How to judge miscarriage or menstruation

People always confuse the clinical manifestations of miscarriage and menstruation because menstrual bleeding will occur during menstruation, and miscarriage will also cause vaginal bleeding. These two have common symptoms. In fact, it is very simple to judge because miscarriage will cause a small amount of bleeding, and you will feel very severe lower abdominal pain, and even a lump will appear when you touch your stomach.

1. Ectopic pregnancy

There are amenorrhea, vaginal bleeding and lower abdominal pain, positive pregnancy test, and clinical symptoms similar to miscarriage. However, the abdominal pain of ectopic pregnancy is often pain on one side of the lower abdomen, with obvious symptoms of internal bleeding, no or little external bleeding, and is often accompanied by a feeling of anal prolapse or syncope. The uterus is slightly larger but smaller than the gestational age. There is obvious tenderness in the posterior fornix, and a mass can be felt in the adnexal area on one side. Posterior fornix puncture produces uncoagulated blood. Ultrasound examination shows a gestational sac or heterogeneous mass outside the uterine cavity or accompanied by free fluid in the peritoneal cavity. Pathological examination of the curettage tissue shows no chorionic tissue, but may contain decidual tissue, which can be used for identification.

2. Hydatidiform mole

The symptoms and signs are similar to those of miscarriage, but the uterus is often larger than the gestational month, and the blood HCG is much higher than the level of the same pregnancy period; B-ultrasound can confirm the diagnosis, and there is no gestational sac, fetal bud, or amniotic fluid segment in the uterus, and a falling snow-like image can be seen. A curettage and dilatation can confirm the diagnosis.

3. Functional uterine bleeding

Anovulatory functional uterine bleeding may have a history of amenorrhea, and the history of bleeding can easily be misdiagnosed as miscarriage. However, the former has a normal or slightly larger uterus, a negative pregnancy test, no embryonic sac in the uterus by B-ultrasound, and no chorionic tissue by curettage.

4. Uterine fibroids

The uterus may enlarge and become soft as fibroids become hyalinized or cystic. When uterine fibroids appear red and degenerate, there will be lower abdominal pain and irregular vaginal bleeding, which can easily be confused with miscarriage. However, the former has no history of amenorrhea, the pregnancy test is negative, and B-ultrasound can clearly identify it.

5. Pregnancy complicated by cervical erosion or polyps

Cervical erosion or polyps often cause small amounts of bleeding, which can easily be mistaken for miscarriage. The former does not cause abdominal pain. After local treatment to stop bleeding, there will be no more bleeding.

Termination of pregnancy before 28 weeks of gestation and with a fetal weight of less than 1000g is called abortion. Abortion that occurs before 12 weeks of pregnancy is called early abortion, and abortion that occurs between 12 weeks and less than 28 weeks of pregnancy is called late abortion. Abortion is divided into spontaneous abortion and induced abortion. The incidence of spontaneous abortion accounts for about 15% of all pregnancies, and most of them are early abortions. There are also two specific types of miscarriage: missed miscarriage and habitual miscarriage.