Threatened miscarriage
Introduction
Introduction to threatened abortion Threatened abortion refers to a small amount of vaginal tract bleeding and/or lower abdomen pain before 28 weeks of gestation. The cervix is not open, the membrane is not broken, the pregnancy is not discharged, and the size of the uterus is consistent with the number of menopause. Early threatened abortion is clinical. The performance often has early pregnancy reaction after menopause, and then there will be a small amount of bleeding in the vagina, or now, or dripping, red, for several days or weeks, no abdominal pain or slight lower abdominal pain, low back pain and lower abdominal bulge. The main manifestation of threatened abortion is that after pregnancy, there is a small amount of bleeding in the vagina. The color can be bright red, pink or dark brown depending on the amount of bleeding and the time of accumulation in the vagina. Sometimes accompanied by mild lower abdominal pain, fetal movement has a sense of falling, backache and bloating. If we say from the folk tradition, the main basis of threatened abortion is seeing red. basic knowledge Probability ratio: 0.5% of women in childbearing age Susceptible population: pregnant women Mode of infection: non-infectious Complications: shock
Cause
Threatened abortion
Embryology (30%):
The insufficiency of the reproductive cells of the father or mother is the main reason. Although the germ cells that are not very healthy are barely combined to become embryos, they will die early, and they will not be able to "get melon" and give birth at full term. The abortion caused by this reason can be said to be a good thing. Because of the abnormal fetus, if it is born in full, there will be deformities or abnormalities. Other causes such as insufficient oxygen supply to the umbilical cord, amniotic fluid disease, placental virus infection, and certain gynecological inflammation can also cause miscarriage. Malnutrition in pregnant women is also one of the reasons for miscarriage. Some pregnant women have severe pregnancy nausea and spit in the early stage, resulting in extreme nutritional feeding, which has a great impact on the development of the embryo and is prone to miscarriage.
Maternal aspect (30%):
After a woman's pregnancy, if the mood is unstable, anger, sorrow and other mental stimuli, disturbing the activity function of the cerebral cortex, causing the contraction of the uterus to force the embryo, or causing the embryo to die in the uterus. Suffering from acute infectious diseases such as flu and rubella, it will cause abortion due to high toxins and toxins released by bacterial viruses. Endocrine disorders, such as dysfunction of the corpus luteum, pituitary gland, thyroid gland, and excessive uterine uterus during uterine dysplasia, cause the uterine cavity to hinder the development of the embryo, which may cause miscarriage.
Other aspects (30%):
Sexual life throughout pregnancy should be cautious, and inappropriate sexual life, especially in early pregnancy, can cause miscarriage. In the second trimester, sexual life should also be moderate, to avoid the sexual intercourse and rough sexual intercourse of the pregnant woman's abdomen, so as not to cause miscarriage. When doing gynecological examinations during perinatal period, if the technique is rude, it is also one of the causes of abortion. This is especially important for pregnant women with weak constitution. Drugs and certain chemicals, such as quinine, carbon monoxide, aluminum, phosphorus, mercury, benzene poisoning, often make embryos difficult to protect.
Abortion is divided into aura, early or late, complete or incomplete, depending on the number of days of pregnancy and the situation at that time. Among them, the most common occurrence of threatened abortion, the incidence of about 50% of all pregnancies. However, the real abortions only account for 10-15, so some can prevent miscarriage, while others are not suitable for miscarriage. Some have been tried to prevent miscarriage. In the end, it is still abortion.
Abortion seems to be a very regrettable thing from the surface, but from a genetic point of view, abortion is not a bad thing. Because in aborted fetuses, the rate of chromosomal abnormalities is quite high.
Prevention
Threatened abortion prevention
Attention to rest
Pregnant women should rest in bed and reduce activities, but it does not mean that they are lying in bed for 24 hours. They should be moderately active. Sexual life must be prohibited and unnecessary vaginal examinations should be minimized to reduce irritation to the uterus. In addition, avoid stimulating the breast, because stimulating the breast can also cause contractions, leading to the occurrence of threatened abortion.
Pay attention to the amount and nature of bleeding
Always observe if there is any tissue excretion in the vaginal discharge. The effluent should preferably be kept for observation by a doctor. If there is an increase in the amount of bleeding, you should go to the hospital in time.
Pay attention to abdominal pain
If the expectant mothers have a backache and a feeling of bloating in the lower abdomen, they will not be able to relieve after the rest, and even when they are aggravated, they must be vigilant. If there is an increase in lower abdominal pain, accompanied by vaginal bleeding, and tissue excretion should be promptly reported to the doctor.
Complication
Threatened abortion complications Complications
First, a big blood loss
Sometimes inevitable abortion or incomplete abortion can cause severe blood loss and even shock. Therefore, it should be actively dealt with. Various measures can be carried out simultaneously. Intravenous or intramuscular injection of oxytocin or pituitrin 10U. Try to give patients blood transfusions. In the absence of a blood bank, the medical staff or their families can be mobilized to donate blood. It is true that blood is not available for a while, and dextran can be temporarily instilled intravenously. At the same time, the curettage is given, and after the removal of the fetal embryo tissue, the bleeding often stops, and even in the presence of infection, the large pieces of embryonic tissue should be taken out. Subsequently, conditions should be actively created to transfuse blood.
Second, infection
All types of abortion can be combined with infection, and more occur in patients with partial abortion. Infection often occurs when abortion is performed on a device that has not been sterilized; the device is damaged by the cervix; or the original infection of the uterine cavity, abortion after surgery or spontaneous abortion can cause infection to spread. In addition, after abortion (natural or artificial abortion), attention to hygiene, premature sexual intercourse, etc. can cause infection. Infectious pathogens are often mixed with a variety of bacteria, anaerobic and aerobic bacteria. In recent years, anaerobic bacteria have been reported to account for 60-80%. The infection can be confined to the uterine cavity, or spread around the uterus, forming salpingitis, tubal oophoritis, pelvic connective tissue inflammation and even beyond the reproductive organs to form peritonitis, sepsis. The patient has cold fever, abdominal pain, vaginal bleeding, sometimes odorous secretions, tenderness of the uterus and attachments, poor uterine relapse, and increased leukocytosis. In severe cases, septic shock can occur. It can be used for smear, culture (aerobic and anaerobic bacteria) of blood, cervix or uterine secretions. B-ultrasound to check the uterine cavity for tissue residue.
Symptom
Symptoms of threatened abortion Common symptoms Vaginal irregular bleeding vaginal bleeding is inevitable abortion or not... Pregnancy abdomen during pregnancy... Pregnant women with small abdominal pain, early pregnancy, abdominal pain, habitual abortion
Vaginal bleeding
Vaginal bleeding can be divided into a small amount of bleeding and massive bleeding, persistent bleeding and irregular bleeding. Although bleeding is often considered the first sign of miscarriage, it is normal for vaginal bleeding to occur during the first trimester of pregnancy. However, although vaginal bleeding is accompanied by pain, this requires special attention, as it may be a sign of miscarriage.
pain
There may be a constant pain in the pelvis, abdomen or lower back. When the symptoms of vaginal bleeding appear, it may start to feel pain in a few hours or a few days.
Vaginal blood clot
The vagina discharges blood clots or light gray tissue.
Examine
Threatened abortion check
Ultrasound examination is mild due to a small amount of bleeding, the side of the fetal sac is surrounded by an anechoic zone, the amount is not much but clear; the severe uterine cavity has a large amount of blood, sometimes the fetal membrane and the uterine wall are stripped, and there is no post-membrane In the echo zone, fetal buds and original fetal heart beats can be seen according to different pregnancy periods. Ultrasound diagnosis: The fetal sac is generally seen in 5 to 6 weeks of pregnancy, and the fetal bud can be seen in 6 to 7 weeks of pregnancy. The transvaginal probe is earlier than the transabdominal. When there is no abortion sign in the clinic, the wilted pregnant egg can be found by ultrasound examination.
Diagnosis
Threatened abortion diagnosis
1. There is a small amount of bleeding in the vagina in early pregnancy, and there is a slight paroxysmal contraction. The cervix is not dilated, and the size of the uterus is consistent with the number of menopause.
2. Positive pregnancy test.
3. Ultrasound examination has fetal heartbeat, fetal sac and fetal movement.
4. Methods for estimating the prognosis of abortion:
1 In vaginal cell smears, such as keratinocytes more than 30%, the prognosis is poor.
2 Early pregnancy test basal body temperature:
Those with abortion aura and a decrease in body temperature have a good prognosis, and those with a lower basal body temperature have a poor prognosis.
Determination of 3 human chorionic gonadotropin (HCG):
If the level of chorionic gonadotropin declines, the prognosis is poor.
