Miscarriage is not only a physical trauma for a woman, but also a moral one. It is for this reason that the article below has collected the maximum amount of information about the diagnosis, causes, symptoms, treatment, and prevention of spontaneous miscarriage.
Miscarriage in the early stages is a very sad and, unfortunately, quite common phenomenon. According to statistics, every eighth woman's pregnancy is terminated in the first twelve weeks. Most of them experience a miscarriage without knowing they were pregnant. And some are already told about the possibility of losing the fetus at the first consultations and are advised to lie down for preservation.
Medicated abortion is considered to have the least impact on a woman's reproductive function and he alth. It is very important not to miss the deadline.
Abortion may not be noticed by a woman in the early stages. The postponement of menstruation is simply written off as a delay, and afterprofuse bleeding begins, which is accompanied by a sensation of pain. When the fetus comes out completely, the bleeding and pain stop, and the woman may never know she was pregnant.
If the fetus does not come out completely, which is the cause of prolonged bleeding, women, as a rule, turn to a specialist who ascertains miscarriage. Most doctors, in order to restore the female body, prescribe a course of medical therapy after such a case.
Reasons
Causes of miscarriage can be as follows:
- Hormonal failure.
- Genetic abnormalities.
- Infectious diseases.
- Rh factor.
- Drugs.
- Injuries.
- Abortion in the past.
The threat of termination of pregnancy in the second trimester is noticeably reduced. According to statistics, only one in 50 women miscarry in the second trimester.
So, let's take a closer look at the causes of miscarriage listed above.
Hormonal disruption
In the female body, hormones and their correct balance are a necessary condition for the normal course of the pregnancy process. In some cases, a failure in the hormonal background can result in a breakdown. Specialists secrete progesterone as a very important hormone that is required to maintain pregnancy. If its deficiency was detected in a timely manner, the woman is prescribed this hormone in the form of medicines, inAs a result, the fetus is saved.
In addition, the balance of androgens affects the safety of the fetus. With their excess in the body of a pregnant woman, the production of estrogen and progesterone is inhibited, and this is also a threat of miscarriage.
Infectious diseases
In preparation for pregnancy, a woman should treat all existing chronic diseases. In addition, it is recommended to avoid infectious diseases. Indeed, when a pathogen enters the female body, the temperature can rise sharply, which will also provoke miscarriage.
A separate threat to the fetus are diseases that are sexually transmitted. Therefore, future parents in preparation for pregnancy should be examined and tested for these diseases. Due to the fact that this type of infection enters the fetus through the blood, in most cases, in the presence of pathology, miscarriage is diagnosed.
Genetic abnormalities
The lion's share of all miscarriages occur for this very reason. Doctors call the figure 73% of their total number. In today's world, this factor plays a huge role. Poor-quality products, radiation contamination, polluted ecology - all this affects the female body every day.
Today, preparing for pregnancy, many women are trying to leave the polluted noisy city and spend this time in the most suitable environment. Although these factors are not easyeliminate the mutations associated with them are not considered hereditary, the next pregnancy may be successful.
Rh factor
This factor almost always provokes abortion in the early stages. For this reason, if a woman has a negative Rh factor, and a man has a positive one, this state of affairs can provoke an Rh conflict and, as a result, miscarriage.
Today, medicine has learned to cope with this problem by introducing progesterone into the female body. Thus, the fetus is protected from the aggressive female immune system. However, even in this case, the problem of miscarriage may arise.
Drugs
Experts recommend avoiding medication during this period, especially in the early stages. It is very important to exclude all analgesics and hormonal drugs. It is also undesirable to use folk recipes in which St. John's wort, nettle, cornflowers and parsley are present as ingredients.
Stress factors
Sudden grief, family quarrels or stress at work are all causes of early miscarriage. These factors should be minimized or, if possible, avoided. An important role in creating a calm environment for a woman belongs to a man. If it is not possible to avoid the action of stress factors, then doctors in this case prescribe light sedatives.
Bad habits
Even before conception, you need to stop takingalcohol and quit smoking. Smoking can adversely affect the fetal cardiovascular system. It is recommended to build a consistent system of he althy nutrition, with a set of essential minerals and vitamins. It is also necessary to adjust the daily routine.
Injuries
Along with the factors listed above, early miscarriage can provoke a strong blow, falling or lifting heavy objects. Therefore, you should behave as carefully as possible.
Abortions in the past
This is not only an argument used to intimidate young women, but also a real factor in future problems. In some cases, abortion can lead to infertility and provoke chronic miscarriage.
Diagnosis
Miscarriage is a multifactorial disease in which in many patients it is combined with several pathogens at the same time. For this reason, the examination of patients should be carried out comprehensively and include all modern laboratory, instrumental and clinical methods.
During the examination, not only the causes of spontaneous miscarriage are established, but also the state of the reproductive system is assessed in order to subsequently prevent the occurrence of such a condition.
Pre-pregnancy screening
The anamnesis includes clarification of the presence of somatic, oncological, hereditary diseases and neuroendocrine pathology. Gynecological history allows to determine the presence of a viralinfections, inflammatory diseases of the genitals, features of reproductive and menstrual function (spontaneous miscarriages, childbirth, abortions), methods of therapy and other surgical interventions, gynecological diseases.
In the course of a clinical examination, an examination is performed, an assessment of the condition of the skin, thyroid gland and the degree of obesity in accordance with the body mass index. According to the hirsute number, the degree of hirsutism is determined, the condition of the internal organs is assessed, as well as the gynecological status. The absence or presence of ovulation, the functional state of the ovaries are analyzed according to the menstrual calendar and rectal temperature.
Laboratory and instrumental research methods
Diagnosis of miscarriage consists of the following tests:
- Hysterosalpinography - carried out after the menstrual cycle on days 17-13, allows you to exclude intrauterine synechia, uterine malformations, ICI.
- Ultrasound - determines the presence of adenomyosis, cysts, uterine fibroids, assesses the condition of the ovaries. Clarifies the condition of the endometrium: endometrial hyperplasia, polyps, chronic endometritis.
- Infection screening - it includes microscopic examination of smears of the vagina, urethra, cervical canal and bacteriological examination of the contents of the cervical canal, PCR diagnostics, testing for virus carriers.
- Hormonal study. It is carried out on the 5th or 7th day of the cycle, providedregular menstruation, in patients with oligo- and amenorrhea - for any day. The content of 17-hydroxyprogesterone, DHEA sulfate, cortisol, testosterone, FGS, LH, prolactin is determined. Progesterone can only be determined in patients with a regular cycle: in the first phase of the cycle on days 5-7, in the second phase of the cycle - on days 6-7 of the rise in rectal temperature. In women with adrenal hyperandrogenism, a small test with dexamethasone is performed to determine the optimal therapeutic dose.
- To determine the risk of miscarriage, it is necessary to determine the presence of anticardiolipin antibodies, anti-CHG and analyze the features of the hemostasis system.
- If a pathology of the endometrium and / or intrauterine pathology is suspected, a diagnostic curettage is performed under the control of hysteroscopy.
- If you suspect the presence of adhesive stress in the pelvis, tube pathology, genital endometriosis, with scleropolycystic ovaries and uterine myoma, operative laparoscopy is indicated.
- Examination of a man includes the determination of a hereditary history, analysis of a detailed spermogram, the presence of neuroendocrine and somatic diseases, as well as clarification of inflammatory and immune factors.
After the causes of habitual miscarriage are determined, a set of therapeutic measures is prescribed.
Pregnancy screening
Surveillance during pregnancy should begin immediately after pregnancy, and it consists of the following research methods:
- Determination of DHEA sulfate and DHEA.
- Periodic determination of hCG in the blood.
- Ultrasonic scanning.
- If necessary, counseling with a psychotherapist and psychologist.
Prevention
According to statistics, the frequency of spontaneous miscarriage is 1 in 300 pregnancies. Despite the fact that the probability of miscarriage decreases with an increase in the term, in the last trimester this figure is about 30%. It also often happens that premature birth and miscarriage in a woman occur repeatedly. As a result, a diagnosis is established - habitual miscarriage (treatment will be discussed below).
The causes of this disease are diverse, in most cases, a whole complex of them leads to premature birth or miscarriage. Moreover, their action can be both sequential and simultaneous. A woman who has a tedious job, combined with nervous and physical overload, or a low socio-economic status, automatically falls into the risk group.
In addition, the factors that increase the likelihood of pathology include diabetes mellitus, kidney disease, bronchial asthma, vascular and heart disease, regular intoxication with drugs, alcohol, and tobacco smoke. If a woman has pregnancy complications, or an obstetric history is burdened, then this also applies to risk factors for spontaneous miscarriage or interruption.pregnancy. It is important to remember that in the short term, spontaneous abortion may be a biological mechanism of natural selection, for this reason, a miscarriage is not yet a harbinger of a subsequent unsuccessful pregnancy.
In fact, the prevention of miscarriage comes down to two main points:
- Timely examination of the body of a woman and a man.
- He althy lifestyle.
It is very important to determine the presence of hereditary diseases, infections in a man, conduct a semen analysis and complete the treatment of all existing problems.
Women face a more difficult task. It should be clarified whether there were somatic, neuroendocrine, oncological diseases, how things are with hereditary pathologies.
Also, as part of prevention, the features of reproductive and menstrual functions are studied, the presence of obesity and its degree are ascertained, the condition of the skin is assessed.
It is advisable to apply for instrumental examinations. Quite informative is hysterosalpingography, which is performed in the second half of the menstrual cycle. As a result, it is possible to find out if the patient has intrauterine pathologies. The results of ultrasound of the pelvic organs allow diagnosing the presence of endometriosis, fibroids, cysts, as well as assessing the condition of the ovaries.
It is important to examine swabs from the urethra, cervical canal and vagina. It is advisable to perform a hormonal study in the first half of the menstrual period.cycle. In addition, it is necessary to think about a blood test, which will include clotting indicators. This will determine the presence of antibodies such as anti-CHG, anticardiolipin and lupus.
Treatment
Treatment of miscarriage occurs in the following sequence: clarification and subsequent elimination of the cause.
One of the reasons is the infection of the fetus, which occurs as a result of infection of the amniotic fluid or penetration of pathogens through the placenta. In this case, spontaneous abortion occurs after the contractile activity of the uterus, triggered as a result of acute intoxication or premature outflow of amniotic fluid, which is due to a change in the structure of the fetal membranes under the influence of infectious agents. Treatment in such a situation can be successful, as the child's ability to withstand negative factors increases with increasing gestational age.
In measures to prevent this disease, it is necessary to include consultations with an endocrinologist, since hormonal deficiency can lead to pathological restructuring of the endometrium and its depletion, which is also considered a prerequisite for miscarriage. Hyperandrogenism (a pathological condition) is also characterized by a hormonal nature and can be the cause of spontaneous interruption.
Acquired or congenital organic pathology of the organs of the reproductive system is also the cause of miscarriage. In addition, the causes of this disease should include psychological overload, stress, actionscertain drugs, diseases of a different nature, intimate life during pregnancy.
Even when recurrent miscarriage is diagnosed, the possibility of spontaneous abortion can be significantly reduced under the condition of constant monitoring by specialists and comprehensive prevention.
