Spontaneous abortion

Spontaneous abortion : – The terminology indicates “miscarriage” an interruption of pregnancy that occurs spontaneously within the first 180 days of pregnancy. However, in most cases, spontaneous abortion occurs during the first trimester of pregnancy. It is a much more widespread condition than we think: it is estimated that it can affect up to 30% of pregnancies.

WHAT IS SPONTANEOUS ABORTION?

Miscarriage can be “complete“(characterized by total spontaneous expulsion of the embryo or lifeless fetus); or”incomplete“or”considered“(When pregnancy is still partially or completely present in the uterine cavity, but there is no cardiac activity of the embryo or fetus).

WHAT ARE THE CAUSES OF SPONTANEOUS ABORTION?

Many and different are the causes that can cause a miscarriage.
These include:

  • chromosomal abnormalities (it is undoubtedly the most frequent cause of spontaneous abortion. The frequency increases with increasing maternal age);
  • congenital (septal uterus, unicorn, etc.) or acquired malformations (polyps, fibroids) of the uterus;
  • cervical incontinence (the cervix tends to dilate very early in pregnancy, even in the absence of contractions, which leads to the expulsion of the fetus);
  • autoimmune or thrombophilic diseases (ie, blood clotting increases);
  • infectious diseases such as toxoplasmosis, rubella, cytomegalovirus infection that can infect the fetus and cause suffering and then death;
  • untreated vaginal infections;
  • corpus luteum insufficiency that does not produce enough progesterone, the hormone that promotes the implantation and maintenance of pregnancy in the first trimester.

WHAT ARE THE SYMPTOMS OF SPONTANEOUS ABORTION?

there silent abortions, that is, without symptoms (in this case, the diagnosis is clinical, by obstetric ultrasound). In other cases, however, abortion manifests itself through blood loss or uterine contractions. The symptoms with which a miscarriage can occur can be very different and variable in relation to different clinical situations.

HOW TO PREVENT A MISCARRIAGE?

Preventive treatments against spontaneous abortion. they differ greatly from each other depending on the cause at the origin of the abortion.
Rest is generally the first and main treatment recommended in case of threat of abortion. – A progesterone-based preventive therapy may be effective in cases where a corpus luteum deficiency is suspected. In the case of autoimmune diseases (such as antiphospholipid syndrome) or in conditions of excessive thrombophilia, the use of heparin or acetylsalicylic acid may be prescribed. In cases of cervical incompetence, a cervical cerclage will be performed. It is good to treat diseases such as diabetes or thyroid dependent already before the beginning of a pregnancy.

DIAGNOSIS

In general, the diagnosis of spontaneous abortion is based on:

They may also be prescribed:

  • pregnancy test;
  • Plasma dose of the beta fraction of pregnancy hormone (HCG). HCG is produced from the implant in the uterus and increases steadily until the third month of pregnancy. Its modifications are useful to understand the evolution or not of a pregnancy.

TREATMENTS

Diagnosed with a miscarriage, there are usually two possible ways:

1) surgical therapy: it is the called “scraping” by hysterosuction. In practice, the abortive material contained in the uterine cavity is suctioned through a cannula inserted through the cervical canal.
2) in some cases you can decide to wait spontaneous expulsion of abortive material from the uterus or facilitate its expulsion by administering medications that facilitate contraction Uterine In this case there is talk of “waiting behavior”, which applies especially in cases of incomplete abortion (more rarely in the case of internal abortions), and especially if the abortion occurred in the first weeks of pregnancy.

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