Problems related to the preservation of pregnancy and miscarriage in pre-eclampsia

  If you have symptoms of preterm miscarriage such as vaginal bleeding or lower abdominal pain, you should go to a regular hospital for a preliminary diagnosis regardless of the amount of bleeding; if the bleeding is heavy or the abdominal pain is increasing, you should go to the emergency room at any time to make a diagnosis and treatment as soon as possible.  However, not all cases of pre-eclampsia can be successfully diagnosed, and sometimes auxiliary dynamic tests such as HCG, progesterone and ultrasound are needed to confirm the diagnosis, so when the diagnosis is not clear, it is not advisable to blindly keep the pregnancy in order to avoid adverse consequences (such as ectopic rupture).  When it comes to the means of fetal preservation, it is important to differentiate them according to the patient’s condition. Generally speaking, progesterone supplementation is very necessary. Progesterone is available in the form of dydrogesterone, progesterone capsules, progesterone injections, etc., in addition to HCG injections. For patients with mild symptoms, it is only necessary to supplement with dydrogesterone in conjunction with recuperation at home, but if there is blood accumulation in the uterine cavity or obvious symptoms of lower abdominal pain or bleeding, hospitalization is required in principle.  Having said that, some patients may have a question. They usually have no vaginal bleeding, but a blood test reveals a low progesterone level, is this considered a preterm abortion? Do I need to take oral progesterone? Generally speaking, since progesterone values can fluctuate widely from one individual to another, they are often judged together with HCG values to be more meaningful. For example, if the HCG value is growing well and the fetus is developing well, and the progesterone value is slightly low, this is fine and does not require excessive stress or treatment, and conversely, progesterone supplementation is needed. However, for a history of previous bad pregnancies or IVF, progesterone supplementation is a routine means of preventing miscarriage.  Pregnant women on oral progesterone should not stop taking the medication blindly, but must take the correct amount of progesterone medication and the correct dosage reduction under the guidance of a doctor. Generally speaking, there is a dose reduction phase before stopping the medication. When the symptoms of preterm abortion completely disappear, the treatment dose can be reduced to maintenance dose, and the medication can be completely stopped after one to two weeks of stabilization. If there is a sudden increase in vaginal bleeding or increased abdominal pain during the period of fetal preservation, you should seek immediate medical attention and hospitalization.  It is worth noting that you should try to keep your bowels open throughout the pregnancy and avoid using abdominal pressure to minimize the stimulation of the uterus. In addition, cold and stimulating foods should be minimized to avoid miscarriage due to stimulation of intestinal peristalsis.  Therefore, it is very important to be positive and optimistic during the whole process of pregnancy preservation, and to follow the advice of your whole life, to review regularly, to consult your doctor promptly in case of abnormalities, and to maintain good communication with your doctor, which will help you to safely pass the ten months of pregnancy.