Threatened abortion

　　The main cause of threatened abortion is chromosomal abnormality. Chromosomal abnormalities include two major categories: quantitative abnormalities and structural abnormalities. Studies have shown that 50%-60% of the products of early spontaneous abortion have chromosomal abnormalities. If one of the couple has a chromosomal abnormality, it can be passed on to offspring, causing abortion or recurrent abortion. In addition to chromosomal abnormalities, there are also maternal factors. The specific situation of maternal factors is as follows:
　　1. Systemic diseases: High fever during systemic infection can induce uterine contraction and cause abortion. Certain known pathogens, such as toxoplasmosis, herpes simplex, human mycoplasma, ureaplasma, and cytomegalovirus, are associated with abortion. Diseases such as heart failure, severe anemia, hypertension, chronic nephritis, and severe malnutrition, which are ischemic and hypoxic diseases, can also lead to abortion. There are also endocrine abnormalities such as insufficient luteal function, hypothyroidism, and uncontrolled diabetes.
　　2. Abnormal immune function.
　　3. Severe nutritional deficiency.
　　4. Bad habits: such as smoking, excessive drinking, excessive coffee consumption, or the use of drugs such as heroin.
　　5. Adverse factors in the environment: harmful chemical substances such as formaldehyde, benzene, and lead.
　　6. Uterine defects: such as congenital uterine malformations, submucosal fibroids, uterine cavity adhesions, etc.
　　7. Trauma: such as abdominal compression or rapid impact, even excessive surgery, sexual intercourse, etc.
　　8. Emotional trauma: such as excessive fear, sadness, anger, etc.

　　Threatened abortion can develop into abortion. Sometimes inevitable abortion or incomplete abortion can cause severe blood loss, even shock. Therefore, it should be actively treated, and various measures can be carried out simultaneously. All types of abortion can be complicated by infection, and infection occurs more frequently in incomplete abortion. Infection can be confined to the uterine cavity, or it can spread to the surrounding uterus, forming salpingitis, salpingo-ovarian inflammation, pelvic adnexal inflammation, or even beyond the reproductive organs to form peritonitis, sepsis. Patients may experience chills and fever, abdominal pain, vaginal bleeding, and sometimes foul-smelling discharge. The uterus and adnexa are tender, the uterus does not recover well, and there is an increase in white blood cells, showing signs of inflammation. Severe cases may develop into infectious shock. Blood, cervical, or uterine cavity secretion smears and cultures (aerobic and anaerobic bacteria) and B-ultrasound examination can be performed to check for retained tissue in the uterine cavity.

　　The initial symptoms of threatened abortion are often vaginal bleeding, usually with little bleeding, often dark red or blood-stained leukorrhea, which may last for 4-5 days to more than a week. Within a few hours to several weeks after the onset of bleeding, there may be mild lower abdominal pain or back pain, and after 12 weeks of pregnancy, the patient may sometimes feel intermittent abdominal pain. Gynecological examination shows that the cervix is not open, there is no expulsion of pregnancy material, and the size of the uterus is consistent with the menstrual cessation time. Most spontaneous abortion patients have a clear history of amenorrhea.

　　To prevent threatened abortion, pregnant women should rest more in bed, reduce their activities, but it does not mean that they should stay in bed without moving for 24 hours. They should appropriately engage in mild activities. It should be noted that sexual activity must be prohibited, and unnecessary vaginal examinations should be reduced to minimize the stimulation of the uterus. In addition, it is also necessary to avoid stimulating the breasts, as stimulation of the breasts can also cause uterine contractions, leading to threatened abortion.
　　Pregnant women should also pay attention to observing whether there is any tissue discharged from the vaginal discharge at any time, and the discharged material should be preserved for the doctor to observe. If there is an increase in bleeding, it is necessary to go to the hospital for treatment in a timely manner. If pregnant women experience lower back pain or a feeling of abdominal distension in the lower abdomen, which does not subside even after rest, or even worsens, they should be vigilant. If there is an increase in lower abdominal pain, accompanied by vaginal bleeding and the discharge of tissue-like material, it should be reported to the doctor immediately.

　　The main observation for early pregnancy, especially in cases of threatened abortion with short menstrual cessation, is the possibility of continuing the pregnancy. The main auxiliary diagnostic methods are ultrasound and detection of blood hCG levels. In normal early pregnancy, there is a doubling time for blood hCG levels, and blood hCG can be continuously measured to understand the fetus's condition. If the blood hCG level does not increase by less than 65% every 48 hours, it may indicate poor pregnancy prognosis. At the same time, the continuous monitoring of ultrasound is also of great significance. If only the fetal sac is seen and the fetus does not appear in time, or if the fetus is seen but the fetal heartbeat does not appear in time, it may indicate poor prognosis.

　　Pregnant women suspected of having threatened abortion should pay attention to a balanced diet, pay attention to the intake of nutrition during pregnancy, and the dietary taboos are mainly as follows:
　　Recommended:
　　1. It is recommended to eat light, easy to digest, and nutritious foods. For those with Qi and blood deficiency, light tonification is recommended, and foods such as milk, soy milk, soy products, lean meat, eggs, pork heart, liver, kidney soup can be consumed.
　　2. Different types of syndrome should consume different foods. Those with Qi deficiency should eat more Qi-tonifying and fetus-stabilizing foods, such as Ginseng Soup, Chicken Soup, Millet Porridge, etc. Those with blood deficiency should nourish the blood and stabilize the fetus, and should eat glutinous rice porridge, longan, black fungus, jujube, Osmanthus, lamb, sheep脊, sheep kidney, Cordyceps sinensis, black bean, etc. Those with blood heat should clear heat and nourish the blood, and should eat luffa, reed root, pear, yam, pumpkin, etc.
　　Avoid:
　　1. Whether it is deficiency or excess, avoid Coix Seed, Cinnamon, Dried Ginger, Peach Kernel, Crab, Rabbit Meat, Hawthorn, Winter Melon Seed, Water Chestnut, etc.
　　2. Those with blood heat should avoid spicy and stimulating, greasy, and humid foods, such as chili, lamb, dog meat, pork head meat, ginger, scallion, garlic, wine, etc.
　　3. Those with deficiency should avoid cold and cool foods, such as cold fruits and vegetables, cold drinks, and ice products.

　　If threatened abortion occurs, pregnant women should pay attention to rest, reduce activity, prohibit sexual life, avoid unnecessary vaginal examination, reduce stimulation to the uterus, and at the same time avoid excessive mental tension, otherwise it may cause abortion. After the bleeding stops, it is best to rest for two weeks before returning to work. This treatment method for threatened abortion is suitable for women with mild threatened abortion symptoms.
　　In addition to this, progesterone has the effect of ensuring embryo development, maintaining pregnancy, inhibiting uterine smooth muscle contraction, and reducing uterine tension. The treatment method of threatened abortion with medication in the early pregnancy can use progesterone to preserve the fetus, or can be treated with intramuscular injection of chorionic gonadotropin (because this hormone has the effect of stimulating luteal function). In the middle and late pregnancy, sedatives and β-blockers can be used to reduce mental stimulation and inhibit uterine contraction. In addition, oral vitamin E is also beneficial to maintain embryo development.