What are the treatments for spontaneous abortion?

What are the treatments for spontaneous abortion? If there are signs of spontaneous abortion, you should go to the hospital for diagnosis and treatment in time, and treat it symptomatically according to the specific type of spontaneous abortion. Because there are many types of spontaneous abortion, different types have different treatments. So what are the treatments for spontaneous abortion?

Spontaneous abortion treatment

1. Threatened abortion: Expectant mothers with threatened abortion should rest in bed, strictly prohibit sexual intercourse, and have adequate nutritional support. Keep emotional stability, and give a small amount of sedatives that are harmless to the fetus to nervous expectant mothers. Those with luteal insufficiency can be given 10-20 mg of progesterone, injected intramuscularly once a day or every other day. Excessive use can lead to missed abortion; or take dydrogesterone (Daphaston) tablets orally, which is an oral progestin and is relatively safe. There is currently no evidence that it cannot be used during pregnancy and lactation. The starting dose is 40 mg orally once, followed by 10 mg every 8 hours until the symptoms disappear; or hCG3000U, injected intramuscularly every other day; vitamin E can also be taken orally to protect the fetus. Expectant mothers with hypothyroidism can take small doses of thyroid tablets orally.

2. Inevitable abortion: Once inevitable abortion is confirmed, the embryo and placental tissue should be expelled as soon as possible. Curettage can be performed, and the scraped material should be carefully examined and sent for pathological examination. In late abortion, the uterus is large and bleeding is heavy. Oxytocin 10-20U can be added to 500ml of 5% glucose solution and intravenously dripped to promote uterine contraction. If necessary, curettage can be performed to remove intrauterine tissue. After the operation, B-type ultrasound examination can be performed to understand whether there is any pregnancy residue, and antibiotics can be given to prevent infection.

3. Incomplete abortion: Incomplete abortion can easily cause heavy uterine bleeding because some tissues remain in the uterine cavity or block the cervix. Therefore, curettage or forceps should be performed at the same time as infusion and blood transfusion, and antibiotics should be given to prevent infection.

4. Complete abortion: Complete abortion means that all the pregnancy products have been discharged, the amount of vaginal bleeding has decreased and gradually stopped, the abdominal pain has disappeared, the cervix is ​​closed during gynecological examination, the uterus has rapidly involuted, and the size of the uterus is close to normal. If there is no infection, no special treatment is required.

5. Missed abortion: If the dead fetus and placental tissue remain in the uterine cavity for too long, it may lead to severe coagulation disorders and the occurrence of DIC. A coagulation function test should be performed first, and a curettage should be performed under the conditions of blood preparation and infusion. If the coagulation mechanism is abnormal, heparin, fibrinogen, fresh blood, platelets, etc. can be used to correct it before curettage.

In case of missed abortion, the placenta tissue is often tightly adhered to the uterine wall, making surgery more difficult. If the coagulation function is normal, 5 mg of ethinyl estradiol can be taken orally before curettage, 3 times a day for 5 consecutive days, or 5-10 U of estradiol benzoate can be added to 500 ml of 5% glucose solution for intravenous drip, or 400 μg of misoprostol can be placed in the posterior fornix of the vagina. For those with a uterus greater than 12 weeks of gestation, oxytocin should be dripped intravenously to promote the expulsion of the fetus and placenta. Uterine perforation should be avoided during curettage. B-type ultrasound examination should be performed routinely after surgery to confirm whether the residual materials in the uterine cavity are completely discharged, and anti-infection treatment should be strengthened.

6. Habitual abortion: Couples with chromosomal abnormalities should receive genetic counseling before pregnancy to determine whether they can get pregnant. They can also perform blood type identification for the couple and sperm examination for the husband to determine whether the woman has reproductive tract malformations, tumors, or intrauterine adhesions. Those with loose cervical os should undergo cervical os repair before pregnancy, or cervical os cerclage at 12-18 weeks of pregnancy. In addition, after the diagnosis of pregnancy, patients with habitual abortion can receive routine intramuscular injection of hCG 3000-5000U every other day until 8 weeks of pregnancy. Or take dydrogesterone orally twice a day, 10 mg each time, until 20 weeks of pregnancy.

7. Abortion complicated with infection: The principle of treatment is to quickly control the infection and remove the intrauterine residue as soon as possible. If it is a mild infection or heavy bleeding, curettage can be performed while intravenously infusing effective antibiotics to achieve the purpose of hemostasis; if the infection is severe but the bleeding is not much, high-efficiency broad-spectrum antibiotics can be used to control the infection before curettage. When curettage, oval forceps can be used to clamp out the residual tissue, and it is forbidden to use a curette to scrape it all over to avoid the spread of infection. Severe infected abortion can be complicated by pelvic abscess, thrombophlebitis, septic shock, acute renal failure and DIC, etc., which should be highly valued and actively prevented. If necessary, the uterus should be removed to remove the source of infection.