Spontaneous abortion

　　Even though we are very careful, some mothers are unfortunately still experiencing spontaneous abortion. Spontaneous abortion refers to abortion with a gestational age of less than 28 weeks and a fetus weighing less than 1000g. The causes include: endocrine disorders in pregnant women, defects in the embryo itself, placental abnormalities, and外伤 to pregnant women. Most spontaneous abortions are early abortions, that is, abortion around 12 weeks of pregnancy, with an incidence rate of about 15％ of all pregnancies. After being saddened, timely care is very important.

　　1. Genetic factors. If the fetus has an abnormal number or structure of chromosomes, it will lead to poor embryo development. In the case of spontaneous abortion, especially the abortion that occurs in the first three months of pregnancy, genetic factors account for 60％-70％, among which chromosomal abnormalities in aborted fetuses account for 50％-60％, and 10％ of the couple or both have chromosomal abnormalities.

　　2. Maternal diseases. Any disease suffered by the pregnant woman that is不利于 the growth and development of the fetus will cause fetal abortion.

　　3. External adverse factors. Such as: pregnant women smoking heavily or passive smoking, drinking, exposure to chemicals or toxins, living in a severe noise, high temperature and vibration environment, emotional excitement, etc., these factors will cause placental and fetal injury, causing abortion.

　　4. Male factors. About 10％-15％ of male seminal fluid contains a certain amount of bacteria, which is asymptomatic prostatitis and can cause abortion.

　　Women may lose confidence in pregnancy after a spontaneous abortion, and if they do not become pregnant after more than half a year, their confidence in pregnancy will quickly diminish. Studies have shown that the abortion rate among those who become pregnant again within three months after a spontaneous abortion is comparable to that of those who become pregnant three months later, both hovering around 16％~20％, and at the same time, the abortion rate is significantly higher among those who become pregnant more than a year after the interval than among those who become pregnant within a year. Therefore, if both husband and wife hope to have a child as soon as possible, and the woman's physical and mental recovery after a spontaneous abortion is complete, they can have a child as soon as possible.

　　1. Massive hemorrhage: It is the most common complication of inevitable or incomplete abortion, and severe massive hemorrhage can lead to hemorrhagic shock.

　　2. Infection: All types of abortions can be complicated by infection, but it occurs more frequently in incomplete abortion, often complicated with pelvic inflammation, peritonitis, systemic infection, and infectious shock.

　　Threatened abortion

　　Before 8 weeks of pregnancy, it often manifests as a small amount of vaginal bleeding, followed by frequent paroxysmal lower abdominal pain or back pain. Gynecological examination shows that the cervix is not open, the amniotic membrane is not broken, the products of conception have not been expelled, and the size of the uterus is consistent with the expected gestational age. After rest and treatment, some patients improve. If the amount of vaginal bleeding increases or the lower abdominal pain worsens, it may develop into inevitable abortion.

　　Inevitable abortion

　　Refers to the inevitable abortion. It develops from threatened abortion, at this time, the amount of vaginal bleeding increases, the cramping lower abdominal pain worsens, or vaginal discharge (rupture of the amniotic membrane) occurs. Gynecological examination shows that the cervix is dilated, and sometimes embryonic tissue or the fetal sac can be seen blocking the cervix, and the size of the uterus is consistent with or slightly smaller than the expected gestational age. At this time, uterine contractions gradually intensify, and the continuation of pregnancy tissue may be partially or completely expelled, developing into incomplete or complete abortion.

　　Incomplete abortion

　　Refers to the partial expulsion of the products of conception outside the body, with some remaining in the uterine cavity, which develops from inevitable abortion. Due to the remaining part of the products of conception in the uterine cavity, it affects the contraction of the uterus, causing continuous bleeding and even hemorrhagic shock due to excessive bleeding. Gynecological examination shows that the cervix is dilated, with continuous bleeding from the cervix, and sometimes placental tissue can be seen blocking the cervix or part of the products of conception have been expelled into the vagina, while some still remain in the uterine cavity. Generally, the uterus is smaller than the expected gestational age.

　　Complete abortion

　　Refers to the complete expulsion of the products of conception, with the gradual cessation of vaginal bleeding and the gradual disappearance of abdominal pain. Gynecological examination shows that the cervix is closed, and the uterus is close to normal size.

　　Missed abortion

　　Refers to the embryo or fetus that has died and remains in the uterine cavity without being naturally expelled. When it occurs in the early stage of pregnancy, it is also known as embryonic arrest. After the death of the embryo or fetus, the uterus no longer enlarges but shrinks, and the early pregnancy symptoms disappear. If it reaches the second trimester of pregnancy, the pregnant woman's abdomen does not enlarge, and the fetus movement disappears. Gynecological examination shows that the cervix is not open, the uterus is smaller than the expected gestational age, and the texture is not soft. No fetal heartbeat is heard.

　　Septic abortion

　　During the process of abortion, if the vaginal bleeding lasts too long, there is tissue left in the uterine cavity, or illegal abortion occurs, it may cause infection in the uterine cavity. In severe cases, the infection can spread to the pelvic cavity, abdominal cavity, and even the whole body, resulting in pelvic inflammation, peritonitis, septicemia, and infectious shock, known as abortion infection.

　　In the early stages of pregnancy, the embryo is very sensitive to various harmful or adverse factors, such as the invasion of certain drugs, radiation, and chemicals, bacterial and viral infections, as well as abnormal levels of endocrine hormones or a lack of certain nutrients in the body. These can cause defects in embryo development and ultimately lead to spontaneous abortion.

　　Some abortions are inevitable, that is, no matter what method is used, it is impossible to avoid the occurrence of abortion. Most spontaneous abortions are caused by incomplete embryos. These atrophic and deformed follicles have 60% to 70% due to chromosomal abnormalities or problems with the sperm itself. After the sperm reaches a certain level, it will atrophy and eventually lead to stillbirth or abortion. Pregnant women should not be too sad, because this is a natural selection and way of natural selection in the process of human reproduction.

　　Pregnant women should understand the preventive measures for abortion:

　　① Plan to give birth at an appropriate age, do not become a geriatric mother or a geriatric father.

　　② Pay attention to balanced nutrition, supplement vitamins and minerals.

　　③ Develop good living habits, maintain regular daily routines, learn to calm emotions, and relieve work pressure.

　　④ Improve the working environment, avoid all pollutants. Adjust the living environment of the residence and keep the residence well-ventilated.

　　⑤ Women with a short luteal phase or insufficient secretion should supplement progesterone during the mid-menstrual period and the early stages of pregnancy.

　　⑥ If there are concurrent medical diseases, they should be treated actively first, and it is best to consider pregnancy after the condition is controlled or stable for a period of time.

　　⑦ Women with habitual abortion (more than 3 spontaneous abortions) should undergo comprehensive examinations, including gynecological ultrasound, special antibody monitoring, endocrine testing, and chromosomal analysis of both partners' blood;

　　Some women often experience spontaneous abortion during their happy pregnancy, which undoubtedly causes great psychological and physical harm. Experts suggest that some checks should be done after a spontaneous abortion. So, what checks should be done after a spontaneous abortion?

　　What checks need to be done after a spontaneous abortion

　　Chapter 1: Examination of the female reproductive tract

　　Check whether there are any malformations in the female reproductive organs, and whether the cervical os is relaxed or not;

　　Chapter 2: Examination of blood types

　　Check whether the blood of the pregnant woman and the fetus is mixed, and check the ABO and Rh blood types of both partners, as well as the anti-A, anti-B antibodies, and related antibodies against Rh;

　　Chapter 3: Examination of chromosomes

　　Examine whether there are any abnormalities in the chromosomes of both partners, and if one of the parents has an abnormal chromosome, they should not get pregnant or terminate the pregnancy in time.

　　Chapter 4: Examination of the environment

　　Check the environment in which the pregnant woman is located, whether she is exposed to toxic substances such as lead and mercury, and whether she is exposed to radioactive substances such as X-rays;

　　Chapter 5: Examination of a woman's physical condition

　　Through infection or endocrine abnormalities, examine whether there are any abnormalities in a woman's body, such as hypothyroidism or hyperthyroidism, diabetes, or immune system abnormalities; and check for nutritional deficiencies, such as folic acid deficiency, and whether the mother smokes or drinks excessively;

　　The introduction above not only introduces what checks should be done for women after spontaneous abortion, but also can clearly identify the causes of frequent spontaneous abortion in women, thus enabling timely and effective treatment to prevent the recurrence of tragedies.

　　Firstly, ensure the supply of high-quality protein, adequate vitamins and inorganic salts, especially sufficient iron to prevent anemia.

　　Food selection should not only be nutritious but also easy to digest and absorb. Fresh fish, tender chicken, eggs, animal liver, animal blood, lean meat, soy products, milk, jujube, lotus seeds, fresh fruits and vegetables can be provided.

　　Eat more easily digestible foods. The time for nourishment should be about half a month. For those with weak bodies, poor constitution, and excessive bleeding, the time for nourishment can be appropriately extended.

　　Avoid or eat less greasy, cold, and raw foods. It is not advisable to eat radishes, hawthorn, bitter melon, tangerines, and other foods with properties of promoting Qi, promoting blood circulation, and being cold in nature.

　　1. Threatened abortion should rest in bed and avoid sexual activity. Sedatives, vitamin E, progesterone, and other agents may be administered if necessary.

　　2. Inevitable abortion and incomplete abortion must be cleaned out of the uterine cavity in a timely manner. For those with shock due to excessive bleeding, shock should be corrected first, the uterine cavity should be cleaned, and uterine contraction agents should be given to stop bleeding.

　　3. Before the operation of curettage for missed abortion, a coagulation function test must be performed. If there are abnormalities, appropriate treatment should be carried out before the curettage operation. Prepare for intravenous fluid and blood transfusion before and during the operation to prevent excessive bleeding when scraping the adherent and organized placenta, and timely administration of uterine contraction agents.

　　4. Infection-related abortion must be treated with antibiotics for several days, and the uterine cavity should be cleaned in a timely manner to prevent the spread of inflammation.

　　5. Habitual abortion should strive to find the cause and treat it accordingly. Both males and females should undergo a comprehensive physical examination and examination of the urinary and reproductive organs before pregnancy. If possible, chromosomal examination, ABO and Rh blood typing, immunological and trace element tests should be performed.

　　6. Early pregnancy bleeding should be differentiated from hydatidiform mole, ectopic pregnancy, and other conditions. The tissue masses discharged from the vagina should be sent for pathological examination.