Indolent miscarriage is also known as premature miscarriage or stillbirth. If the embryo dies and remains in the uterine cavity, and the pregnancy product is usually expelled within 1 to 2 months after the onset of symptoms. Therefore, it is stipulated that if the embryo has not been expelled spontaneously 2 months after it has stopped developing, it is called an indolent abortion.
Etiology.
1, mental stress: such causes include excessive tension, anxiety, fear, sadness, etc.
2, genetic defects: such as chromosomal abnormalities, chromosomal variants in one of the spouses, and blood type incompatibility between the spouses.
3, bad habits: such as excessive smoking, alcohol abuse, excessive coffee, heroin, etc.
4, environmental factors: frequent exposure to chemicals such as arsenic, lead, formaldehyde, benzene, chloroprene, ethylene oxide, radiation, etc. can easily lead to abortion.
5, maternal factors: the mother’s body itself has diseases, such as: reproductive organ abnormalities and uterine tumors, herpes simplex virus, cytomegalovirus infection, etc.
6, endocrine abnormalities: such as severe uncontrolled diabetes, luteal insufficiency, hypothyroidism, etc.
7, abnormal immune function: pregnancy is similar to homozygous transfer, there is a complex and special immunological relationship between embryo and mother, so that the embryo is not rejected. If both mother and child are immunologically maladapted, it can cause maternal rejection of the embryo and result in miscarriage.
Symptoms.
1. Menopause and early pregnancy reaction: there may be symptoms of pre-miscarriage in the previous period, but later the uterus no longer increases or shrinks instead. If it has reached the middle of pregnancy, the pregnant woman does not feel the increase in abdomen, no fetal movement, the cervical opening of the uterus is closed during gynecological examination, the uterus is smaller than the month of pregnancy for more than 2 months, and the texture is not soft. No fetal heart can be heard.
2, abdominal pain: early miscarriage began to bleed after the uterine cavity with blood, especially blood clots stimulate uterine contraction is persistent lower abdominal pain late miscarriage, there are paroxysmal uterine contractions first and then placental abruption so vaginal bleeding before the abdominal pain.
3, the color of the blood flow: abortion starts with bright red and turns dark red or brown in the long term. ectopic pregnancy is often a small amount of light red or brown; gravida is often dark red.
4, vaginal bleeding: in abortion within 3 months of gestation begins when the chorionic villi and meconium are separated and the blood sinuses are open that is when the embryo is all stripped and expelled the uterus is strongly contracted the blood sinuses are closed and bleeding stops.
Treatment.
1, luteal insufficiency, progesterone supplementation can be given. If there is a possibility of conception, progesterone should be given 10-20mg/d from the 3rd to 4th day of elevated basal body temperature, and continue treatment until the 9th to 10th week of pregnancy after the pregnancy is confirmed.
2. For those who have chromosomal abnormalities, if you are pregnant again, you must undergo prenatal examination to find out whether the fetus has congenital abnormalities through karyotype analysis of amniotic fluid cells, and if abnormalities are found, the pregnancy should be terminated in time.
3, the female vaginal and cervical discharge, the male semen bacterial culture positive, according to the drug sensitivity test to be treated accordingly, until cured. During the treatment period, use penis condom to prevent pregnancy.
If the fibroid is small, it can be treated with medication; if it is large and single, it can be treated with surgical excision.
5.For those who have loose cervical opening, cervical ligation can be performed during 12-20 weeks of pregnancy according to the time of previous miscarriage, and vaginal inflammation must be cured before surgery. If there are signs of miscarriage or preterm labor, the stitches should be removed in time to avoid serious damage to the cervix. If fetal preservation is successful, admission to hospital for delivery 2-3 weeks before the expected date of delivery is required. The sutures can be removed when signs of labor or cesarean delivery appear.
Prevention.
1. The latest opinion on how long it is appropriate for women to get pregnant again after spontaneous abortion is that women who wish to get pregnant quickly after spontaneous abortion do not need to wait, and pregnancy at any time does not increase the chances of miscarriage. At the same time, rapid pregnancy after spontaneous abortion is beneficial to women’s psychological health, which can enhance confidence in pregnancy, shorten the trauma caused by spontaneous abortion and reduce the occurrence of depression.
2.To do genetic examination, both couples should receive chromosome examination at the same time.
3.Do blood group identification including Rh blood group system.
4.For those who have loose endometrium, endogastric suturing can be done.
5, for luteal insufficiency treatment of drugs to be used for a period longer than the duration of pregnancy of the last miscarriage (such as the last miscarriage in the third trimester, the treatment time can not be shorter than the third trimester).
6, with low thyroid function, to maintain normal thyroid function before pregnancy, and also to take anti-low thyroid medication during pregnancy.
Precautions after induced abortion.
Care and conditioning after an abortion is necessary to reduce some damage. You should observe for 2 hours after the end of the indolent abortion, noting the vaginal bleeding and abdominal pain, and if there is no reaction, you can go home. You may experience mild lower abdominal discomfort, pain or a small amount of vaginal bleeding on the day after an induced abortion. If the abdominal pain is severe or the vaginal bleeding is heavy or prolonged, you should seek prompt medical attention.
It is necessary to increase nutrition appropriately after indolent abortion because the operation will cause a small amount of bleeding and make the body suffer some damage, so it should be supplemented with foods rich in protein and vitamins, such as lean meat, fresh fish, eggs, milk or soy products in time. Eat more foods with high protein and vitamin to nourish your body, and also eat more vegetables and fruits, don’t avoid eating or partial eating.
Take a good rest after abortion. After abortion, pay attention to proper rest, and it is better to rest in bed for the first 3 days. Generally, you should rest in bed for 3-5 days after the operation. If your body temperature is normal, your vaginal discharge is less bloody and there is no abdominal pain and other discomfort, you can get up and move around and do some light housework appropriately. Because the endometrium of the uterus is traumatized after abortion, premature activity may prolong the vaginal bleeding time.
The body’s resistance to abortion is reduced, so we should pay more attention to personal hygiene. Keep the vulva clean and do not take a tub bath within two weeks after the operation, it is better to take a shower. As the endometrium leaves a traumatic surface, vaginal secretions increase, making it a breeding ground for bacterial infection and reproduction. Therefore, we should pay special attention to the cleanliness of the vulva, take a shower to clean the vulva in time, disinfect the toilet paper and change it from time to time; avoid taking a tub bath within half a month and change the underwear regularly; and absolutely prohibit intercourse within a month to prevent bacterial infection. In addition, contraception should be further strengthened.