The conception of life is both a joyful anticipation and full of twists and turns, and natural abortion is undoubtedly the biggest obstacle. "I miscarried," which is probably the most unbearable word for a mother-to-be. But miscarriage is not just a matter for women, nor is it because expectant mothers are not taking care of themselves.
Director Profile
Zhu Pengyun
Director of the Fourth Consultation
Master of Clinical Medicine
Attending
Proficient in clinical medicine, molecular genetics and other fields of expertise;
Proficient in the diagnosis and treatment of infertility, including the grasp of various assisted reproductive technology indications, the selection and monitoring of ovulation induction regimens, the regulation of clinical medications and the prevention and treatment of complications;
Skilled in surgical procedures, proficient in assisted reproductive surgery such as ultrasound-guided egg retrieval.
Miscarriage is maternal
Not careful enough?
What is spontaneous abortion?
Spontaneous abortion refers to the natural loss of a pregnancy before 28 weeks of pregnancy, or in a fetus weighing less than 500 grams. According to the gestational week of miscarriage, it can be divided into early spontaneous abortion and late spontaneous abortion. Gestational age, 12 to 28 weeks' gestational age, is called late pregnancy miscarriage. About 80% of spontaneous abortions are early miscarriages, and the vast majority of spontaneous abortions occur before 8 weeks.
Spontaneous abortion
Common causes
Once a miscarriage occurs, expectant mothers react first by blaming themselves for doing something wrong. Did you mention the weight? Did you eat something you shouldn't? Choosing "not to disclose" in the first trimester is also because many people can hardly withstand the doubts, blames, and even sympathetic and pity eyes of others.
In this regard, Director Zhu Pengyun explained: "In fact, there are many factors related to miscarriage. Not everyone can completely avoid it through their own "carefulness", nor are expectant mothers not taking care of themselves. ”
1
Genetic factors
In early spontaneous abortion that occurs incidentally, the incidence of embryonic chromosomal abnormalities accounts for about 50% to 60%, including chromosomal abnormalities and embryonic chromosomal abnormalities in both husband and wife. Embryo chromosomal abnormalities in a single spontaneous abortion are the main cause, and the incidence of embryonic chromosomal abnormalities decreases with the increase in the number of abortions.
Q
If this examination finds that the embryo has an abnormal karyotype of the chromosome, resulting in a miscarriage, will the remaining embryos also be abnormal? Can it continue to be used for transplantation?
Director Zhu Pengyun: These embryos can be used because each embryo is a different individual, developed by different sperm and egg fertilization, and the karyotype of one embryo chromosome is abnormal, most of the time it is an accidental event, and there is no correlation with other embryos. If the couple has chromosomal abnormalities, genetic counseling is needed to prepare for the next pregnancy.
2
Maternal factors
Maternal factors include: abnormalities in the anatomy of the reproductive tract, such as uterine malformations, uterine fibroids, uterine cavity adhesions, cervical insufficiency, and so on.
The influence of uterine fibroids is related to the type, location, size and number of fibroids, when the fibroids are close to the lining and compress the uterine cavity, it will reduce the chance of embryo implantation and increase the chance of miscarriage, such as uterine fibroids under the mucous membranes, it is recommended to do the corresponding treatment before pregnancy.
For friends with suspicious uterine adhesions, such as previous thin endometrium, low menstrual flow, repeated uterine effusions, etc., it is recommended that hysteroscopy be done before pregnancy, if a uterine adhesions are found, it is necessary to separate the adhesions to restore the normal uterine cavity structure before becoming pregnant.
Patients with cervical insufficiency should pay attention to avoiding multiple pregnancies in the process of re-pregnancy.
3
Endocrine factors
For example, luteal insufficiency, polycystic ovary syndrome, thyroid dysfunction, and diabetes mellitus.
4
Infectious factors
Including systemic infections or infections of the reproductive tract, such as chlamydia infection, toxoplasmosis rubella, herpes simplex virus, as well as bacterial vaginosis, cytomegalovirus and so on. It is generally associated with sporadic spontaneous miscarriage, and the cause can be found to be targeted for treatment.
5
Immune factors
Immune factors and prethrombotic status are a hot topic of research in recent years, and about 30% of spontaneous abortions are related to immune factors. Common ones such as antiphospholipid antibody syndrome, nk cell ratio, increased activity, prethrombotic status, hyperhomocysteinemia and so on.
6
Male factor
Male factors mainly include male genetic factors and sperm factors, genetic factors mainly refer to male chromosomal abnormalities, Y chromosome microdeletions, etc., sperm factors mainly refer to the quality of sperm, as well as sperm DNA fragmentation rate and so on.
7
eld
With the liberalization of the two-child and three-child policies, the complications and risks of the entire pregnancy process (including conception, implantation, and pregnancy) are significantly increased by elderly mothers (older than 35 years old) due to the significant decline in ovarian function.
8
environmental factors
There are many studies suggesting that environmental factors such as obesity, nutritional deficiencies, and poor habits have a high correlation with miscarriage, and stress and stress can also increase the risk of miscarriage.
How to prevent spontaneous abortion
1. Pre-pregnancy examination
1. Do a good job of preconception examination before pregnancy
Routine physical examination, blood pressure, blood glucose, infection four items, CT, mycoplasma, chlamydia, uterus and appendages, B ultrasound;
Endocrine-related tests, such as thyroid function, prolactin, etc.;
Eugenics and eugenic examinations, such as TROCH, etc.;
There are also land poverty, blood type, and if necessary, check the chromosomes of both husband and wife.
2. Supplement vitamins and folic acid in advance;
3. Maintain a regular lifestyle, quit smoking and alcohol, avoid staying up late, etc.
2. First trimester
Affected by the early pregnancy reaction, pregnant mothers should reasonably arrange rest to ensure adequate sleep; diet diversification, eat less raw cold and spicy foods, avoid diarrhea; adjust their mentality to avoid excessive tension.
In the first trimester, attention should be paid to good health, avoid colds and colds, maintain physical and mental pleasure, and reduce harmful radiation exposure.
Sexual activity is prohibited in the first trimester, especially for pregnant mothers with a history of recurrent miscarriage.
3. Overall
Actively prepare for pregnancy, and consult and understand abnormal situations with professional doctors in a timely manner;
Natural abortion needs to be taken seriously and prepared, but not hesitant because there is a risk of miscarriage.
brief summary
Finally, Director Zhu Pengyun would like to say to the majority of expectant mothers: abortion does not mean that you cannot have children, although we all hope that every pregnancy can have a happy ending, but in the face of abortion, we also need the courage and love to face reality. The diagnosis and treatment of the causes of spontaneous abortion is a challenge for both patients and doctors, requiring close cooperation and perseverance between doctors and patients; through scientific diagnosis and treatment, the vast majority of patients with repeated spontaneous abortion can get their own babies.