Threatened miscarriage

Introduction Threatened abortion refers to a small amount of intravaginal bleeding and/or lower abdominal pain before 28 weeks of gestation. The cervix is not open, the membrane is not broken, the pregnancy is not discharged, and the size of the uterus is consistent with the number of menopause; the clinical manifestation of early threatened abortion The performance often has early pregnancy reaction after menopause, and then there will be a small amount of bleeding in the vagina, or now, or dripping, red, for several days or weeks, no abdominal pain or slight lower abdominal pain, low back pain and lower abdominal bulge. The main manifestation of threatened abortion is that after pregnancy, there is a small amount of bleeding in the vagina. The color can be bright red, pink or dark brown depending on the amount of bleeding and the time of accumulation in the vagina. Sometimes accompanied by mild lower abdominal pain, fetal movement has a sense of falling, backache and bloating. According to the folk tradition, the main basis for threatened abortion is seeing red.

Cause

There are many reasons for threatened abortion, such as abnormal pregnancy, endocrine disorders, placental dysfunction, blood group incompatibility, maternal systemic disease, excessive mental stimulation, genital malformation and inflammation, trauma, etc., can lead to threatened abortion. In early spontaneous abortions, 50%-60% of pregnancies have chromosomal abnormalities. If a couple has a chromosomal abnormality, it can be passed on to the offspring, which can lead to miscarriage or repeated abortion.

an examination

Related inspection

Human chorionic gonadotropin (HCG) progesterone obstetrics B-ultrasound test system fetal ultrasound examination

1. History: There is no history of repeated abortion, with or without abdominal pain, with or without fever, changes in vaginal secretions.

2. Physical examination: body temperature, pulse, respiration, blood pressure, etc., gynecological examination to see if the cervix is dilated, whether the amniotic sac bulges. The size of the uterus is the same as the number of weeks of menopause.

3. Auxiliary examination: B-ultrasound, pregnancy test, progesterone determination.

4. There is a doubling time of blood hCG level in normal early pregnancy, and blood hCG can be continuously measured to understand the fetus. If the blood hCG level rises less than 65% every 48 hours, it may indicate a poor prognosis of pregnancy.

Differential diagnosis

1. There is a small amount of bleeding in the vagina in early pregnancy, and there is a slight paroxysmal contraction. The cervix is not dilated, and the size of the uterus is consistent with the number of menopause.

2. Positive pregnancy test.

3. Ultrasound examination has fetal heartbeat, fetal sac and fetal movement.

4. Methods for estimating the prognosis of abortion:

1 In vaginal cell smears, such as keratinocytes more than 30%, the prognosis is poor.

2 basal body temperature in early pregnancy: a prognosis of abortion and a decrease in body temperature, and a poor prognosis in patients with reduced basal body temperature.

Determination of 3 human chorionic gonadotropin (HCG): If the level of chorionic gonadotropin is decreasing, the prognosis is poor.

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