Fetal arrest refers to the cessation of embryonic development in early pregnancy due to some reasons. The ultrasound examination shows that there is no fetal bud in the gestational sac or the fetus is irregular in shape, no fetal heartbeat, or the gestational sac is withered. Most pregnant women have no obvious symptoms after the fetus stops developing, some of them may see redness and usually no abdominal pain.
Fetal arrest is a kind of spontaneous abortion, and 2 or more spontaneous abortions are called recurrent spontaneous abortion (ERSA).
I. Common causes of fetal abortion in clinical practice
1.Infection factor: mycoplasma infection.
2, embryonic arrest: the number of development is positively correlated with the positive rate of mycoplasma and chlamydia infection.
3, subclinical mycoplasma infection: it is an important cause of spontaneous abortion, especially recurrent abortion.
4. Endocrine factors: 23% to 67% of early spontaneous abortions are due to endocrine disorders, which cause embryonic arrest.
5. Immunological factors: the implantation of fertilized eggs in the mother can be regarded as a semi-identical transfer phenomenon; the number of embryonic arrests is positively correlated with abnormal immune function.
II. The concept of infertility
The World Health Organization’s Standard Examination and Diagnostic Manual for Infertile Couples, prepared in 1995, sets the diagnostic year limit for infertility at one year, and the American Infertility Society’s criterion is a one-year history of non-contraceptive sexual intercourse without conception. Secondary infertility is when a couple has a history of pregnancy but has not conceived again without contraception for more than one year.
Common causes of secondary infertility
1. Tubal factors: Inflammatory diseases of the reproductive system leading to tubal incompetence, poor patency, fluid accumulation or pelvic adhesions are the most common causes of secondary infertility.
2. Endocrine factors: endocrine disorders causing ovulation and luteal insufficiency lead to infertility.
Immunological factors: Immunological infertility accounts for about 10-30% of infertility patients, including anti-sperm antibodies, anti-endometrial antibodies, anti-ovarian antibodies, and other types of immunological infertility.
IV. The relationship between fetal abortion and secondary infertility
Normal sperm and eggs are fertilized in the female fallopian tube through the unobstructed male and female reproductive tracts, enter the uterus, and develop and complete the entire pregnancy and delivery in an excellent embryonic embedding environment.
Inflammatory diseases of the female reproductive system such as pelvic inflammatory diseases are the most common and serious infectious diseases in women. The CDC defines it as a group of diseases caused by infections in the upper female reproductive tract, including endometritis, tubal inflammation, tubo-ovarian abscess and pelvic peritonitis. 60% of pelvic inflammatory diseases have mild symptoms or even no symptoms of discomfort and are often mistaken for menstrual cramps and mistaken for treatment. This is called occult pelvic inflammatory disease, if there is no inflammatory mass or pelvic fluid, only the body of the uterus, adnexal edema, congestion, ultrasound examination can not be found.
Pelvic inflammatory disease can be confined to one area or involve several areas at the same time. If the degree of inflammation does not affect conception, the patient can conceive successfully. However, if the inflammation involves the endometrium and affects the regeneration, repair and normal contraction of the endometrium, it may lead to fetal abortion. Fetal abortion may also be triggered by inflammation affecting the function of the ovaries. Infertility can be caused by the spread of inflammation due to miscarriage and uterine clearance after fetal abortion if it involves the fallopian tubes and leads to tubal obstruction. A poorly patent fallopian tube can cause infertility also easily lead to ectopic pregnancy. There are many cases of ectopic pregnancy or secondary infertility after 1-2 fetal stoppages in patients in clinical practice.
V. How to prevent fetal abortion and secondary infertility
Improve the pre-conception examination for both spouses and advocate the same examination and treatment for both spouses. Obtain timely knowledge of reproductive health care, reduce bad habits and prevent or carry out targeted treatment. Do a gynecological internal examination every six months to a year to detect hidden pelvic inflammatory disease in time. Regular gynecological examinations are a talisman for women to prevent and control pelvic genital infections and prevent pelvic adhesions. The standard gynecological internal examination is not just to check the vagina and cervix and take some secretions for a routine white belt examination, but must be performed as a double examination. The absence of duplex examination causes some patients with hidden pelvic inflammatory disease that should have been detected to go undetected, even until serious sequelae such as infertility, ectopic pregnancy, or fetal abortion occur, and then they are discovered to be due to pelvic inflammatory disease. If you have pelvic inflammatory disease, the chances of infertility are much higher for those who are treated after 3 days than those who are treated within 3 days. Therefore, it is best for women who are sexually active to go to the hospital every six months to a year for a gynecological examination that includes internal gynecological examination, and once you are diagnosed with the disease, start antibiotic treatment early under the guidance of your doctor.