Embryo closure is not a sudden occurrence, it's just that many people ignore these 4 key signals...

For medical professionals only

Fetal cessation, there are these signs...

Having children, passing on the generations, and enjoying the joys of the world are the good wishes of countless couples who aspire to be parents. However, it is too difficult for the family below.

A 31-year-old woman, married for 4 years, has been pregnant 3 times in the past 3 years, stopped developing after the first 2 pregnancies of 7-9 weeks B ultrasound, and performed uterine evacuation; the last miscarriage was 1 year ago, and no fetal buds and fetal heart beats were seen for 8 weeks after amenorrhea. He is 158 cm tall and weighs 50 kg, and has normal gynecological examination.

Many times the fetus has stopped, and even the strongest family can't bear it!

@ First Sister: Four promotions and four shifts, three hysteroscopic surgeries, two unneeded and one biochemical, one twin stop.

@Second Sister: Experienced 3 unexplained fetal arrests.

@ Third sister: experienced four IVF transplants, one induction, one fetal stop, one extrauterine, one abortion, one laparoscopy, and one hysteroscopy.

Again and again, blows are often injured, sad and hurt money. Why is there fetal cessation? What should I do if the fetus is stopped?

What is fetal cessation?

The fertilized egg is like a seed, under conditions such as sunshine, rain and dew soil, after undergoing a series of complex and wonderful processes, it will eventually grow into a healthy baby. If, at the initial stage, the fertilized egg does not grow well, then it is likely to stop growing.

We call this abnormal phenomenon of embryonic development that occurs in the first trimester "embryo aborted". "Embryo abortation" differs from second- and third-trimester miscarriages in that it stops developing before the embryo has formed.

What are the signals of fetal cessation?

If embryos are stopped, all pregnancy reactions in pregnant women will gradually disappear:

There is no longer nausea, vomiting and other early pregnancy reactions

The feeling of breast swelling is weakened

Vaginal bleeding, often with a dark red bloody vaginal discharge

Pain in the lower abdomen, discharge of embryos

Clinical manifestations vary from person to person, and some people do not even have any signs, they directly have abdominal pain, and then miscarry, or asymptomatic after embryo cessation, which is found by B ultrasound.

Does the above signal in the body necessarily mean that the fetus is stopped?

The diagnosis of fetal abortation also depends on ultrasound, which monitors the embryo:

≥ 6 weeks without a gestational sac, or with a gestational sac but deformed and shrunken;

When the gestational sac has ≥ 4 cm but no fetal buds can be seen;

The head and arm length of the fetal buds are ≥ 1.5 cm but there is no fetal heartbeat.

The above three conditions can diagnose fetal cessation.

Why do I encounter fetal cessation?

Common causes of embryo cessation include the following:

1

Genetic factors

The number of chromosomes is large or small (86%), the structure of chromosomes is missing, inverted, translocation, etc. (accounting for 6%), and others such as chromosome mosaic phenomenon and submicroscopic chromosome abnormalities (accounting for 8%). This chromosomal problem may originate from the embryo itself or from both spouses.

2

Anatomical abnormalities of the genital tract

The uterus is the place where the embryo grows and develops, and when the "house" structure is not right, the space becomes smaller or the environment is problematic, it will inevitably affect the growth of the embryo.

The most common congenital anomalies of the reproductive tract are the uterine mediastinum, saddle uterus, bicornuate uterus, double uterus, uterine dysplasia, etc.

Acquired abnormalities are common in cervical insufficiency, uterine adhesions, uterine fibroids, endometriosis, and adenomyosis.

It turns out that fibroids in different locations are so different!

3

Endocrine factors

Estrogen, progesterone and human chorionic gonadotropin are dependent on embryo implantation and development, endogenous hormone deficiency or internal environment disorders, blood sugar rise, insulin rise, etc. will not meet the needs of the embryo or affect the fetal growth environment.

For example, luteal insufficiency, polycystic ovary syndrome, thyroid dysfunction, diabetes mellitus, hyperprolactinemia and endometriosis.

Commonly used tests include reproductive hormone levels, including prolactin (PRL), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, and androgen levels on the 7th to 12th day after ovulation. In addition, thyroid function and fasting blood glucose should be measured, and glucose tolerance tests should be performed if necessary.

4

Infectious factors

These include systemic infections and infections of the female genital tract. Systemic infections caused by bacteremia or sepsis can have toxin effects on embryos or fetuses during pregnancy or trigger contractions.

Reproductive tract infection During pregnancy, bacteria infected by the vagina and endocervical canal can travel up the mucosa of the genital tract, or infect the fetal membrane or placenta through the blood, causing chronic endometritis and chorioamnionitis, and inducing local tissue immune responses in the endometrium, interfering with and destroying the development of the embryo.

5

Immune factors

Autoimmune factors are caused by the production of autoantibodies by the mother, and the common ones are antiphospholipid antibodies and thyroid antibodies. The same immune factor is that the maternal immune system has immune recognition of fetal antigens, resulting in immune intolerance and immune attack on the fetus.

In addition, there is the currently widely concerned "prethrombotic state", which is a blood coagulable state caused by the increase of the component of the coagulation agent in the mother or the decrease in the concentration of inhibiting coagulation substances. In this state, blood clots are extremely easy to produce, when the thrombus causes degenerative blood vessels and placental vascular infarction, can cause embryonic ischemia death.

If you have sisters, when can you be assured? In fact, I have seen so many cases of sisters who have stopped fetal arrest and reborn. Only by giving birth safely and smoothly and looking at a healthy baby can we put down that hanging heart.

6

Unknown cause

The causative factor cannot be identified using current examination techniques.

7

environmental factors

Overweight increases the burden on various systems and organs of the human body, leading to metabolic diseases such as hypertension and diabetes.

Nutritional deficiencies such as folic acid and vitamins can also lead to miscarriage of fetal malformations.

Occupational exposure to high lead environment, engaged in computer operation for more than 20h per week in the first trimester, noise > 85dB in the working environment, and stress will increase the risk of miscarriage.

What should I do if I have stopped having a fetus?

Here we would like to remind everyone that it is impossible to reverse the situation that fetal cessation has occurred, and the residual embryos in the uterine cavity have stopped developing, and there is no point in remaining in the uterine cavity.

It is necessary to do uterine clearance in time to avoid the long-term residue of the sterilized embryos in the uterine cavity, causing a miscarriage and causing inflammation in the uterine cavity.

Therefore, early diagnosis and early treatment are needed.

Before 12 weeks, management is relatively easy, usually a medical abortion is used, using mifepristone plus misoprostol, and if the third day is not excreted or bleeds heavily during discharge, an abortion is performed. Hospitalization for induction of labour for more than 12 weeks.

For women who have had embryonic discontinuation, if they want to explore the cause, the main consideration should be the number of embryos stopped.

| if it is only one embryo stop

If it is only an embryo suspension, in general, there are many occasional factors, because the embryo suspension itself is the result of natural selection of survival of the fittest, which may be a problem with the conception, resulting in chromosomal abnormalities, and it will continue to be observed in pregnancy in the future.

A single embryo arrest can be examined for the cause of fetal abortation. If there is no targeted examination, close observation should be carried out when the second pregnancy is made.

The most important thing is to relax your mind, adjust your body, and prepare for your next pregnancy, which generally does not affect the second pregnancy. Like the following sisters are a little anxious, you can arrange some other things in your life to divert your attention, the mood is relieved, and maybe a good pregnancy will come!

| if there are more than two consecutive embryos to be stopped

If it is two fetal cessations, it is necessary to pay attention to it, as comprehensive as possible, genetic testing of the second flow product, detection of the chromosomes of both husband and wife, and looking for the cause of multiple fetal cessations.

If there are more than two consecutive embryos to be stopped, the possibility of recurrent miscarriage should be considered, and the possible causes should be examined to clarify the causes so that the next pregnancy can be guided.

Repeated fetal cessation, the possibility of immune factors is large, pregnant women often have too strong immune system, under the guidance of embryos and appendages, triggering an autoimmune response. At this time, under the guidance of rheumatology and immunology and obstetric experts, a reasonable treatment plan should be jointly formulated and preconception examination should be done. Like this sister, hold on well, after a period of pain, it is possible to harvest a big treasure!

Now let's talk about the case at the beginning.

The couple underwent chromosomes, vaginal ultrasound, hysterosalpingogram, hysteroscopy, TORCH series, and endocrine and immune factors, and finally found that the reason for the couple's repeated fetal cessation was: uterine malformations (mediastinal uterus).

After hysteroscopic combined with mediastinectomy and adjustment three months after surgery, a baby girl was finally delivered at 37+ 5 weeks of pregnancy, weighing 3000g.

It can be seen that after some treatment, the ending is very happy!

An accidental fetal abort is not terrible, and fetal abort is the result of natural selection of the fittest. For many inevitable fetal cessations, the most important thing is to find the cause, relax the mentality, actively correct the reasons for fetal cessation, and strive to meet the next baby.

Source of this article: Reproductive Medicine Space

Editor-in-Charge: Ichikawa