Abortion or miscarriage is termed abortion on the gestation period of up to 28 weeks. Miscarriage before 12 weeks is considered early, after this period - late. Interruption of pregnancy after 28 weeks and up to 38 is called premature birth.
Spontaneous abortion occurs without any intervention, and does not depend on the desire of the woman. Most often, miscarriage occurs in the first 12 weeks of pregnancy.
Causes of miscarriage.
The causes of spontaneous miscarriages are numerous and diverse in nature.
Chromosomal abnormality of the embryo often causes a miscarriage in the first trimester of pregnancy. Chromosomal abnormalities arise as a result of defects in the ovum or spermatozoa or in connection with temporary problems of dividing the zygote.
Infectious diseases during pregnancy often lead to spontaneous abortion. Especially often, these are acute infectious diseases that occur in the first weeks of pregnancy. Among infectious diseases, influenza, which is the most common, plays an important role. Interruption of pregnancy often occurs with infectious hepatitis, acute rheumatism, with rubella, scarlet fever, measles. Miscarriage can happen with angina, pneumonia, pyelonephritis, appendicitis. Interruption of pregnancy in acute infectious diseases contribute to: high temperature, intoxication, hypoxia, malnutrition and other disorders; in the decidual membrane, dystrophic changes are formed, and hemorrhages; weaken the barrier properties of the chorion and microorganisms can penetrate into the embryo.
Chronic infectious diseases can also contribute to abortion. With toxoplasmosis, tuberculosis, brucellosis, syphilis, abortion occurs much less frequently than with acute diseases. With a full-fledged treatment of chronic infectious diseases, pregnancy can be maintained and it develops normally.
Chronic non-infectious diseases can also be the cause of abortion, especially in severe disease. Such diseases include: organic heart diseases with circulatory disorders, chronic glomerulonephritis and hypertensive disease of severe form. Pregnancy can be interrupted in case of a serious course of blood system diseases (anemia, leukemia).
Infantilism is one of the most common causes of abortion. With infantilism, there is a functional insufficiency of the endocrine function of the ovaries and other endocrine glands, often there is an increased excitability of the uterus and insufficient narrowing of the internal pharynx.
The frequent causes of miscarriage include neuroendocrine diseases of the endocrine glands. Miscarriage often occurs with hyperthyroidism, hypothyroidism, diabetes, adrenal and ovarian diseases.
Intoxication of the body very often leads to the death of the embryo and to miscarriage. The most dangerous are lead, mercury, nicotine, gasoline and other toxic chemicals.
If the blood of the spouses is incompatible by the Rh factor, the fetus can inherit the antigens of the father. Embryo antigens (incompatible with maternal) when they penetrate the placenta into the body of a pregnant woman, contribute to the formation of specific antibodies. Antibodies penetrate the fetus and can cause hemolytic disease, which can cause fetal death. Most often, in this case, there is an interruption of a repeat pregnancy. This is due to the fact that sensitization of the body during repeated pregnancy increases.
Anomalies of the ovum and sperm that occur before conception can also lead to spontaneous abortion.
To frequent causes of termination of pregnancy include the transferred piece abortion, which leads to disorders in the endocrine and nervous system, chronic endometritis and other inflammatory diseases. With the widening of the cervix during instrumental abortion, damage to muscle fibers in the isthmic-cervical region of the cervix can occur, leading to an ischemic-cervical insufficiency, in which bearing pregnancy becomes problematic.
Inflammatory diseases of the genitals are a frequent factor in the interruption of pregnancy. As in inflammation, the function or structure of the endometrium is impaired. The cause of miscarriage can be adhesive processes, oncological formations in the small pelvis, which prevent the normal growth of the pregnant uterus.
In women with an unbalanced nervous system, termination of pregnancy can occur with severe mental trauma. Physical trauma - fractures, bruises, concussions - all these factors can also contribute to miscarriage, in the case of infantilism, inflammatory diseases and other abortion-promoting moments.
In the case of spontaneous abortion, which has arisen as a result of the action of the factors described above, the end result is the same process - the contractile activity of the uterus increases. The fetal egg gradually flakes from the mucous membrane of the uterus and is pushed out of its cavity, resulting in cramping pains and uterine bleeding of varying intensity. Late miscarriage is similar to the current for childbirth (the cervix opens, the amniotic fluid leaves, the fetus is born, and then the placenta)
The clinical picture of spontaneous abortion depends on the period of pregnancy, the stage, the cause, which led to the termination of pregnancy.
For a miscarriage in the first trimester of pregnancy is characterized by a combination of pain and bloody discharge, in the second trimester, early signs of miscarriage have cramping pains in the lower abdomen, bleeding joins after the birth of the fetus. Depending on the etiological factors that caused spontaneous abortion, there may be features of its clinical manifestations.
In the case of prolonged spontaneous abortion, pathogenic microorganisms (staphylococci, streptococci) often enter the uterus, which lead to the development of an infected abortion.
Another formidable complication of spontaneous abortion is the placental polyp. This complication, which occurs when the placenta remains in the uterine cavity, the membranes that germinate with a connective tissue and are tightly attached to the walls of the uterus. Clinically, it is manifested by prolonged bloody discharge. Treatment is performed by scraping the uterine cavity.
With the threat of spontaneous abortion, the patient is immediately hospitalized. The hospital provides comprehensive treatment aimed at eliminating the main cause of miscarriage, as well as maintaining a pregnancy.