What are the symptoms of miscarriage?

Abortion is a topic that many women do not want to talk about. Whether it is a voluntary abortion or a forced abortion, women suffer from both physical and mental pain. Families who are eagerly looking forward to the birth of their children hope to understand some symptoms of abortion so that they can detect danger in time. So, what are the symptoms of abortion?

1. The main symptoms of miscarriage are bleeding and abdominal pain

(I) 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.

(ii) Abdominal pain: After the bleeding starts in early miscarriage, there is blood, especially blood clots, in the uterine cavity, which stimulates uterine contraction and presents as 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. Clinical classification of miscarriage

Most abortions have a certain development process, although some stages are not obvious in clinical manifestations and may not develop in order. But generally speaking, there are several processes listed below, namely clinical classification: threatened abortion, inevitable abortion, incomplete abortion and complete abortion. Postponed abortion is another special case of abortion development. Habitual abortion is named after its characteristic of repeated abortion. However, both still contain the above clinical classifications in the process of abortion.

(I) Threatened abortion: There are signs of abortion, but after treatment to preserve the pregnancy, the pregnancy may continue to term. It often occurs in the early stages of pregnancy, with only a small amount of vaginal bleeding and mild intermittent uterine contractions. During the examination, the cervix is ​​not dilated, the amniotic sac is not ruptured, the size of the uterus is consistent with the month of amenorrhea, and the pregnancy test is positive.

(ii) Inevitable or unavoidable miscarriage: The above processes occur, but the embryo continues to separate from the uterine wall. Bleeding lasts for a long time, the amount of bleeding increases, exceeds the normal menstrual volume, and blood clots are discharged. The paroxysmal lower abdominal pain intensifies and is spasmodic or a feeling of heaviness. Examination shows that the cervix is ​​gradually dilating. In later months of pregnancy, some amniotic sacs have bulged or ruptured. Some embryonic tissue is blocked in the cervical canal and even exposed at the external cervical os. Miscarriage is bound to occur and the pregnancy cannot continue.

(III) Incomplete abortion: It often occurs in the late pregnancy (after 10 weeks), when the placenta is developing or has already formed. During abortion, the fetus and part of the placenta are expelled, and the whole placenta or part of the placenta is still attached to the uterine wall. The uterus cannot contract well, resulting in heavy vaginal bleeding. The remaining placenta can form placental polyps over time, causing repeated bleeding and easily inducing infection.

(iv) Complete abortion: Through the process of threatened and inevitable abortion, the embryonic tissue is completely expelled within a short period of time, and the bleeding and abdominal pain stop.

(V) Missed abortion: Also known as overdue abortion or stillborn fetus. It refers to the embryo that dies but is still retained in the uterine cavity, and the pregnancy products are generally discharged within 1 to 2 months after the symptoms occur. Therefore, it is stipulated that if the embryo has not been discharged naturally 2 months after the cessation of development, it is called missed abortion. Most pregnant women have experienced early pregnancy threatened abortion. After that, the uterus no longer grows, but gradually shrinks, and is not as soft as normal pregnancy. The pregnancy test changes from positive to negative, and the placenta is tightly adhered to the uterine wall and is not easy to separate. On the other hand, due to insufficient sex hormones, the uterine contraction force is reduced, and it is not easy to be discharged and retained in the uterine cavity. After the embryo dies, the placenta dissolves, and hemolytic enzymes are produced to enter the maternal blood circulation, causing microvascular coagulation and consuming a large amount of coagulation factors. The longer the time of retention in the uterine cavity, the greater the possibility of coagulation dysfunction. In recent years, B-ultrasound has been widely used in clinical practice. The gestational sac and fetal bud can be detected 6 to 7 weeks after menstruation. If the embryo stops developing, B-ultrasound observation can be used to make a timely diagnosis and treatment. Therefore, some people have raised the question of whether the term missed abortion should still be used today. However, clinically, there are also cases where the symptoms are not obvious and do not attract the patient's attention. When they come to the clinic, the embryo has been retained in the uterine cavity for a long time.

(VI) Habitual miscarriage: Three or more consecutive spontaneous abortions are called habitual miscarriages, and the miscarriages often occur in the same month. The miscarriage process may go through the aforementioned clinical classification.

The above is an introduction to the symptoms of miscarriage. I hope it will be helpful to you.