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Abstract: A 25-year-old patient came to the clinic with no fetal heartbeat for 2+ months of menopause and no obvious early pregnancy symptoms. The patient had no symptoms after the operation.
Basic information】Female, 25 years old
Type of disease】Detained abortion, fetal abortion
Hospital】Huangshi Central Hospital
Date of Consultation】May 2022
Treatment plan】Surgical treatment (uterine curettage)
Treatment Period】4 days in hospital, review after 1 week
Results】Typical villi were visible after removal of intrauterine pregnancy tissue
I. Initial consultation
The patient complained of no fetal heartbeat even after 2+ months of menopause, and no obvious early pregnancy reaction, then the patient was examined and consulted. The patient and her family actively cooperated with the treatment.
II. Treatment process
After the patient was admitted to the hospital, the relevant examinations, i.e. physical examination, urine routine, HCG and other examinations were completed, which were consistent with the characteristics of fetal abortion and clearly identified as indolent miscarriage, and then we communicated with the patient and her family about the patient’s condition and informed them that the cause of the disease was due to chromosomal abnormalities of the pregnancy tissue, and that the fetal heart was visible in most patients at about 7 weeks of menopause, and that the visible fetal heart was a criterion for judging the early development of the pregnancy tissue. The fetal heart was not visible under ultrasound, so it was recommended to perform a clearance procedure under ultrasound immediately, and it was suggested that the pregnancy tissue be subjected to chromosomal examination to understand the cause of fetal arrest. After the family agreed, the operation was performed immediately and the procedure went smoothly.
III. Treatment results
The patient recovered well after the operation, with a small amount of vaginal bleeding and slight abdominal pain, which was considered normal after the operation, and the operation went smoothly. The patient was discharged at the end of 4 days of hospitalization. The patient was instructed to observe her bleeding and menstruation at home and to return to the hospital 1 week later for a follow-up HCG and ultrasound to check the recovery of the uterus and the presence of intrauterine residues.
IV. Precautions
We feel sorry for the patient’s occurrence of indolent abortion, but fortunately, the patient has no discomfort after the operation of uterine clearance. We suggest the patient to pay attention to the following matters after discharge.
1. Pay attention to vaginal bleeding and lower abdominal pain, pay attention to vulvar cleanliness and hygiene, and avoid sexual intercourse for 1 month.
2. Patients should have a light diet after discharge home, do not eat too much spicy and stimulating food, and stay up less.
3. Return to the hospital 1 week after discharge to review the decline of blood HCG and gynecological ultrasound. If abdominal pain worsens or bleeding increases and the discharge is odorous, it is recommended to consult a doctor immediately.
V. Personal insight
1, the indolent miscarriage is different from the general miscarriage, most of the patients have no symptoms such as bleeding and abdominal pain, but only the sudden disappearance of early pregnancy reaction and accidental detection during ultrasound, so it is necessary to draw the attention of the patients and their families and seek medical consultation in time if there is any discomfort.
2. for the causes of free-flowing miscarriage, patients need to analyze and deal with them appropriately to avoid the recurrence of the same problems.
3. There are certain difficulties in the diagnosis of indolent miscarriage, and the judgment needs to be combined with ultrasound and HCG test results for comprehensive analysis. If the diagnosis is indolent miscarriage, patients are advised to follow the doctor’s advice to terminate the pregnancy in time to avoid increasing the risk.