Five month fetal miscarriage

During the pregnancy process, I believe miscarriage is something that no one wants to encounter, but there are many factors involved in the occurrence of miscarriage, many of which are beyond our control. Miscarriage of a five-month-old fetus is also very common, and miscarriage can be divided into different types, and the response measures for different situations are different. Let’s take a look at the different situations of miscarriage of a five-month fetus.

Abortion is a common disease in obstetrics and gynecology. Once symptoms of abortion occur, appropriate treatment should be given in a timely manner according to the different types of abortion.

1. Threatened abortion

You should pay attention to rest, avoid sexual intercourse, and vaginal examination should be performed gently. Patients with luteal insufficiency can supplement with progesterone, which has the effect of preserving pregnancy. Secondly, vitamin E and small doses of thyroxine (suitable for patients with hypothyroidism) can also be used. In addition, psychological treatment is also very important for patients with threatened abortion to calm their emotions and enhance their confidence. If symptoms do not improve or even worsen after treatment, it indicates possible abnormal fetal development. B-ultrasound examination and β-HCG measurement should be performed to determine the condition of the fetus and give appropriate treatment, including termination of pregnancy.

2. Miscarriage is inevitable

Once the diagnosis is confirmed, the embryo and placental tissue should be completely expelled as soon as possible. In the case of early miscarriage, vacuum aspiration should be performed promptly, and the products of pregnancy should be carefully examined and sent for pathological examination. In case of late miscarriage, if the uterus is large and suction or curettage is difficult, 10 units of oxytocin can be added to 500 ml of 1% glucose solution and dripped intravenously to promote uterine contraction. After the fetus and placenta are expelled, it is necessary to check whether they are complete. If necessary, a curettage should be performed to remove the remaining products of pregnancy in the uterine cavity.

3. Incomplete abortion

Once diagnosed, curettage or curettage should be performed promptly to remove residual tissue in the uterine cavity. Patients with heavy bleeding and shock should receive blood transfusion and fluid infusion, and be given antibiotics to prevent infection.

4. Complete miscarriage

If there are no signs of infection, no special treatment is generally required.

5. Missed abortion

It is more difficult to handle. Because the placental tissue is organized and tightly adhered to the uterine wall, it makes curettage difficult. If the retention time is too long, coagulation dysfunction may occur, leading to disseminated intravascular coagulation (DIC) and severe bleeding. Before treatment, routine blood tests, clotting time, platelet count, fibrinogen, prothrombin time, clot retraction test and plasma protamine paracoagulation test (3P test) should be checked, and preparations for blood transfusion should be made. Uterus less than 12 weeks of gestation. Curettage and dilation can be performed, during which uterotonic agents can be injected to reduce bleeding. If the placenta is ossified and tightly adhered to the uterine wall, the operation should be performed with extreme caution to prevent perforation. If the placenta cannot be completely scraped off in one operation, another curettage can be performed 5 to 7 days later. If the uterus is larger than 12 weeks of gestation, oxytocin should be given intravenously. Prostaglandins or ethacridine can also be used to induce labor and promote the expulsion of the fetus and placenta. If there is a coagulation disorder, heparin, fibrinogen and fresh blood transfusion should be used as soon as possible. After the coagulation function improves, induced labor or curettage can be performed.

6. Habitual miscarriage

Women with a history of habitual miscarriage should undergo necessary examinations before pregnancy, including ovarian function tests, chromosome tests and blood typing of both husband and wife, and semen tests of their husbands. The woman also needs to undergo a detailed examination of the reproductive tract to determine whether the uterus has any deformities or lesions and to check whether the cervix is ​​relaxed. Find out the cause and, if it can be corrected, treat it before pregnancy.

7. Abortion infection

Abortion infection is mostly incomplete abortion combined with infection. The principle of treatment is to actively control the infection. If the vaginal bleeding is not excessive, broad-spectrum antibiotics should be used for 2 to 3 days. After the infection is controlled, curettage should be performed to remove residual tissue in the uterine cavity to stop the bleeding. If there is a lot of vaginal bleeding, intravenous infusion of broad-spectrum antibiotics and blood transfusion should be performed at the same time, and the residual tissue in the uterine cavity should be removed with an oval forceps to reduce bleeding. Do not use a scraper to completely scrape the uterine cavity to avoid the spread of infection. Continue to use antibiotics after the operation, and perform a thorough curettage after the infection is controlled. If the patient has complicated infectious shock, the shock should be corrected actively. If the infection is severe or an abscess has formed in the abdomen or pelvis, surgical drainage should be performed and the uterus removed if necessary.