Should I keep my baby in early preterm labor?
This is a tedious question! Because, there is ample medical evidence to prove that:
More than half of the miscarriages are caused by chromosomal abnormalities of the embryo itself. If there is something wrong with the embryo itself, in principle, it should not be treated with fertility preservation, and even if it is, it will fail. Then how can we identify which are chromosomal abnormalities of embryos? This is where there is no help. Currently, it is medically possible to take a chorionic villus biopsy for chromosomal examination, however, there are certain risks involved in taking chorionic villus, such as miscarriage. Unless there is a clear family history of genetic disease or a clear medical indication, few people are willing to undergo this invasive test. Therefore, whether or not fetal preservation should be performed has become a point of debate in the medical community.
The medical debate seems to be just a medical thing, the people don’t buy it. It is an indisputable fact that 10 years ago, the common complaint heard in family planning clinics was “Doctor, please help me figure out how to prevent pregnancy? I’m pregnant even with the IUD, and I’m pregnant even with the pill, how can I grow this land so well?”
Now, 10 years later, the complaint I often hear is: “Doctor, what’s wrong, this is the second time, why did the embryo die?”
What has happened in these 10 years? We should think about it!
But how can people not ask for “fertility preservation” in the face of repeated pregnancy and egg abortion? No matter you say “blind fertility preservation is not advisable”, no matter you say “drugs are just placebo”, people only have one belief: “I want to keep this baby!”
Pre-implantation embryo genetic diagnosis: the genetic material is analyzed before embryo implantation, and embryos without genetic material abnormalities are selected for transfer.
Pre-implantation embryo genetic screening: it selects embryos with whole chromosome ploidy for transfer to improve the success rate of IVF.
These two methods can avoid the mental and physical trauma of miscarriage caused by prenatal diagnosis in the past and are therefore of great interest to doctors. Modern medicine promotes “precision medicine”, and if we can safely identify whether the embryo has a genetic disease in the early stages of pregnancy, then we can be more sure of the treatment of preterm abortion.
Let’s look forward to the medical progress together!
Treatment of Pre-eclampsia in early pregnancy
There is no definite and reliable method. The following are some of the accepted views.
I. General methods of fetal preservation treatment.
1, home rest or appropriate bed rest, prohibition of sex, appropriate supplementation of multivitamins, folic acid and nutrition.
2, mental relaxation is also very important. The pregnant woman herself should first have the sense of active relaxation and stay away from the negative environment. Be responsible for the baby in your belly.
3, family care is also a must. If you are a husband, think about it, your wife is pregnant, she is very uncertain, this never before experience not only makes her new, but also makes her helpless. After all, the baby is in her belly, and the constant vaginal bleeding means that it is slowly departing from this invisible, untouchable little thing, a pain that the husband cannot understand. Therefore, the sympathy and care of the family is especially important.
Drug treatment for fetus preservation
1.Treatment of vaginal bleeding: you can use medicine to stop bleeding (rarely used)
2, abdominal pain: antispasmodic drugs (rarely used)
3. Insufficient luteal function of ovaries or low progesterone level: progesterone supplementation.
4.Patients with hypothyroidism: can take small doses of oral thyroid tablets
With or without fertility treatment, regular monitoring is needed to understand the condition of the embryo and adjust the treatment plan. The monitoring includes ultrasound, blood Hcg, progesterone, etc.
Fetal preservation is not endless
Foreign scholars have suggested that if the diameter of the fetal sac exceeds 13mm but there is no yolk sac, embryonic death is considered. If the diameter of fetal sac is more than 17mm and there is no fetal bud, the embryo is considered dead. If the fetal sac is visible on ultrasound but the blood HCG level is less than 1000 IU/L, consider embryonic death.
It is wise to stop the fertility treatment in these cases. Some patients, who are desperate to have a baby and cannot face the reality of embryo death, repeatedly ask their doctors for fertility preservation treatment, or even buy their own fertility preservation pills. As a result, the dead embryo stays in the uterus for a long time, leading to infection. When the operation to clear the uterus was done, it smelled bad. Imagine if this situation will also affect the next pregnancy?
The pregnancy outcome is not promising in the following cases.
1. only a fetal sac without a fetal bud on consecutive ultrasound examinations
2. fetal heart is not visible despite the presence of a fetal bud
3. Large and irregular gestational sac
4. Fetal heart rate is less than 85 beats per minute
5. Significant post-chorionic hemorrhage, with hematoma exceeding 25% of the size of the gestational sac
6. If the increase of blood HCG level is less than 65% every 48 hours
The above situation needs to be brought to the attention of the patient. If the embryo is aborted, there is a possibility of heavy bleeding, and only when the bleeding exceeds the maximum of the usual menstrual bleeding, it is necessary to go to the hospital for examination. If there is embryonic tissue flowing out, it can be collected in a clean, dry bottle, preferably kept refrigerated, and sent to the hospital for laboratory examination as soon as possible. Routine pathological examination is done to rule out abnormalities such as staph, and if the financial condition is good, embryonic chorion chromosome examination is recommended.