Non-developing pregnancy up to 12 weeks of gestation in women of reproductive age

Objective. To analyze the clinical characteristics of non-developing pregnancy (NDP) cases in the first trimester.

Materials and methods. A retrospective study was conducted by reviewing medical records of patients with non-developing pregnancy (NDP) up to 12 weeks of gestation. The analysis focused on associated gynecological and somatic comorbidities, as well as the leading clinical manifestations of this condition.

Results. The obtained data demonstrated that the highest incidence of non-developing pregnancy was observed among women living in urban areas, suggesting a possible impact of environmental and epigenetic factors on this gestational pathology development. Contrary to literature data highlighting the key role of maternal age as a risk factor, our analysis found no statistically significant differences between age groups. However, a high prevalence of somatic comorbidities was observed among the examined patients, irrespective of age and residence. Notably, there was a high prevalence of adverse obstetric and gynecological history, including menstrual dysfunction, spontaneous miscarriages, induced abortions, ectopic pregnancies, and recurrent episodes of non-developing pregnancy.

Analysis of the timing of pregnancy termination showed that in most cases, the pregnancy loss occurred at up to 5–6 weeks of gestation. The most common clinical symptom was vaginal bleeding, however, in 21 % of cases, NDP was asymptomatic and diagnosed only by ultrasound examination. This underscores the crucial importance of first-trimester ultrasound screening, especially in high-risk groups, such as women with a history of pregnancy loss.

Conclusions. Currently, it is generally accepted that for patients with a complicated obstetric history, the absence of preparation and consideration of the pathophysiological features of the reproductive system recovery prior to conception significantly increases the risk of recurrent pregnancy loss.