What is a biochemical pregnancy?

The Mexican Social Security Institute (IMSS) offers coverage for all types of pregnancies, including chemical pregnancies. But what exactly is it?

The IMSS has protocols to care for patients with data of Biochemical pregnancy, a condition where the sperm fertilizes the egg and forms an embryo that implants in the uterus, and either the embryo or the implanted sac has stopped developing in the first weeks of gestation, which generally results in a spontaneous abortion. .

The head of the Department of Complications in the First Half of Pregnancy at the Obstetrics-Gynecology Hospital No. 4 "Luis Castelazo Ayala," Dr. Arely Peñaloza Nolasco, said that patients who present with this condition are admitted to the ward and provided support by the Psychology Department if needed; they are also evaluated by the Psychiatry Department, and medication is started if necessary .

The specialist from the High Specialty Medical Unit (UMAE) added that they are provided counseling on family planning methods and their application before their discharge, and medical follow-up continues in the outpatient clinic.

He explained that in A biochemical pregnancy occurs when the body produces the hormone human chorionic gonadotropin (beta-hCG), which causes a pregnancy test to be positive. However, a few days later, these levels decrease or do not increase as they should, indicating that the pregnancy did not develop properly. .

She added that it's common for a patient to be referred for a positive or doubtful pregnancy test, only for it to be negative when repeated days later. When transvaginal bleeding doesn't occur, it's often detected during surveillance ultrasounds, which don't show normal pregnancy progression and growth .

He explained that the protocol followed by the IMSS is aimed at patients detected with biochemical pregnancy data with transvaginal bleeding, where a comprehensive review is performed that includes an endovaginal ultrasound (USG) to determine if there is still a gestational sac or the embryo without a heartbeat .

The head of the Department of Complications in the First Half of Pregnancy added that if the pregnancy continues, an abortion is induced in accordance with the Clinical Practice Guide (GPC) for the Diagnosis and Treatment of Spontaneous Abortion and Initial Management of Recurrent Abortion and the Technical Guideline for Safe Abortion Care in Mexico 2022 .

He highlighted that analgesic therapy and comprehensive management are provided with a psychology service . When the pregnancy is expelled, a new ultrasound examination is performed to verify that there are no remains and the patient is discharged. , with a subsequent appointment for review of the pathology results of the expelled remains.

He indicated that in patients detected with biochemical pregnancy data without transvaginal bleeding, a review is performed that includes endovaginal USG and subsequently the abortion is induced according to the aforementioned mechanisms .

Arely Peñaloza reported that, in special cases of patients with underlying pathologies, high-risk maternal ages, and recurrent pregnancy losses, a monitoring and management protocol is initiated , which is carried out jointly with the UMAE Reproductive Biology Service.

She recalled that during care by healthcare personnel, patients are provided with information and any questions are answered. For this purpose, study protocols have been established focused on the main risk groups, including: women of reproductive age or with recurrent miscarriage, minors and those over 35 years of age, and beneficiaries with underlying conditions such as systemic arterial hypertension (SAH), diabetes, endocrinopathies, rheumatological conditions, among others.

The specialist said that nurses trained in thanatology are available to support them during their hospital stay and provide perinatal grief counseling to those women who accept it.

She recommended that women in at-risk groups, in order to prevent a biochemical pregnancy , maintain control of modifiable risk factors, such as maintaining healthy habits and physical activity; promote family planning to avoid short periods between births; carry out screening and monitoring based on identified risk factors; and monitor and detect underlying pathologies early .

Dr. Peñaloza Nolasco reported that in 2023, 486 patients with signs of biochemical pregnancy were treated, an estimated 40.5 cases per month. Meanwhile, in the first half of 2024, services were provided to 217 beneficiaries with early termination of embryo development, an average of 36.16 cases per month.

Dr. Arely Peñaloza noted that Miscarriage occurs in 50 to 70 percent of pregnancies, most of these losses are unrecognizable because they occur before the next menstrual period occurs. .

He commented that 15 to 20 percent of clinically diagnosed pregnancies are lost in the first trimester or early second trimester, without any maternal repercussions. Most of them go undiagnosed because they are confused with a delayed period .

With information from the IMSS

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