Why are there still pregnancy reactions when the embryo has ceased to develop?

Written by Du Rui Xia
Obstetrics
Updated on June 11, 2025
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Women experience various pregnancy reactions to different degrees after conceiving, such as nausea, vomiting, loss of appetite, and fatigue. These are primarily caused by hormonal changes in the body following pregnancy. When there is a case of embryonic arrest, the hormones in the body will gradually decrease, and the pregnancy reactions will also gradually weaken. Some may also experience abdominal pain and vaginal bleeding. Therefore, after embryonic arrest occurs, some pregnant women may exhibit early signs, such as the disappearance of breast tenderness and vaginal bleeding, along with a reduction in pregnancy reactions. These signs indicate that timely treatment is necessary.

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Written by Zhang Lu
Obstetrics
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Can an ultrasound detect an embryonic arrest?

Embryonic arrest refers to a condition in early pregnancy where no fetal heartbeat appears in the gestational sac. The diagnostic criteria mainly include the lack of observable primitive heart tube pulsation via ultrasound after two months of pregnancy, at which point embryonic arrest can be confirmed. The definitive diagnosis of embryonic arrest is primarily through ultrasound. The following situations observed during an ultrasound can lead to a diagnosis of embryonic arrest: 1. If the diameter of the gestational sac exceeds three centimeters without a clear fetal heartbeat or embryo visible inside, it can be diagnosed as embryonic arrest. 2. If an embryo is already present and approximately 10 days after the appearance of the embryo, an ultrasound still does not show a fetal heartbeat, this situation can also be determined as embryonic arrest.

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Written by Zhang Lu
Obstetrics
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Does an embryonic arrest require a dilation and curettage?

According to the different intervention methods, surgical abortion is needed during an abortion procedure, while medical abortion might not be necessary. Embryonic arrest, also known as missed abortion, occurs during pregnancy due to various factors which result in the absence of a fetal heartbeat in the gestational sac or fetus. Most cases of embryonic arrest occur during early pregnancy. If no fetal heartbeat is observed by the 9th week of pregnancy, it is diagnosed as embryonic arrest. Once embryonic growth ceases, it is crucial to intervene artificially as soon as possible to expel the gestational sac from the uterus. Common methods of artificial intervention include medical abortion and surgical abortion. If surgical abortion is chosen for an embryonic arrest, it involves direct curettage or evacuation of the uterus. Embryonic arrest can also be treated with medical abortion, which involves taking oral medication to stimulate uterine contractions, soften the cervix, and expel the gestational sac from the uterus. A follow-up is required about two weeks after the abortion. If there is no residual material in the uterine cavity, then curettage is not necessary; however, if substantive residuals or blood signals are present inside the uterine cavity, then curettage is needed.

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Written by Du Rui Xia
Obstetrics
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What are the reasons for embryonic arrest with no fetal heartbeat?

Embryonic arrest without a fetal heartbeat can be caused by many factors. For example, taking medications prohibited during pregnancy, exposure to harmful substances, radiation, or infections with bacteria or viruses during pregnancy. Other factors include genetic issues and poor emotional state of the pregnant woman during pregnancy. All these factors can affect the normal development of the embryo. If an ultrasound examination reveals no fetal heartbeat, it can be determined that the embryo has ceased to develop, and prompt treatment should be carried out.

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Written by Liu Wei Jie
Obstetrics
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Do you need to be hospitalized for uterine evacuation after a missed miscarriage?

The criteria for diagnosing embryo arrest generally involve the appearance of the embryonic bud and heart tube between six to eight weeks. If these are not visible beyond eight weeks, the situation is referred to as embryonic arrest. Embryonic arrest requires abortion, which for safety reasons typically involves hospitalization and a combination of medication and uterine evacuation. However, if the gestational sac is relatively small, an outpatient abortion procedure might be sufficient. Whether hospitalization is necessary should be assessed by a doctor, who will consider factors such as previous scar pregnancies, the condition of a scarred uterus, and the size of the current gestational sac, to make a comprehensive decision.

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Written by Zhang Lu
Obstetrics
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Will the gestational sac shrink if the embryo stops developing?

Embryo arrest, also known as missed abortion, refers to a condition in the early stages of pregnancy where the gestational sac does not develop normally due to various factors. Generally, the gestational sac will not begin to shrink until the embryo has been arrested for a considerable period. In the initial stages of embryo arrest, since the duration is relatively short, the trophoblastic cells within the gestational sac can still secrete estrogens, progesterone, and chorionic gonadotropin. These hormones stimulate the possible continued growth of the gestational sac in the short term. However, as the duration of the embryo arrest extends, the proliferation of the trophoblastic cells decreases, leading to a decline in hormone levels in the body. This reduces the stimulation to the gestational sac, causing it to gradually shrink, decrease in size, and possibly leading to a natural miscarriage.