complete miscarriage
Introduction
Introduction to complete abortion Complete abortion means that the pregnancy has been completely discharged, the amount of vaginal bleeding is reduced, gradually stopped, abdominal pain disappears, the cervix is closed during gynecological examination, the uterus is quickly revived, and the size of the uterus is close to normal. The causes of miscarriage are complex and diverse. The most common causes of early abortion are chromosomal abnormalities, endocrine abnormalities, uterine dysplasia or deformities. Inevitable abortion refers to abortion is inevitable, all measures should be stopped, because at this time the miscarriage has no meaning, it will only cover up the clinical symptoms. In addition, you should pay close attention to the shape and texture of the vaginal discharge. It is necessary to collect and retain the effluent. After the doctor confirms that it is completely aborted, the effluent is disposed of, because if it is not completely aborted, it is necessary to cure the uterus and avoid it. Major bleeding. In the inevitable abortion, if the embryo is completely discharged, vaginal bleeding will often decrease or stop, and abdominal pain will be alleviated or disappeared. This is a complete abortion. basic knowledge Probability ratio: 0.5% of women in childbearing age Susceptible people: good for pregnant women Mode of infection: non-infectious Complications: chronic pelvic inflammatory disease infertility endometriosis
Cause
Complete abortion cause
The causes of miscarriage are complex and diverse. The most common causes of early abortion are chromosomal abnormalities, endocrine abnormalities, uterine dysplasia or deformities.
1. Chromosomal abnormalities: Chromosomal abnormalities include abnormal chromosome numbers, such as monomer, trisomy, and polyploid; structural abnormalities such as breaks, deletions, and translocations can cause abortion. Chromosomal studies of spontaneous abortions and therapeutic abortions have found that 60% of karyotype abnormalities occur in spontaneous abortions. A karyotype abnormality is accompanied by a structural abnormality such as a fetus or a placenta. The fetuses with abortion in normal karyotype are more normal.
Second, endocrine disorders: excessive estrogen and progesterone deficiency are also the cause of early abortion. Because it is in the period of placenta formation instead of pregnancy luteal function in the 12-14 weeks of pregnancy, it is easy to have endocrine disorders, especially the luteal function. In addition, the lack of thyroxine, the cell's oxidation process is impeded, and hyperthyroidism and diabetes are prone to miscarriage.
Third, placental abnormalities and endocrine endocrine deficiency: decidual inflammation in early pregnancy can cause bleeding or hyperplasia of the decidua, villus epithelial cells and decidual cells are dissolved, blood vessels in the villi are blocked, affecting the absorption and transport of nutrients, resulting in pregnancy Eggs are separated from the attachment, bleeding and abortion. In addition, such a large infarction in the placenta can reduce the function of the placenta, affecting the survival of the fetus, and it is not uncommon for the placenta and placental villus edema to become abortion. In the maternal blood after pregnancy, -hCG, hPL, P, E2, estrone, if these hormone values decrease in early pregnancy, 50% abortion.
Fourth, blood type incompatibility: due to previous pregnancy or blood transfusion, Rh factor, incompatible ABO blood group factor produces antibodies in the mother, this pregnancy from the placenta into the fetus and red blood cells agglutination to produce hemolysis, resulting in miscarriage.
Fifth, mental and neurological factors: such as fright, severe mental stimulation can also cause miscarriage. In recent years, through research, noise and vibration have a certain impact on human reproduction.
6. Maternal systemic diseases
1, severe acute infectious diseases and infectious diseases: such as lobar pneumonia, many with high fever leading to uterine contractions, or / and embryo death can cause miscarriage.
2, chronic diseases: severe anemia, heart disease, heart failure can cause fetal hypoxia, suffocation and death. Chronic nephritis, severe hypertension can cause infarction or early dissection of the placenta and cause miscarriage.
3, malnutrition or drug poisoning: such as vitamin deficiency, especially vitamin E - the lack of tocopherol, mercury, lead, alcohol and morphine and other chronic poisoning, can cause miscarriage.
Seven, reproductive organs disease uterine malformations, such as the double-horned uterus, uterine cavity mediastinum, often the cause of miscarriage.
Eight, immune factors for unknown reasons, in recent years, studies have found that most of them are closely related to immune factors.
Prevention
Complete abortion prevention
To prevent and avoid miscarriage, the following points should be noted:
First, note:
1. Acute infectious diseases must be cured after a period of recovery. Patients with chronic diseases should be treated until they are stable and approved by a specialist before they can become pregnant.
2, for couples who have had a history of abortion, should go to the hospital in time to check the cause of miscarriage, no matter which side of the couple has problems, they should be treated in time, and then the child is cured.
3. Women who are pregnant should avoid exposure to harmful chemicals such as benzene, mercury, and radiation. Early pregnancy should be less common in public places to avoid viral and bacterial infections. If the pregnant woman is sick, it is necessary to take the medicine under the guidance of the doctor in time, and do not use the medicine at will.
4, early pregnancy (within 12 weeks of pregnancy) In addition to pay attention to food hygiene and avoid excessive fatigue, but also to avoid excessive tension, to maintain emotional stability, to benefit the fetus. Do not share the same room for the first 3 months of pregnancy. If the fetal development is abnormal after examination, the doctor thinks that the curettage should be performed, the patient should not delay, so as not to cause excessive blood loss (even shock, death, or the formation of internal genital inflammation affecting future fertility, it is known that most of the embryos that are aborted are generally It is a congenital defect, and it belongs to the natural elimination. It must not be caused by small loss and endanger the health of pregnant women.
Second, a history of abortion to prevent abortion:
1. Contraception should be taken within half a year after abortion, and pregnancy should be repeated after half a year to reduce the occurrence of miscarriage.
2, to do genetic testing, both couples accept chromosome examination.
3, do blood type identification including Rh blood type system.
4, there is a loose internal uterus can do internal suture.
5, the use of drugs for luteal insufficiency treatment time exceeds the pregnancy period of the previous abortion.
6, those with hypothyroidism, to maintain normal thyroid function and then pregnant, also take anti-A low drug during pregnancy.
7, pay attention to rest, avoid sexual intercourse, emotional stability, and the rules of life.
8. The man should check the reproductive system. If the bacteriophagus is treated thoroughly, the wife will be pregnant.
9. Avoid contact with toxic and radioactive materials.
10. Computer workers should work less than 20 hours a week.
11, rest after four weeks of abortion.
Spontaneous abortion is a misfortune for pregnant women, but in a sense, spontaneous abortion is a way for human beings to continually optimize themselves. It is also a choice for gestating new life. The survival of the fittest is the law of nature, accounting for more than 50% of abortion. Chromosomal abnormalities Early abortion of the fetus will reduce the birth of the deformed child. Therefore, the cause should be ascertained as possible before the miscarriage, and blind fetus should not be blinded.
Complication
Complete abortion complications Complications chronic pelvic inflammatory disease infertility endometriosis
1, surgical complications: uterine bleeding in more than 200 ml, abortion syndrome, also known as cardio-cerebral syndrome, the incidence rate of 12%, the subject suddenly appeared bradycardia, arrhythmia, blood pressure decreased, pale, sweating A series of symptoms, severe cases even fainting and convulsions, uterine perforation, leakage, embryonic tissue failed to suck out, and even the pregnancy continues to develop.
2, long-term complications: chronic pelvic inflammatory disease, abnormal menstruation, secondary infertility, endometriosis.
3, pregnancy complications again: infertility, late abortion is high, premature delivery is high, perinatal mortality is high, prenatal, postpartum hemorrhage rate increases, neonatal hemolysis increases.
Symptom
Complete abortion symptoms common symptoms missed abortion threatened abortion habitual abortion peritonitis sepsis
1, missed abortion: refers to the embryo or fetus has been dead in the uterine cavity has not been naturally discharged. After the embryo or the fetus is dead, the uterus no longer increases, but shrinks, and the early pregnancy reaction disappears. If the pregnancy has reached the mid-term pregnancy, the pregnant woman's abdomen does not increase, and the fetal movement disappears. Gynecological examination of the cervix is not open, the uterus is smaller than the number of weeks of menopause, and the texture is not soft. Did not smell the fetal heart.
2, habitual abortion: refers to spontaneous abortions that occur 3 times or more. In recent years, recurrent spontaneous abortion has been used internationally to replace habitual abortion. Each abortion occurs in the same pregnancy month, and its clinical course is the same as general abortion. The causes of early abortion are often luteal function, hypothyroidism, and chromosomal abnormalities. The most common cause of late abortion is due to relaxation of the internal cervix, uterine malformation, and uterine fibroids. After the pregnancy, the cervix is usually in the middle of pregnancy, the fetus grows up, the amniotic fluid increases, the intrauterine pressure increases, the fetal sac protrudes into the cervix, and the cervical canal gradually shrinks and expands. The patient has no symptoms, and once the membrane is broken, the fetus is expelled.
3, abortion infection: in the process of abortion, if the vaginal bleeding time is too long, tissue residual in the uterine cavity or illegal abortion, etc., may cause intrauterine infection, severe infection can be extended to the pelvic cavity, abdominal cavity and even the body, and pelvic cavity Inflammation, peritonitis, sepsis and septic shock, etc., are called abortion infections.
Examine
Complete abortion check
Ultrasound image:
1. The normal size of the uterus or normal is slightly larger.
2, see the regular intrauterine wave in the uterine cavity, no irregular light group.
Laboratory inspection:
1, blood chorionic gonadotropin value decreased.
2. The urine pregnancy test gradually becomes weakly positive or negative.
3, blood routine examination.
Check the body:
Vaginal bleeding often decreases or stops, and abdominal pain also reduces or disappears.
More than 50% of spontaneous abortions are chromosomal abnormalities. Early abortion of the fetus will reduce the birth of deformed children. Therefore, it is necessary to find out the causes, such as chromosome examination, closed antibody examination, and eugenics examination.
Diagnosis
Complete abortion diagnosis
diagnosis
Diagnosis can be performed based on clinical performance and laboratory tests.
Differential diagnosis
1. Ectopic pregnancy: The patient has sudden severe pain in the lower abdomen, and even shock occurs, but the amount of vaginal bleeding is small, which is inconsistent with the degree of shock. Abdominal examination sometimes has mobile dullness, vaginal examination of the uterus attachment has mass and tenderness, and the posterior hernia puncture can extract blood, which is helpful for diagnosis.
2, functional uterine bleeding: patients often have a history of menstrual disorders, the uterus can be smaller or slightly larger than normal.
3, uterine muscle pain: no history of menopause, menstrual disorders, the uterus are increased or uneven, more rigid than normal uterus.
4, chorionic epithelial cancer: often secondary to vesicular embryos, after abortion or full-term delivery, there are irregular vaginal bleeding, uterus enlargement and soft, and early lung metastasis, patients may have cough, hemoptysis and Anemia, dyscrasia.
