1.Chromosome abnormalities
Chromosomal abnormalities include chromosomal and embryonic chromosomal abnormalities of both spouses.
There are structural and numerical chromosomal abnormalities. The structural abnormalities mainly include reciprocal translocation, Robertson translocation, inter-arm inversion, intra-arm inversion, gene polymorphism and sex chromosome abnormalities; the numerical abnormalities mainly include aneuploidy, polyploidy and chimerism.
About 50% of early miscarriages are caused by chromosomal abnormalities in embryos, including chromosomal number abnormalities and, in a few cases, chromosomal structure abnormalities and other abnormalities such as chromosomal mosaicism and submicroscopic chromosomes. Common chromosomal abnormalities include trisomy, polyploidy, X haploidy, unbalanced chromosomal translocation, etc.
2.Anatomical abnormalities of the reproductive tract
Any abnormalities in the structure and function of the reproductive tract that can affect embryo implantation and growth and development can lead to miscarriage.
The main congenital factors are genital tract malformation and dysplasia. These include longitudinal uterus, bicornuate uterus, bowed uterus, unicornuate uterus, bicornuate uterus, uterine dysplasia and congenital cervical insufficiency, etc. Longitudinal uterus is the most common.
Acquired anatomical abnormalities of the reproductive tract mainly include endometrial damage caused by various reasons, resulting in cavity adhesions, cervical insufficiency and uterine fibroids, etc.
3.Endocrine disorders
The main causes are luteal insufficiency, diabetes mellitus, abnormal thyroid function, polycystic ovary syndrome (PCOS), hyperprolactinemia, etc.
4.Infectious diseases and miscarriage
There are mainly systemic infections and female reproductive tract infections.
Systemic infections include acute pneumonia, acute pyelonephritis, acute pancreatitis and acute appendicitis, toxoplasma, cytomegalovirus, herpes simplex virus, rubella virus, etc.
Reproductive tract infections include infections caused by pathogens such as bacteria, viruses, trichomonas, mycobacteria, chlamydia, mycoplasma, toxoplasma, Neisseria gonorrhoeae infection, syphilis and human immunodeficiency virus (HIV).
5, immune factors
The autoimmune type mainly includes antiphospholipid antibody syndrome, systemic lupus erythematosus, dry syndrome, etc. Alloimmune type refers to the dysregulation of maternal-fetal immune tolerance microenvironment. It is common to have closed antibody deficiency.
6. Pre-thrombotic state
It is a pathological process in which the coagulation and anticoagulation systems, fibrinolytic and antifibrinolytic systems are dysfunctional or impaired due to multiple factors, and patients have risk factors for thrombosis.
It includes congenital and acquired.
The congenital form is mainly due to mutations in genes related to coagulation and fibrinolysis, such as coagulation factor V mutations, antithrombin III, prothrombin gene mutations, protein C and protein S deficiencies, etc.
Acquired conditions include antiphospholipid antibody syndrome and various diseases that cause hypercoagulable states. The diagnosis of recurrent miscarriage is aimed at etiological diagnosis, and a rigorous, systematic and comprehensive etiological screening must be performed before treatment, so that treatment can avoid blindness and be targeted.