For pregnant mothers, it is a miracle that a small life is conceived and formed in the body; however, for some couples who often have fetal cessation, these are difficult things. Repeated fetal cessation is not only hurtful but also sad, but why does fetal cessation occur? What should I do after the fetus is stopped? Today we will talk about the issue of fetal cessation.
What is fetal cessation?
The fertilized egg is like a seed that goes 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 growing healthily, we call this abnormal phenomenon of embryonic development that occurs in the first trimester of pregnancy "embryonic abortation".
What are the signals of fetal cessation?
If embryos are stopped, all pregnancy reactions of the pregnant mother will gradually disappear. The first is that there is no longer nausea, vomiting and other early pregnancy reactions, and the feeling of breast swelling will also be weakened. Then there will be bleeding in the vagina, often with a dark red bloody vaginal discharge. Finally, pain in the lower abdomen may also occur, and the embryo is excreted. The above manifestations vary from person to person, and some even have no signs at all, direct abdominal pain, and then miscarriage, or asymptomatic detection of the embryo after the cessation of the embryo through routine ultrasound examination.
Most pregnant women have no obvious symptoms after the fetus stops developing, and some pregnant women may see redness and generally have no abdominal pain, which is different from threatened miscarriage.
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.
Common causes of fetal abortation?
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. Abnormal anatomy 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.
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.
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 infections During pregnancy, bacteria infected with the vagina and endocervical canal can travel up the mucous membrane 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.
6. Unknown cause
The causative factor cannot be identified using current examination techniques.
7. Environmental factors
Excessive weight will increase the burden on various systems and organs of the human body, causing metabolic diseases such as hypertension and diabetes and endocrine function.
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.
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, resulting in a miscarriage and causing inflammation in the uterine cavity.
Therefore, early diagnosis and early treatment are needed.
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 cessation
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.
If there are more than two consecutive embryos to stop sterilizing
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. 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.
How can I prevent fetal arrest?
1. Chromosomal abnormalities. Preconception testing and medical diagnosis are required before pregnancy, and if there is a family genetic history, consideration may be given to not becoming pregnant or effective care.
2. Abstain from harmful substances. If you work in a related industry, you can transfer to another department a few months before conception. For the family room that has just been renovated, it is recommended not to move in too early, and can only move in after passing the test. Choose clean and pollution-free food in your diet.
3. Radioactive light. Avoid X-ray tests before pregnancy, and when the microwave oven is running, it should be kept at a certain distance, about one meter or more. Do not carry your phone around for a long time, and use it only when necessary.
4. Drug effects. If there is no intention of conceiving, contraception should be done. When preparing for pregnancy, if a condition occurs, first confirm whether you are pregnant, and if so, you should take the medicine with caution. It is best to consult a doctor to choose drugs that are beneficial to your condition and have no effect on the fetus.
5. Smoke and drink alcohol. Both husband and wife should quit smoking and alcohol for a period of time before childbirth and during pregnancy, so as to avoid the impact of tobacco and alcohol on the fetus in the abdomen.
6. Infected with virus. For rubella, pregnant women should be vaccinated against rubella in advance. In the first trimester of pregnancy, avoid staying in public places for too long, and carry out appropriate physical exercise to enhance physical fitness and autoimmunity. Maintain a balanced nutrition.
7. Chronic serious diseases. Drugs for chronic diseases can have a great impact on the fetus, and if the patient needs to be pregnant, the drug should be discontinued for a period of time, and it is suitable for pregnancy when the condition is stable.
8. Abnormal immune system. For women with abnormal immune systems, pregnancy should not be available until the condition has fully recovered. It is also necessary to exercise more in life, maintain nutritional balance, and enhance immunity.
The Reproductive Medicine Center of Taihe County People's Hospital is a regular assisted reproduction institution approved by the National Health Commission, with Director Yang Ping as the discipline leader, and has a unique insight into the accurate fetal preservation related to fetal cessation. If you are facing the pain related to fetal cessation, please go to the center in time for consultation, find out the cause as soon as possible, and timely symptomatic treatment, so as not to miss the best time for treatment.
Text: Fertility Center Liu Huihui
Review: Liu Quan
EDIT: Public Information Section