The term "spontaneous abortion" in obstetrics is usually used to refer to the complication of the pregnancy process, in which its interruption occurs for up to 22 weeks. This spontaneous termination of gestation does not allow the fetus to reach a mature state, its death occurs. Consider in detail the causes of the violation, signs, methods of therapy.
Why does miscarriage occur?
The reasons for spontaneous abortion are so diverse that it is difficult to determine exactly which one caused the miscarriage. Among the main reasons for it at the initial stages of gestation, doctors call chromosomal abnormalities. Many gene disorders cause a malfunction in the process of intrauterine bookmarking of the axial organs, as a result - miscarriage at an early stage. Among other reasons:
- disruption of the endocrine system - a lack of progesterone , hypothyroidism;
- autoimmune diseases to women (antiphospholipid syndrome);
- congenital anomalies in the structure of the reproductive system - bicornic uterus , the presence of a septum in the uterine cavity;
- inflammatory and tumor-like processes in the uterus - myoma, adhesions, endometritis , adnexitis, oophoritis;
- presence of abortions in the anamnesis;
- infectious processes in the body - chlamydia, mycoplasmosis, toxoplasmosis, influenza, which can occur after conception.
The risk of developing spontaneous abortion is significantly increased when (spontaneous early abortion):
- habitual miscarriage;
- multiple pregnancy;
- Rhesus-conflict;
- the presence of diabetes in a woman;
- renal failure;
- deficiency of folic acid in the body;
- presence of IUDs at conception.
Miscarriage in early pregnancy
The threat of miscarriage in the early stages of gestation is often associated with a violation of the implantation process. In this case, a failure occurs at the stage of introduction of the fetal egg into the wall of the uterus. As a result, a destructive process is observed, which leads to the death of the future fetus. In addition, spontaneous abortion at an early stage can be caused by hormonal disorders. A low level of hCG causes a failure of embryo development at the stage of division.
Late miscarriage
Not eliminated threat of spontaneous abortion at the beginning of pregnancy, on later terms provokes abortion of pregnancy It is caused more often by an incorrect course of the gestation process or by a woman's non-adherence to medical recommendations. Miscarriage at the term of 12-22 weeks is called late. Causes of complication are:
- chronic diseases of the reproductive system;
- genital tract infections - ureaplasmosis, chlamydia, gonorrhea;
- abdominal and abdominal injuries;
- violation of fetal development.
Symptoms of spontaneous abortion
Talking about the signs of miscarriage in the early stages of pregnancy, doctors among the first symptoms called uterine bleeding. With abortion, the embryonic membranes are detached from the uterine wall, in which the integrity of the blood vessels is disturbed, which is accompanied by:
- cramping pains in the lower abdomen;
- tachycardia;
- blanching of the skin;
- dizziness;
- weakness;
- lowering blood pressure.
Stages of spontaneous abortion
Depending on what clinical picture is observed in this complication, midwives distinguish the following stages of spontaneous abortion:
1. Threatening spontaneous abortion. This stage indicates a high risk of interruption of the onset of gestation. In this case, the woman fixes the appearance of the corresponding symptomatology:
- Stretching pains in the lower abdomen, giving in the lower back;
- scanty spotting from the vagina.
When a woman is examined by a gynecologist, there is an increase in the tone of the uterine myometrium, which is fixed with and palpation through the anterior abdominal wall. The cervix is not shortened at this stage, the internal pharynx is completely closed, and the size of the uterus body corresponds to the gestation period. When diagnosing complications at this stage, the outcome is favorable.
2. Started abortion. Characterized by the appearance of pronounced bloody discharge from the genital tract. Examination of the patient in the gynecological chair helps to establish the condition of the pharynx, which is slightly opened. Started spontaneous abortion is accompanied by a small opening of the cervix, but cramping contractions of the myometrium are absent.
3. Abortion in the course. At this stage, doctors fix the appearance of regular cramping contractions of the uterus. In this case, the size of the reproductive organ decreases - the size of the uterus does not correspond to the gestational age. Upon examination, the doctor fixes the opening of the external and internal throats, and the elements of the fetal egg or embryo are located in the cervical canal or vaginal cavity.
4. Incomplete abortion. It is characterized by a delay in the uterine cavity of the individual elements of the fetal egg, due to the absence of uterine contractions, the closure of the uterine cavity. As a result, prolonged uterine bleeding develops, leading to large blood loss.
5. Complete abortion. Occurs in late periods, accompanied by the full release of the fetal egg and the embryonic membranes. The uterus shrinks forcefully, and its size is shorter than the time. With ultrasound, the contours are clear, there are no remaining tissue in the cavity.
Is spontaneous abortion without blood?
Considering the symptoms of miscarriage in the early stages, it must be said that in some cases, bleeding may be absent. This makes it difficult to diagnose pathology. A similar situation is possible with an incomplete type, when the fetal egg does not leave the uterine cavity independently. Doctors spend a scraping, for exception of an infection - antibioticotherapia is appointed.
Miscarriage - what to do?
When there are drawing pains in the abdomen, bloody discharge from the vagina, deterioration of general well-being, the pregnant woman should consult a doctor. Depending on the stage of abortion, physicians develop tactics of therapy. In most cases, it reduces to:
- removal of membranes, tissues from the uterine cavity - cleansing after miscarriage is indicated for incomplete abortion;
- restoration of the volume of lost blood;
- prevention of reproductive system infection (antibiotic therapy);
- Prolongation of pregnancy is possible with threatening abortion, when detachment of the fetal egg does not occur.
Pregnancy after spontaneous abortion
After miscarriage, gynecologists are advised to refrain from planning pregnancy. In this case, women are recommended to use contraceptives to prevent the next gestation. It takes at least 6 months to restore the body. This time a woman can actively prepare for planning:
- to be screened for hidden infections;
- To pass or take place inspections for an establishment of the cause of abortion.