incomplete abortion
Introduction
Introduction Pregnancy is not enough for 28 weeks, and the weight of the fetus is less than 1000g. For some reason, the pregnancy is interrupted, which is called abortion. It occurs as early abortion before 12 weeks of gestation and occurs as late abortion after 12 weeks. Incomplete abortion means that part of the embryo has been excreted and some remains in the uterine cavity. It usually develops from late abortion. At this time, due to the residual embryo in the uterine cavity, the uterus can not shrink very well, and bleeding is not limited.
Cause
Cause
Embryo (or fetal) factors:
1. Abnormal embryonic development: the most common cause of early abortion, abortion caused by chromosomal abnormalities accounted for about 50 to 60%.
2. Abnormal placenta: due to incomplete development of the trophoblast, placental villus degeneration, or placenta attachment position is too low, which can cause fetal placental circulation disorder, leading to miscarriage.
Maternal factors:
1. Acute infectious diseases, which may cause fetal death due to pathogens or toxins invading the placenta, or due to high fever, poisoning caused by contractions leading to miscarriage;
2. Severe anemia or heart failure, causing fetal hypoxia to die;
3. Endocrine disorders, such as luteal dysfunction, causing dysplasia of the diaphragm, affecting the development of pregnant eggs;
4. Uterine dysplasia, uterine fibroids or deformities can also hinder embryonic development;
5. Factor cervical sinus relaxation, can not withstand the increased fetal fetal sac pressure, leading to late abortion;
6. Strong mental stimulation, trauma or sexual intercourse can also cause miscarriage.
Examine
an examination
Related inspection
IgG anti-A-potency determination IgG anti-B-potency determination eugenic five-column pregnancy latex agglutination inhibition test
Ask the patient whether there is a history of menopause and a history of repeated abortion, whether there is early pregnancy reaction, vaginal bleeding, if there is vaginal bleeding, should ask the amount of bleeding and its duration, whether there is abdominal pain, the location, nature, degree of abdominal pain, no water in the vagina Sample drainage, vaginal discharge color, quantity, taste, with or without tissue discharge. Observe the general condition of the patient, whether there is anemia, measure blood pressure, pulse, body temperature and so on.
Gynecological examinations should be carried out under sterile conditions. The operation should be gentle during the examination to avoid aggravating symptoms; pay attention to whether the cervix is dilated, whether there is tissue clogging, and whether the amniotic sac bulges. Whether the position and size of the uterus are consistent with the menstrual month, whether there is tenderness, etc.;
Determination of hCG, hRL, progesterone, estradiol, such as significantly lower than normal levels, suggesting that trophoblast cells and placental function are insufficient, may abortion. The hCG assay is commonly used clinically to determine the prognosis of the embryo.
B-ultrasound examination of abortion can be used to observe the presence or absence of embryo sac and fetal heart movement, to determine whether the embryo survives, to identify the type of abortion and some causes of abortion, in order to choose the appropriate treatment.
Diagnosis
Differential diagnosis
Differential diagnosis of incomplete abortion:
1. Threatened abortion: Early threatened abortion is mainly characterized by early pregnancy reaction after a period of menopause, followed by vaginal bleeding, small amount, red color, duration of several days or weeks, painless or mild lower abdominal pain, with low back pain and falling sense. Gynecological examination of the cervix is closed, the size of the uterus is consistent with the menstrual period, after treatment and rest as the fetus survives, the pregnancy can still continue.
2, inevitable abortion: refers to abortion has been inevitable, generally developed by threatened abortion, at this time increased vaginal bleeding, abdominal pain increased, after the amniotic membrane has been broken or not broken.
3, complete abortion: the embryo has been completely discharged. As the embryo has been discharged, the uterus contracts well, the vaginal bleeding gradually stops or only a small amount is seen, and the abdominal pain disappears.
4, expired abortion: refers to the embryo has died in the uterus for more than two months, but still not naturally discharged. If the time is less than 2 months, the embryonic development is terminated or the embryo is dead.
5, habitual abortion: refers to the spontaneous abortion continuously produced two or more times. Its clinical features are the same as general abortions.
