How much harm does a miscarriage do to women? What are the symptoms of a miscarriage?

When pregnancy ends before 20 weeks and the fetus weighs less than 500 grams, it is called miscarriage. Miscarriage is divided into spontaneous abortion and artificial abortion; artificial abortion is the termination of pregnancy by artificial or drug methods, which is called early pregnancy termination. Spontaneous abortion refers to the embryo or fetus being automatically separated from the mother and discharged for some reason before 28 weeks of pregnancy, and its incidence rate is about 15% to 20%. Spontaneous abortion occurs 3 or more times in a row and occurs within three months of pregnancy, which is also called recurrent early spontaneous abortion. At the same time, spontaneous abortion also has a kind of missed abortion, which refers to the embryo or fetus that has not been naturally discharged after 2 months of intrauterine death. The causes of spontaneous abortion are very complicated, including chromosomal abnormalities, abnormal fertilized eggs, poor embryo quality, poor egg quality at an older age, poor sperm quality at an older age, genetic diseases, environmental pollution, etc.

1. Symptoms

The main symptoms of miscarriage are bleeding and abdominal pain

1. Vaginal bleeding

In the case of miscarriage within 3 months of pregnancy, the chorionic villi and decidua separate at the beginning, the blood sinuses open, and bleeding begins. When the embryo is completely peeled off and expelled, the uterus contracts strongly, the blood sinuses close, and the bleeding stops. Therefore, the whole process of early miscarriage is accompanied by vaginal bleeding. In late miscarriage, the placenta has been formed, and the miscarriage is similar to premature and full-term births, and generally there is not much bleeding.

2. Abdominal pain

After the bleeding starts in early miscarriage, there is blood in the uterine cavity, especially blood clots, which stimulate uterine contractions and cause persistent lower abdominal pain. In late miscarriage, there are paroxysmal uterine contractions first, followed by placental detachment, so there is abdominal pain before vaginal bleeding.

Abdominal pain and bleeding are mostly progressive and are related to their clinical course and progress.

2. Diagnostic Criteria

1. First, determine whether you have miscarriage

1) Detailed medical history

Whether there is a history of amenorrhea, whether there is vaginal bleeding, the amount and nature of the bleeding, whether it is accompanied by abdominal pain and other discharges, etc.

2) The amount of uterine bleeding during abortion is generally greater than that during ectopic pregnancy

It is also different from other abnormal pregnancies. Ectopic pregnancy is mostly vaginal bleeding; the bleeding of hydatidiform mole is often dark red, and it can also bleed repeatedly, or even cause a lot of vaginal bleeding. If carefully examined, sometimes blister-like tissue can be found in the blood. Dysfunctional uterine bleeding often occurs at both ends of the reproductive age. Those who occur over 40 years old often have a history of amenorrhea. Although there is a lot of vaginal bleeding, there is usually no abdominal pain, and there are rarely other discharges. All these situations are not difficult to distinguish, combined with the history of pregnancy and childbirth and the presence or absence of contraceptive measures. If there is any doubt, diagnostic curettage can be performed, and pathological examination can usually confirm the diagnosis; it is also conducive to treatment. Many cases of miscarriage are indeed misdiagnosed as functional uterine bleeding. Patients with uterine fibroids have no obvious history of amenorrhea but have a history of menorrhagia and infertility. If the uterus is large and the myonuclei can be touched, the diagnosis will be clearer.

3) The time from bleeding to the last menstrual period

That is, the time from the last menstrual period to the onset of vaginal bleeding is often shorter in ectopic pregnancy, but longer in miscarriage and hydatidiform mole.

4) The color of the blood

The abortion is bright red at the beginning, and it turns dark red or brown over time. Ectopic pregnancy is often small in size and light red or brown in color; hydatidiform mole is often dark red.

5) Abdominal pain

Abdominal pain in cases of miscarriage and hydatidiform mole is generally mild and paroxysmal, mostly in the center of the lower abdomen. Ectopic pregnancy is severe pain in the lower abdomen on one side, which may affect the whole abdomen and gradually subside after 1 to 2 days. There is usually no lower abdominal pain in cases of functional uterine bleeding. Uterine fibroids may cause a feeling of heaviness in the pelvis or mild pain.

6) Understand whether there is early pregnancy after menopause and the causes of miscarriage

Such as sex life, weight bearing, travel, etc.

2. Bimanual examination

Pay attention to the position, size, shape, and hardness of the uterus; whether the isthmus of the uterus is particularly soft, as if the uterine body and cervix have lost continuity; whether there are lumps, tenderness, or resistance in the appendages on both sides; whether there is erosion or bleeding at the cervical opening; and whether there are cervical polyps; and it is necessary to identify whether the bleeding is coming from the uterus. If it is a miscarriage, the bleeding must be coming from the uterus.

What are the reasons for miscarriage in women? Most of the miscarriages are caused by the early stages of pregnancy. There are many reasons for the process. In addition to the factors we are familiar with, excessive smoking, alcoholism, excessive coffee, heroin and other drugs, as well as food, such as turtles and crabs, which have the effect of promoting blood circulation and promoting blood circulation, are common causes of miscarriage. In addition, staying up late and work pressure can not be ignored.

Through the above introduction, I believe many friends have some understanding of the reasons for women's miscarriage. Relevant experts pointed out that there are many reasons for women's miscarriage, but the focus of women's miscarriage is often different, so women's miscarriage should be treated with caution. After all, successful pregnancy is difficult, and it is also for the purpose of better achieving the goal of eugenics.

1. Prevent and avoid miscarriage

The following points should be noted

1. Patients with acute infectious diseases must wait for a period of time after recovery before becoming pregnant. Patients with chronic diseases should be treated until their condition is stable and approved by a specialist before becoming pregnant.

2. Couples with a history of miscarriage should go to the hospital for examination in time to find out the cause of the miscarriage. No matter which party has the problem, they should be treated in time and have children after recovery.

3. Pregnant women should avoid contact with harmful chemicals, such as benzene, mercury, radiation, etc. In the early stages of pregnancy, you should avoid going to public places to avoid viral and bacterial infections. If a pregnant woman is sick, she should take medication under the guidance of a doctor in a timely manner and should not take medication at will.

4. In the early pregnancy period (within 12 weeks of pregnancy), in addition to paying attention to dietary hygiene and avoiding excessive fatigue, you should also avoid excessive tension and maintain emotional stability to help protect the fetus. Do not have sex in the first three months of pregnancy. If the fetus is found to be abnormal after examination and the doctor believes that a curettage should be performed, the patient should not delay to avoid excessive blood loss (even shock, death) or internal genital inflammation that affects future fertility. It should be noted that most aborted embryos are generally congenitally defective and belong to the category of natural elimination. Do not lose sight of the big picture and endanger the health of pregnant women.

2. Preventing miscarriage for those with a history of miscarriage

Contraception should be used within six months after a miscarriage, and waiting six months before getting pregnant again can reduce the occurrence of miscarriage.

To do genetic testing, both husband and wife undergo chromosome testing at the same time.

Blood typing includes the Rh blood typing system.

If the internal os of the uterus is loose, internal os suture can be performed.

The duration of medication for the treatment of luteal phase insufficiency should exceed the gestational age of the last miscarriage.

People with hypothyroidism should maintain normal thyroid function before becoming pregnant, and should also take anti-hypothyroidism drugs during pregnancy.

Pay attention to rest, avoid sexual intercourse, maintain emotional stability, and lead a regular life.

The man should have his reproductive system checked. Those with bacteriospermia should be treated thoroughly before getting his wife pregnant.

Avoid contact with toxic and radioactive substances.

Computer workers should work less than 20 hours per week. After a miscarriage, you should rest for four weeks.

3. Spontaneous abortion is a misfortune for pregnant women

But in a sense, spontaneous abortion is a way for humans to continuously optimize themselves, and it is also a selection for new life in the making. Survival of the fittest is the law of nature. Early abortion of fetuses with chromosomal abnormalities, which account for more than 50% of abortions, will reduce the birth of deformed babies. Therefore, before preserving the fetus, the cause should be found out as much as possible, and do not preserve the fetus blindly.

General treatment

1. Threatened abortion

1. In clinical practice, the principle of treatment is to preserve pregnancy.

About 60% of threatened abortions are cured with proper treatment. For those who have survived the embryo after B-ultrasound examination, they should stay in bed and rest, and do appropriate activities after the symptoms disappear. Try to avoid all stimulations that can cause uterine contractions, such as vaginal examinations and sexual intercourse. Reduce unnecessary mental tension and concerns of patients. Let patients understand from the perspective of eugenics that most early abortions are due to abnormal embryos due to various reasons, and abortion is a natural elimination and should not be regretted.

2. Pay attention to adequate nutrition.

Sedatives that are harmless to the fetus, such as Lumina 0.03-0.06g, 3 times a day. Keep bowel movements smooth. If constipation occurs, take laxatives, such as 1-2 tablets of Tongbianling (Luhui, Amber, etc.). The dosage is easier to control than that of Guolao and diacetol tincture, and it has a good effect in softening stool.

3. Endocrine therapy such as luteal insufficiency,

Progesterone 20 mg can be used, 1 to 2 times a day, intramuscularly, to help the growth of decidua and inhibit uterine muscle activity. Treatment should be under B-ultrasound monitoring.

4. Application of estrogen,

In recent years, many scholars have reported that baby girls are prone to vaginal adenosis and even adenocarcinoma.

5. Early application of chorionic gonadotropin,

Promote progesterone synthesis. Vitamin E (tocopherol) is beneficial to the development of pregnant eggs, 100 mg per day, orally. Some authors believe that vitamin E has a similar effect on the local uterus as progesterone and acts on the central nervous system, 200 mg each time, twice a day.

For those with low basal metabolism, 0.03g/d of thyroid tablets can be taken orally.

The condition of the embryo can be understood under B-ultrasound monitoring to avoid unnecessary pregnancy preservation.

2. Miscarriage is inevitable

1. Treatment principle: remove the embryonic tissue in the uterine cavity

Vacuum extraction should be performed in early pregnancy. If there is a lot of bleeding, 10U of posterior pituitary hormone (or oxytocin) can be injected immediately to promote uterine contraction, expel tissue, and prepare for uterine suction. If it is mid-term pregnancy, posterior pituitary hormone (or oxytocin) can be given to induce labor. Methods: ① 5U of posterior pituitary hormone (or oxytocin), once every half an hour, intramuscular injection, 4 to 6 times in a row, waiting for it to be discharged automatically. However, those with a history of uterine trauma or infection should use it with caution or not at all to avoid uterine rupture; ② High-concentration pituitary hormone induction of labor, 1-5% oxytocin (1-5U per 100ml) can be given by intravenous drip, starting from a low concentration, gradually increasing to an effective concentration (causing strong uterine contractions), and maintaining this concentration until the embryonic tissue is discharged.

2. Bleeding for a long time

The cervix is ​​dilated and the embryo can be removed surgically.

3. Incomplete abortion

1. The uterine cavity should be cleared.

If there is a lot of bleeding and shock, the patient should be given fluid or blood transfusion to correct the shock, and oxytocin 10U should be given intravenously or intramuscularly, and the uterine cavity should be prepared for cleaning. Once the shock is corrected, the placenta can be scraped or sucked out of the bleeding placenta.

2. Prevent infection after surgery.

At the same time, iron supplements and Chinese medicine are given to correct anemia.

4. Complete abortion

After the embryonic tissue is discharged, the bleeding stops and the abdominal pain disappears. No special treatment is required except that the patient is advised to rest and pay attention to postpartum health. However, whether the embryonic tissue is completely discharged must be correctly judged. If the discharged tissue has a complete fetal sac, decidua or fetal placenta, combined with symptoms and examinations, and confirmed by B-ultrasound examination when necessary, it can be diagnosed as a complete abortion; if it cannot be determined, it should be treated as an incomplete abortion, and another curettage is appropriate.

5. Missed abortion

1. Different opinions on handling

There are even completely opposite opinions. Some people think that there is no need to interfere and wait for it to be discharged naturally. But some people think that surgery should be performed after diagnosis. The current commonly used treatment principle is: if the fetus is confirmed to be dead within 3 months of pregnancy, the uterine cavity can be immediately cleared. If the pregnancy period exceeds 3 months, a large amount of estrogen is used first, and then oxytocin is used to induce labor. If it is unsuccessful, surgery can be considered. In missed abortion, the longer the embryo has died, the more difficult it is to perform curettage due to tissue organization; and in recent years, clinical and literature reports have shown that missed abortions over 16 weeks of pregnancy may cause coagulation disorders and severe bleeding, so active treatment is appropriate after diagnosis.

2. Give estrogen or diethylstilbestrol 5 mg before surgery

4 times a day for 3-5 days to make the uterus sensitive to oxytocin. Before the operation, check the blood routine, blood coagulation time, and if conditions permit, check fibrinogen and prepare for blood transfusion.

3. Within 3 months,

Uterine suction or uterine intubation 12 hours before surgery, followed by curettage. For older women, B-ultrasound examination is performed first to understand the size of the fetus at the time of death and whether there is amniotic fluid. If there is amniotic fluid, amniocentesis can be performed, and 80-100 mg of rivanol can be injected into the amniotic cavity to induce labor. Oxytocin can also be used to induce labor if necessary, and the former is more convenient and safer.

TCM treatment for miscarriage

Treatment based on syndrome differentiation

2. Traditional Chinese Medicine Treatment

1. Weak Qi and blood

The treatment method is as for threatened abortion. After the symptoms improve, take one dose every 3 to 5 days for up to 4 months. For those with morning fever, double the amount of Scutellaria baicalensis and reduce the amount of Amomum villosum; for those with cold stomach, use more Amomum villosum and less Scutellaria baicalensis. For those with vaginal bleeding, use Jiao Ai Tang, sometimes with Eucommia ulmoides and Viscum album; for those with strong fetal fire, use Phellodendron chinense and Anemarrhena asphodeloides.

2. Kidney Qi is not solid

Treatment method: Nourish the kidney and consolidate the Chong.

Prescription: Bushen Guchong Pills: 75g of Cuscuta, 30g of Dipsacus asper, 45g of donkey-hide gelatin, 30g of antler frost, 45g of Rehmannia glutinosa, 30g of Atractylodes macrocephala, 30g of Eucommia barbarum, 10g of Amomum villosum, 24g of Angelica sinensis, 30g of Morinda officinalis, and 20 pieces of jujube pulp. Grind them into fine powder and make honey pills, each weighing 10g. Dosage: 1 pill each time, 3 times a day. Stop taking it when menstruation comes, and one course of treatment is two months. If you have conceived, you can take Bushen Antai Drink with added flavor: 12g of Codonopsis pilosula, 10g of Atractylodes macrocephala, 12g of Eucommia barbarum, 12g of Cibotium barometz, 10g of donkey-hide gelatin, 10g of Artemisia argyi charcoal, 10g of Cuscuta, 10g of Viscum album, 10g of Alpinia oxyphylla, and 10g of Psoralea corylifolia.

Start taking the medicine two weeks before the month of habitual abortion, one dose every other day, and continue taking it until the month of habitual abortion.

Traditional Chinese medicine believes that threatened abortion is mostly caused by weak Qi and blood, damaged kidney Qi, and unstable fetus, which lead to imbalance of Qi and blood, unstable Chong and Ren meridians, affecting embryo implantation and development, and causing miscarriage.

3. Weak Qi and blood

In early pregnancy, there is vaginal bleeding, back pain and abdominal distension, or in mid-pregnancy, there is restless fetal movement, vaginal bleeding, fatigue, pale tongue, and slippery and weak pulse.

Treatment method: Invigorate Qi, nourish blood and stabilize the fetus.

Prescription: Taishan Panshi Drink with modifications: Codonopsis pilosula 10g, Atractylodes macrocephala 10g, Astragalus membranaceus 10g, White Peony 10g, Scutellaria baicalensis 10g, Chuanduan 10g, Tangerine peel 6g, Rehmannia glutinosa 10g, Amomum villosum 10g.

4. Kidney deficiency

It is caused by low back pain, weak legs or a history of miscarriage, restless fetal movement during pregnancy, or even low back pain, abdominal pain, fetal bleeding, frequent urination, deep and weak pulse, pale red tongue and little coating.

Treatment method: Nourish the kidney and stabilize the fetus.

Prescription: Shoutai Pills with added ingredients: Cuscuta 30g, Viscum album 10g, Dipsacus asper 10g, Eucommia ulmoides 10g, Rehmannia glutinosa 10g, donkey-hide gelatin 10g (taken with water), and roasted liquorice root 3g.

5. Blood heat

The fetus is restless, falling, the discharge is bright red, there is dry mouth, irritability, hot palms, yellow and red urine, red tongue, thin yellow fur, and slippery and rapid pulse.

Treatment method: Clear away heat and stabilize the fetus.

Prescription: 10g of raw rehmannia, 10g of peony root, 10g of scutellaria, 10g of chuanduan, 10g of yam, and 10g of Houttuynia cordata.

1. Diet therapy after miscarriage

1. Egg and Date Soup:

2 eggs, 10 red dates, and appropriate amount of brown sugar. Put water in a pot and boil it, then add the eggs and boil them. Then add the red dates and brown sugar and simmer for 20 minutes. It has the effect of replenishing qi and nourishing blood. It is suitable for the conditioning of anemia and insufficient qi and blood after illness and childbirth.

2. Lychee and jujube soup:

7 dried lychees and 7 dried jujubes. Add water and decoct them together, 1 dose per day. It has the effect of nourishing blood and promoting body fluid. It is suitable for women with anemia and physical weakness after miscarriage.

3. Soy milk rice porridge:

2 bowls of soy milk, 50 grams of rice, and an appropriate amount of sugar. Wash the rice and cook it with soy milk to make porridge. Add sugar after it is cooked. Take it on an empty stomach every morning. It has the effect of harmonizing the spleen and stomach, clearing away heat and moistening dryness. It is suitable for the conditioning of physical weakness after abortion.

4. Pigeon and wolfberry soup:

1 pigeon, 30g wolfberry, a little salt. Remove the hair and internal organs of the pigeon, wash it, put it in a pot, add water and wolfberry and stew it together. Add a little salt when it is cooked. Eat the meat and drink the soup twice a day. It has the effects of invigorating qi, replenishing blood, and regulating deficiency. It is suitable for physical weakness after abortion and qi deficiency after illness, fatigue, spontaneous sweating due to superficial deficiency, etc.

5. Candied red dates:

50g dried red dates, 100g peanuts, 50g brown sugar. Wash the dried red dates and soak them in warm water. Boil the peanuts briefly and peel them for later use. Put the dates and peanut skins into a small aluminum pot, add the water used to boil the peanuts, and then add an appropriate amount of water. Boil for 30 minutes over low heat, remove the peanut skins, add brown sugar, and wait until the brown sugar dissolves and the juice is collected. It has the effects of nourishing blood and regulating deficiency. It is suitable for anemia after miscarriage or low blood count.

1. First of all, we must ensure the supply of high-quality protein, adequate vitamins and inorganic salts, especially sufficient iron to prevent the occurrence of anemia.

2. Food selection should be nutritious and easy to digest and absorb. Fresh fish, tender chicken, eggs, animal liver, animal blood, lean meat, soy products, milk, jujube, lotus seeds, fresh fruits and vegetables can be provided.

3. As the body is weak and prone to sweating, it is advisable to replenish water in small amounts and multiple times. Sweat excretes more water-soluble vitamins, especially vitamin C, vitamin B1, and vitamin B2. Therefore, you should eat more fresh vegetables and fruits. This is also helpful to prevent constipation.

4. Nourishing blood and replenishing qi: When it comes to nourishing qi and blood, there are many traditional dietary methods worth learning from, such as astragalus, donkey-hide gelatin, brown sugar, jujube, glutinous rice, polished rice, old chicken, ginger, spinach, black plum, etc., which have extraordinary effects of astringing and stopping bleeding, replenishing qi and blood. In addition, pork, animal liver, and blood tofu also have the effect of replenishing iron and producing blood. At the same time, sufficient intake of vitamin C can increase the efficiency of iron absorption and utilization. For this reason, it is necessary to pay attention to the combination of meat and vegetables in diet. Traditional medicine believes that weakness, paleness, back pain, and fatigue that often occur after artificial abortion are caused by damage to qi and blood. Indeed, abortion can cause blood loss, and pain and tension can damage qi. People will be more sensitive to the damage of abortion when they are older, and often need a longer time to replenish qi and blood.

1. Do not eat or eat less greasy and cold food

It is not advisable to eat foods that regulate qi, promote blood circulation, or are cold in nature, such as radish, hawthorn, bitter gourd, and orange.

2. Eat less hot and irritating foods

Such as leeks, pickled mustard tubers, snow mustard, coriander, lamb and other foods.

3. Avoid eating irritating foods

Such as chili, wine, vinegar, pepper, ginger, etc., these foods can stimulate congestion of sexual organs and increase menstrual volume.

4. Foods that may cause miscarriage

1) Avoid eating foods

Unpasteurized protein foods

This includes milk, cheeses such as Brie, feta, Camembert, Roquefort, white cheese, fresh cheese, frozen or smoked meats, seafood such as salmon, trout, cod, tuna, mackerel (often labeled "Rising Star Foods," "Smoked Salmon," "Smoked," "Smoked Products," or "Dried Meat.") These foods often contain harmful bacteria. Frozen or smoked seafood is safe to eat if it is cooked, such as baked or steamed.

Here we want to talk about whether it is better for pregnant women to drink fresh milk or yogurt. Fresh milk is fresh and its nutrients are rarely damaged, so it has a higher nutritional value, so many mothers prefer fresh milk, but its disadvantage is that it is easily contaminated and spoiled, so when buying fresh milk, try to go to large supermarkets and choose products from well-known companies.

But some mothers cannot drink fresh milk. Due to the lack of lactase or low lactase activity, the lactose in the milk cannot be broken down in the intestines, and fermentation produces a large amount of carbon dioxide, leading to bloating and diarrhea. These expectant mothers can choose to drink yogurt. Yogurt is made by adding lactobacillus to fresh milk for fermentation. Due to its small clots, the minerals calcium, iron, zinc, etc. in it are more easily absorbed. At the same time, it can inhibit pathogenic bacteria in the intestines and stimulate intestinal peristalsis, thereby playing a two-way regulatory role on intestinal function. Therefore, for mothers with lactose intolerance, yogurt is a good choice.

2) Avoid food 2: Instant noodles

Many expectant mothers say that they don’t want to eat, their mouths have no taste, and they want to eat instant noodles. But in fact, even normal people should not eat too much instant noodles, because the main ingredient of instant noodles is carbohydrates, and the soup contains only a small amount of MSG, salt and other condiments, and the nutritional content is very small, while the normal life activities of expectant mothers require protein, fat, carbohydrates, minerals, vitamins and water. As long as one of these nutrients is lacking for a long time, you will get sick. So expectant mothers should try not to eat this kind of food or prohibit eating it. Although there is no benefit for expectant mothers to eat instant noodles, some mothers really can’t resist the temptation of the delicious instant noodles. At this time, expectant mothers must pay attention to the following points when eating instant noodles:

(1) You can only take it once a day and not every day.

(2) When eating, you should add some side dishes to make up for the nutritional deficiencies.

(3) Third, expectant mothers who suffer from gastrointestinal diseases, poor appetite, and malabsorption should not eat instant noodles.

3) Avoid food 3: Hawthorn

Hawthorn is sweet and sour, appetizing and aiding digestion. It has always been a popular snack for many women, especially in the early stages of pregnancy. Many women prefer to carry some with them, so they will eat a lot of hawthorn during this period. Medical experts point out that although hawthorn is good, it is not advisable to eat too much, as some of the ingredients in it will stimulate the uterine muscles to become excited, causing uterine contractions and leading to miscarriage. Especially for brides who have experienced spontaneous abortion, habitual abortion, or signs of threatened abortion, they should eat less hawthorn during this period to prevent accidents.