Fetal arrest, also known as abortion, is a type of spontaneous miscarriage. A miscarriage that occurs in a natural state (not caused by artificial purposes) is called spontaneous abortion. The incidence is about 15%. Miscarriages that occur before 12 weeks of gestation are defined as early miscarriages and miscarriages from 12 weeks to less than 28 weeks of gestation are defined as late miscarriages.
Causes of morbidity.
More than 80% of miscarriages occur within 12 weeks of gestation, after which the miscarriage rate decreases rapidly. At least half of early miscarriages are due to chromosomal abnormalities of the embryo. The risk of spontaneous abortion increases with the number of births and the age of the parents. Common causes of miscarriage include.
1. chromosomal abnormalities.
These include chromosomal abnormalities in the couple and chromosomal abnormalities in the embryo. Common chromosomal abnormalities in couples are balanced translocation, Robertson translocation, etc. The most common chromosomal abnormalities in embryos are triploidy, followed by polyploidy, X monosomy, autosomal monosomy, balanced chromosomal translocation, deletion, chimerism, inversion, and overlap. The incidence of chromosomal abnormalities in couples with recurrent miscarriage is 4%, compared with 0.2% in the normal population, with the ratio of maternal to paternal origin being 3:1. Chromosomal abnormalities in embryos are the main cause of single spontaneous miscarriages, and the incidence of chromosomal abnormalities in embryos decreases as the number of miscarriages increases.
2. Maternal endocrine disorders.
(1) Luteal insufficiency: accounting for about 23%-60%, basal body temperature biphasic type, but the high temperature phase is less than 11 days, or the difference between high and low temperature is less than 0.3, endometrial biopsy shows that the secretory response is at least 2 days behind, progesterone in the luteal phase is less than 15ng/ml causing poor gestational meconium response, 2-3 cycles of luteal function tests show deficiency before inclusion in the diagnosis, luteal insufficiency affects the implantation of pregnant eggs.
(2) Polycystic ovary syndrome: high levels of luteinizing hormone, hyperandrogenism and hyperinsulinemia reduce egg quality and endometrial tolerance, which can easily lead to the occurrence of miscarriage.
(3) Hyperprolactinemia: The presence of luteinizing receptors in luteal cells and hyperprolactin inhibits granulosa cell luteinization and steroid hormones, leading to luteal insufficiency and decreased egg quality. It has been found that prolactin reduces the secretion of early human placental chorionic gonadotropin.
(4) Thyroid disease: Hypothyroidism is associated with recurrent spontaneous abortions.
(5) Diabetes mellitus: subclinical or satisfactorily controlled diabetes mellitus does not cause miscarriage, and uncontrolled insulin-dependent diabetes mellitus has an increased rate of spontaneous abortion.
3. Abnormalities of the maternal reproductive tract.
(1) Uterine malformations: including unicornuate uterus, bicornuate uterus, double uterus and uterine longitudinal septum. Among them, especially incomplete longitudinal uterus is most likely to lead to miscarriage and preterm delivery. The main reason is that the endometrium of the mediastinum is poorly developed, insensitive to steroid hormones and poor blood supply.
(2) Asherman syndrome: The uterine cavity is reduced in size and the response to steroid hormones is decreased.
(3) Cervical insufficiency: causes late miscarriage and preterm delivery, and is the main cause of midtrimester abortion.
(4) Uterine fibroids: submucosal fibroids and intermuscular fibroids larger than 5 cm are associated with miscarriage.
(4) Reproductive tract infections.
The incidence of late pregnancy miscarriage and preterm delivery is increased in patients with bacterial vaginosis; endometritis or cervicitis caused by Chlamydia trachomatis and Mycoplasma hyopneumoniae can cause miscarriage.
5, Other.
Unhealthy lifestyles are associated with miscarriage. Some scholars have reported that women who smoke more than 14 cigarettes a day have a 2-fold increased risk of miscarriage compared to the control group. The effects of alcohol abuse, excessive caffeine consumption and environmental factors such as organic solvents and toxins.
Disease prevention.
Lifestyle changes, reduce the occurrence of spontaneous abortion
1, regular life: adjust the work and rest time, appropriate exercise, and ensure 8 hours of sleep daily. Avoid staying up late, irregular work and rest, etc. Adjust work status, avoid excessive work pressure.
2, keep a relaxed mood .
3, pay attention to personal hygiene: change your clothes more often and bathe regularly. Pay special attention to the cleanliness of the pubic area to prevent germ infection. Clothing should be wide, the belt should not be tight.
4, choose the right diet: food should be easy to digest. Especially choose food rich in various vitamins and trace elements, such as various vegetables, fruits, beans, eggs, meat, etc.
5, careful to abstain from intercourse: for pregnant women with a history of spontaneous abortion, intercourse should be avoided within the third trimester of pregnancy.
6, regular prenatal checkups: regular prenatal checkups should be started early in pregnancy to facilitate timely detection and treatment of abnormalities by doctors and to guide pregnancy care.
7. Patients who have had spontaneous abortion should seek medical consultation as soon as possible once they are pregnant again.
What should I pay attention to after a spontaneous miscarriage?
1. Pay attention to proper rest.
Because after miscarriage, the amount of bleeding is more than normal menstruation, such as overexertion and poor uterine regeneration, the vaginal bleeding time may be prolonged, and the usual rest time is two weeks. Physical labor and physical exercise should be avoided within two weeks after miscarriage.
2.Pay attention to personal hygiene
Vaginal bleeding may be prolonged to 1-2 weeks after miscarriage, and at the same time, the body’s resistance decreases, so infection may occur and so on. Therefore, pay special attention to the cleanliness and hygiene of the vulva, take a shower to clean the vulva in time and change the toilet paper from time to time. Avoid bathing for two weeks and change your underwear regularly; for one month, intercourse should be prohibited to prevent bacterial infections. If you have sex during this period, it may cause endometritis, tubitis, pelvic inflammatory disease and other gynecological diseases. Repeated miscarriages and a history of unclean sex may cause infertility to occur.
3. Increase nutrition appropriately.
On the basis of adequate rest and reasonable diet structure, increase food rich in high-quality protein, trace elements and vitamins. Food selection should be both nutritious and easy to digest and absorb. Do not eat or eat less greasy and cold food usually weak, poor constitution, blood loss, can be properly prolonged supplementation time as appropriate. Food with both comprehensive nutrition, variety, but also to avoid excessive calories of fat, because excessive weight gain, hyperlipidemia and other conditions are equally detrimental to health. There is no need for transitional supplementation during pregnancy, as long as the normal and reasonable nutritional mix can be.
4, before the next pregnancy to do the examination of factors related to spontaneous abortion.
The best time to examine the causes of miscarriage is 2-3 months after the miscarriage couples at the same time, the consultation requirements: 2-3 days after the female party clean menstruation without intercourse; 3-5 days after the male party masturbation ejaculation consultation for a comprehensive examination.