Miscarriage or spontaneous abortion is called termination of pregnancy for up to 20-28 weeks. In this case, pregnancy can not be completed by birth, and the fruit does not reach a viable state. This obstetrical pathology, in which the development of the fetus prevent all sorts of factors.
Miscarriage - one of the most dangerous consequences pregnancy complications in the first trimester.
general information
According to statistics, 20% of pregnancies terminated spontaneous abortion, the developing fetus ends at a certain stage of its development, when independent living and nursing baby impossible.
Most of the miscarriages occur in the first trimester, when all the organs and systems has not yet been formed, and the placenta is not yet fully developed. The development of two or more consecutive miscarriages is called habitual miscarriage or habitual miscarriage.
Classification
According gestation abortions are divided into early, up to 10-12 weeks, and later, from 12 to 26-28 weeks.
Spontaneous abortion include:
- spontaneous miscarriage,
- anembrioniyu (empty, no embryo fertilized egg)
- missed abortion.
By process step can be divided threatened abortion, miscarriage started, in the course of miscarriage, miscarriage accomplished.
According to the degree of separation from the fruit stand out of the uterine cavity full of miscarriage when the fetus is completely out of the cavity uterus and she declined, part-time - when the fetus is partially peeled from the uterine cavity, but was unable to leave her cavity.
Causes
The causes of miscarriage are many environmental factors and internal states of the organism. The main concern:
- chromosomal and genetic abnormality that causes the disease, incompatible with life,
- severe malformations, and are not compatible with life,
- violation of the balance of hormones - sexual, and adrenal hormones thyroid gland, Pituitary hormones,
- severe metabolic and somatic diseases - diabetes, obesity, hypothalamic syndrome, Hypertension, kidney disease,
- genital infections,
- viral infections in early pregnancy,
- violation of the structure of genital organs (fibroids, Partitions, structural abnormalities of the uterus)
- disturbances in the cervical region, with its failure,
- appearance Rh conflict
- autoimmune pathology.
It increases the risk of spontaneous abortion:
- pregnancy by IVF,
- multiple pregnancy,
- smoking and alcohol.
- previous abortions and miscarriages,
- stresses,
- heavy exercise,
- baths,
- taking medication,
- vitamin deficiency,
- injury.
development mechanism
With the threat of miscarriage is increased tone of the uterus, which interferes with fetal nutrition, but it is also detachment, as a rule, no. At the same time the fruit of a living and can eliminate the cause of his suffering and to continue the pregnancy.
Next begins to occur detachment of the ovum, are beginning to appear naked and bleeding vessels.
With a small detachment of possible continuation of the pregnancy with timely assistance.
The progression of the process leads to a complete detachment of the ovum and its exit from the uterus, which is accompanied by bleeding.
signs of miscarriage
With the threat of a miscarriage occur:
- abdominal pain or cramping in nature drawing,
- sukrovichnye or mucous from the genital tract.
- increases tone of the uterus, its size is reduced,
- cervical area is closed, its length is normal,
- the fetus normal heartbeat, his normal development.
Which began miscarriage appears:
- severe pain,
- bloody discharge from the genital tract,
- ajar cervix uteri.
Miscarriage in the course enhances all manifestations:
- profuse bleeding,
- pain cramping in nature,
- opens the cervix,
- fertilized egg in the neck area or in the vagina,
- uterine size dramatically less time.
With the full fruit of abortion is completely expelled, the uterus contracts and the bleeding stops.
Incomplete miscarriage in the uterus are the elements of the ovum, which requires medical intervention to save the life of the mother.
The major complications of abortion are:
- habitual abortion,
- threatening bleeding life
- infection of the uterus.
Diagnostics
The basis of diagnosis of miscarriage are described above clinical manifestations and examination of the uterus on the chair.
With the threat of miscarriage is necessary to conduct ultrasound of the fetus and pelvis to determine the status and viability of the fetus, the degree of detachment and the possibility of continuing the pregnancy.
If necessary, a complete blood count, blood test for hormone levels, blood coagulation (coagulogram).
When an accomplished abortion material compulsorily sent for histological examination.
Treatment for miscarriage
treatment strategy depends on the stage of miscarriage. With the threat of interruption or a small area of detachment is used all methods of preservation of pregnancy:
- full of sexual and physical rest,
- hospitalization
- use of hormone replacement maintenance therapy,
- antispasmodics, tocolytics (magnesia solution was, papaverine),
- sedation with the purpose of removing the panic and fear,
- vitamin.
With a large amount of detachment or death of the embryo shown scraping the uterine cavity to remove the remnants of the ovum. This is shown and incomplete abortion.
After the operation is carried out:
- oxytocin for the purpose of uterine contractions,
- antibiotics,
- vitamins and nourishing diet.
After discharge from the hospital shows complete examination to ascertain and eliminate the causes of miscarriage.
prevention
Pregnancy when an abortion in the future need to be carefully planned, having passed all the necessary tests. It is necessary to maintain a healthy lifestyle. Refusal of bad habits and closely monitored from the very first stages of pregnancy.
Some studies in pregnancy
- Smears during pregnancy.
- Tests during pregnancy by trimester.
- Ultrasound during pregnancy.
- Urinalysis in pregnancy.
- Coagulation.
- Installing pessary.
- Glucose tolerance test.
- Homocysteine in pregnancy.
- Amniocentesis.
- Anesthesia during childbirth.
- Fetal CTG (cardiotocography)
- Cordocentesis.
- Epidural anesthesia during childbirth.
