A fertilized egg is like a seed, it needs to go through a series of complex and wonderful processes to eventually grow into a healthy baby, if in the initial stage, the fertilized egg does not sprout well, then it is likely to stop healthy growth or even die, which is "embryo de-fertilization".
Originally in the midst of joy, the small life in the body suddenly stopped developing, which is a big blow for any couple who are trying to conceive, but in the face of embryo suspension, in addition to heartache and tears, we should also actively screen, clarify the cause, and symptomatic treatment to prepare for the next healthy pregnancy. So, what exactly should I check after the first fetal stop? 10 mandatory inspection items, understand it ~
10 mandatory inspection items after fetal stoppage
1. Chromosomal screening of both husband and wife
Considering that abnormal embryonic chromosomes are the main cause of embryo cessation, clinical recommendations: first undergo blast dye test after fetal stoppage, and if it cannot be checked for special reasons (such as miscarriage, etc.), the couple's chromosomes must be screened to confirm whether the parent chromosomes have chimerism, inversion, balance translocation and so on.
2. Uterine cavity anatomy screening
Uterus as the internal environment of conception, all kinds of abnormalities may have an impact on the embryo, and then cause the occurrence of embryonic cessation, therefore, the clinic recommends that after the fetal cessation, women should go to the hospital in time to complete the work of uterine cavity screening, and it is clear that there are various uterine malformations such as the unmatched uterus, the mediastinal uterus, the saddle uterus, etc., especially the mediastinal uterus, which is related to miscarriage, therefore, once it is found that it must be treated first, and then pregnant.
3. Thromboelastogram screening
The maternal coagulation mechanism is abnormally easy to form thrombosis, which can lead to the placenta being blocked by multiple thrombosis during the formation process, resulting in embryo cessation, therefore, it is clinically recommended to screen for thromboelastogram after fetal stoppage to reflect the overall picture of the coagulation system and determine whether there is hypercoagulation.
4. Monitoring of blood flow in uterine arteries
The uterus is the hotbed of life, the uterine arteries and their branches provide raw materials for the "hotbed", deliver nutrients to the uterus, and provide guarantees for the development of the embryo, so if the uterine arteries are blocked, encounter blood clots or blockages, it may lead to embryonic dysplasia, recurrent miscarriage and repeated implant failure.
Uterine arterial blood flow is the only tool to monitor whether the nutrient transport channel is unobstructed, so it is necessary for women to perform this test after fetal arrest, and try to choose the peri-implantation period, that is, the 3-5 days (or 3-7 days) after ovulation, which is the blood flow status of future fertilized eggs.
Clinical studies have found that in the peri-bed stage uterine artery blood flow RI < 0.85, PI<3, bilateral S/D sum of <12 is more ideal.
5. Homocysteine examination
Studies have shown that the serum homocysteine level of patients with recurrent miscarriage in the first trimester of pregnancy is significantly higher than that of normal pregnancies, and the earlier the abortion, the higher the concentration of homocysteine, so it is necessary to pay attention to this test after fetal cessation.
At present, most scholars believe that patients with recurrent miscarriage should reduce homocysteine levels below 8 before trying to conceive. At the same time, because the man is highly bloody, it may also cause infertility or miscarriage in women, so it is recommended that the man also check the homocysteine level.
6. Antinuclear antibody profile examination
The production of antinuclear antibodies indicates that the cells in the human body are suffering from immune damage, indicating that there is an immune problem. It is worth mentioning that the titer of the antibody is not related to the degree of disease, the high titer does not mean that the disease is serious, and the low titer does not mean that the disease is very mild, so if the antinuclear antibody is checked after fetal arrest, even if the result is weakly positive, it may also need treatment.
Seven, antiphospholipid antibodies three
The three antiphospholipid antibodies mainly include three anticardiolipin antibodies (IGG, IGM, IGA), anti-β glycoprotein I antibodies (IGG, IGM, IGA), and lupus anticoagulants.
It should be noted that the three antiphospholipid antibodies need to be checked at least twice, with an interval of 12 weeks, and all of them are positive to determine abnormalities.
8. Insulin release test
Insulin is the "key" to open the door of the cell, without this key, the cell can not have an energy supply, so insulin resistance will affect the system of the whole body, of course, will not let go of the reproductive system. Clinical studies have found that when insulin resistance affects the energy supply of follicles, it will lead to follicle atrophy and affect conception; when it affects placental trophoblasts, it will cause insufficient trophoblastic invasion, causing fetal cessation and abortion. In addition, the increase of the blood fibrinolysis activator inhibitor-1 in insulin-resistant patients causes the blood to enter a hypercoagulable state, which increases the risk of thrombosis and also affects embryonic development.
Usually, serum insulin peaks at 0.5-1 hours after oral glucose, about 5-10 times the level of fasting insulin, followed by a decrease in serum concentration, 30 mU/L < after 2 hours, and 3 hours after taking sugar, blood insulin returns to fasting levels.
9. Thyroid function screening
Thyroid hormone (TH) secreted by the thyroid gland is involved in the regulation of the menstrual cycle, follicle development, and ovulation by the hypothalamic-pituitary-ovarian (H-P-O) axis, and may have a direct impact on endometrial tolerance and pregnancy outcomes, such as possibly increasing miscarriage rates, preterm birth rates, and neonatal mortality. Therefore, after fetal abortion, it is necessary for pregnant mothers to screen for thyroid function, and patients with Hashimoto's thyroiditis should maintain a TSH < 2.5; patients without Hashimoto's thyroiditis should maintain a TSH <4.0.
10. Chronic endometritis
If the lining is regarded as the "soil" for embryo planting, then chronic endometritis is the desertification of the "soil", which is likely to lead to the embryo being difficult to take root and sprout because it is not supplied with "nutrients", resulting in fetal arrest and miscarriage, therefore, it is clinically recommended that pregnant mothers must pay attention to the screening of chronic endometritis after fetal stoppage. If the results of the screening are abnormal, then it is necessary to carry out treatment and re-examination, and only after passing the re-examination can you prepare for the next pregnancy, remember!