missed abortion
Introduction
Introduction Missed abortion: also known as expired abortion or stillbirth. Refers to the embryo death and still stay in the uterine cavity, and the pregnancy products are generally discharged within 1 to 2 months after the symptoms are produced. Therefore, it is stipulated that the embryos have not been naturally discharged 2 months after the embryo ceases to develop, which is called missed abortion. Pregnant women often have a threatened abortion in early pregnancy, after which the uterus no longer grows up, but gradually shrinks, and is not as soft as normal pregnancy. The pregnancy test changed from positive to negative, and the placenta was mechanically adhered to the uterine wall and was not easily separated. On the other hand, due to insufficient sex hormones, the uterine contractility is reduced, and it is difficult to discharge and the uterine cavity is reserved. After the embryo dies, the placenta dissolves, and the lysozyme is produced into the maternal blood circulation, causing blood coagulation in the microvessels, consuming a large amount of clotting factors, and the longer the period of the uterine cavity is, the greater the possibility of causing coagulation dysfunction. In recent years, B-ultrasound has been widely used in clinical practice. It can be used to detect fetal sac and fetal buds after 6 to 7 weeks of menopause. If you suspect that the embryo has stopped developing, you can use B-ultrasound to make a diagnosis and treatment in time. Therefore, it is suggested that the term "missing abortion" should be used again, but the clinical symptoms are not obvious, and the patient's attention is not noticed. The embryonic death of the embryo is longer in the diagnosis.
Cause
Cause
1. Congenital abnormalities in the embryo: About 60% of early abortions fall into this category. There are many causes of congenital abnormalities in the embryo, such as genetic diseases, viral infection during pregnancy, food during pregnancy or chemical poisoning. Some people say that abortion is a process of human beings under the conditions of nature, and there seems to be some truth.
2, genetic factors: embryonic dysplasia caused by the number of chromosomes or structural abnormalities, is the most common cause of abortion, especially abortion within the first 3 months of pregnancy, chromosomal abnormalities accounted for 50% -60%.
3, the impact of external factors: a large number of smoking, drinking, exposure to chemical poisons, such as lead, cadmium, radioactive materials and severe noise and vibration. The above-mentioned harmful factors may directly affect the fetus to cause death, or affect the fetus through the placenta. Serious mental stimuli such as fright and emotional agitation can cause imbalance in the body of pregnant women and induce contractions leading to miscarriage. The lower abdomen or genital area is subjected to impact and fall, etc., which can cause the placenta to be stripped from the uterine wall and cause miscarriage. Excessive sexual life during pregnancy, intense exercise, high temperature environment and important physical labor are also one of the causes of miscarriage. During gynaecological or surgical procedures during pregnancy, such as ovarian cancer resection and appendectomy, traction during surgery can cause uterine contractions and lead to miscarriage.
4, maternal disorders: mother's poor health or suffering from serious diseases, such as acute infectious diseases, severe anemia and malnutrition, reproductive tract malformations and reproductive organs tumors, endocrine dysfunction, maternal and child blood type incompatibility, etc., can endanger the fetus abortion.
5, the father factor: In recent years, an asymptomatic sputum syndrome has been found to cause miscarriage. The results show that 10% to 15% of male semen contains a certain amount of bacteria, which will affect pregnant women and cause embryo abortion.
Examine
an examination
Related inspection
IgG anti-A-potency assay for urine pregnancy latex agglutination inhibition test
1 There is a history of menopause, there may be a history of pregnancy reaction in early pregnancy, and even a history of threatened abortion, but with the death of the embryo, the signs of pregnancy in the early stages of pregnancy gradually subsided, such as nausea disappeared, breasts shrinked.
2 vaginal bleeding, dark red.
3 The enlarged uterus stops growing, the cervix is closed, the uterus is less than the menopause month, and it is not as soft as during pregnancy. Laboratory tests were negative for urine pregnancy tests.
Ultrasound examination shows:
1 The uterus is enlarged, and there are scattered light spots or light groups in the palace.
2 no gestational sac, placenta and fetal head sound image.
3 Use a fast scanner to detect fetal heart disease and fetal movement reflex.
Diagnosis
Differential diagnosis
Mainly differentiated from ectopic pregnancy, hydatidiform mole, dysfunctional uterine bleeding.
1) The amount of uterine bleeding during abortion is generally higher than that of ectopic pregnancy; it is also different from other abnormal pregnancy. Ectopic pregnancy is mostly a vaginal bleeding.
2) The bleeding of the hydatidiform mole is often dark red, and it can also repeatedly bleed, and even a large amount of vaginal bleeding occurs. For example, a careful inspection may sometimes find a blister-like tissue in the blood.
3) dysfunctional uterine bleeding occurs at both ends of the reproductive age. It occurs in people over 40 years old and often has a history of menopause. Although there is a lot of bleeding in the vagina, there is no abdominal pain, and there are few other discharges.
4) In this case, it is not difficult to distinguish between the general history of pregnancy and the presence or absence of contraception. If it can not be diagnosed, it is feasible to diagnose the curettage. After pathological examination, it can be diagnosed and it is also beneficial to treatment.
1 There is a history of menopause, there may be a history of pregnancy reaction in early pregnancy, and even a history of threatened abortion, but with the death of the embryo, the signs of pregnancy in the early stages of pregnancy gradually subsided, such as nausea disappeared, breasts shrinked.
