To avoid miscarriage. Consequences after a miscarriage in the early stages. Endocrine Disorders

16.04.2019

In a simple sense, when they talk about miscarriage, they mean by this definition a miscarriage in the early or late stages, which is already called preterm birth.

A case of relapse is not excluded, this phenomenon was given the name - habitual miscarriage, which means that spontaneous abortion occurred sequentially several times in a row in the same mother, more than two times. The rate of cases of recurrent miscarriage tends to reach 2% of the total number of pregnancies, which is quite a lot in itself.

As you know, everything happens not without reason - this is the deterioration of the ecological state of the environment, and stressful situations, and the individual characteristics of the mother's body, hormonal disorders in the mother's body. At the current level of development of science and technology, it is already possible to conduct research on the origin and development of such a phenomenon as miscarriage.

(jb_yellowbox) A case of miscarriage in the early stages of gestation is most often associated with genetic abnormalities, that is, it can be considered as a defense mechanism of the body against malformations. This means that the female body has evolved in such a way that if the fetus initially develops with abnormalities, then rejection, miscarriage occurs. (/ Jb_yellowbox)

Genetic research

For quite a long time, studies in the field of genetics came to the conclusion that half of the cases of early miscarriages occur precisely because of chromosome mutations, thus, this phenomenon can be equated with natural selection. For this reason, in a number of European countries it is not customary to prescribe conserving therapy in early pregnancy. So should a threatened miscarriage be treated? It is necessary, since only 50% of cases of termination of pregnancy are already mentioned above, due to genetic abnormalities in the fetus, all other factors must be taken into account, these are immunological and hormonal disorders on the part of the mother and others more rare.

There is no need to interfere with natural selection, but as practice suggests, measures aimed at preserving pregnancy usually do not save pregnancy in case of genetic abnormalities in the fetus, and conducting a mandatory ultrasound scan at certain times can reduce the number of these cases to a minimum.

Hormonal dysfunctions

Hormonal disorders are one of the most well-known problems among women. And this is actually the case, especially during pregnancy, when a woman gets out of the ordinary course of life, if we consider all periods of pregnancy, then these violations are the most common causes of miscarriages. The first, according to statistics, in the list of hormonal diseases are problems with the ovaries, namely, a violation of their activity in the form of a deficiency of the luteal phase (LFL) and is characterized by a lack of the sex hormone progesterone.

It is possible to determine exactly the presence of disturbances in the work of the ovaries by ultrasound diagnostics of the state of the endometrium and ultrasound of the ovaries, and of course a blood test for hormones. The next problem for which a pregnancy is terminated is hyperandrogenism of various origins, the essence of which is an increased androgen index in the blood. Since an excessive amount of male sex hormones is alien to the female body, this jeopardizes the fetus in the early stages. Distinguish between adrenal, ovarian and combined hyperandrogenism.

(jb_info) Thus, mild or worn out, which manifests itself during pregnancy, a form of one of the above diseases can cause miscarriage. (/ jb_info)

Endocrine diseases

Diabetes mellitus belongs to the group of endocrine diseases that cause miscarriage. Lack of insulin in the body leads to hyperglycemia, which means that the level of glucose in the blood rises significantly. Diabetes mellitus negatively affects all types of metabolism in the body, from mineral to protein. The severity of diabetes determines the consequences of pregnancy - a miscarriage may occur, or the pregnancy may stop developing, the so-called frozen pregnancy. The determining factor in such a situation is treatment, which is important to carry out even during pregnancy planning. In such cases, you need to get a glucometer so that you can measure blood sugar at home and carry out prevention.

(jb_warning) Depending on the factors of origin of recurrent miscarriage, the gestational period can be divided into four periods. This division makes it possible to timely identify the threats associated with pregnancy, as well as take precautions regarding health conditions. (/ Jb_warning)

At-risk groups

The duration of the first, earliest period during which a miscarriage may occur - up to 6 weeks. This is where diseases associated with genetic malfunction and immunity problems come into play. At the genetic level, any mutation of the karyotype of the fetus, incompatibility of the antigens of both parents, can occur, and cases of an increase in cytokines - the information molecules of the body - are also common. Women expecting a baby should be especially careful about their health, because pregnancy, in fact, is a process of allotransplantation. This is due to the fact that there is an immunological relationship between mother and child, which means that half of the antigen in the body of a pregnant woman does not belong to her. Immunology has come to the conclusion that rejection of the fetus by the maternal organism can occur, as happens in some cases of organ transplantation. As a result, an autoimmune situation may arise, as a protective feature of the mother's body against male antigens.
The second period is interval from 7 to 9 weeks, and at this time there is a threat of endocrine disorders. Miscarriage can be a consequence of a high level of androgens in the mother's blood, a deficiency of the luteal phase. As mentioned above, treatment with a simple intake of hormones is not always effective, since in some cases there is simply a violation in the hormone receptors, that is, even if there are a lot of hormones in the blood, but the body does not accept them. In 10% of women who suffer from recurrent miscarriage, the blood contains antibodies to a certain hormone, for example, to progesterone, therefore, such treatment will also be ineffective due to the fact that the body will reject this hormone further. That is why, for proper treatment, endocrinologists prescribe complex treatment to patients.
In the third period (from 10 to 16 weeks) especially dangerous are autoimmune diseases and thrombophilic disorders. The most common of them are hyperhomocysteinemia, antiphospholipid syndrome, as well as thrombophilia, mutational processes of the prothrombin G20210A gene and factor V Leiden.
In the last period, which lasts from the 16th week, the cause of miscarriage can be infectious diseases and isthmico-church failure, any of these diseases can threaten with serious complications during pregnancy, placental insufficiency, delayed fetal development and late toxicosis. Also, a case of placental detachment ahead of time is not excluded.

In addition to the above periods, at any time during pregnancy, no one is safe from miscarriage due to anatomical abnormalities in the structure of the mother's genitals.

Anatomical factors of miscarriage

The most common cause of spontaneous abortion in the second trimester is cervical insufficiency (ICI). This disease is characterized by such a pathological condition of the cervix and isthmic part of the uterus, in which their muscles are no longer able to hold the fetus in the correct position. The incidence of miscarriages with ICI is about 40%.

(jb_pin) The cervix is composed of smooth muscle (about 15%) and connective tissue (main part). As you approach the upper pharynx, the connective tissue is replaced more by muscles, which function in a similar way to the sphincter principle. Violation in the development of the uterus is a very serious problem, especially if we are talking about pregnancy, because 15% of cases with such a diagnosis end in miscarriage. If we talk about the anatomical features of the female genital organs, which lead to spontaneous abortion, then one of these reasons can be the uterus with various anomalies, saddle uterus, bicornuate uterus, complete or incomplete intrauterine septum. (/ Jb_pin)

Recently, given the increasingly late age of women planning pregnancy, cases of pregnancy against the background of a benign tumor of the uterus, fibroids, have become more frequent. The miscarriage rate for this diagnosis is 6%. This indicator varies depending on the location and size of the tumor, for example, the risk of miscarriage is seriously increased if in the lower half of the uterus the placenta is adjacent to the nodes of the fibroid. All the other factors listed above are also aggravating.

Features of the somatic status of a woman

Cardiovascular disease ranks first in the ranking of causes of death. This statistic is applicable not only to the elderly, but to absolutely the entire population. Among pregnant women, heart defects of any origin, problems with veins, and even vegetative-vascular dystonia, which, as a rule, are usually completely overlooked, are becoming a particular threat. Spontaneous abortion can occur due to old kidney problems, chronic pyelonephritis or glomerunephritis. Immunological aspects of miscarriage

Good immunity is the key to good health. And this is true, because most of the diseases occur due to a weak immune system.

Infectious diseases of the mother

Each of us has come across some kind of infectious disease, and, as a rule, everyone is used to taking it for granted. But in the case of pregnancy, this matter needs to be treated completely differently, because spontaneous abortion can occur not only from infection, but also from its complications.

Acute viral diseases such as herpes, rubella, chickenpox, cytomegalovirus and others can lead to miscarriage, the birth of a dead or physiologically defective child with defects. To the fetus, the virus crosses the placenta, causing damage to it. In addition to such a specific route of transmission of infection, there is a possibility of infection of the child even during conception through sperm. In this case, spontaneous termination of pregnancy occurs even in the initial periods of gestation. It is equally important to pay attention to infectious diseases in a chronic form, chronic pyelonephritis, cystitis, tonsillitis, etc., as well as infectious diseases that can pass in a latent state, for example, toxoplasmosis.

(jb_info) Quite often you can encounter colpitis (up to 65%) in women of reproductive age, as a result of which the vaginal mucosa becomes inflamed. Colpitis can be caused by urogenital diseases, chlamydia (15-20%), candidiasis (15%), mycoplasmosis (25%). All of the aforementioned infections can also lead to missed pregnancies. Chronic inflammation of the inner lining of the uterus is called chronic endometritis, which also has an extremely negative effect on pregnancy. (/ Jb_info)

Diagnosis of early and late spontaneous miscarriages

It is possible to diagnose miscarriage in early and late pregnancy using specific determinants. The first step is to check for any signs of pregnancy in general, for example, the presence of a delay in the menstrual cycle, to make sure of this. Further attention is paid to the presence of pain below the abdomen or bleeding from the genital tract. The last step to determine pregnancy is to conduct clinical trials, such as tests and ultrasound diagnostics. If there is at least any threat of miscarriage, or such a case has occurred, then it is necessary to conduct a thorough check even in the first period of gestation. For example, echographic diagnostics are effective enough to identify problems that can occur with the fetus.

Treatment of early and late spontaneous miscarriages

In the initial period of pregnancy, many processes take place in the mother's body, which will be the determining factors in the course of pregnancy. We are talking about the development of the fetus, the creation of the placenta around it, with the help of which a kind of connection is established between the mother's body and the child's body. That is why it is very important not to break this connection, but on the contrary to strengthen it.

(jb_warning) As mentioned earlier, many are inclined to believe that 90% of miscarriages that occur at very early stages are the result of natural selection. Based on this, you must be prepared for negative treatment results. (/ Jb_warning)

Preservation of the fetus

The issue of fetal preservation is very complex, and the proposed treatment methods are rather controversial. According to Western experts, they include, first of all, support at the psychological level, which is a very important factor. During treatment, it is considered correct to take sedatives, bed rest, a calm environment and restriction of sexual intercourse.

In contrast to the above methods of preventing spontaneous abortion, domestic obstetricians-gynecologists do not consider such treatment to be effective, but prefer more aggressive tactics. In our country, as a rule, a pregnant woman is prescribed antispasmodic, vitamin, anti-inflammatory and hormonal, in particular progesterone, estrogen drugs.

It is worth noting that domestic treatment methods also do not have enough evidence to confirm a positive or negative effect. As you know, during pregnancy, it is extremely dangerous to disrupt any of the metabolism in the mother's body; in case of insufficient diagnosis, an erroneous diagnosis can be obtained, which will lead to the prescription of the wrong drug. This is especially true of hormonal drugs, a lack or excess of a certain hormone in the blood is a common phenomenon, but you should not rely on empirical facts and start taking the missing hormone. The first step is to find out the reason that led to a disruption in the endocrine system, which means that you need to conduct a thorough examination.

Often, the mother's body simply rejects a certain hormone, and it will be impractical, if not dangerous, to prescribe it. It is worth recalling that after the 14th week of gestation, the placenta begins to produce all the necessary hormones by itself, which is why the treatment, which was carried out using sex steroid hormones, must be stopped completely by 16 weeks. Doses of any prescribed drugs are prescribed to each patient separately, depending on the test results, diagnosis, the nuances of fetal development and the individual tolerance of the drug components.

Treatment of pregnant women with cervical insufficiency

For spontaneous abortion at impressive stages of pregnancy, isthmic-cervical insufficiency (ICI) is usually responsible. This disease is characterized by the fact that the cervix and isthmus of the uterus are pathologically changed so that they are not able to withstand intrauterine pressure, and, accordingly, to hold the fetus. To solve this problem, there are certain methods of treatment that are responsible for the pathogenetic correction of the desired area of the uterus. Of course, it is first necessary to identify the cause of ICI in order to direct the treatment in the right direction. To restore this condition, surgical intervention is necessary, for example, the imposition of a circular suture. But the effectiveness of such a method is not always high if it is carried out at the wrong time.

Main criteria when it is worth undergoing surgery for ICI:

if the patient has already had cases of spontaneous abortion or premature birth, not in early gestation.
expansion of the cervical canal, determined by manual examination and ultrasound of cervicometry.
descent of the fetal bladder into the cervical canal.

When it is impossible to perform surgery for ICI:

in the case of hypertonicity of the uterus (increased sensitivity of the uterine muscles), which cannot be cured with medication.
if an ultrasound examination reveals fetal malformations.
in case of inflammation of the uterine lining.
the patient has III-IV degree of purity of the vaginal contents.

(jb_code) The scope of the operation for ICI is from 14 to 25 weeks, but the most favorable terms are set from 17 to 21 weeks of gestation. Depending on the moment the signs of ICI appear and the presence of contraindications, the time of the operation is set on an individual basis. (/ Jb_code)

Examination during pregnancy planning, preparation for pregnancy

To prevent possible complications during pregnancy, you must undergo a thorough examination. First of all, doctors study the information of the patient's past medical research, in particular the menstrual cycle and reproductive function. Further, a genetic examination is carried out, the purpose of which is to determine the chance of a hereditary disease in an unborn child. After that, it is necessary to undergo a general check, pass a number of blood and urine tests, undergo examination for infections, immunological tests, hemostasiogram, hormonal status, according to their results it will be possible to determine the level of estrogen, progesterone, antibodies to chorionic gonadotropin, as well as antibodies to the tissues of one's own ovaries and to the sperm of the future father. In order to be able to identify latent infections, an in-depth examination of the vagina is performed. Ultrasound diagnostics is one of the most important measures before and during pregnancy.

Diagnosis of hormonal disorders

If it is necessary to diagnose complex hormonal disorders, it is necessary to determine the state of the pituitary gland, while magnetic resonance imaging of the skull with a picture of the Turkish saddle will help. Also, in some cases, it is worth doing an endometrial biopsy or hysteroscopy to detect changes in the endometrium. In addition to examining a woman, an important factor is the future father's examination by a urologist-andrologist. In this situation, it is important whether a man can reproduce offspring, whether everything is in order with the endocrine system, as well as the presence of diseases that can be transmitted to the mother of the unborn child and the fetus. If the patient is suspected of luteal phase failure (LF), then it is necessary to determine the correspondence of the levels of the hormone progesterone in the blood in the first and second phases of the menstrual cycle.

Upon receipt of the test results, the patient is prescribed complex therapy on an individual basis, which lasts until the indicators are brought back to normal.

The threat of termination of pregnancy is a fairly common diagnosis. Having heard it from doctors, you shouldn't panic. A threat is not yet a miscarriage, and modern doctors know many ways to eliminate the problem that has arisen. But expectant mothers need to know what it is, the causes of this condition and treatment.

What is the threat of miscarriage

A miscarriage is the spontaneous termination of a pregnancy. There are two types of miscarriages:

Preclinical spontaneous abortion or biochemical pregnancy is a diagnosis that is made when the embryo itself was not detected due to a short period, but the level of hCG in the blood and urine has already increased.
Spontaneous abortion (miscarriage) is a pathological termination of a diagnosed pregnancy that occurred earlier than 20 obstetric weeks (18 weeks after conception).

If the loss of a child occurs after 20-22 weeks, it is called premature birth.

It should be noted that in modern obstetrics there is no diagnosis "threat of miscarriage", this concept is outdated. Any pregnant woman is at risk of losing a child, and doctors can really assess the likelihood of miscarriage. But the theoretical possibility of miscarriage is not a disease or a diagnosis. Moreover, according to experts, every fifth pregnancy fails early, even before the delay occurs. In this case, a woman does not notice changes in her condition and perceives bleeding as another menstruation.

When doctors talk about the threat of miscarriage, they imply a high likelihood of termination of pregnancy. But the risk is not treated, it is necessary to determine the cause of miscarriage and decide on the need to save the embryo. In most cases, the miscarriage is biologically feasible, so no conservative therapy is needed.

Why arises

It is very difficult to stop a miscarriage that has begun, so you must try to prevent it. The main causes of fetal loss are:

Low progesterone levels in the luteal phase are one of the reasons for miscarriage

Symptoms and Signs

The threat of early miscarriage is rarely symptomatic. If they are, then they differ little from the usual signs of pregnancy. Discomfort in the lower abdomen is quite common, as is the feeling of tension. Bleeding is also often found during implantation of the ovum and for some time after it.

The expectant mother herself cannot determine the threat of miscarriage, but the doctor can do it. First, he can study the woman's anamnesis and her current state of health, which will make it possible to make some predictions. If your risk of miscarriage is high, your doctor may order regular blood tests to monitor your progesterone and hCG levels. A decrease in their number indicates a possible termination of pregnancy.

Many women confuse implantation bleeding and the threat of miscarriage. A small amount of spotting about a week after conception is normal.

Often, the threat of miscarriage is diagnosed by ultrasound. It is not right. Firstly, the safety of ultrasound examination for the fetus in the early stages has not been proven. Secondly, exposure to high-frequency sounds can provoke uterine hypertonicity. Some experts argue that such a diagnosis in itself can pose a threat of termination of pregnancy.

Prevention methods

The best prevention of the threat of miscarriage in the early stages is the conscious planning of pregnancy. If a woman undergoes a medical examination in advance and makes sure that everything is normal with her health, this will significantly reduce the risks of interruption. It is also very important to give up bad habits and uncontrolled medication in time.

We should also remember about overdiagnostics. Nowadays, this is a very common problem: illiterate or unscrupulous doctors, using all the achievements of modern medical science, find in a woman even those diseases that do not carry any risks for pregnancy. And then they begin to treat them, excluding the very likelihood of conception. For example, the danger of latent infections is greatly exaggerated. Asymptomatic carriage in most cases does not threaten anything, and forcing a woman to take antibiotics, doctors do not give her the opportunity to become pregnant until the end of therapy.

What to do and how to be treated?

The threat of miscarriage, especially at an early stage, is not a reason to panic and immediately start conserving therapy. As we have already said, in most cases, pregnancy is terminated due to chromosomal abnormalities of the fetus, incompatible with life. Too active preservation of such defective conception will only delay the death of the embryo and make the abortion more painful, both physically and psychologically. Treatment is justified only in cases where the pregnancy is terminated due to hormonal imbalance or Rh-conflict.

Drug treatment

Conservation therapy is a painful topic in Russian gynecology. The fact is that the mechanisms of conception and gestation are very complex, and modern science does not yet know all the subtleties. Any interventions in this process are carried out almost blindly, therefore, in most developed countries of the world, when there is a threat of miscarriage in the early stages, expectant tactics are recommended.

Most progesterone drugs have such a low concentration of active ingredient that they act more like a placebo.

Domestic doctors in such a situation try with all their might to preserve the pregnancy and often make many unnecessary and meaningless steps, roughly interfering with the functioning of the body. Worst of all, there is no proven effective preservation therapy.

Progesterone (Duphaston, Utrozhestan, Endometrin) are hormonal drugs designed to compensate for the insufficiency of the luteal phase. Every month after ovulation, a special endocrine organ - the corpus luteum - is formed in the follicle in place of the egg that has come out of it. It functions until the end of the cycle and the beginning of menstruation. The task of this organ is to produce progesterone, which prepares the uterine epithelium for implantation and maintains it in this state. After implantation of the ovum, it begins to produce hCG, which stimulates the corpus luteum to increase the production of this hormone. If fertilization has not occurred, then gradually the level of progesterone falls, the inner layers of the endometrium flake off and menstrual bleeding begins. But for some unknown reason, some women experience a hormonal failure, and an increase in progesterone levels does not occur even after implantation. This threatens with detachment of the endometrium along with the ovum. And only in such cases is the use of tablets such as Duphaston, Utrozhestan and other similar drugs justified, helping to avoid rejection of the fetus.
Papaverine, magnesium and other antispasmodics with the threat of miscarriage are not indicated, since the muscles of the uterus are insensitive to them in the early stages. They can affect the uterus only for a long time, when attempts begin with premature birth. Their widespread use in domestic hospitals at the very beginning of pregnancy is due to their low cost and relative safety.

Duphaston is the most popular medicine prescribed for the threat of miscarriage

Non-drug therapy

Sometimes, with the threat of early termination of pregnancy, women are recommended electroanalgesia, electrorelaxation of the uterus, acupuncture, and magnesium electrophoresis. These are methods that have nothing to do with evidence-based medicine. Their results are unpredictable, and their safety and effectiveness have not been studied.

The appointment of progesterone before fertilization makes it impossible for ovulation, and hence conception.

If the worst happened

If the threat still failed to be prevented, and the pregnancy was terminated early, this can be a severe blow to the woman. But there is no need to panic, you need to understand the reasons. In most cases, miscarriages occur due to the nonviability of the embryo and, most likely, everything will be fine the next time.

Many women, after a miscarriage, become depressed and afraid of getting pregnant again. In this case, it is better to consult a psychologist in order to solve the problem as soon as possible.

Just in case, you can monitor the level of progesterone in the blood for several cycles. Although the insufficiency of the luteal phase is rare, it does not hurt to exclude it, as well as to be tested for infectious diseases of the genital area. Remember if taking drugs, alcohol or other substances could have provoked the miscarriage.

If doctors do not find any obvious reasons for a spontaneous abortion, it is necessary to tune in to the best and start taking folic acid. As soon as the body recovers, you can plan a pregnancy.

The threat of early miscarriage is not a diagnosis and in most cases does not require any treatment. Conservation therapy is justified only in case of hormonal imbalance or Rh-conflict. In other cases, expectant tactics are recommended.

A serious serious problem for the female body and a test of strength are complications of pregnancy - the threat of early miscarriage. How to prevent such a phenomenon, determine the causes, identify symptoms, avoid complications, every expectant mother should know at least briefly.

A miscarriage is the spontaneous rejection of the fetus in early pregnancy without the intervention of doctors. This process can occur in the first 12 weeks of pregnancy. Most miscarriages occur in the first days of conception and fetal development, when the expectant mother may not even assume that she is pregnant.

In medicine, the following types of miscarriages are distinguished:

№	A type	Description
1	Threatening	There is a contraction of the uterus, its tone is disturbed
2	Started	The fetus is still inside the uterus, but there is a process of rejection from its walls, the cervix opens. If you determine in time, consult a doctor, take measures, then it is possible to save the fetus
3	Incomplete miscarriage	In this type, the cervix is partially or completely open, while the fetus partially extends beyond the uterus
4	Complete miscarriage	It is characterized by a clear opening of the cervix and the rejection of the fetus, its tissues from the intrauterine cavity
5	Failed	This type is observed when the fetus dies and stops its development inside the uterus without leaving it
6	Anembryony	With this phenomenon, the fetus is absent. When a sperm cell enters the nucleus of the egg, a bubble forms at the uterine wall, and the formation of the embryo is not carried out, therefore rejection occurs
7	Chorionadenoma	The formation of a tissue clot, which is rejected on its own in a large number of episodes of the occurrence of this phenomenon
8	Repeated miscarriage	This is an arbitrary termination of pregnancy, which occurs not for the first time, but for the third and each subsequent

Video - The main causes of miscarriage

Pregnancy at risk: reasons

There are at least 10 reasons for the threat of miscarriage in primiparous mothers, and each of them has its own dangerous warnings:

№	A threat	Description
1	Hormonal imbalance	The ovaries and adrenal glands, which are responsible for the production of hormones in the female body, fail. Hormones of one type begin to be produced in an increased amount, others - in a reduced amount. Excess male hormones are dangerous for pregnancy, so there is a threat of breakdown. Such a hormonal disruption occurs due to hereditary predisposition, stress, improper lifestyle, a serious illness of one of the internal organs
2	Increased blood clotting	This is the cause of a hereditary predisposition
3	The presence of an infectious disease	In severe form or several less dangerous
4	Incompatibility of rhesus of mother and unborn child	This is a fairly common reason for the threat of miscarriage.
5	Immunological incompatibility	With this phenomenon, the parents are too similar at the genetic level and the woman's immunity suppresses the embryo inside. This is a rare threat in practice.
6	Accident during physical or mechanical stress	Any external factors (falls, poisoning, abdominal trauma, heavy lifting, careless sexual intercourse) often lead to the threat of rejection, even if the woman is completely healthy physically
7	Sperm abnormalities	When planning a pregnancy, it is better to do special test samples that will save a woman from psychological trauma if there is a threat of rejection
8	Defects of the uterus	Fibroids, underdevelopment of the uterus, irregularity of its shape, postoperative internal scars limit the space in which the fetus should develop
9	Endocrine disruptions, severe chronic diseases	Diabetes, thyroid disorders, arthritis, hypertensive crises, renal failure, heart defects - all this adversely affects the development of the unborn baby and complicates the course of pregnancy
10	Bad habits	Not quite healthy life position, stress

In the early stages, you need to be vigilant, monitor your well-being. Warning signs for which you should be alert:

strong, aching, pulling pain in the lower abdomen, in the lumbar region;
cramping pains lasting a day, possibly longer;
bloody, smeared, multiple discharge of a saturated, possibly pale color, accompanied by pain or painless;
frequent bouts of nausea, vomiting;
feeling of tone of the uterus.

The bleeding may stop and start again. Not all discharge indicates the threat of termination of pregnancy, some may be signs of less significant failures - implantation of the ovum, hormonal disruption. Pain and discomfort in the lower abdomen also do not always hint at rejection. But it is better to protect yourself and the child and go to a specialist for an examination. A woman for a period of up to 12 weeks may not know about pregnancy and take discharge for critical days.

If symptoms are found, it is advisable to immediately seek medical help, this is the only way to save the fetus in the early stages. Examination and ultrasound examination will help assess the level of danger. Upon confirmation of the diagnosis, hospitalization is made. The woman lays down to save, because she needs bed rest and complete rest without worries.

Prevention methods

A responsible approach to your condition and health will help to avoid unpleasant moments. Below are small recommendations for preventing problems at the stages of inception, fetal development, which will later help to bear a healthy, strong baby. Simple rules:

planning pregnancy in advance;
healthy lifestyle;
proper nutrition;
protection from stress;
avoiding contact with unhealthy people;
do not overstrain;
do not repair, move furniture;
do not lift more than 2 kilograms of weight;
elimination of all bad habits.

When planning a pregnancy, it is necessary to do a medical examination, if any abnormalities or diseases are found, treat them. With an unplanned pregnancy, you immediately need to give up bad habits, regularly undergo an examination by your attending gynecologist, and strictly follow all his recommendations. The nutrition of the expectant mother is of great importance. Food should be rich in fiber-based foods. A pregnant woman should not forget that she now eats for two.

In no case should you self-medicate, prescribe any medication to yourself, even if it's just vitamins. Stress, physical activity is categorically excluded. Protect yourself from falls, shaking, jolts, do not jump. At first, it is also recommended to exclude intimacy, this will help to avoid the introduction of a possible infection, uterine contractions.

Effective treatment for threats, means of prevention

If you identify symptoms of a threat, suspected miscarriage, you should urgently seek medical help. Treatment begins after a full examination - examination by a gynecologist and ultrasound. The examination will help to identify the tone of the uterus, the structural features of the uterus and its cervix, to show the state of the placenta, the fetus in it. A blood test is also done. After identifying the cause of the threat, treatment is selected.

Treatment depends on the severity of the woman's condition and the reasons for the condition. In case of serious concern, a woman is admitted to a hospital. Less serious cases require the patient to be managed by a doctor, but in her usual home environment.

It is forbidden to take drugs on your own - this can lead to irreversible consequences. Treatment is prescribed only by a doctor.

In case of failures of genetic origin, it is rarely possible to maintain a pregnancy, but doctors will try to do everything possible until the last moment. It is important to maintain complete psychological and physical peace during pregnancy. To ensure such calmness, the doctor prescribes light sedatives, antispasmodics to relieve the tone of the uterus, vitamins of general strengthening effect.

The complex of preventive measures primarily includes giving up bad habits, healthy eating, regular visits to antenatal clinics and a gynecologist. It is important to avoid stress, unnecessary physical exertion, to monitor your personal hygiene. An obligatory moment in planning pregnancy is the need to treat all infectious and general diseases.

Pregnancy is great. But sometimes it happens that the body itself decides to get rid of the incipient new life, and then a miscarriage occurs. In most cases, this occurs early in pregnancy, in the first 12 weeks.

Statistics say that one in five women loses a child without even knowing that she is pregnant. From a gynecological point of view, a miscarriage is a spontaneous termination of pregnancy up to 22 weeks, since children born prematurely - after 22 weeks and weighing 500 grams, today's medicine has the ability to save. But, if the weight is below 500 grams, then the possibilities are zero.

As we have already said, in most cases it happens that the woman does not even suspect that she is pregnant and nothing bothers her. Waiting for the onset of her period, she simply registers that she has a delay, and after a few days, her period begins, but goes more profusely than usual and with pain.

Sometimes, an early miscarriage is characterized by only moderate pain in the lower abdomen and profuse bleeding, then a woman does not even consult a doctor if the bleeding stops soon. If the bleeding is profuse for several days, then going to the doctor cannot be avoided.

In some cases, such periods with a delay are very painful, and one day a blood clot comes out. Then you can definitely say about spontaneous miscarriage at an early date. Usually, this clot resembles a bursting bubble of blood. This phenomenon always scares those who encounter it for the first time. After the release of a blood clot, it is imperative to consult a doctor: first, to undergo an examination and determine exactly what it was; secondly, to check if cleaning is necessary.

A miscarriage is a phenomenon that makes both the body and the soul suffer. Many people know that there is such a danger as spontaneous abortion, but not everyone knows about its causes, and how it can be prevented.

If we talk about early miscarriage up to 12 weeks, then basically it is a test and warning for parents. A miscarriage at this stage of development suggests that either the mother's body is not yet ready for the normal development of the baby inside it, or something is wrong with the health of both parents, and it needs to be strengthened so that the baby will develop healthy in the future, and the organism from unhealthy ones and will get rid of it on its own in the future.

Early miscarriage: causes

Genetic disorder in the fetus... Special attention is paid to the healthy laying of all organs of the future person, which requires equal 23 chromosomes from mom and dad. And if a mutating element suddenly appears in one of them, then it is recognized as incompetent, and a miscarriage occurs.

The presence of such elements is influenced by ecology, viruses, occupational hazards. It is very difficult to avoid these factors; you can only reduce the risk of their influence on the body by going on vacation: for fresh air and for a long time. By carrying out a miscarriage, in this way, the body produces natural selection, characteristic of all life on earth.

Hormonal Disorders. It is known that hormones are responsible for the good vital functions of a woman's body, therefore, their incorrect balance in the body can lead to an early miscarriage. Also, a lack of the hormone progesterone or an excess of the male hormone causes this phenomenon. If such a problem in a woman is diagnosed in advance, then hormone therapy is prescribed to her before planning a pregnancy, which avoids a miscarriage.

Rhesus conflict. No wonder, when planning a pregnancy, they are obliged to take a blood test to determine the group of both the mother and the father (if the mother has a negative Rh factor). In this case, the father's Rh is important, since its opposite indicator can lead to the development of Rh-conflict, when the embryo inherits a positive Rh from the father, and the mother's body determines its tissues as foreign and rejects them, saving itself, as it seems to it.

If the father also has a negative Rh factor, then this problem does not arise. With the timely diagnosis of such a pathology, the hormone progesterone is used, which plays a protective role for the embryo and eliminates this cause of spontaneous miscarriage at an early stage.

Infections. Infection is bad anyway. If you know that you or your partner have a sexually transmitted infection, you need to get rid of it before pregnancy. With the onset of pregnancy with such a diagnosis, the fetus becomes infected and, again, the body will get rid of the embryo at an early stage.

Infectious and inflammatory diseases of internal organs. Any temperature rise up to 38 degrees, caused by a disease of the internal organs, can cause early miscarriage. Usually, such a temperature is accompanied by intoxication of the whole organism, and therefore it is unable to hold the embryo. This is why it is so important to undergo a full examination when planning a pregnancy to detect and treat all chronic diseases and get vaccinated if necessary.

Abortion. As you know, this is an interference with the ordinary life of the female body. If an abortion has ever taken place, then it can lead either to habitual spontaneous miscarriages or to infertility.

Medicines. In the first trimester, the use of any medications is generally not recommended, which can lead to defects in the development of the fetus. There are also herbs that are contraindicated in early pregnancy: parsley, nettle, cornflower, St. John's wort, tansy.

Bad mood. More precisely, severe stress, grief, prolonged mental stress can negatively affect the emergence of a new life. In this case, only with the recommendation of a doctor, it is possible to take some sedatives.

Lifestyle. You need to change your habits right away when planning a pregnancy. Getting rid of bad habits, balanced and nutritious nutrition are the first conditions for the development of a healthy child, the opposite can lead to miscarriage.

Physical impact. Unsuccessful falls, heavy lifting are the starting point for miscarriage and contribute to it, only if one of the above reasons is on the face. If the mother is healthy, then this effect must be very strong to cause a miscarriage.

Early miscarriage: symptoms

The most common signs of a miscarriage are lower abdominal pain and bleeding... Also, pain from the lower abdomen can indulge in the lower back. This pain is intermittent. Vaginal discharge talk about the threat of early miscarriage. If such discharge has a reddish or even brownish tint, then you should see a doctor to avoid miscarriage.

Often referred to as a symptom of miscarriage uterine tone, but only in cases where it is accompanied by discomfort for the mother and pain. If it is not accompanied by anything, then the recommendations of doctors stop at reducing physical exertion and reducing stressful situations.

In some cases, even after the above symptoms, the pregnancy proceeds normally in the future, only under the more careful supervision of doctors, then they talk about the threat of miscarriage.

The symptoms of a miscarriage at any stage of pregnancy are relatively similar. Only they can be accompanied by more severe pain and profuse discharge.

Second trimester: symptoms of miscarriage:

the damage to the bag of amniotic fluid is indicated by the liquid that drips from the vagina, in this case, an appeal to the doctor should be instant;
vaginal bleeding is a sign of miscarriage in any trimester of pregnancy;
blood clots that appear during urination, accompanied by pain;
internal bleeding, which can be indicated by very severe pain in the shoulder or in the stomach area.

How is a threatened miscarriage diagnosed?

If your pregnancy is planned, and you went through all the procedures necessary for the preparation, which the doctor told you about, passed all the tests and treated all the diseases found in the disease, then the possibility of miscarriage is reduced to a minimum. If some contraindications were discovered in advance, then great attention is paid to them already at the conception of the baby. In this case, the diagnosis of the threat of miscarriage takes place at the planning stage, and treatment is prescribed in advance.

If pregnancy occurs spontaneously, without prior treatment and examination, then any gynecologist can diagnose a miscarriage during a routine examination. Examining a woman who came with a delay problem, the doctor determines the expected gestational age.

checks the conformity of the size of the uterus to the given period;
checks for the presence of uterine tone;
determines if the cervix is closed;
draws attention to the nature of the discharge (bloody or mucous).

The most reliable way to diagnose miscarriage or premature birth at a later date is transvaginal ultrasound, which is performed by an experienced doctor. When using this method, the length of the cervix and the condition of the internal os are checked.

Early miscarriage treatment

The most basic and first thing that a doctor advises in case of a threat of miscarriage at any stage of pregnancy is adherence to bed rest... In some cases, in order to maintain the pregnancy, the woman is even forbidden to get out of bed. It is clear that your physical activity should be reduced to zero when there is a threat of miscarriage.

It is also recommended to reduce the level of anxiety, bad news and thoughts. From the first weeks of existence, the nascent life feels you from the inside, any of your excitement can negatively affect its state. And disturbances in the condition can lead to its rejection by your body. To avoid these nervous tensions, your doctor may prescribe valerian or motherwort.

You yourself can use relaxation therapy: sit comfortably on a sofa or armchair and think about something good. The best thing in this case can be dreams of a future baby, choosing a name, mentally drawing his portrait. But all this after consulting a doctor.

If the threat of termination of pregnancy is more serious and just good thoughts cannot be dispensed with, then the first thing the doctor does is determine the cause of the threat. After determining the cause of the threat of miscarriage in the first weeks of pregnancy, prescribe hormonal drugs, which are designed to maintain a good course of pregnancy.

You may be prescribed progesterone (it is part of urozhestan, duphaston), drugs for hyperandrogenism (with a large number of male hormones), as well as drugs when there is a threat of Rh-conflict, can be prescribed.

If the doctor deems it necessary, then an additional intrauterine ultrasound examination can be performed. If such an examination reveals a failure, then stitches are placed on the cervix that stop the fertilized egg inside the uterus. Such an operation is performed in a hospital and under anesthesia, while relaxing drugs are injected into the uterus.

Most cases of a threat of miscarriage in early pregnancy are treated in a hospital, sometimes women have to remain under the supervision of doctors until the very end of pregnancy, that is, before childbirth. In some cases, treatment begins in a hospital, and then goes to home conditions, subject to bed rest. Sometimes, having undergone treatment with a threat of miscarriage at an early stage, a woman does not return to him until the very birth.

Prevention of miscarriage

It is possible to avoid miscarriage in most cases. If the couple treats their decision in a balanced and responsible manner, then a doctor will be examined in time, which will reveal all kinds of deviations and inconsistencies in the organisms of a man and a woman. A preliminary examination will allow you to cure all kinds of infectious and hormonal diseases that can cause miscarriage later.

Six months before the planned conception, the couple's habits and lifestyle should be changed. Maintaining a healthy lifestyle will help reduce your risk of miscarriage.

Consequences after a miscarriage in the early stages

From a medical point of view, serious consequences after a spontaneous miscarriage in the early stages are extremely rare. Big problems can arise if this miscarriage is caused on its own with the help of medications or folk remedies, or if fetal particles remain in the uterus, which most often happens at a later date with miscarriages.

It is in order to avoid such problems and in the early stages that gynecologists prefer to do preventive cleaning of the uterus after a miscarriage. If a woman goes to a doctor, she is always given a control ultrasound.

Many believe that the consequence of one miscarriage is subsequent spontaneous miscarriages. But in reality this is not the case. Subsequent miscarriages occur after the first only if the cause of the first miscarriage has not been identified or this cause has not been treated.

A miscarriage in early pregnancy does not bear serious consequences only with a timely visit to a doctor. If this fact is neglected, then severe uterine bleeding may occur, that is, a large loss of blood, which will lead to death, or blood poisoning, which is also extremely unpleasant and dangerous.

Even if the next menstruation does not go as usual (more abundant or with severe pain), it is better to consult a doctor with this, and suddenly you were pregnant and did not notice it. The answer to the question of what to do in case of early miscarriage is to consult a doctor, if it is very bad, then even call an ambulance.

Replies

You can still effortlessly fit into tight skinny jeans, not suffer from nausea in the morning, not find age spots on the cheekbones and stretch marks on the abdomen. But at the same time, already know the most important female secret: two test red stripes, proving that a tiny, but already a real new life has arisen in you! No supersensitive device is yet able to see or hear her presence. However, the maternal instinct is already pushing to come up with a name for the fetus, talk with him, look closely at the cute little things in children's stores.

Thunder from a clear sky breaks this rainbow of illusions by an unexpected interruption or, as gynecologists say, a miscarriage. According to stubborn statistics, in one case out of five, pregnancy ends in a treacherous miscarriage at an early stage, when a woman may not even know about her “interesting” situation. But don't despair! Do not complain about over-employment, but go to preservation! A visit to the doctor will help to find out the causes of what happened and eliminate problems on the way of a successful attempt to bear a healthy and strong baby.

What to do?

In this case, against the background of emotional experiences, girls may not make entirely adequate decisions. Some, frightened, fear pregnancy like fire for several years, while others immediately try to get pregnant again, and do it as soon as possible. Experts say that neither one nor the other is right. The most reasonable solution would be to identify and eliminate, together with a professional doctor, the causes of spontaneous abortion. Only then is it worth trying to conceive a new life and bear a healthy child. Acceleration of the process for unexplained reasons leads to repeated miscarriage. Doctors called such cases "habitual miscarriage." At least three months are required for the female body to recover, then it is necessary to undergo examination and full treatment. Haste in this case is destructive!

Bloody discharge;
Pulling or cramping painful sensations in the lower abdomen or in the lumbar region;
In the later stages of pregnancy - with leakage or complete outpouring of amniotic fluid.

Miscarriage statistics take into account the condition of women, called missed pregnancies. The embryo that died in the womb due to the negative effects of a number of factors remains in the uterine cavity and begins to decompose. This leads to the most powerful intoxication of the female body, leading to a serious condition, up to and including death. Timely medical care saves a woman's life, and the next conception can only be planned after treatment with full recovery after 12 months.

Different periods of pregnancy lead to different causes of miscarriages.

Before 6 weeks of pregnancy, miscarriage usually occurs due to genetic malformations of the embryo itself. Scientific studies have shown that most (70 to 90 percent) of the extracted embryos have chromosomal abnormalities. This can happen if the expectant mother carried infectious diseases (in particular, the flu) on her legs, took medications on her own that were not prescribed by a doctor, has bad habits (alcohol and smoking), or conception occurred with a partner with an inappropriate chromosome set. Therefore, the tragedy of the loss of a child should be replaced by the understanding that fate saved you in this case from the birth of an unviable or very sick baby. The next pregnancy should be planned after a complete examination and treatment of both partners.

At 6-12 weeks of gestation, a miscarriage is also considered early. At a period of 7-8 weeks, a miscarriage of the ovum sometimes occurs, in which the embryo itself is absent. Doctors call this fact "anembryony". And the woman should take into account that in this case she did not lose anything, since there was actually no fruit inside.

These disorders occur when not enough female hormones are produced in the ovaries to keep the fetus inside the uterus. Male sex hormones in larger quantities than necessary in the female body are also the cause of miscarriage.

If the hormonal balance in the woman's body is disturbed, there is a lack of progesterone or the tone of the uterine muscles is increased, then it is possible to provoke the expulsion of the fetus.

Progesterone is a hormone that provides the main function of preparing the uterine mucosa before implantation and maintaining pregnancy, especially in the first trimester. Its deficiency is corrected by doctors in time, and the pregnancy can be safely saved.

Male sex hormones - androgens, which are in excess in a woman, suppress the production of progesterone and estrogen. Thyroid and adrenal hormones also play an important role in the preservation of the fetus. Medical care that regulates the level of hormonal levels can solve the problem and prevent spontaneous abortion.

Sexually transmitted diseases: trichomoniasis, syphilis, chlamydia, toxoplasmosis, herpes and cytomegalovirus infections are subject to early treatment before conception. Depending on the conditions of the course of the disease, they either lead to the formation of malformations during the development of the fetus, to its infection inside the womb or miscarriage.

Inflammatory process in the uterus

The consequences of gynecological diseases, previous abortions can cause miscarriage.

Viral infections

Any diseases that cause intoxication of the body and a rise in temperature from 38 degrees Celsius can lead to miscarriage. Viral hepatitis, influenza and rubella are the leaders of this black list. At a dangerous period of 4-10 weeks, ordinary angina can cause tragedy, pneumonia can also be fatal to the fetus. Appendicitis and pyelonephritis cause early labor. In order to avoid such consequences, it is necessary to undergo an examination and cure all infectious foci before conception. And during pregnancy, avoid hypothermia, communication with sick people.

Rubella infection during pregnancy is an indication for medical termination of pregnancy, since this disease causes severe fetal malformations.

Any disease is extremely dangerous for the embryo, because if a woman has developed immunity and can resist ailments, then the fetus does not have such strong protection and may become unviable. Therefore, nature, through miscarriage, insures a woman from an unhealthy child. Moreover, the next pregnancy for most expectant mothers is going well.

Immune causes

The conflict between the positive Rh factor of the father and the negative Rh factor of the mother can lead to the production of antibodies that are hostile to the embryo. If a pregnant woman is constantly monitored by a doctor, then control of the antibody titer and the introduction of immunoglobulin will allow the child to be carried.

Reduced immunity

The body of a woman with lowered immunity will not be able to raise a baby in itself. First you need to take care of your own health, and then, with strong strength, try to conceive and endure a new life.

Anatomy

If a woman suffers from malformations of the uterus, then doctors consider this a hopeless case. After a miscarriage, gynecologists recommend simply resigning yourself.

Late miscarriage occurs at 12-22 weeks. In addition to the above reasons (anatomical, immune, endocrine and infectious), there are also specific ones.

Weakness of the cervix (in 15-43% of women) does not hold the fetus and may open. How to avoid miscarriage in the second or even third trimester? Delicate surgical correction (a suture or a ring is applied) and constant supervision will help to carry a healthy baby. However, the ring is not considered a completely reliable method, since it can slip off the cervix ahead of time and the uterus will open on its own.

In addition, the operation will require the use of antibiotics and other drugs that normalize the vaginal microflora. At 37 or 38 weeks, the stitches are removed. If labor begins earlier, then they are removed before it. Therefore, careful monitoring is essential.

After 22 weeks, a miscarriage is perceived psychologically especially difficult, since after 28 weeks obstetricians consider the baby born to be viable. Modern medicine sometimes keeps children at an earlier age, but the risk is still great.

A thorough preliminary examination will reveal other diseases that can cause a miscarriage.

Antiphospholipid syndrome - the female body with this disease "does not recognize" the child and rejects him as a foreign body. Correction with medications gives a chance to carry a child.

Hemostasis disorders - there are two types: thrombophilic (with increased blood clotting) and hemorrhagic (with a tendency to bleeding). Both types of disorders are dangerous to the fetus.

Headaches from an unknown cause, lethargy, fatigue, temporary loss of hearing or smell may indicate a blood clotting disorder. When planning a pregnancy, in this case, we must undergo a genetic examination and carry out a full-fledged treatment. This prevents miscarriage almost completely (in 98% of cases). If the pathology of hemostasis is detected already during pregnancy, then its preservation can be very difficult.

How to avoid a second miscarriage?

Look for the reason, do the examination of both future parents! It is better to spend a couple of months on visits to medical institutions and tests than to conceive, hope, and then survive the tragedy and return to professionals again. Get ready for conception, and then Mother Nature will present you with a wonderful healthy child!

Figures confirming the severity of the survey:

In 4/5 or 80% of cases, miscarriages might not have happened if expectant mothers followed the recommendations of doctors;
3/5, or 60% of miscarriages occurring for the first time, are associated with hormonal disruptions in the female body;
The smallest baby, whose life was saved by doctors, weighed 283 grams;
3/4 of miscarriages are due to the pathology of the blood coagulation system;
Three menstrual cycles are the shortest period in which a woman can recover in order to prepare for conception. Experienced gynecologists say that this problem can be corrected in a maximum of 12 months.