Inevitable or inevitable miscarriage

Introduction It is inevitable that abortion will inevitably lead to abortion, and it is generally developed by threatened abortion. At this time, vaginal bleeding increased, paroxysmal abdominal pain gradually increased, or vaginal water (rupture of the membrane). The result of the examination is that the cervix has been dilated, there is tissue blockage or water outflow, or seeing the capsular sac bulge, the uterus and the number of menopause weeks are generally small or inevitable abortion.

Cause

The causes of miscarriage are complex and diverse. The most common causes of early abortion are chromosomal abnormalities, endocrine abnormalities, uterine dysplasia or deformities.

First, chromosomal abnormalities

Chromosomal abnormalities include abnormal chromosome numbers, such as monomer, trisomy, and polyploid; structural abnormalities such as breaks, deletions, and translocations can cause abortion. Chromosomal studies of spontaneous abortions and therapeutic abortions have found that 60% of karyotype abnormalities occur in spontaneous abortions. A karyotype abnormality is accompanied by a structural abnormality such as a fetus or a placenta. The fetuses with abortion in normal karyotype are more normal.

Second, endocrine disorders

Excessive estrogen and progesterone deficiency are also causes of early abortion. Because it is in the period of placenta formation instead of pregnancy luteal function in the 12-14 weeks of pregnancy, it is easy to have endocrine disorders, especially the luteal function. In addition, the lack of thyroxine, the cell's oxidation process is impeded, and hyperthyroidism and diabetes are prone to miscarriage.

Third, placental abnormalities and endocrine insufficiency in the early pregnancy, decidual inflammation can cause decidual hemorrhage or hyperplasia, villus epithelial cells and decidual cells are dissolved, vascular obstruction in the villi, affecting the absorption and transport of nutrients, resulting in pregnant eggs Isolation from the attachment, bleeding and abortion. In addition, such a large infarction in the placenta can reduce the function of the placenta, affecting the survival of the fetus; and the placenta, placental villus edema and degeneration into abortion is not uncommon. In the maternal blood after pregnancy, -hCG, hPL, P, E2, estrone, if these hormone values decrease in early pregnancy, 50% abortion.

Fourth, blood type incompatibility

Due to the previous pregnancy or blood transfusion, the Rh factor and the incompatible ABO blood group factor produce antibodies in the mother. The pregnancy enters the fetus from the placenta and the red blood cells aggregate to produce hemolysis, resulting in miscarriage.

Five, mental and neurological factors

Such as fright, severe mental stimulation, etc. can also cause miscarriage. In recent years, through research, noise and vibration have a certain impact on human reproduction.

6. Maternal systemic diseases

(1) Severe acute infectious diseases and infectious diseases: such as lobar pneumonia, many with high fever leading to uterine contraction, or / and embryo death can cause miscarriage.

(B) chronic diseases: severe anemia, heart disease, heart failure can cause fetal hypoxia, asphyxia and death; chronic nephritis, severe hypertension can cause infarction or early stripping of the placenta and cause miscarriage.

(3) Malnutrition or drug poisoning: such as vitamin deficiency, especially the lack of vitamin E-tocopherol, chronic poisoning such as mercury, lead, alcohol and morphine, can cause miscarriage.

Seven, reproductive organs diseases

Uterine malformations, such as the double-horned uterus, the uterine cavity mediastinum, are often the cause of miscarriage. But uterine dysplasia is often the cause of infertility. In addition, such as uterine fibroids, especially submucosal fibroids that develop into the uterine cavity or ovarian cysts that are embedded in the epiphysis, can affect the development of the fetus and cause miscarriage. Relaxation of the uterus is one of the common causes of habitual abortion. In recent years, about 14% of patients with intrauterine adhesions have developed after abortion. Adhesion causes uterine contraction, deformation, and reduction of endometrial area, and hardening, affecting embryonic development.

Eight, immune factors

For those whose causes are unknown, recent studies have found that most of them are closely related to immune factors.

(1) Histocompatibility locus antigen (HLA): The HLA complex is located on a segment of the short arm of the sixth pair of chromosomes of humans, including at least 4 gene loci associated with transplantation: HLA-A, B, C, D/DR, etc. HLA incompatibility in normal pregnancy can maintain genetic diversity and prevent the production of lethal homozygotes. The frequency of HLA antigen compatibility between habitual abortion couples is greater than that of normal pregnancy, and the chance of DR antigen is the same. Excessive consensus antigens prevent the mother from recognizing the pregnancy as an allogeneic antigen, and cannot stimulate the mother to produce antibodies required for maintenance of pregnancy, and lack the regulation of antibodies. The maternal immune system is susceptible to an immunological attack on the fetus, leading to miscarriage.

(B) anti-phospholipid antibodies: a group of autoimmune antibodies, including lupus anti-coagulant antibody (LA) and anti-cardiolipin antibodies (acl). In recent years, studies have found that in autoimmune diseases, certain infections, drugs, or unexplained diseases, such as antiphospholipid antibodies, the incidence of habitual abortion is extremely high. Patients often have arteriovenous thrombosis, thrombocytopenia, and the cause of abortion is due to thrombosis, which causes dysfunction of the diaphragm or placenta. Antiphospholipid antibodies do not act on abortion in the early pregnancy, but in the middle and late pregnancy to cause fetal death. Antiphospholipid antibodies may be a factor in the middle and late abortion.

(3) Anti-sperm antibodies: In couples of recurent spontaneous abortion (RSA), studies have found anti-sperm antibodies in the serum of both sides or men. Animal experiments have shown that anti-sperm antibodies have the effect of killing embryos. This suggests that the presence of this antibody is associated with RSA. Domestically, it has been reported that the female anti-sperm antibody is more common, indicating that the woman's allogeneic immunity to sperm and her husband's autoimmunity are related to RSA.

Abortion caused by anti-sperm antibodies occurs in early abortions within 3 months, that is, sperm agglutination antibodies in the mother continue to act on the lesions of early embryonic tissues, causing embryo damage and miscarriage.

an examination

Related inspection

Vaginal bleeding test

Inevitable abortion refers to abortion is inevitable. From the development of threatened abortion, the amount of vaginal bleeding increased, paroxysmal lower abdominal pain increased or vaginal fluid (rupture of the membrane). Gynecological examination of the cervix has been dilated, sometimes visible embryonic tissue or fetal sac is blocked in the cervix, the size of the uterus is consistent with or slightly smaller than the number of menopause. If there are more and more vaginal bleeding during the process of miscarriage, the amount of menstrual flow is reached or exceeded, and the stomach is getting more and more painful. This indicates that the abortion has entered an inevitable stage, which is inevitable abortion. At this time, it is impossible to prevent miscarriage. Further development, there may be a part of the organization, that is, pink meat-like things are discharged from the vagina.

Differential diagnosis

Abortion must be differentiated from functional uterine bleeding, tubal pregnancy, hydatidiform mole, uterine fibroids, and chorionic epithelial cancer. In addition, various types of abortion should be identified in order to clarify the diagnosis and choose different treatments depending on the type.

Inevitable abortion refers to abortion is inevitable. From the development of threatened abortion, the amount of vaginal bleeding increased, paroxysmal lower abdominal pain increased or vaginal fluid (rupture of the membrane). Gynecological examination of the cervix has been dilated, sometimes visible embryonic tissue or fetal sac is blocked in the cervix, the size of the uterus is consistent with or slightly smaller than the number of menopause. If there are more and more vaginal bleeding during the process of miscarriage, the amount of menstrual flow is reached or exceeded, and the stomach is getting more and more painful. This indicates that the abortion has entered an inevitable stage, which is inevitable abortion. At this time, it is impossible to prevent miscarriage. Further development, there may be a part of the organization, that is, pink meat-like things are discharged from the vagina.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.