Diagnosis of recurrent miscarriage

Habitual abortion is a frequent miscarriage phenomenon. There are many reasons for habitual abortion. Therefore, the treatment of habitual abortion requires some scientific examinations to make a correct diagnosis and treatment. Here I remind my friends that once habitual abortion occurs, both husband and wife need to go to the hospital in time for simultaneous treatment. Then I will introduce how to diagnose habitual abortion.

Patients with habitual abortion need to undergo the following necessary examinations for diagnosis:

Genetic examination: Experts tell us that the most commonly performed genetic examination at present is the chromosome examination of couples. Genetic examination is relatively difficult and all patients need to undergo chromosome examination.

Anatomical factors examination: Anatomical factors that cause habitual abortion mainly include the following aspects: cervical insufficiency, uterine malformation (such as uterine septum, unicornuate uterus, bicornuate uterus, saddle uterus, etc.), uterine fibroids or adenomyomas, intrauterine adhesions, etc. Diagnosis mainly relies on ultrasound, intrauterine iodized oil angiography, hysteroscopy, laparoscopy, cervical dilator and other examinations.

Immune examination: Immune abortion includes alloimmune disorders and autoimmune abnormalities. The screening of alloimmune disorders requires blocking antibodies, couples' HLA matching and other tests. Currently, blocking antibodies are the most common and practical tests. If the blocking antibodies are negative, it means that the mother cannot produce "blocking antibodies" that protect the embryo. The embryo will be attacked by the mother's immune cells and easily stop growing. Autoimmune abnormalities require the examination of antibodies in the mother's body, such as antiphospholipid antibodies, antisperm antibodies, antiprogesterone antibodies, antiestrogen antibodies, etc. Doctors must find out which antibodies have a greater impact on habitual abortion.

Pathogen infection examination: Although infection factors are not the direct cause of habitual abortion, Professor Zhang mentioned that the positive rate of various infections in the reproductive tract of patients with habitual abortion is very high, reaching about 50%. It is necessary to conduct pathogen examinations on the reproductive tract before getting pregnant again to understand whether there is microbial infection and give corresponding treatment.

Endocrine diagnosis: Endocrine abnormalities that lead to miscarriage include gynecological endocrine abnormalities and internal medicine endocrine abnormalities. Gynecological endocrine abnormalities include common luteal insufficiency, hyperprolactinemia, polycystic ovary syndrome, etc. Gynecological endocrine abnormalities require basal body temperature measurement (BBT), endometrial biopsy, hormone measurement, serum prolactin (PRL) measurement, etc.; internal medicine endocrine abnormalities are mainly diabetes and thyroid dysfunction, and related diseases and hormones should also be checked.

Diagnosis of prethrombotic state: The diagnosis of prethrombotic state requires examination of the patient's coagulation function. The coagulation function test is quite complicated. The tests that can be done currently are just the tip of the iceberg of the overall picture of coagulation function. In addition, the cost of coagulation function tests is relatively high, and the examination items currently carried out in hospitals are relatively limited.