the lack of motor activity and heartbeat. Pathology is also indicated by an abnormal position of the body, a drooping jaw, discrepancy in the outlines of the skull bones, a clearly visible deformation of the chest, and a pathological change in the spine.

Insomnia during pregnancy

Sleep problems are very common during pregnancy. For many women, insomnia begins already in the first trimester of pregnancy. There are a lot of thoughts in the head of the expectant mother that do not allow her to sleep, she cannot find a comfortable position, she tosses and turns, in the second trimester the growing belly begins to interfere, and in the third trimester thoughts about the upcoming birth prevent her from falling asleep. How can I sleep here? To overcome insomnia during pregnancy, you need to establish its causes and eliminate them yourself and with the help of specialists.

Causes

Hormonal changes in a woman’s body can lead to insomnia in the very early stages:

for example, during pregnancy the level of progesterone and a number of other hormones increases. By mobilizing strength to carry a pregnancy to term, they at the same time put the body in a state of “combat readiness” and sometimes simply do not allow one to relax. As pregnancy progresses, there are more and more reasons for insomnia.

The causes of sleep disturbances in pregnant women can be physiological:

• difficulties in finding a comfortable position (increased weight and a larger belly make this process very difficult);
• back and lower back pain;
• fetal movement;
• frequent urge to urinate at night (the enlarged uterus puts pressure on the bladder, now it needs to be emptied much more often);
• heartburn (disorders of the gastrointestinal tract are generally characteristic of pregnancy);
• cramps (pregnant women especially often complain of leg cramps);
• itching in the abdominal area due to stretching of the skin;
• shortness of breath (increased body weight makes breathing difficult, in addition, the uterus puts pressure on the lungs);

and psychological:

• chronic fatigue;
• nervous tension, stress (fear of upcoming changes, anxiety for the child, fear of childbirth);
• nightmares.

Any of these reasons is quite enough to deprive a woman of sleep, and most often they are also combined!

How to deal with insomnia?

From the tips listed below, try to choose only what suits your case and what you personally like. If one recommendation doesn't help, try another one. Each situation is individual, each woman needs to choose her own method, her own combination of techniques.

During the day:

1. Avoid overexertion. Fatigue accumulated during the day does not always lead to sound sleep; sometimes it turns out that after a hard day you simply cannot relax.
2. If you are used to sleeping for some time during the day, try to give up this habit for a few days or at least reduce the time you sleep during the day - maybe night sleep will be restored.
3. If you are tormented by nightmares, which you then cannot forget about, talk about them in the morning or afternoon with a loved one (husband, mother, friend). Psychoanalysts consider discussing night dreams a very effective means of overcoming the fear of them: firstly, loved ones will try to calm you down, and most likely they will succeed, and secondly, by putting into words the vague visions that tormented you, you yourself will discover that there are no special reasons for no fear.
4. During the day, find time and opportunity to do simple exercises that you can do. Swimming, walking and even dancing are considered very useful (in the latter case, of course, it all depends on the stage of pregnancy and your well-being).
5. Your body should get used to the fact that the bed is a place only for sleeping: break the habit of lying in bed - you should not read, watch TV, etc. while lying down.

In the evening, about two hours before bed, begin preparing for the coming night to be calm and peaceful. Experts talk about sleep hygiene, which includes a number of activities:

1. Do not eat heavy food shortly before bed: on a full stomach you will toss and turn until the morning.
2. Do not schedule tasks that require physical or mental effort for the evening.
3. Avoid emotional tension and stressful situations during this period of the day (do not schedule unpleasant conversations and heated explanations for the evening, ask your family and friends not to call you in the evening and, of course, do not watch action films and thrillers at night).
4. Take a warm bath or shower before bed. You can add a decoction of chamomile or a few drops of some aromatic oil (for example, lavender) to your bath - this will help you relax.
5. Try to drink less in the evening (keeping your total daily fluid intake at 6-8 glasses), this will help you cope with the cause of insomnia, such as the need to empty your bladder frequently.
6. Before going to bed, drink a cup of warm milk (if you don't like the taste of milk, you can add cinnamon, a little honey or sugar) or herbal tea (chamomile is often recommended for its relaxing effect). But you need to give up regular tonic tea (not to mention coffee!). By the way, milk contains tryptophan, which can be called a mild natural sleeping pill - this substance has a calming, sedative effect.
7. You can eat a small sandwich with boiled turkey before bed (the meat of this bird is also rich in tryptophan).
8. If you feel weak, lightheaded, or have an increased heart rate in the evening, your insomnia may be due to hypoglycemia (low blood sugar). In this case, sweet tea, juice, or just a piece of sugar can help you (and be sure to tell your doctor about these symptoms so that he can confirm or deny this diagnosis and take appropriate measures).
9. Before going to bed, apply lotion to the skin of your abdomen, this can prevent itching.
10. Ask your husband or someone close to you to give you a massage before going to bed: it will give you the opportunity to relax, relieve back and lower back pain, and massage your feet and ankle joints will help avoid cramps. Shiatsu acupressure massage can also be effective, if someone in your family knows its technique, why not try it.
11. It is possible that homeopathic remedies correctly selected by a specialist will help in the fight against insomnia.
12. For some people, sex will help them fall asleep. If you have no medical contraindications to having sex, you feel desire and know that you usually feel sleepy after sex - why not?

But now the nightly ritual of getting ready for bed is completed, and you are already in bed. What to do at night so that the desired dream comes to you?

At night:

1. First of all, try not to get nervous, don’t think about not being able to sleep, this will only make the situation worse.
2. The bedroom should be cool (however, you must avoid overcooling your feet - you can sleep in socks). If it is not possible to sleep with the window open, you need to ventilate the room well before going to bed.
3. Nightwear (shirt, pajamas) should be comfortable, made from natural materials, and not restrict movement and breathing.
4. It is best to sleep on a comfortable mattress. Find out what is right for you - maybe a feather bed, maybe a textured mattress with a surface reminiscent of cartons for transporting eggs, or maybe, on the contrary, it will be easier for you to sleep on a hard surface, and you just need to put boards under the mattress.
5. A pregnant woman will need many pillows (at least 3) of various shapes and sizes to sleep. It’s good if you manage to purchase a special pillow for pregnant women - it has a wedge shape and is specially designed to be placed under the stomach. After giving birth, you can use it while breastfeeding. Pillows can be placed under the side, under the neck, pressed between the legs; You can cover the entire mattress with pillows - this improved bed will better conform to the shape of your body. You can place an extra pillow under your head - in some cases, this not only makes breathing easier, but also proves to be an effective remedy against heartburn.
6. Look for a comfortable position in which you can fall asleep. If you can’t sleep on your stomach and back, that means you’ll have to lie on your side (some doctors believe that it’s better to lie on the left, as this increases blood flow to the uterus). Place one pillow under your stomach, squeeze the other between your knees, if your back and lower back hurt, you can tuck another pillow under your side. Sometimes women are advised to sleep in the fetal position (it is unnecessary to remind you how physiological it is, I will only say that by stimulating blood circulation, it promotes maximum relaxation of all muscles).
7. However, it should be remembered that in the last months of pregnancy it is not recommended to sleep on your back, since the weight of the uterus can compress the inferior vena cava, which runs along the spine. This causes loss of consciousness in a pregnant woman and oxygen starvation in a child.
8. When you feel sleep approaching, try to breathe slowly and deeply.
9. It is possible that aromatherapy will help you. A drop of lavender oil can be useful not only in the bath, but also in bed.
10. If you are unable to fall asleep within half an hour, get up, go into another room, leaf through a magazine or read a book that can induce sleep, start knitting, listen to soothing music and go to bed only when you feel sleep approaching.

What not to do?

In any case, remember: under no circumstances make your own decision to use sleeping pills! Even if you already resorted to it before pregnancy. Even if your pregnant friend drank it. Even if it was recommended to you by a compassionate saleswoman from a pharmacy kiosk. The decision to use sleeping pills can only be made by an obstetrician-gynecologist!

Discharge during frozen pregnancy

Bloody or brown discharge during pregnancy may signal the death of the embryo. During a frozen pregnancy, pathological leucorrhoea is distinguished by a viscous consistency, small volumes, an unpleasant odor and is accompanied by nagging pain in the lower abdomen.

Discharge can warn of developing infection, inflammation, and that the fetus has begun to decompose. At the first symptoms, you must urgently contact a gynecologist, who will prescribe the necessary diagnostics.

The impact of anxiety for the child during pregnancy

The influence of anxiety for the child during pregnancy on the characteristics of maternal behavior and certain conditions of the child during infancy

G.N. Chumakova, E.G. Shchukina, A.A. Makarova

To date, a lot of evidence has been accumulated indicating that the mother’s inappropriate behavior during pregnancy, her emotional reactions to the stresses that fill our lives, cause a huge number of different pathological conditions in the child, both behavioral, psychological, and somatic [2 , 3]. During the perinatal period of development, the child lives practically “one life” with his mother. Today it has been proven that during stress, the mother’s adrenal hormones release catecholamines (stress hormones) into the blood, and during positive emotions (joy, calm), the hypothalamic structures produce endorphins (joy hormones), which, penetrating the placental barrier, directly affect the fetus. Consequently, mother and child represent a single neurohumoral organism, and each of them equally suffers from the unfavorable influence of the external world, which is recorded in long-term memory, affecting the entire subsequent life of the child [4]. Positive maternal emotions cause increased fetal growth, calmness and an increase in the level of sensory perception of the fetus [30]. Her stress leads to low fetal weight, increased mortality, respiratory infections, asthma, and weakened cognitive development [31].

The mother’s attitude towards the fetus during pregnancy leaves lasting marks on the development of its psyche [27]. Emotional stress correlates with premature birth, greater child psychopathology, more frequent occurrence of schizophrenia, often with school failures, high levels of delinquency, a tendency to drug addiction and suicide attempts [15, 28, 29, 32].

Fetal trauma may be reflected in the affective sphere of the adult [26]. Maternal emotional stress can cause a biochemical imbalance in the fetus, overactivation of the adrenocortical and sympathoadrenal systems with a subsequent increase in the adrenocorticotropic hormone cortisone, pituitary hormones, catecholamines and glucagon, and this, in turn, is perceived by the fetal DNA receptors. Thus, maternal hormonal imbalance can cause fetal emotional dysfunction [2, 10, 23].

The successful development of the newborn and his favorable attitude towards the outside world is the basis of his mental health. The child’s personality, his character, inclinations and much more are formed later, but the favorable course of the antenatal period and early stages of ontogenesis creates the preconditions for optimal development. That is why it is so necessary to provide good care in the first months of life, which is also a means of education. A newborn and an infant are absolutely dependent creatures. This should determine the attitude of others towards the newborn child and his experiences. Being in a state of complete dependence, he has certain needs that can be divided into physical and mental.

The list of bodily needs should include feeding and the need for sucking, urination and defecation, the need for physical contact with the mother, the need for warmth, for bodily comfort and absence of pain, and the need for safety.

Mental needs are contact with the mother, positive emotions, cognition, the need for sensations (sounds, smells, tastes, colors and images, the need for tactile sensations, etc.), the need for communication.

Only a mother can give the baby the necessary support, fully adapting her life to his needs and coming into full compliance with his mental and psychosomatic development [1, 13,15,23,24].

If the attitude is incorrect in the postnatal period, the baby may end up in a chronic psychotraumatic situation, which leads to disruptions in the adaptation process, deviations and delays in psychomotor development. One of the most common and serious mistakes is the failure to understand that “the baby’s environment is his mother” [5]. Only in the “mother-child” system does a process called “individualization” by E. Fromm begin, leading to the development of self-awareness.

For a child's mental health, it is necessary that his relationship with his mother bring mutual joy and warmth. The development of children is favorably influenced by mothers whose contacts with the child are varied, emotions are expressive, and movements are synchronous with those of the infant during communication with him. Communication of children with rigid mothers, who rarely take them in their arms and restrain their emotions, on the contrary, does not contribute to the development of the child’s mental functions. The same can be said about the communication of children with mothers who are distinguished by inconsistent, unpredictable behavior [1, 12, 17, 22].

In the formation and implementation of mother-child interaction, the maternal attitude is central and determining. It is this that underlies all the behavior of the mother, thereby creating a unique developmental situation for the child, in which his individual typological and personal characteristics are formed [5, 6, 20, 21].

The main sign of motherhood is the woman’s ability to identify herself with the child, which is expressed not in understanding his states at the level of reason, but in experiencing these states together with the baby. This unique ability is an organic continuation of the symbiotic unity of mother and child during pregnancy and serves as the basis for the manifestation of motherhood [10, 16, 22–25].

Maternal care and guardianship are for the baby an expression and continuation of maternal love. This feeling allows him to live [7].

In this regard, research related to the possibility of predicting certain conditions of a young child during pregnancy, as well as the adequacy of the maternal role, is relevant.

The purpose of our study was to study the influence of an anxious attitude towards a child during pregnancy on his condition in the first six months of life.

41 mother-child pairs took part in the study. The age of women is from 19 to 32 years (average age is 23.5 + 3.1 years). They had no children. Pregnancy was planned for half of the women and desired by all. At a gestational age of 30–35 weeks, they voluntarily underwent a psychological examination according to a unified program in the conditions of an antenatal clinic or pathology wards.

The following methods were used in the study:

• “Pregnant Woman Relationship Test” I.V. Dobryakova [9] to identify the characteristics of the psychological component of the gestational dominant;
• Projective drawing “Me and my child”, developed by G.G. Filippova [22].

All women gave birth at 38–40 weeks of pregnancy. The children were examined after birth on days 4–5, then at the ages of one, three and six months. After birth, the somatic state and neurological status were assessed using the depression-irritation profile [18].

In infancy, the somatic state, behavioral characteristics, and psychomotor development were assessed using the L.T. scale. Zhurba and E.A. Mastyukova [11].

Maternal behavior was assessed for the adequacy of interaction with the child.

Relationship test for pregnant woman I.V. Dobryakova allows us to identify the types of psychological component of gestational dominance (PCGD). PKGD is determined by a set of mental self-regulation mechanisms that are activated in a woman during pregnancy. The following types of PCGD are distinguished: optimal, euphoric, ignoring, anxious, depressive. The test includes three blocks of answers that determine a woman’s attitude towards her pregnancy, towards the mother-child system, and towards the attitude of others.

The drawing test “Me and my child” allows you to identify the peculiarities of the experience of pregnancy, the situation of motherhood, the perception of yourself and the child, the value of your future baby. The technique developed by G.G. Filippova [22], was used in the work of V.I. Brutman, G.G. Filippova, I.Yu. Khamitova [6] to study the dynamics of the mental state of women during pregnancy. The technique allows us to identify the peculiarities of the experience of pregnancy and the situation of motherhood, the perception of oneself and the child, and the value of the child. This test takes into account the presence of mother and child figures in the drawing; replacing the image of mother and child with an animal, plant, symbol, the content of the image of the child and his image; ratio of the sizes of the figures of mother and child; reflection of joint activities; distance and location features of characters; isolation of the child's figure; as well as characteristics of the general state (well-being, self-doubt, anxiety, signs of conflict and hostility related to the theme of the drawing) based on the formal characteristics of the drawing and behavioral manifestations during drawing. The interpretation of the data was carried out according to the criteria accepted in psychodiagnostics for drawing tests, as well as those specially developed for the interpretation of this technique by its author.

Assessment of psychomotor development using the L.T. scale Zhurba and E.A. Mastyukova consists of tables that allow you to quantitatively assess the development of a child every month up to 12 months. In each age period, 10 indicators of psychomotor development are studied: communication skills, unconditioned reflexes, muscle tone, etc. Each indicator includes 4 levels of assessment: from 3 points (normal) to 0 (severe violation). In general, a score of 27–30 points is an indicator of normal psychomotor development, a score of 23–26 points allows children to be classified as an absolute risk group, a score of 13–22 points clearly indicates developmental delay.

Statistical processing of the data was carried out in the Excel program, the significance of the differences was assessed using the Fisher criterion.

Research results

Pregnant women were divided into two groups in accordance with the statements they selected from the section “attitude towards their child” in the block “attitude of a woman in the emerging mother-child system” according to I.V. Dobryakova. The first group included women whose answers corresponded to the anxious type “I constantly listen to the movements of the unborn child, without good reason, I worry about the state of his health.” This answer was chosen by 18 women who were included in the first (main) group, which we defined as the group of “anxious” mothers. The second group (comparison) consisted of 23 women, whose answers corresponded to the optimal type of PCGD.

Comparison of groups by social status revealed the following.

Registered marriage is observed with the same frequency in pregnant women of both groups (44.4 and 47.7%, respectively). It should be noted that marriage was not registered in the first group for 55.5%, and in the second group for 39% of women. 14.4% of pregnant women in the second group planned to raise a child without a husband, while there were no such women in the first group.

Differences were revealed in the level of education of the two study groups: for example, 47.6% of women in the second group had higher education, in the first group only 16.8%. The majority of pregnant women in the first group had secondary specialized education (61.0%), in the second group - 42.8%. Studied in higher educational institutions during pregnancy: in the first group - 22.2%, in the second group - 9.6%.

The material level of the families of the first group of women was lower. Thus, 49.5% of families in the first group had incomes above the minimum subsistence level, while in the second group - 71.4%.

In the obstetric and gynecological history, noteworthy is the high percentage of cases of threatened miscarriage in the first group of women (85.7%), in the second group - 52.3% (significant difference according to Fisher's test at p≤0.05). Probably, anxiety about the condition of the unborn child can be explained by this particular pathology of pregnancy.

Children of mothers of the first group in the early neonatal period tend to suppress the central nervous system. According to the depression-irritation profile in the first group, the average profile score was 0.24 ± 0.02 points, which corresponds to mild depression of the central nervous system. In the second group, children had an average score of 0.11±0.04, which corresponds to a balance of oppression and irritation. The differences between the groups are significant (p≤0.01). It can be assumed that in the first group the condition of newborn children was influenced by both the pathology of pregnancy and the anxiety of pregnant women.

In the main group, children are characterized by emotional instability. If at least one of the parents (especially the mother) has an unstable emotional state, then such a child is at risk of problems associated with disturbances in the emotional sphere, the formation of insecure attachments, and a decrease in the level of functioning in the cognitive sphere [16]. The following characteristics were classified as emotional instability: frequent mood swings, frequent crying, predominance of a negative emotional state. Moreover, if at one month there were no significant differences between the groups, then at three months in the first group there were 27.5% of emotionally unstable children, and by six months it increased to 33.0%. There were no such children at all in the comparison group at three and six months (p≤0.01). The influence of anxiety during pregnancy on manifestations of emotional instability is confirmed in many literary sources. Facts have accumulated indicating that the mother’s behavior during pregnancy and her emotional stress cause the emergence of various forms of child psychopathology (neuroses, anxiety states, etc.), mental retardation and other forms of pathological conditions [2, 10].

It was revealed that in the first group of children, night sleep disturbances were observed. Thus, significantly more children in the main group fall asleep slowly and sleep restlessly. Moreover, with age, they experience a deterioration in the quality of sleep, while in the second group there is an improvement (Tables 1 and 2).

Table 1

Slow falling asleep (%)

table 2

Restless sleep (%)

As follows from the literature, several factors play a role in the origin of sleep disorders in young children. Acute and chronic psychotraumas occupy a special place among the causes leading to sleep disorders at an early age. Disturbances in falling asleep and frequent awakenings in children are caused by constant conflicts that occur in the family in the evening hours, shortly before the child goes to bed. For the most part, these are quarrels between parents, including over the right to control the behavior of children. Psychotraumatic circumstances associated with experiencing a sharp fright, fear of loneliness, closed space, etc. are important for sleep disturbance.

A predisposing factor for the occurrence of sleep disorders should also be considered cerebral-organic insufficiency of perinatal origin, the cause of which is the pathology of pregnancy and childbirth [14].

Our study did not reveal significant differences between groups in the presence of perinatal damage to the central nervous system in children, as well as conflict relationships in the family.

No data on the influence of a pregnant woman’s anxiety on sleep pathology have been found in the literature. Our study suggests the existence of such a connection, given that sleep pathology in children of the main group can be traced already at the age of one month. Over time, sleep pathology persists and even worsens; it is possible that the disturbance in maternal behavior observed in women of the first group begins to have an impact.

Psychomotor development is one of the important indicators of the health status of young children. Its level allows one to judge the quality of the environment, the nature of teaching work and other factors.

Psychomotor development was assessed using the L.T. scale. Zhurba and E.A. Mastyukova. We found that the average scores of psychomotor development in children of mothers in the main group are lower than in children of mothers in the comparison group. Thus, a tendency towards a lag in the indicators of psychomotor development of children in the main group was revealed. Moreover, the lag can be traced throughout all age periods we observed (Table 3).

Table 3

Assessment of the level of psychomotor development of children aged 1–6 months (points)

It should be noted that children of anxious mothers only by six months reach the level of psychomotor development score corresponding to the first month in the comparison group.

An important indicator of a child’s development is the formation at the age of three months of a full-fledged “revival complex”, which includes a smile, vocalizations and motor reactions. The “revitalization complex” simultaneously performs two functions - it accompanies the child’s joy about perceived impressions (communication with adults, looking at toys, perceiving sounds) and serves as a means of communication with adults, and the function of communication in the development of the “revitalization complex” itself is the main one [1] . The appearance of a “revitalization complex” reflects the child’s desire to communicate, the usefulness of interaction between a child and an adult.

Our study revealed significant differences in the manifestation of a full-fledged “revitalization complex” in children of the two groups. Thus, in the first group it was observed only in 55.0% of children, while in the second group - in 90.3% of cases (the differences are significant at the p≤0.01 level), i.e. Fewer children of anxious mothers exhibit a full-fledged “revival complex.”

The study of the laws of development of higher nervous activity has shown that sensory organs develop only when they are influenced accordingly [1]. Any contact of an infant with the outside world is mediated by the adult environment that is significant to him. It is well known that J. Bowlby stated that “the undifferentiated psyche of an infant requires the influence of a mental organizer—the mother” [14]. For a child to fully develop, it is not enough to hear speech or see objects and living objects. He needs interaction. Therefore, the mother should not only address the child, but also respond to his own initiative. It is the lack of interaction that becomes the main reason why even healthy children in orphanages lag behind in their development already in the first half of life [1, 19].

In the study, it was the inferiority of the maternal role in the main group that was the cause of the lag in psychomotor development and the manifestation of an inferior “revitalization complex.”

We found that in the first group, 40.5% of children had manifestations of autonomic dysfunction syndrome in their somatic status, while in the second group there were half as many of them (21.5%) (the differences are significant at the p≤0.05 level).

An analysis of the success of women in the role of mother revealed the following differences between groups: women of the main group do not know well the reason for their baby’s crying and therefore respond inadequately to the needs of the child, therefore, this complicates full interaction between mother and child. In the first month of life, only 11.0% of mothers in the first group knew what the child was showing by crying, while in the second group - 55.9%. By the age of six months, only half of the mothers from the first group had learned to understand their baby, while in the second group all women had mastered this.

We also identified significant differences in the child’s tactile stimulation, which included stroking, hugging, and kissing the child. It turned out that at the age of three months, only 40.0% of mothers from the group who were anxious during pregnancy pay daily attention to stroking their baby, while in the comparison group - 91.0% of women. By six months, there is a decrease in this indicator in both groups, while maintaining significant differences (first group - 14.2%, second group - 54.5% | women). Mothers explained this by saying that the child began to play with toys more on his own; he could be left awake alone, for example, in a “jumping room.” However, this trend cannot satisfy specialists (psychologists, pediatricians, teachers), because The affectionate touch of parents has an emotional and energetic impact on the child, acquiring the meaning of social approval, recognition and love by the people around him. In early childhood, a child’s lack of opportunity to experience and personally show various forms of love and affection with people close to him often leads to a feeling of emotional alienation and loneliness not only at home with adults, but also with peers [13].

During communication with mothers, it was noticed that mothers of the first group talk less with the child and less often try to establish contact through non-verbal methods of communication.

In general, it was noted that mothers of the main group are less satisfied with their child. Thus, they are significantly less likely (p≤0.01) to talk about how good their baby is, both at three and six months.

The results of the drawing test “Me and my child” made it possible to divide pregnant women from the groups under consideration into four subgroups of the emotional experience of pregnancy: 1 - favorable situation; 2 - minor symptoms of anxiety; 3 — presence of anxiety and uncertainty; 4 - conflict with pregnancy (Table 4).

Table 4

Distribution of drawing test scores (%)

A favorable situation is reflected in only 7.1% of the drawings of pregnant women in the main group and in 13.6% of the comparison group. A favorable situation is characterized by the fact that in the drawings there are a mother and a child, the child’s age is an infant, the child is drawn, and is in the mother’s arms.

Minor symptoms of anxiety are present in the majority of women in the comparison group (59.0%), in the drawings of pregnant women of the main group they are reflected in 28.8%. In these drawings, the child’s figure is depicted with changes in ratio. The husband or other people are present in the drawings. The presence of other items is noted. The child is in a stroller, crib or holding his mother's hand. The child's age corresponds to early.

The presence of anxiety and self-doubt prevails in the drawings of pregnant women of the first group (35.7%), among the second group it occurs in 22.7% of cases. In the drawings of this group there is a large number of additional images, careful drawing of the details of clothing with insufficient drawing of one’s own figure, one’s face and the child’s face, the presence of schematization, and the absence of joint activity. The dimensions of the child's figure are disturbed.

In our study, attention is drawn to the reliability of differences between pregnant women in identifying conflict with pregnancy (p≤0.01). Thus, signs of conflict with pregnancy are found in the drawings of pregnant women in the main group in 28.8% of cases, while in the drawings of women in the comparison group - in only 4.5% of pregnant women. Signs of conflict with pregnancy are characterized by the absence of oneself or the child in the drawing or its replacement with images. The baby is either hidden in the stroller or in the mother's belly. There is a distance between the figures of mother and child and the presence of a large number of additional objects.

In the drawings of both groups there is an image of a mother and child, but there are more symbolic drawings in the main group of pregnant women, the sizes of the figures of the mother and child are violated more often. There were more drawings depicting joint activities in the comparison group. Women of the second group have already identified themselves with the unborn child and are focused on communicating with him. In the first group there are images of a child without a mother, a large distance in the depiction of figures. This may indicate that pregnant women in the main group do not perceive themselves and the child as a single whole.

Thus, this work allows us to draw the following conclusions:

1. Women who experience increased anxiety during pregnancy about the condition of the unborn child, nevertheless discover its low value, are not psychologically confident in the successful outcome of the pregnancy, and are not focused on future motherhood.
2. Anxious experiences of a pregnant woman have a significant impact on the development of the child in the first months of life. Children of mothers with a high level of anxiety are characterized in the neonatal period by a tendency to depression of the central nervous system, emotional instability, impaired sleep quality, have lower scores on psychomotor development, impaired communication functions in the form of an inferior “revival complex” and a syndrome of autonomic dysfunctions.
3. Anxious pregnant women subsequently prove to be less successful in the role of mother than women with an optimal type of pregnancy experience. They do not know well the reasons for crying, are not sufficiently involved in interaction with the child, have little tactile contact with him, less often talk about how good the child is, talk to him less, and less often try to establish contact through non-verbal methods of communication.
4. The diagnostic significance of the drawing test conducted during pregnancy in predicting disturbances in maternal behavior in the future has been revealed.

Literature

1. Avdeeva N.N., Meshcheryakova S.Yu., Razhnikova V.G. Psychology of your baby. - M.: AST, 1996.

2. Batuev A.S. The emergence of the psyche in the prenatal period // Psychological Journal. –2000.-T. 21.-No. 6.-S. 51–56.

3. Batuev A.S., Sokolova L.V. The doctrine of the dominant as a theoretical basis for the formation of the “mother-child” system // Bulletin of St. Petersburg State University. - 1994. -Issue 2.-S. 82–102.

4. Bauer T. Mental development of the baby. - M.: Progress, 1985.

5. Brekhman G.I. Perinatal psychology // Bulletin of the Russian Association of Obstetricians and Gynecologists. - 1998. - No. 4. - P. 49–52.

6. Brutman V.I., Filippova G.G., Khamitova I.Yu. Dynamics of the psychological state of women during pregnancy and after childbirth // Questions of psychology. - 2002. - No. 3. - P. 59–68.

7. Winnicott D.V. Little children and their mothers. - M.: Nezavisimaya, 1998.

8. Dobryakov I.V. Perinatal psychology // World of Medicine. - 2000. -No. 5–6. — P. 45–46.

9. Dobryakov I.V. Clinical and psychological methods for determining the type of psychological component of the gestational dominant // Reader on perinatal psychology. - M., 2005. - P. 93–102.

10. Drapkin B.Z. Psychotherapy with maternal love. - M.: DeLiPrint, 2004.

11. Zhurba L.T., Mastyukova E.A. Impaired psychomotor development of children in the first year of life. - M.: Medicine, 1981.

12. Kozlovskaya G.V., Bazhenova O.V. Micropsychiatry and the possibilities of correcting mental disorders in infancy // Journal of Neurology and Psychiatry. - 1995. - No. 5. - P. 48–51.

13. Lopatina O.G. The importance of physical contact with the mother in the prevention of behavioral disorders in the child // Social and clinical psychiatry. - 1992. - T. 2. - Issue. 2. - pp. 79–82.

14. Mikurtumov B.E., Koshchavtsev A.G., Grechany S.V. Clinical psychiatry of early childhood. - St. Petersburg: Peter, 2001.

15. Mukhamedrakhimov R.Zh. Forms of interaction between mother and baby // Questions of psychology. - 1994. - No. 6. - P. 16–25.

16. Mukhamedrakhimov R.Zh. Interaction and attachment of mothers and infants at risk // Questions of psychology. - 1998. - No. 2. - P. 18–33.

17. Mukhamedrakhimov R.Zh. Mother and baby; psychological interaction. - St. Petersburg; Speech, 2003.

18. Palchik A.B. Evolutionary neuroscience. - St. Petersburg: Peter, 2002.

19. Prikhozhan A.M., Tolstykh N.N. Psychology of orphanhood. - St. Petersburg: Peter, 2005.

20. Smirnova E.O., Radeeva R.P. Development of attachment theory // Questions of psychology. - 1998. - No. 1. - P. 105–116.

21. Filippova G.G. Motherhood: a comparative approach // Psychological Journal. - 1999. - T. 20. - No. 5. - P. 81–88.

22. Filippova G.G. Psychology of motherhood. - M.: Publishing House of the Institute of Psychotherapy, 2002.

23. Tsaregradskaya Zh.V. Child from conception to one year. - M.: AST, 2002.

24. Shchukina E.G. Features of families raising children with disabilities: solutions // Modern family: problems, ways of formation and development. Digest of articles. - Arkhangelsk: SSMU, 2003.-S. 18–20.

25. Shchukina E.G. The role of the family in the process of expecting a child // Questions of prenatal psychology. Method. allowance. - Arkhangelsk: SSMU, 2003. -S. 5–10.

26. Ede1man G. The Remembered Present: A Biologisa Theory of Consciousness. - N.-Y.: Basis Books, 1989. - R. 44.

27. Fries M.E. Longitudinal Study: Prenatal Period to Prenatalhood // J. of American Psychoanalytic Association. - 1987. - Vo1. 25. - R. 115–140.

28. Fereira A.J. The Pregnant Womens Emotiona Attitude // American J. of Orthopsychiatr. - 1980. - Vol. 30. - R. 553–556.

29. Nerren L.R.. The Ankhietu-Prone Personalitу // The Biologu of Ankhietu. - 1982. - R. 51–86.

30. RapthiraatrhornCh. Pgenata1 Infant Stimulation Program // Prenatal Perception / Ed. D. Blum. - 1994. - R. 187–220.

31. Verpu T.R.. Pge- and Perinata1 Psyho1ogu: An Intoduction. - N.-Y.: Human Science Press, 1987. - R. 25. •

32. WardA.J. Pgenata1 stress and childhod psuhorato1ogy // Child Psychiatru and Human Development. - 1991. - Vol. 22. - R. 97–110.

Source: Journal “Perinatal psychology and psychology of parenthood” No. 1, 2006, p. 85

Cleaning during frozen pregnancy

Cleansing the uterine cavity is a surgical procedure that is performed under general or local anesthesia. Before the operational event:

• analysis for hCG, syphilis, hepatitis, HIV;
• cardiogram;
• ultrasonography;
• general smear examination;
• coagulogram.

Gynecological cleansing is mandatory in the early stages, unless a spontaneous miscarriage has occurred. If medical aspiration fails. For periods of more than 8 weeks, the procedure is necessary even in case of spontaneous miscarriage, since fragments of the fetus may remain in the uterus, which will lead to inflammatory processes and blood poisoning, which is fraught with dangerous complications and death.

Medical aspiration is the most gentle, but not the most effective method of abortion. A woman, under the supervision of a gynecologist, takes a special pill that causes contractions of the uterus, during which the body independently pushes out the dead fertilized egg. Unfortunately, this method does not always lead to the expected effect.

In addition to medication, there are two types of cleaning: vacuum and surgical. In the first case, special vacuum equipment is used, which gently separates the fertilized egg from the walls of the uterus. This method has a minimum of side effects and a short rehabilitation period. Vacuum aspiration is less traumatic and rarely leads to infertility and complications.

A surgical abortion is performed using forceps and a curette, which crushes the embryo to effectively remove it from the uterine cavity. The fetus is practically scraped out, which can negatively affect the condition of the uterus.

Often, after such an intervention, inflammatory processes develop, and there is some risk of infertility. After curettage, some time is required for recovery, additional treatment and regular visits to the doctor, who will monitor the patient’s condition for a certain period.

How to properly prepare for the next pregnancy after a frozen one

After pregnancy fading, it is important to determine the cause of the pathology that occurred and, if possible, eliminate it. When planning a subsequent conception, it is important to restore hormonal levels and normal physical condition, in which the uterus will be ready to accept a new fertilized egg.

After freezing during pregnancy planning, it is recommended:

• lead a healthy lifestyle;
• eliminate large, debilitating loads;
• in case of severe psycho-emotional stress, take a course of sedatives, preferably herbal ones;
• carry out antibacterial therapy;
• visit a gynecologist regularly;
• take hormonal contraceptives for at least three months.

If serious illnesses are detected, it is important to undergo full treatment and follow all doctor’s recommendations. If freezing occurs again during a second pregnancy, it is necessary to look for the causes of the pathology and only after it has been eliminated, prepare for the next pregnancy.

During the rehabilitation period, it is advisable to walk a lot, take vitamin and mineral complexes, give up alcohol, smoking, and especially taking drugs. The psychological attitude is also important during this period, since the result of recovery depends on a balanced psycho-emotional background no less than on taking medications and other therapeutic measures.

The first examinations of the patient are scheduled immediately after cleaning. The fetus undergoes histological studies, which are necessary to identify genetic abnormalities, mutations, and anomalies. The examination also indicates the presence of infections, inflammations and other diseases in a woman. You can plan a subsequent conception only with a qualified doctor, after his permission to do so.

Why is depression dangerous in pregnant women?

Anxiety and depressive disorders can occur in mild forms with unexpressed symptoms. However, there is a possibility of developing the following consequences:

1. Miscarriage.
2. Insomnia.
3. Increased risk of bleeding, hypertension, maternal mortality.
4. Fetal growth retardation, rapid heartbeat, risk of mental (rarely somatic) diseases in the newborn.
5. Severe gestosis, the appearance of preeclampsia.
6. Suicidal thoughts and behavior.
7. Premature delivery, the need to resort to caesarean section.
8. Introducing the expectant mother to cigarettes, alcohol, and drugs.
9. Low adherence to obstetric and gynecological supervision, late seeking help.
10. Insufficient baby weight at birth, subsequent problems with appetite.
11. Self-harm, attempts to independently terminate pregnancy and even get rid of the fetus.

Clinical studies have established a connection between prenatal depression and the appearance of psychoneurological diseases in children in the future, for example, ADHD (attention deficit hyperactivity disorder). Depression can threaten the lives of mother and baby. However, in most cases, babies develop absolutely normally.

Treatment after a frozen pregnancy

After carrying out procedures to eliminate the consequences of a frozen pregnancy, the patient is prescribed antibacterial agents, antibiotics, hormonal drugs, and vitamins.

It is also recommended that a woman follow the pastel regime for some time and refuse intimate relationships.

For several days, in order not to cause bleeding and complications, you should not lift heavy objects or expose yourself to heavy loads.

After cleansing, the woman experiences intense discharge. During this period, it is strictly not recommended to use tampons; it is better to use standard hygiene products designed for heavy menstruation.

There is no specific treatment regimen after a frozen pregnancy. Each therapy is individual and depends on the method of aspiration, the patient’s condition, and the complexity of the situation. It is important to take precautions for some time after fading, since subsequent conception requires time for rehabilitation and recovery.

How long does it take to get pregnant after a frozen pregnancy?

If menstruation is fully restored, pregnancy can occur immediately after surgery. Therefore, it is important to take all measures for contraception, since you cannot conceive a child right away and the body must optimally rehabilitate and prepare.

After freezing, the patient may be in a depressed psychological state that needs to be stabilized. The injured endometrium must undergo a regeneration process. The same applies to hormonal and physical background.

Experts advise delaying conception for at least 6 months.
Also, when choosing when to plan your next pregnancy, it is important to take into account the fact that many drugs are eliminated on average for three months. Publication date 2019-11-16

Common symptoms and manipulations in gynecology:

• Vaginal discharge
• Discharge from the urethra
• Discharge from the uterus
• Intrauterine device
• Female infertility
• Delay of menstruation
• Itching in the vagina
• Brown discharge
• Abortion
• Perineal pain
• Cervical erosion
• Abortion pills
• Vacuum abortion
• Medical abortion
• Surgical abortion
• Cervical biopsy
• Diagnostic curettage
• Folliculometry
• Make an appointment with a gynecologist