The first trimester is the most crucial period in pregnancy, as it is during this period that the embryo develops into a fetus and vital organs form. However, in some pregnancies, fetal development can stop before entering the second trimester. This condition is known as a missed miscarriage , when the embryo has formed but its growth has stopped and it has not spontaneously exited the uterus.
Unlike a blighted ovum, in this condition, the embryo is visible in the uterus but is no longer developing. Because symptoms are often nonspecific, regular checkups with an obstetrician are essential to confirm the pregnancy.
Why Can a Fetus Not Develop?
The most common cause is a chromosomal abnormality that occurs during fertilization. This abnormality prevents the embryo from developing normally, leading to a natural termination of the pregnancy. Several other factors that can increase the risk include maternal age over 35, uterine abnormalities, hormonal disorders such as uncontrolled diabetes or thyroid disease, and certain blood clotting disorders.
It is important to note that this condition is generally not caused by everyday activities, such as working, walking, climbing stairs, or light exercise.
Will Mom Feel the Symptoms?
Initially, many women still experience pregnancy symptoms such as nausea, breast tenderness, fatigue, and positive pregnancy tests. This is because the body is still producing pregnancy hormones.
Over time, some women may experience bleeding or spotting, abdominal cramps, or a decrease in pregnancy symptoms. However, many women experience no symptoms at all, and their condition is only discovered during an ultrasound examination.
How Do Doctors Determine a Diagnosis?
A diagnosis cannot be made based on symptoms alone. The doctor will perform an ultrasound to assess the size of the embryo and detect a fetal heartbeat. If growth stops or a heartbeat is not detected at the expected gestational age, the doctor can confirm that the pregnancy is not progressing. In some cases, a repeat ultrasound will be performed approximately 7–14 days later to confirm the diagnosis.
What is the treatment?
Treatment is tailored to the mother's condition and the examination results. The doctor may recommend waiting for the miscarriage to occur naturally, administering medication to help expel the pregnancy tissue, or performing a curettage if medically indicated, such as heavy bleeding or incomplete expulsion of the pregnancy tissue.
After treatment, the doctor will usually schedule a follow-up check-up to ensure the uterus is clean and the mother's condition is back to normal.
Conclusion
First-trimester fetal distress occurs when a developing embryo stops growing before 13 weeks of pregnancy. The most common cause is a chromosomal abnormality that occurs spontaneously and is generally unpreventable. Because symptoms often mimic a normal pregnancy, regular prenatal checkups and scheduled ultrasounds are the best way to ensure fetal development. If you experience bleeding, abdominal pain, or any concerns about your pregnancy, consult your obstetrician immediately for appropriate evaluation and treatment.
This article was written by Dr. Lisa Puspadewi Susanto, Sp.OG, FICS (Obstetrics and Gynecology Specialist at EMC Alam Sutera Hospital).