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Abstract: The patient had sex with her husband even during early pregnancy, which led to stimulation of uterine contraction, abdominal pain and vaginal bleeding, and outpatient examination with ultrasound indicating uterine effusion, indicating active intrauterine bleeding.
Basic information】Female, 36 years old
Type of disease】Premature miscarriage
Hospital】Guangxi Zhuang Autonomous Region Jiangbin Hospital
Date of Consultation】April 2021
Treatment plan】Medication for fetal preservation (progesterone injection + progesterone capsule + kidney fixation pill)
Treatment Period】9 days in hospital
Results】The abdominal pain and vaginal bleeding disappeared, the embryo developed well, and the pregnancy was successfully preserved.
I. Initial consultation
The patient reported that she had two abortions in the past, her menstruation was regular and she had no contraception, her last menstruation was on February 11, 2021, and her expected delivery date was November 18, 2021. On April 18, she had sex with her husband for a short time in the evening, after which she had slight pain in her lower abdomen, but did not pay attention to it. She was admitted to the hospital with an outpatient ultrasound indicating intrauterine pregnancy, equivalent to 9 weeks + 5 days of pregnancy, and a uterine effusion of 24×14 mm, and was considered to have intrauterine bleeding.
II. Treatment history
The patient was admitted to the hospital and underwent routine blood tests, three pregnancy tests, thyroid function, coagulation function, five eugenics tests, etc. The progesterone result was 18.12 pmol/L. The rest of the tests showed no significant abnormalities. We communicated with the patient and told her that the stimulation of intercourse had caused uterine contraction, resulting in active bleeding in the uterus and causing abdominal pain, vaginal bleeding and other symptoms of preterm abortion. At the same time, the patient should be told to rest in bed, reduce activities, avoid excessive straining during bowel movement, relax, don’t get angry, and try to eat light food, not to eat stimulating food, which is more conducive to the success of fetal preservation.
III. Treatment effect
On April 25, the result of progesterone was 30.64pmol/L, which was higher than before, and there was no obvious vaginal bleeding. The patient had stopped vaginal bleeding for 3 days, indicating the effectiveness of fetal preservation treatment, and was discharged from the hospital.
IV. Notes
We are glad that the patient’s symptoms improved after treatment, but the following points should be noted by the follow-up patient.
1. The patient should go to the obstetrics clinic for regular obstetric checkups after discharge, and NT examination is feasible after 11 weeks of pregnancy.
2. patients should pay attention to continue to rest for 1 week, do not do strenuous exercise and do not go to work too early, otherwise the strain of work may lead to symptoms of preterm abortion again.
3, patients should not have intercourse in early and late pregnancy, which may easily lead to miscarriage, premature rupture of membranes, preterm delivery, infection, etc.
4. Patients should keep a calm state of mind. Although there is preterm miscarriage, the effect is very good after fetal preservation treatment, so there is no need to worry too much, anxiety and depression.
V. Personal insight
In early pregnancy, the embryo has just been laid and is not yet stable, and early pregnancy is also a critical period for the differentiation of embryonic organs, so pregnant women must pay attention to rest, do not have intercourse, do not do strenuous exercise, do not eat stimulating food, and avoid the stimulation of bad emotions, otherwise it will easily cause preterm abortion or affect the development of embryo. In addition, early pregnancy should pay attention to take folic acid to prevent fetal neural tube defects malformation, avoid contact with toxic substances, avoid their own indiscriminate use of drugs, if pregnant women appear unwell, to seek early medical treatment, under the guidance of doctors.