I. What is embryonic abortion
The fertilized egg is like a seed, which has to go through a series of complicated and wonderful processes to grow into a healthy baby. If the fertilized egg does not germinate well at the initial stage, then it will probably stop growing healthily.
Causes of embryonic abortion
Embryonic arrest refers to the cessation of the development of the embryo in the early stages of pregnancy due to some reasons, which may be manifested by an ultrasound examination of the fetal buds or fetuses in the gestational sac, or by the absence of fetal heartbeat, or by the withering of the gestational sac. The clinical category is miscarriage or stillbirth. There are many causes of embryonic abortion. (1) Endocrine disorders.
Embryo implantation and continued development depend on the coordination of the complex endocrine system with each other, and any malfunction in any one of them can lead to miscarriage. The early development of the embryo requires three important hormone levels: estrogen, progesterone, and human chorionic gonadotropin, and the mother’s own endogenous hormones are insufficient to meet the needs of the embryo, which may result in embryonic arrest and miscarriage. Luteal insufficiency can cause delayed endometrial development and short luteal phase, which can affect the implantation of fertilized eggs or early pregnancy miscarriage. Luteal insufficiency is often accompanied by other glandular abnormalities, such as hyper- or hypothyroidism, diabetes mellitus, androgenism and hyperprolactinemia, all of which are detrimental to the development of the embryo and are closely related to miscarriage.
(2) Immunological factors.
The embryo or fetus in the womb of pregnancy is actually a homozygous transfer because the fetus is a combination of genetic material of the parents and the mother cannot be identical. The immune maladjustment between mother and fetus causes the rejection of the fetus by the mother. Common autoimmune diseases are systemic lupus erythematosus, scleroderma, mixed connective tissue disease, dermatomyositis, etc. The second is the problem of reproductive immunity, if we carry certain antibodies ourselves, it may affect the development of the embryo. In fact, the detection of antibodies is not the same in every hospital, and the doctors’ opinions are not the same. From the perspective of our research, we believe that there are four factors that affect the development of the embryo. The fourth is the anti-chorionic gonadotropin antibody, which is an important hormone that is secreted seven days after the union of sperm and egg, but if you have this antibody, it will resist the secretion of the hormone and may cause the embryo to stop.
(3) Uterine abnormalities.
The internal environment of the uterus and the overall environment of the uterus may have an effect on the embryo. The internal environment is the endometrium, if it is too thin or too thick, it will affect the implantation. Miscarriages due to uterine defects account for about 10% to 15%, commonly (1) congenital abnormalities of the Mullerian ducts including unicornuate, bicornuate and bicornuate uterus resulting in a narrow uterine cavity and restricted blood supply. Abnormal development of the uterine arteries can lead to asynchronous müllerianization and abnormal implantation. (2) Uterine adhesions, mainly caused by uterine adhesions and fibrosis after uterine trauma, infection or residual placental tissue. This prevents normal molting and placental implantation. (3) Pregnancy failure can also be caused by reduced blood supply due to fibroids and endometriosis resulting in ischemia and venous dilatation, asynchronous metaplasia, abnormal implantation, and hormonal changes caused by fibroids. (4) Congenital or injurious endocervical relaxation and abnormal cervical development due to intrauterine treatment with ethylene estradiol often result in miscarriage in midterm pregnancies.
(4) Chromosomal problems.
Chromosomal abnormalities can also lead to early miscarriage if the embryo does not develop. Chromosomal abnormalities include quantitative and structural abnormalities, quantitative abnormalities can be divided into aneuploidy and polyploidy, the most common abnormal karyotype is triploidy, and trisomy 16 accounts for 1/3, which is often lethal. 25-67% of trisomy 21, 4-150% of trisomy 13, and 6-33% of trisomy 18 are bound to miscarriage. Others are haploid (4SX) and tetraploid due to abnormal oogenesis resulting in embryonic failure. Structural abnormalities include deletions, balanced translocations, inversions, overlaps and other closures. Balanced translocations are the most common chromosomal abnormalities. Current research on chromosomal issues suggests that chromosomes pair, interchange and separate to form gametes, and gametes combine to form conjoined gametes. If there is an abnormality in one of the congeners, it results in failure to develop normally and can lead to miscarriage, stillbirth, stillbirth, and malformed children; therefore, prenatal diagnosis is required to prevent the birth of chromosomally affected children. There is no effective treatment for miscarriage and fetal abortion caused by carrying chromosomal abnormalities in Western medicine, and only prenatal genetic counseling and diagnosis can be performed. For chromosomal abnormalities, theoretically there is a chance of delivering normal karyotype and carrier babies, and prenatal diagnosis is done for these couples to ensure the birth of normal babies. Of course, current research has also shown that both couples have normal chromosomes, but chromosomal abnormalities occur during gamete formation and embryo development. For example, if a woman is older than 35 years old and her eggs are aging, she is prone to chromosomal non-separation, resulting in chromosomal abnormalities; abnormal semen, such as large-headed malformed sperm that are mostly diploid and form polyploid embryos after fertilization leading to miscarriage. The influence of adverse environment such as toxic chemicals, radiation, high temperature, etc. can also cause chromosomal abnormalities in embryos. Therefore, the key to preventing chromosomal abnormalities that lead to fetal abortion is to regulate the bodies of both spouses so that the functions of the internal organs are normally coordinated, the yin and yang are balanced, and the best pregnancy is selected and kept away from adverse environments.
(5) Reproductive tract infection.
In addition to the above factors, early pregnancy miscarriage due to infection has received more and more attention from scholars at home and abroad. Severe TDRCH infection in early pregnancy can cause embryonic death or miscarriage, while milder infections can also cause embryonic malformation. Studies have shown that cytomegalovirus can cause premature miscarriage and intrauterine fetal death. After maternal infection, the pathogens can travel to the placenta through the bloodstream, causing damage to the chorionic villus and capillary endothelium, and destroying the placental barrier, resulting in miscarriage, embryonic arrest and fetal malformation. In recent years, many studies have shown that mycoplasma infection is associated with embryonic arrest, and the positive rate of cervical secretion mycoplasma infection in women with embryonic arrest is significantly higher than that in normal women, and there is an extremely significant difference.
(6) Environmental factors.
Changes in the physiological state during pregnancy cause large changes in the absorption, distribution and excretion of therapeutic drugs and various environmentally harmful substances in the mother’s body. In the early stages of development, the embryo is extremely sensitive to the effects of therapeutic drugs and environmental factors, and at this time various harmful factors can lead to embryo damage and even loss. Many drugs and environmental factors are important factors in causing early embryonic death or fetal malformations. Environmental hormones can act directly on the central neuroendocrine regulatory system, causing disruption of reproductive hormone secretion, decreased fertility and abnormal embryonic development. There are various environmental factors that cause miscarriage, including physical factors such as X-rays, microwaves, noise, ultrasound, high temperature, and heavy metals such as aluminum, lead, mercury, and zinc that affect the fertilized egg’s implantation or directly damage the embryo and cause miscarriage. Various chemical drugs such as dichlorohydrin, carbon disulfide, anesthetic gases, oral antidiabetic drugs, etc. can interfere with and impair reproductive function, causing embryo miscarriage, stillbirth, malformation, developmental delay and functional disorders. The company’s products and services are also available in a wide range of sizes and sizes.
Symptoms of embryonic abortion
If embryonic abortion occurs, all the pregnancy reactions of pregnant women will gradually disappear. First of all, there will be no more nausea, vomiting and other early pregnancy reactions, and the feeling of breast swelling will be reduced. Then there will be bleeding from the vagina, often dark red bloody leukorrhea. Finally, there may be pain in the lower abdomen and discharge of the embryo. The above manifestations vary from person to person, and some have abdominal pain directly without any signs at all, followed by miscarriage, or embryonic abortion is detected by routine ultrasound examination without symptoms.
Preventing embryonic abortion
1. Chromosomal abnormalities. Before pregnancy, preconception tests and medical diagnosis are needed. If there is a family history of genetic disorders, you can consider not getting pregnant or taking effective care measures.
2, abstain from harmful substances. If you work in a related industry, you can transfer to another department a few months before conception. For family rooms that have just been renovated, it is recommended not to move in too early and to move in only after passing the test. Choose clean and non-polluted food.
3. Radioactive light. Avoid X-rays before pregnancy, microwave ovens should be operated at a certain distance from them, about one meter or more. Do not carry a cell phone in your body for a long time, and only use it when necessary.
4. Drug influence. If there is no intention to conceive, you should do a good job of contraception. When preparing for pregnancy, if you have a medical condition, you should first confirm whether you are already pregnant, and if so, you should take the medication carefully. It is best to be able to consult your doctor and choose drugs that are beneficial to your condition and have no effect on the fetus.
5. Smoking and drinking. The couple should stop smoking and drinking during the period before the birth and during pregnancy, so as to avoid the impact of smoking and drinking on the fetus in the womb.
6, infected with the virus. For rubella, pregnant women should be injected with rubella vaccine in advance. In the first trimester of pregnancy, avoid staying in public places for too long and take appropriate physical exercise to enhance your physical fitness and your own satisfaction. Keep a balanced nutrition.
7.Chronic and serious diseases. Drugs for the treatment of chronic diseases can have a great impact on the fetus, and if the patient needs to get pregnant, she should stop taking the drugs for a period of time and only when her condition is stable is she suitable for pregnancy.8. Immune system abnormalities. For women with immune system abnormalities, they should get pregnant only after they have fully recovered from the disease. It is also necessary to exercise more in life, maintain a balanced nutrition and strengthen the immune system.
V. Treatment of embryonic abortion
The first thing you need to do is to get an abortion. When a pregnant mother is unfortunately diagnosed with fetal stoppage, she should not panic and usually needs to do abortion under the guidance of her doctor. The first thing you need to do is to take a look at the actual results.
How long can you get pregnant after embryonic abortion
If a woman has had a fetal abortion, she should get pregnant again at least six months later from the perspective of eugenics, because it takes at least two to three months for the ovarian function to recover and at least six months for the endometrium to recover.
VII. How to prevent embryonic abortion when conceiving again
1, psychological relaxation, women who are ready to get pregnant, whether they themselves or their friends around them have had a fetal abortion, should not be overly worried about it. The fact is that the woman’s stress and pressure will lead to an imbalance in the body’s endocrine system, which is not good for the healthy development of the embryo and fetus.
2, pre-pregnancy preparation, women should have a proper preparation period, pay attention to a balanced diet, regular life, exercise and pre-pregnancy check-ups, and actively participate in the special health classes prepared by the women and infants hospital for mothers-to-be, communicate with the doctor, and understand all aspects of pre-pregnancy, pregnancy and post-pregnancy knowledge.
3. Timely examination, generally the embryo has a fetal heart around 8 weeks, and the phenomenon of fetal abortion may appear at 8-12 weeks, so it is recommended that pregnant women should go for ultrasound at around 8 weeks to check the development of the fetus and placenta early. If a fetal heart appears, you can generally rest assured.
VIII. Early diagnosis of embryonic abortion
(1) Symptoms.
Most pregnant women have no obvious symptoms after the fetus stops developing, some of them may see redness and usually no abdominal pain, which is different from pre-eclampsia miscarriage.
(2) Diagnosis.
The patient has a history of menopause, regardless of whether there is redness or not, ultrasound should be performed in early pregnancy to avoid missing the diagnosis of embryonic arrest. ultrasound monitors the embryo and fetal development, if there is no gestational sac at ≥6 weeks, or if there is a gestational sac but deformed and wrinkled, when the gestational sac is ≥100px but no fetal bud is visible, and the head and arm length of the fetal bud is ≥37.5px but there is no fetal heartbeat, the embryo or fetus can be diagnosed with abnormal development. The last three cases can be diagnosed as embryonic abortion. In addition, blood β-hcG measurement is also helpful in the diagnosis of embryonic abortion. If the blood β-hcG is <100IU/L at ≥5 weeks, or <2000IU/L at ≥6 weeks, m indicates that the chorionic gonadotropin secretion is insufficient, and if the value is no longer rising under dynamic observation, it can be determined that the chorionic epithelium is declining and the embryo is abnormal.
How to avoid the occurrence of embryonic abortion
Chinese medicine has a long history and has accumulated a wealth of experience through thousands of years of clinical practice. It has made great contributions to the reproduction of the Chinese nation. TCM treatment for embryonic abortion should be started before conception to lay a good foundation for future pregnancies and to prevent embryonic abortion, miscarriage, fetal atrophy, fetal leakage and other diseases.
For pre-pregnancy with miscarriage, TCM treatment has obvious advantages over Western medicine. TCM can provide effective treatment according to the patient’s physical condition, such as consolidating the innate kidney, replenishing the postnatal spleen, and regulating the qi and blood to make the qi and blood flourish and the kidney energy enrich, so as to facilitate the fetus to be tied after pregnancy. Patients with a history of embryonic abortion should use contraception for six months to one year after the last abortion, and use Chinese herbal medicine to regulate the body so that it can gradually recover. Before ovulation, add Yu Jin and Danshen to assist ovulation, and in the late stage of ovulation, use Epimedium, Chinese yam and deer horn cream to maintain the luteal function. In Chinese medicine, it is believed that the system of maintaining the fetus lies mainly in the consolidation of the two veins of the Punch and Ren, which are the sea of blood and the main veins of the cell, while the root of the Punch and Ren is the kidney. Therefore, in cases of embryonic abortion, except for obvious chromosomal abnormalities, thalassemia or uterine anomalies of the female partner, which cannot be improved, a period of pre-treatment should be provided before the second pregnancy to ensure a smooth pregnancy.
The kidneys are the foundation of the heaven, the kidneys collect the essence and are the master of reproduction. If the kidney is strong, the heavenly sperm will arrive, and the Renchong will be strong, so that the menstruation can come on time and the child can be born. The kidney is strong, the fetus has a system, the fetus is carried, the blood is full, the fetus is nourished, the fetus is safe. If the body is not endowed with enough, the kidney is weak and weak, the punch is not solid, it is easy to develop fetal anxiety. The modern women mostly marry late and have children late because of their career, and the Suwen? The first thing you need to do is to consider having a baby after the age of 30, which is prone to fetal anxiety. In addition, if there is a history of miscarriage before conception and delivery, and if repeated pregnancies and abortions deplete the essence and blood and damage the kidney energy, it is also easy to develop fetal discomfort. The internal pathogenesis of embryonic abortion is related to the depletion of the kidney, spleen, qi and blood, and the two chakras, with loss of kidney qi being the main cause.
The clinical treatment of embryonic abortion is mostly divided into kidney yin deficiency, kidney yang deficiency, and kidney deficiency in the three meridians. If menopause is followed by lumbar soreness, abdominal pain or small amount of vaginal bleeding, pale mouth, pale complexion, loose stools, pale tongue with thin white fur and slippery pulse, it is identified as kidney yang deficiency. We use Cuscuta sinensis, Radix et Rhizoma, Radix et Rhizoma mulberry, Radix Aconiti, Radix Codonopsis pilosulae, Rhizoma Atractylodis Macrocephalae, Rhizoma Polygonati, Radix Rehmanniae Praeparata, Radix Paeoniae Alba, Radix et Rhizoma Sugae, Radix Glycyrrhiza Uralensis to nourish the innate kidney and strengthen the acquired spleen. If the patient has dry mouth, dry stool, red face and lips, red tongue with thin yellow coating, and smooth and slightly counted pulse, it is identified as kidney-yin deficiency. If the patient’s dry mouth is not obvious, the stool is normal, the tongue is light red, the moss is thin and white, and the pulse is slippery, the patient should be identified as having kidney deficiency.
Once a fetal abortion has occurred, you will be faced with a long list of tests prescribed by your doctor. In fact, according to Chinese medicine, it is sufficient to do some tests that can exclude organic causes. If these tests are normal, then the rest of the work is yours to grasp. These tests are mandatory.
① Genetic factors: peripheral blood chromosomes, chorionic villi or embryonic chromosomes of the couple; sperm viability and morphological examination of the male.
② Endocrine examination: six sex hormone tests for women (with progesterone checked one week before menstruation and the remaining five on the 3rd-5th day of menstruation); nail function, insulin, glucose tolerance.
③ Infection factors: TORCH, UU, CT, routine white belt examination.
④ Immunological examination: APA, ACA, LA, ANA, SS-A, SS-B, RNP, ASA, EmAb, AOA/closing antibody, T-cell subpopulation
⑤ Coagulation function: PAGT/GMP-140/APTT/D-dimer, FDP
⑥ Hysteroscopy
⑦ Ultrasound of uterus and adnexa