1.What is spontaneous miscarriage?
It usually refers to the death of the embryo and the expulsion of the embryo and its appendages during pregnancy, generally the expelled embryo and its appendages are <1000g and the gestational week is <28 weeks, including what we often call "embryonic development arrest, fetal arrest and spontaneous abortion".
2.What does habitual miscarriage mean?
The occurrence of 3 or more spontaneous miscarriages in a row is called recurrent miscarriage or habitual miscarriage.
3.What are the causes of habitual abortion?
(1) Chromosomal abnormalities: Miscarriage caused by chromosomal abnormalities of both spouses or one of them or the embryo.
(2) Anatomical abnormalities of the reproductive tract: miscarriage due to anatomical abnormalities of the uterus, including congenital developmental abnormalities and/or anatomical abnormalities due to acquired uterine diseases.
(3) Endocrine abnormalities: mainly refers to miscarriage due to endocrine dysfunction, including luteal function, thyroid function, etc.
(4) Reproductive tract infection type: mainly refers to miscarriage due to Toxoplasma gondii, cytomegalovirus, herpes simplex virus and other infections.
(5) Coagulation abnormalities: miscarriage due to maternal hypercoagulability.
(6) Immune factors.
Autoimmune type: mainly refers to miscarriage caused by antiphospholipid antibodies, which actually belongs to the category of antiphospholipid antibody syndrome.
Homoimmune type: the diagnosis of this type of miscarriage is an exclusion diagnosis, that is, excluding chromosomal, anatomical, endocrine, infection, coagulation function and autoimmune etiology, failing to find other causes of miscarriage, called homoimmune type, which can also be called recurrent miscarriage of unknown cause.
4.How to examine habitual miscarriage.
According to the above, the examination of habitual miscarriage mainly includes the following major categories.
(1) chromosomal examination of both spouses and, if available, chromosomal examination of the aborted fetus.
(2) Hysterosalpingography or hysteroscopy to understand the morphology of the uterine cavity.
(3) Progesterone, estrogen, lactogen and thyroid function will be checked one week after ovulation.
(4) Examination of infections, especially local infections of the reproductive tract.
(5) Blood clotting tests.
(6) Routine semen, morphology and microbiological examination of the male partner.
(7) Immunological examination: examination of autoantibodies, including anti-cardiolipid antibodies, anti-sperm antibodies, autoantibody profile, etc. Homozygous antibodies, mainly closed antibody examination, and peripheral lymphocyte typing can be done if available.
5.Treatment
Mainly based on the examination results, targeted treatment.