Miscarriage is defined as termination of pregnancy at less than 28 weeks. Termination before 12 weeks of pregnancy is called early miscarriage; termination from 12 weeks to less than 28 weeks of pregnancy is called late miscarriage. Miscarriage is divided into spontaneous abortion and induced abortion. The incidence of spontaneous abortion accounts for 10-15% of all pregnancies, and most of them are early abortions.
Infertility and spontaneous abortion are both tormenting for women. Compared with infertility, spontaneous abortion patients not only have to undergo mental stress, but also physical trauma, thus causing more damage to women.
I. The common causes of miscarriage are
1, embryonic factors: embryonic chromosomal abnormalities are the main cause of early miscarriage and belong to natural elimination. Early spontaneous abortion occurs in 50-60% of embryos with chromosomal abnormalities.
2. Maternal factors: Common maternal factors are
(1) Endocrine abnormalities: common causes of maternal endocrine abnormalities include hypothyroidism, luteal insufficiency, severe uncontrolled diabetes, etc.
(2) Abnormalities of reproductive organs: spontaneous abortion may occur due to uterine fibroids (especially submucosal fibroids), adenomyosis, uterine malformations (such as longitudinal uterus, uterine dysplasia, bicornuate uterus, etc.), excessive scraping resulting in thin endometrium, cervical insufficiency, etc.
(3) Traumatic stimulation: such as excessive sexual intercourse during pregnancy, direct impact, surgery; excessive mental tension, anxiety, fear, sadness, etc. can lead to uterine contraction and cause miscarriage.
(4) Systemic diseases: such as high fever causing contractions and miscarriage; bacterial toxins such as rubella virus, cytomegalovirus, chlamydia entering the fetal blood circulation through the placenta and causing fetal death leading to miscarriage; severe hypertension and nephritis in pregnant women leading to placental infarction.
3, abnormal immune function: there is a complex and special immunological relationship between the embryo and the mother, once the immune relationship is abnormal the embryo will be rejected by the mother, resulting in miscarriage. The common immune function abnormalities that lead to miscarriage are insufficient closed antibody, positive anti-cardiolipin antibody, and the presence of anti-sperm antibody, etc.
4, environmental factors: exposure to excessive toxic and harmful or radioactive substances can cause miscarriage.
5, bad habits: excessive alcohol consumption, smoking, excessive coffee, drug use, etc.
Second, the classification of miscarriage.
According to the process of miscarriage, miscarriage can be divided into pre-eclampsia miscarriage, inevitable miscarriage, incomplete miscarriage and complete miscarriage. Pre-eclampsia miscarriage can also continue pregnancy after active treatment. In addition, there are three special cases of miscarriage: abnormal miscarriage/embryonic arrest, habitual miscarriage and miscarriage infection.
Third, the groups at risk of miscarriage.
Advanced age, polycystic ovary syndrome, irregular menstruation, luteal dysfunction, thyroid dysfunction, uterine fibroids, adenomyosis, history of cervical lacerations, hypertension, hyperglycemia, severe anemia, and those who are engaged in high-risk occupations (medical personnel in radiology, pesticide factories, chemical plants, etc.).
IV. Countermeasures against miscarriage.
Active examination before pregnancy to exclude diseases causing miscarriage, such as checking the five items of eugenics, thyroid function, checking pelvic ultrasound to exclude organic lesions, etc. Basal body temperature measurement to understand luteal function.
Promptly inform the patient of the precautions for fetal preservation and external factors that may cause miscarriage, such as sexual life during early pregnancy, bad living habits and foods and drugs that should not be consumed, and avoid straining, etc.
Actively take the initiative to preserve the fetus after pregnancy. For patients at high risk of miscarriage, once the pregnancy is found, they should actively preserve the pregnancy, understand the hormone level in the body and take timely measures, and should not wait for passive treatment when there are symptoms of pre-miscarriage. Promptly take blood to check the progesterone level and the doubling of β-HCG, and timely combine Chinese and Western medicine to preserve the pregnancy once it is abnormal. On the one hand, supplement progesterone or HCG, and on the other hand, use oral fetus preservation herbs.
In conclusion, miscarriage is a common and frequent disease. The prevention of miscarriage is as important as the treatment. The cooperation between doctors and patients, proactive prevention and treatment is more effective than passive treatment.