Fetal egg twins. Gemini: from conception to birth. Definition of the concept of anembryony

Children born as a result of multiple pregnancies are called twins. In addition, you can often hear the word "twins", which is colloquially called "dissimilar" twins.

How does it work?

Twins are of two types. Dizygotic (fraternal, non-identical) twins develop from two fertilized eggs. Moreover, in some cases, the simultaneous maturation of two or more eggs occurs in one or both ovaries. A third way of origin of fraternal twins is possible: the fertilization of two or more eggs that have matured in one follicle. Interestingly, sometimes the difference between the time of conception of dizygotic twins can range from several hours to several days. Fraternal twins are no more genetically similar than regular siblings; they are of the same sex and of different genders with approximately the same frequency.

Monozygous (identical, identical) twins are obtained by fertilizing a single egg with one sperm. Then the resulting zygote begins to divide as usual, but with an interesting feature: as a result of division, independent embryos are subsequently formed. The reasons for the development of this process by science have not yet been precisely established due to the complexity of the biochemical mechanisms that regulate cell division. Such twins are almost exact copies of each other, although, of course, there are still minor differences between them. Indeed, in the initially identical DNA of each embryo, different mutations can occur. The second reason for the differences is non-genetic influences, for example, the characteristics of the areas of the female uterus or the effects of other factors. Monozygotic twins are 5 times less common than dizygotic twins. Among monozygotic twins, boys predominate.

A separate topic is Siamese twins. This is the name of identical twins, who have grown together to varying degrees. The alleged reason is the late splitting of the embryo into independent forms. The later this happens, the higher the risk. Siamese twins are extremely rare. They are born once every 10 million births.

Many conceptions of twins do not end with birth. For every pair of twins born, there are 10-12 people who had a twin in the womb.

Can twins be scheduled?

Naturally - practically not. If pregnancy has already begun and the woman knows about it, then in any case it is impossible to change the course of events by any means, because in the process of fertilization information is laid about the unborn child, including whether he will be one or two of them.

But some factors still increase the likelihood of conceiving fraternal twins, while the likelihood of having identical twins is not associated with any hereditary and external factors and is constant - on average 3 per 1000 pregnancies, that is, 0.3%.

So, in women aged 35-39 years, the likelihood of such conception increases. The fact is that in the late childbearing period in female body the concentration of the hormone increases, which stimulates the maturation of the egg. Thus, several eggs ready for fertilization can ripen at the same time. It is also known that the duration of daylight hours affects the production of this hormone. Therefore, it is more likely to conceive twins in the spring, when the sun begins to noticeably warm up.

If the family already had twins, then the closer the generation in which this happened, the higher the probability of giving birth to fraternal twins. The tendency to give birth to fraternal twins is manifested only in women. Men from such families can pass this property on to their daughters, although in the offspring of these men themselves, an increased frequency of twins is not observed.

More often, several eggs mature in women with a short menstrual cycle - 20-21 days, as well as in women with abnormalities in the development of the uterus, for example, in the presence of a septum in the uterine cavity or a two-legged uterus (pathology of uterine development, in which the organ is not pear-shaped, but as if bifurcated).

In recent years, hormonal drugs that stimulate egg maturation and ovulation have been widely used to treat infertility and other gynecological diseases. As a result, a long-awaited pregnancy after many years of infertility often turns out to be twins or triplets! Successfully developing in vitro fertilization (IVF) technologies have also led to the fact that pregnancy with twins or triplets is no longer a rarity. Twins after IVF are always heterogeneous, often heterosexual, each with its own appearance and character.

The frequency of twin births is significantly higher during various social upheavals and wars.

When can you find out about twins?

Fifteen to twenty years ago, twins were recognized only during childbirth or not earlier than the 20th week of pregnancy. When recognizing multiple pregnancies, the following signs were taken into account.

The enlargement of the uterus with multiple pregnancies occurs faster than during pregnancy with one fetus, so the size of the uterus does not correspond to the gestational age. At the same time, a significant volume of the pregnant uterus does not correspond to the small size of the presenting head of the fetus. In addition, with twins, a deepening of the area of ​​the bottom of the uterus (saddle uterus) can be determined, the formation of which is associated with the protrusion of the corners of the uterus by large parts of the fetus; as well as a longitudinal depression on the anterior wall of the uterus, if the twins are in a longitudinal position, or the presence of a horizontal groove on the anterior wall of the uterus when the twins are transverse. Long time important for the diagnosis of twins was a clear definition in the uterus during obstetric examination of three or more large parts of the fetus (two heads and one pelvic end or two pelvic ends and one head). Equally important was the presence of two distinct heartbeat points in different parts of the uterus.

Today, ultrasound examination, already at the 5th week of pregnancy, can tell the expectant mother how many babies she can expect. In this case, the doctor on the screen identifies two "bubbles" of nascent life. It is interesting that such a find for a woman who hesitated between having or not having an abortion, in almost 100% of cases, persuades the expectant mother to maintain the pregnancy. An experienced doctor for up to 14 weeks of pregnancy can determine the type of twins (monozygous or dizygotic) by the thickness of the septum between the "bubbles".

To diagnose multiple pregnancies, phonocardiography is also used, with which you can register the heart sounds of twins not only in the last months of pregnancy, but also at periods of 20-22 weeks and earlier.

The price of double joy

As soon as the antenatal clinic doctor determines that the expectant mother is expecting twins, or even triplets, he enrolls her in the category of pregnant women with an increased degree of risk. This is due to the fact that women with multiple pregnancies have two or more times the risk of developing serious health problems compared with women who carry only one child.

Even with an uncomplicated multiple pregnancy, a woman may feel tired; already in the second trimester, shortness of breath appears, heart palpitations. This difficulty in the activity of the heart and lungs is associated with a significant displacement of the diaphragm by the bottom of the uterus, the size of which is larger in multiple pregnancies than in single pregnancies, while the load on the heart muscle increases three to four times. During pregnancy with several fetuses, the risk of arterial hypertension increases - an increase in blood pressure, varicose veins, deep vein thrombosis are more often noted. Naturally, professional physical activity, lifting serious weights is out of the question. Moderate exercise is ideal - hiking in the fresh air, swimming. While sitting, it is better to place your feet on a special stand or a low coffee table - this will serve as a preventive measure against varicose veins. A good bandage and special tights for "double" moms are also a must. Fast growth The uterus can outpace the skin's ability to stretch, so multiple pregnancies often cause stretch marks (tissue breaks). Special products for abdominal and thigh skin care help to reduce their appearance.

In women expecting twins, early toxicosis is often observed. This is due to the fact that the level of hormones in the blood is much higher than during normal pregnancy. In multiple mothers, such a formidable complication of pregnancy as gestosis, a condition in which all organs and systems of the mother are affected, and the fetuses suffer, more often and more severely. Gestosis is manifested by an increase in blood pressure, the appearance of protein in the urine, edema on the legs.

By the end of pregnancy, there is often an increase in the urge to urinate due to pressure from the uterus on bladder... Pregnant women often complain of heartburn and constipation. The volume of the stomach of the expectant mother decreases due to the compression of it by the stretched uterus. For this reason, you should divide your meals into six small servings. Despite the small volumes, the food should be balanced. For each "overweight" baby, 300 kcal, additional protein and calcium should be supplied. The expectant mother especially needs iron and folic acid, a lack of them leads to the development of anemia (a decrease in the amount of hemoglobin) in the mother and oxygen starvation in children. In addition to the diet, special vitamins for pregnant women and additional preventive intake of special iron preparations will come to the rescue. It is good if it is possible to keep hemoglobin not lower than PO g / l.

The most serious complication of multiple pregnancies is the risk of miscarriage. Double or even triple load on the uterus often leads to the fact that the uterine pharynx begins to open ahead of time. Sometimes, in order to bring a pregnancy to at least 36 weeks, you have to resort to special devices that prevent the cervix from opening, or to put a suture on the cervix, which is removed at 36-37 weeks. For the same purpose, the doctor may recommend expectant mother"Rest" in the department of pregnancy pathology at the maternity hospital at the time when miscarriages occur most often or premature birth... You should not refuse such an offer.

In case of fraternal twins, the frequency of intrauterine malformations is the same as in singleton pregnancies, and in case of identical twins, it is 2 times higher. The course of such a pregnancy is often complicated by a delay in the growth of one of the fetuses. The most pronounced degree of such a delay is observed in fetofetal blood transfusion syndrome (identical twins with one placenta feed on each other). In this case, the lives of both are in danger. Usually the difference in body weight between twins is small and is about 200-300 grams. With fetofetal blood transfusion syndrome, this difference reaches a kilogram or more.

Nevertheless, the overwhelming majority of multiple pregnancies go well up to 37-38 weeks, when labor begins. Usually, doctors at this time recommend hospitalization in a maternity hospital, the purpose of which is to examine the pregnant woman and determine the time and method of delivery.

Read about childbirth and the postpartum period in multiple pregnancies in the next issue of the magazine.

Pregnancy is the most important stage in the life of the fair sex, so every woman is in a hurry to testify and confirm the fact of future motherhood as early as possible. The very first question that worries all mothers is how does the baby develop?

When an embryo appears in the ovum

As a result of conception, the fertilized egg, after two weeks, enters the uterus and attaches to the endometrium - the inner mucous layer of the uterus. It is from this moment that cardinal changes begin to occur in the woman's body. One of the main ones is the release of chorionic gonadotropin (hCG) - a hormone that protects the fetus from harmful external influences. The production of the hormone provokes the first signs of pregnancy and a positive pregnancy test result about 5-7 days after conception.

It is worth noting that a full-fledged embryo has not yet formed at this time. And ultrasound diagnostics can consider the appearance of an embryo in fetal egg not earlier than in 5-6 weeks. On the screen of an ultrasound scanner, the ovum appears as a small dark gray oval in the uterine cavity. And the embryo, in turn, is visualized as a barely noticeable white formation, one might say a tadpole with a tail, which does not yet look like a human.

Why are there two embryos in the ovum?

When diagnosed at 6-8 weeks in the ovum of two embryos, we can talk about the presence of a multiple pregnancy. On an ultrasound study, you can notice a difference in the size of embryos, but it is impossible to unequivocally determine whether twins or twins will be impossible. Conception and formation of twins or identical twins is due to the following reasons:

• fertilization of two eggs with two different spermatozoa;
• the formation of two merged gametes from one egg.

At the first development of the situation, pregnancy is called "bizygotic", while babies can be either same-sex or heterosexual. Due to the second reason, two identical copies of the embryos appear in the mother's womb.

Cases when not one, but two or more babies settle in the mother's stomach, are not so common - 1.5-2.5% of all pregnancies. How does it work? What is the difference between multiple pregnancies? Can twins be scheduled? Our expert - Anna Romanovna PASTUKHOVA, obstetrician-gynecologist of the Zdravitsa family medicine centers answers all questions.

What is the likelihood of getting pregnant with twins?

First, some statistics. As we have already mentioned, this amazing phenomenon occurs in 1.5-2.5% of pregnancy observations in European countries. It is believed that the appearance of twins, triplets and twins is genetically determined - more often they are born in families where one or both parents were born as a result of multiple pregnancies. However, there are other reasons, among which .

• The birth of twins occurs with a frequency of geometric progression, obstetricians even have a special formula: for 87 births there is one twins, for 87 twins - one triplet, for 87 triplets - one quadruple, etc. True, today this formula needs correction - multiple pregnancies are becoming more common.

• Identical or identical twins are less common: an average of 1 in 250 births.

• Most often, multiple pregnancies are observed in Africa, least often in Asian countries.

Types of multiple pregnancies

Let's start with a well-known fact. There are two types of twins: identical or monozygous and fraternal (they are also called dizygotic).

• Monozygous twins result from the division of one egg, fertilized by one sperm. They surprise everyone with their striking resemblance.

• Fraternal twins are the result of the fertilization of multiple eggs with multiple sperm. They can be either the same or different sex, often differ in character and are not always similar in appearance.

Expert commentary

Multiple pregnancy is a pregnancy when more than one fetus develops in the mother's body, but several at once. In medicine, there are identical or fraternal twins (triplets and so on). Identical twins are always the same sex, have the same blood type, and look very similar. Fraternal twins have phenotypic differences (eye color, facial features), there may be both the same and different blood groups. Fraternal twins can be heterosexual.

How identical twins are made

To be honest, we have no idea! The reasons why, instead of a single baby from one egg and one sperm, two (three, four) appear are not really known - a miracle, and nothing more. The mechanism of the emergence of monozygotic twins, however, is described in sufficient detail. It all starts as if nothing had happened: one egg, one sperm, meeting, fertilization ... Then the resulting zygote begins to divide, grow and, at some point, under the influence of not entirely clear factors, suddenly splits into two or more parts, each from which begins to live a life of its own.

Expert commentary

The development of identical twins occurs when one ovum is fertilized by one sperm, in the process of dividing the ovum into two, three or four parts at different stages of its development. Moreover, each part develops as a separate organism. It is believed that such a separation can occur when the implantation (attachment) of the ovum is delayed due to oxygen deficiency... Also, the occurrence of identical twins is associated with the fertilization of an egg that had two or more nuclei.

Are the twins interfering with each other?

It is very important at what point the egg is split, since the further intrauterine development of the twins depends on this.

There are 3 options for the development of monozygotic twins

• The separation of the ovum occurred in the first five days after fertilization. In this case, both future babies begin to develop completely independently, each "grows" its own placenta and ... Until recently, it was believed that such a development is characteristic only of fraternal twins and identical twins in such cases were mistakenly identified as dizygotic (maybe this happened with the Olsen sisters?)

• The zygote split approximately 5-8 days after fertilization. By this time, the outer fetal membrane had already begun to form: remains common in babies, however, the inner fetal membrane (amnion) develops in each individual. If babies have a common placenta, then one child can suppress another - their competition begins with conception.

• Separation occurred on day 8 or later (1% of all monozygotic twins). At this time, the fetal bladder is already beginning to form, so the divided embryos will grow in the common amnion and common fetal waters. This situation is considered not the most favorable, there is a risk that babies each other.

The life of fraternal twins in the womb is organized with great comfort: each of them develops its own personal placenta (sometimes they grow together by the walls), which means that babies do not need to compete seriously for a place “under the sun”.

So, if the embryos are in different placentas, then, most likely, they are heterogeneous, and if the children "settled" with a common placenta, then these are identical twins who will be born similar like ... twins.

Expert commentary

There are the following types of multiple pregnancies:

• Monochorionic monoamniotic twins, when there is a common placenta and there is no septum between the twins. It's always identical twins.
• Monochorionic diamniotic twins, when there is a common placenta and septum, i.e. each fetus has its own amniotic bladder
• Dichorial diamniotic twins, when each fetus has its own placenta and its own amniotic bladder.

How fraternal twins are made

Non-identical twins develop from two or more fertilized eggs. How does this happen? The most common reason for this is the so-called "multiple ovulations", when several mature eggs are released from one or both ovaries at once. The reasons for this phenomenon may be different: genetic predisposition, artificial stimulation of the ovaries, the first cycle after the abolition of hormonal contraceptives.

Do you know that....

• The difference in time of conception of fraternal twins can be from several hours to several days.

• In very rare cases, a new one is added to an existing pregnancy. As a rule, after fertilization and implantation of the ovum, ovulation is immediately blocked. If, due to hormonal imbalance, this mechanism does not work immediately, a younger brother or sister is added to the older child in utero.

At 12 weeks on ultrasound, they saw that twins, monochorial, the 1st - ktr 64, in the 2nd ktr 69. At 20 weeks, the difference in fetal weight was 100 g 361/262. Doctors are afraid of the possible development of SFT (fetal transfusion syndrome). What percentage of the difference between them and will it really lead to the death of both fruits?

With monochorionic twins, the risk of developing fetal-fetal transfusion syndrome is very high. Therefore, as a rule, there is a difference in fetometry indicators, their condition and adaptive capabilities. Monitoring during pregnancy allows for a timely assessment of the condition of the fetus, without waiting for a critical condition.

One fetal egg was placed on an ultrasound scan at 3 weeks. HCG showed 5-6 weeks. On ultrasound at 13 weeks, 100% of the girl said back wall, and at 17 weeks said that one fetus is a boy on the front wall. I have identical monochoreal twin brothers. Could it be that two uzists in a hurry found different babies, but did not look for the second or did not notice.?!

At 13 and 17 weeks, the diagnosis of a single / multiple pregnancy is not difficult. Highly specialized ultrasound specialists of our center will be able to answer your questions.

Dee Dee has twins 24 weeks pregnant. On ultrasound, one fetus is developed in terms of time and size for 24 weeks and 1 day, and the second for 22 weeks and 3 days. Is this lagging the norm?

Unfortunately, it is impossible to answer your question without information about the size of both fruitlets in the period of 11-14 weeks, screening data for the first trimester and information about the state of the placenta, umbilical cord, the amount of amniotic fluid and the results of Doppler measurements of your babies. Or send the question again, indicating all the necessary data. Or make an appointment by calling the Unified Call Center: 8-495-636-29-46

18-19 weeks of pregnancy, did ultrasound: monoamnitic monochorionic undissociated twins. Do I have different sex children or same sex? How to understand this? What is this in general and can it threaten me with something?

Monoamniatic monochorionic twins mean that babies have not only one placenta for two, but also one amniotic cavity for two. In this case, the sex of the babies should be the same. Undissociated twins means that the babies are not separated, "fused" with each other (the so-called "Siamese twins"). In this case, the prognosis for the life and health of babies may be unfavorable. To clarify this serious diagnosis, it is advisable to conduct an expert ultrasound scan, and then consult a geneticist.

At the first ultrasound at a period of 7 weeks, the pregnancy is monochorionic biamniotic, and in the maternity hospital at 11 weeks, it is bichorial biamniotic. Due to the doctor's excitement about the reduction of the cervix, she did an ultrasound scan at 15 weeks and again put a monochorionic pregnancy. At the same time, the doctor was completely convinced that these were twins. At 19 weeks, they said that they could not see how many placentas. How to find out twins or twins? And is this possible on subsequent ultrasounds? The kids are same-sex, neither me nor my husband had twins in the family.

Most accurately, chorion (how many placentas) is determined in the first trimester, when the thickness of the amniotic septum and the presence of chorionic tissue between the membranes of the amnial cavities can be estimated. With an increase in pregnancy, these signs lose their significance and the determination of chorionicity when both placentas are located on the same wall becomes difficult. An indirect indicator of monochorionic twins is the same sex in both babies, but this option is also possible if there are two placentas. It will be possible to finally resolve the issue of twins after childbirth.

We are planning a pregnancy. In October, the ovarian cyst was removed. After laparoscopy, the doctor prescribed treatment: 3 injections of Zoladex, 3 months of drinking to Vizanne and Klayra. On the husband's side, his grandmother was twins, my husband had twin cousins, and there were no twins on my side. After taking the listed drugs and taking into account the husband's heredity, do we have an increased chance of having a multiple pregnancy?

If more than three months pass from the moment you stop taking the drugs until conception, then the effect of the increased risk of multiple pregnancies will come to naught. As for heredity, the likelihood of multiple pregnancies is increased, but insignificantly compared to the population.

The first day of the last menstrual period was April 27, my periods were always irregular, they were diagnosed with polycystic disease. Conception could have occurred on May 10, 11, 17, June 2 and 13. Considering the first day of the last menstruation, it should have been 9 weeks of pregnancy on June 29, but the embryo was not visible. HCG - 22000 (corresponding to 9 weeks gestation), said anembryonic pregnancy, suggested cleansing or pills. Is there a chance of multiple pregnancies? My father is a twin and I have twins from my grandmother. Could there be just a short period in which the embryo is not visible? Is hCG high because multiple pregnancies develop?

To clarify the situation, it is necessary to undergo a study in dynamics.

At 12 weeks of pregnancy by ultrasound: dichorial diamniotic twins, at 21 weeks: monochorionic diamniotic, at 24 weeks: monochorionic, the sex is the same. The consultation decided that the first ultrasound should be believed. How to be?

To determine chorionicity with twins, ultrasound of the early stages is the most informative, therefore it is better to focus on ultrasound at 12 weeks.

6-7 weeks of pregnancy by ultrasound, according to the last months - 9-10 weeks. Cycle 34-36 days, ovulation was late, on May 10 by ultrasound: fetal egg 18 mm, 1 embryo: CTE 4.7, heart rate 93 beats / min., Yolk sac 3.1 mm, 2 embryo: CTE 3.4, no heartbeat, yolk sac 2.8 mm, corpus luteum in the right ovary 15 mm. Could the second embryo be delayed in development, or does this mean that the second embryo froze? And isn't the heart rate low in the first embryo?

The heart rate of the first fetus is within normal limits. CTE of the second fetus (3.4 mm) corresponds to a period of less than 5 weeks. At this time, the fetal heartbeat may not yet be detected. The sizes of embryos can differ significantly already by early dates pregnancy, so it is quite possible that the second embryo still needs to grow up. To assess the growth rate of embryos and the presence of a heartbeat in both babies, it is advisable to repeat the ultrasound scan in 2-3 weeks.

7 weeks of pregnancy, multiple fetuses are called into question. On November 22, there was a spontaneous abortion, the period for menstruation is 8-9 weeks, according to ultrasound a few hours before the miscarriage, the ovum was 4-5 weeks in size After cleaning, they gave recommendations not to get pregnant for 6 months, but in February I found out about pregnancy, they wanted to do medication interruption, but the doctor dissuaded, I want to save the pregnancy. What is the likelihood that a frozen and spontaneous abortion will not happen again?

The causes of a frozen pregnancy are various - genetic, antiphospholipid syndrome, luteal phase insufficiency, viral infections... It is necessary to examine and adjust the taking of drugs, depending on the results obtained.

7 (obstetric) weeks of pregnancy, according to ultrasound: two fetal eggs, but one has an embryo and a heartbeat is heard, and the other is empty. Can the second egg be delayed with the development of the embryo, or is it already certain that it will dissolve?

Sometimes two fetal eggs are laid, in one of which the embryo develops, and in the second fetal egg the embryo is not laid. In the period of I screening at 11-14 weeks, it will be possible to accurately determine the number of embryos and how they develop.

One fruit and two bubbles, are they twins or twins? What is it?

Sometimes two fetal eggs are laid, in one of which the embryo develops, and in the second, the embryo is not laid. Judging by your data, you have a singleton pregnancy. The second "empty" fertilized egg has no effect on the development of the fetus.

The second pregnancy, 22 weeks, monochorionic diamniotic twins, the first was 5 years ago, she gave birth on time, the son - everything is fine. On a period of 21 weeks, one fetus froze. The gynecologist sent for an interruption, I refused, as I hope to endure the second until a viable period, for this moment the child is healthy, all indicators correspond to the term. What are our chances? What are the risks for a living child and for me? I am 27 years old.

With diamniotic twins, there is a chance of delivering a second child. But careful observation is necessary in dynamics, including ultrasound and Doppler. For you, the risks are similar to those of ordinary twins.

13 weeks of pregnancy, monochorionic diamniotic twins, one pathology of MVPD with CHD omphalocele. What happens in such cases? Is it possible to save a second healthy baby?

In theory, yes. But if a fetus with congenital malformation dies in utero, then this can negatively affect the formation of the second fetus and there may be secondary changes in it, including quite serious ones.

5-6 weeks of pregnancy, ultrasound identified one fetal egg with a size of GS-21.3 mm, and in it two yolk sacs of 4.2 mm and 4.4 mm. Does this indicate twins?

An ultrasound scan is needed in dynamics in 1-2 weeks, when it will be possible to determine the number of embryos and their heartbeat.

My first pregnancy came at the age of 19, twins, two girls. A spontaneous miscarriage occurred at 17 weeks. The second pregnancy came in 1.5-2 months, one fetus, gave birth to a boy at the age of 20. I did not have twins in my family, my husband had a twin grandmother, his mother and her sisters and brothers did not have twins, the children of her sisters and brothers also do not have yet. What is the likelihood that I will have more twins?

The likelihood is increased, but it is impossible to say in numbers.

At 7 weeks of pregnancy by ultrasound: two embryos in one fetal egg, fetal CTE of 9 mm, monochorionic biamniotic twins. On ultrasound at 9 weeks, another doctor did not see the second fetus. The CTE of the fetus during the ultrasound scan varied from 26 to 28 mm. Can the second hide behind the first? And why did the CTE change?

When measuring CTE, an error within 2 mm is permissible, we recommend a screening ultrasound scan for a period of 11-12 weeks to clarify the situation.

6 weeks pregnant. By ultrasound: in the uterine cavity there are two fetal eggs, in one of which a developing embryo with a heartbeat, in the second - the embryo is not visualized. Is there a possibility of fertilization of two eggs with a difference of several days? What is the reason for the development of the second embryo lagging behind the first? Does this mean a suspension in the development of the second egg?

Most likely, we are talking about a non-developing ovum. The death of the second fetal egg will not affect the bearing of the remaining baby.

4 weeks pregnant, a week ago, two fetal eggs were found in a private clinic. I did an ultrasound in another place, one fetal egg is 7.7 mm, the other is not seen. What could it be? Has it disappeared? Is it a doctor's mistake or a different quality of equipment? There were no allocations.

It is not uncommon for one of the fetal eggs to die early in pregnancy and dissolve.

First pregnancy, 7 weeks. Ultrasound at 4.4 weeks: signs of a two-egg uterine pregnancy in one ovum and anembryony in the second. Now what to do with the second frozen egg? Should it be deleted or will it "come out" by itself? What will happen now with a normally developing ovum? I am 27 years old.

There is no cause for concern. The dead ovum will dissolve without harm to the remaining one. We recommend that you repeat the ultrasound scan to clarify the situation.

I am pregnant with twins. Is biochemical screening informative?

The first day of the last menstrual period is December 2, the average cycle time is 28 days. The first ultrasound scan on January 4: a fetal egg of 3 mm was detected in the uterine cavity, the corpus luteum was not identified. On January 5, the result of the analysis for hCG is 4471.0 mIU / ml. At the 11th week of the obstetric term, I found out that I have twins. Is it possible not to see twins at 4 weeks of obstetric term? Is it possible to conceive two babies in such different terms?

For a very short time (as in this case) it is quite possible not to see the second ovum. And if we are talking about identical twins, then they can be seen only when the embryos are well visualized.

At the first ultrasound, the doctor did not see the ovum, he set a period of no more than two weeks, the result of hCG on the same day was twice as high. Two weeks later I came to register with another doctor, the doctor examined it without an ultrasound, set the deadline for 8 weeks. At 12 weeks, at the screening, they wrote that one fetal egg and one fetus. Could not see the second baby on the ultrasound or is it impossible?

12 weeks of pregnancy, the ultrasound said that one embryo froze at 9-10 weeks, and the second is developing well. What is the likelihood of carrying a child? Will there be no infections from the dead fetus?

The likelihood of carrying a child is good enough. With a frozen fetus at this stage of pregnancy, it can dissolve without damage to the second fetus.

I did IVF. Last menstruation on April 10, puncture on April 28, postponed on April 30. The result of hCG on May 14 is 403. How long can a multiple pregnancy be detected? When to do an ultrasound? The doctor recommended on June 11, and the doctor who performed IVF on May 25.

Is it possible with a multiple pregnancy at the same time the ectopic development of one fetus and the fading of the second? How will the ectopic fetus develop if the frozen one was removed? although it was clear from the condition of the pregnant woman, as well as the size of her uterus, that the fetus had died?

The existence of a uterine and ectopic pregnancy is possible at the same time. Ectopic pregnancy will develop up to the rupture of the fruit receptacle. It is important not to allow this, but to carry out preventive surgical treatment with minimal health consequences.

In the 6th week, I had identical twins. One 5.7 mm, the other 6.2 mm. The first has a heartbeat of 154 beats / min, the second - 156 beats / min. Now I have 11 weeks. Can one of them "disappear" by this time?

In some cases, in the early stages, one twin fetus may stop developing, which can lead to its "disappearance".

By my calculations, I have three weeks and three days of pregnancy. Menstruation was from September 21 to 26. I know I got pregnant on October 9th. Everything was planned. She began to drink vitamins with folic acid in early September. On October 31, I passed the analysis of hCG - 19795. On the same day, I did an ultrasound scan, which showed 5 weeks and six days. Can an ultrasound doctor make a mistake and not see a multiple pregnancy, but put a longer term?

In the conclusion of the ultrasound, the obstetric gestational age is indicated, from the first day to the last menstruation. You count from conception, the true time. It will not be useful to anyone except you. All terms (decree, childbirth, etc.) are counted in obstetric weeks. Details on calculating the timing of pregnancy are written in the articles on our website.

My grandmother on my father’s side had twins, and my grandmother’s husband on my mother’s side had twins twice, I have two sons and I am currently 4 weeks pregnant, can I have twins?

Given your pedigree, you are more likely to have twins compared to the population frequency. On the ultrasound, everything will be visible.

I went for an ultrasound at 16 weeks of pregnancy, everything was fine. But when I came for an ultrasound at 24 weeks, I was told that I had uterine fibroids, although I did not have it. Could uterine fibroids have formed in 2 months?

Most likely, the uterine fibroids were, but small in size. During pregnancy, fibroid nodes rapidly increase in size.

The embryo and the membrane that surrounds it is the fertilized egg. As the embryo grows, the size of the ovum increases by week, which can be observed during examination using ultrasound. But it should be remembered that the accuracy of studies in the early stages of pregnancy is low, and when a woman is diagnosed, the possibility of error is not excluded.

Formation of the ovum

The first stage of the cycle that goes through reproductive cell- release of the egg from the follicle. Usually 3-4 follicles mature, but only one egg passes through the woman's fallopian tubes during ovulation.

The growth and development of a new life begins with the fusion of the egg and sperm. Immediately after ovulation and fusion, a protective membrane forms around the egg. This upper protective layer around the embryo will subsequently develop into the fetal bladder, which contains amniotic fluid in the cavity.

On early stages pregnancy during ultrasound, you can see the formation of an ovoid shape of a small diameter. This is the fertilized egg. The first stage of its development is the morula, consisting of 12-32 blastomeres formed as a result of division of the zygote, which turn into a compact ball.

As the cells multiply, the embryo continues to move through the fallopian tubes until it becomes attached to the mucous wall inside the uterus. After that, the outer layer of the shell begins the production of hCG (chorionic gonadotropic hormone), which is one of the first indicators of a woman's pregnancy. All this time, the nutrition of the fetus is carried out at the expense of the internal resource of the egg. In the process of further development, the place of attachment is transformed into the placenta. At this time, to prevent infection, a mucous plug forms, which closes the entrance to the uterus. This whole process takes about two days. If the embryo does not attach to the wall of the uterus, then along with menstruation at the end of the cycle, a miscarriage occurs, and often the woman does not even know that she was pregnant. On the next cycle, the ovum leaves the follicle again, ovulation, and the whole process is repeated once more.

What does a fertilized egg look like, structure:

• Villous membrane, chorion;
• Amnion (amniotic sac or aquatic membrane);
• The embryo.

It is difficult to accurately discern what a fertilized egg looks like, even with the help of an ultrasound scan. Due to the small diameter, the embryo is difficult to detect inside the uterus if the woman is less than a month pregnant.

It happens that even at a period of 6-7 weeks, the embryo is not visible inside the egg - this may indicate an undeveloped pregnancy. An empty ovum is quite rare and is often a symptom of a genetic disorder in a woman or her partner.

Study of the ovum

The diagnostic method by which the study of the life cycles of the ovum is carried out is called echography or, in other words, ultrasound diagnostics. It allows you to identify SVD, the average inner diameter of the ovum, and CTE, the coccygeal-parietal size of the fetus.

Usually, the doctor prescribes the first ultrasound for a woman at a period of 10 to 13 weeks of pregnancy. If necessary, the diagnosis is carried out at 3-4 weeks. This is due to the fact that a fertilized egg is completely fixed inside the uterus only 10 days after conception. With the help of ultrasound, you can track the time of ovulation and the maturation of the follicle.

There is no need to worry that ultrasound examinations will harm the fetus. Even at an early stage, radiation does not affect the health of the unborn child in any way.

It is worth considering separately the 4th obstetric week of pregnancy, since it is during this period with the help of ultrasound that you can see the nascent life. In the first days of the fourth week of pregnancy, the ovum has a diameter of only 1 mm, and it is not possible to assess the details of the formation of the fetus. That is why an additional ultrasound scan is prescribed a few weeks after the first examination. Nevertheless, after a couple of days, the size of the ovum will increase to 3 mm, and it will be possible to see the yolk sac, with which the embryo is fed until the umbilical cord appears. Towards the end of the fourth week, the diameter of the ovum increases to 4 mm, during this period, vital organs begin to form: the heart, lungs, liver and pancreas. On the last day of this period, the diameter of the ovum is 5 mm, and during an ultrasound scan it is already possible to detect an embryo, the size of which is only 1 mm. In just a day, the egg grows up to 6 millimeters.

The formula for determining the duration of pregnancy:

The average inner diameter of the ovum is + 35 (if its size is less than 16 mm) or 30 (if the fetus is more than 16 mm). For example, diameter 17 + 30 = 47 weeks.

Pathology of the ovum

When studying the ovum by echography, pathologies can be detected already in the early stages. The absence of an embryo inside the shell, an "empty egg" or anembryonia, may indicate a missed pregnancy, which will result in miscarriage or cleansing.

A picture in which a discrepancy between the size of the growing embryo and the egg is seen in the absence of a heartbeat may indicate fetal freezing, which also leads to miscarriage.

For example, if the embryo is much smaller than the shell or the size of the bubbles is too small for a given period, then there is a high probability that a miscarriage will occur at the end of the cycle. The most common cause is chromosomal changes during conception, both congenital and external. For example, a woman, not knowing about pregnancy, takes pills, drinks alcohol or is exposed to other harmful influences, which leads to serious pathology in the development of the fetus and miscarriage.

Deformation of the ovum is not always a pathology, and in most cases is caused by an increased tone of the uterus in the first period of pregnancy. Often, the tone is accompanied by small bloody discharge and pain in the lower third of the abdomen.

This problem is solved medically, pills are prescribed to reduce the number and intensity of contractions of the muscles of the uterus and hormonal pills to keep the fetus inside.

In case of detachment of the ovum in the case of a small lesion area, hormonal treatment is performed. For a woman during this period, bed rest is required in a hospital setting.

An ectopic pregnancy is characterized by the fact that the ovum develops in an inappropriate place: in the fallopian tubes or ovaries. The main manifestation is profuse bleeding. It is impossible to maintain such a pregnancy, since the growth and development of the embryo in the fallopian tube leads to its rupture and severe consequences for the woman's health.

During the screening, the nasal septum is measured at 12 weeks. If the bone is less than 2.5 mm in length or is absent, doctors can establish a preliminary diagnosis: trisomy 21 of chromosomes or Down's disease. In this case, the woman herself will be able to decide whether it is worth keeping the pregnancy.

In rare cases, two embryos are found in the ovum at once - this is not an anomaly, but a factor indicating the presence of twins. A similar situation occurs when two bubbles are found in a woman's uterus at once. In the latter situation, the chorions of both membranes in the future form the placenta, with the help of which each fetus feeds separately. In the first case, the embryos will feed from one placenta. The detection of twins in the early period is often not confirmed, and the study gives a reliable result only at 6-7 weeks of pregnancy.

The size of the ovum by week

The fourth was considered above. obstetric week... Nevertheless, the development of the ovum lasts up to 8 weeks, and according to some sources up to 10, and in further periods of development, the embryo is called the fetus. Data on the stages of development of the embryo in each week can be viewed in the table below. This table with detailed description each stage of development of the ovum will help a woman understand how the baby develops inside her uterus during this period. Rates of growth:

• Up to 15-16 weeks 1 millimeter per day;
• From 16-17 weeks 2-2.5 millimeters per day.

Sizes of the ovum by week, table:

Especially during this period of intrauterine development, the sixth week is important, since during this period the birth occurs. digestive system, spleen and cartilage buds. When the size reaches 16 mm, we can say that the embryo has the rudiments of the stomach and esophagus, as well as 3 intestinal loops. By the end of the week, the embryo develops fingers and muscle tissue.