Chromosome abnormality accounts for 50% ~ 60% in early abortion, and maternal-fetal blood group incompatibility often leads to late abortion. According to the development process and characteristics of abortion, it can be divided into threatened abortion, inevitable abortion, incomplete abortion, complete abortion, overdue abortion and habitual abortion, which are called "abdominal pain in pregnancy, fetal leakage, restless fetal movement", "incomplete abortion, bloody collapse after abortion", "abortion" and "fetus" in Chinese medicine.
The main clinical manifestations are abdominal pain and vaginal bleeding: threatened abortion is less, lower abdominal pain is mild, there is no pregnancy secretion, or backache and fall. It is inevitable that there will be more vaginal bleeding, more menstrual flow, no pregnancy, aggravated abdominal pain, falling, or amniotic membrane rupture during abortion. Incomplete abortion is characterized by persistent massive vaginal bleeding, abdominal pain during pregnancy and even hemorrhagic shock. Complete abortion is characterized by the reduction or cessation of vaginal bleeding and the disappearance of abdominal pain after pregnancy discharge. Most of overdue abortions have a history of threatened abortion, and the uterus will no longer increase or decrease in the future. If you have reached the second trimester, your abdomen has not enlarged and there is no fetal movement. Habitual abortion refers to three or more consecutive spontaneous abortions, each occurring in the same pregnancy month.
Doctor's diagnosis 1? Threatened abortion: typical symptoms, gynecological examination shows that the cervix is not open, and the size of the uterus is consistent with the month of menopause. B-ultrasound shows that the embryo or fetus is alive.
2? Inevitable abortion: according to typical symptoms, gynecological examination shows that the cervix has been opened, and sometimes tissue is blocked in the cervix, and the uterus is the same as or slightly smaller than the month of menopause. B-ultrasound showed gestational sac and carcass, but no fetal heart beat.
3? Incomplete abortion: According to typical symptoms, gynecological examination shows that the cervix is dilated, there is tissue obstruction in the cervix, and the uterus is mostly smaller than the month of menopause. B-ultrasound showed that there were light spots or light masses with enhanced echo in the uterus.
4? Complete abortion: According to typical symptoms, gynecological examination shows that the cervix is closed and the uterus is slightly larger or normal. B-ultrasound showed that there was no gestational sac in the uterus.
5? Expired abortion: According to the medical history and symptoms, gynecological examination showed that the cervix was closed and the uterus was smaller than the pregnancy month by more than 2 months. B-ultrasound showed a stillbirth.
6? Habitual abortion: diagnosis can be made according to medical history and symptoms.
7? Differential diagnosis of tubal pregnancy (1) It is difficult to distinguish between unruptured tubal pregnancy and threatened abortion, and it is necessary to check with B-ultrasound. After rupture, there is tearing pain on one side of the lower abdomen, even syncope and shock, and the diagnosis can be made if the posterior fornix puncture is not solidified.
(2) hydatidiform mole: vaginal bleeding is more, sometimes mixed with vesicular tissue, and the uterus is longer than the month of menopause. B-ultrasound shows that diagnosis can be made without fetal sac and fetal heart.
Western medicine diagnosis and treatment (1) threatened abortion: progesterone 20 mg intramuscular injection, 1 time/day. Take vitamin e 30 ~ 50mg orally, 1 ~ 2 times a day; Folic acid 5 mg, 3 times a day.
(2) Inevitable abortion: timely official clearance or mid-line induced labor to terminate pregnancy. Antibiotics and uterine contractions were given after operation.
(3) Incomplete abortion: clear the uterus in time, give antibiotics and uterine contractions after operation, and replenish water and blood transfusion when bleeding.
(4) Complete abortion: generally no treatment is needed, and vaginal bleeding should be closely observed. When you are not sure that the pregnancy is completely discharged, you will have a formal operation.
(5) Expired abortion: If the blood coagulation function is normal, take diethylstilbestrol 5 mg orally, three times a day for five days, and then curettage or introduction. If the coagulation function is abnormal, fibrinogen, heparin or fresh blood can be given. After the coagulation function is normal, induced labor or curettage can be performed.
(6) Habitual abortion: intramuscular injection of progesterone 20 mg, 1 time/day. The patients with cervical internal orifice relaxation were treated with cervical internal orifice suture.
Chinese medicine prescription (1) threatened abortion ① kidney deficiency: a small amount of vaginal bleeding after pregnancy, pale color, dull pain in the lower abdomen, backache and tinnitus, frequent urination, pale tongue, thin and white fur and heavy and slippery pulse.
Methods: Tonifying kidney and preventing miscarriage.
Medication: 20 g of Semen Cuscutae, 0/5 g of Taxilli/kloc-,0/5 g of Radix Dipsaci and 0/0 g of Colla Corii Asini.
Reference Chinese patent medicine: Ding Kundan.
② Deficiency of qi and blood: less vaginal bleeding after pregnancy, pale and thin color, abdominal distension, dizziness and fatigue, palpitation and shortness of breath, pale tongue, thin and white fur, thin, smooth and weak pulse.
Methods: Supplementing qi and nourishing blood, tonifying kidney and preventing miscarriage.
Medicines: Radix Codonopsis, Radix Astragali, Rhizoma Atractylodis Macrocephalae, Poria, Radix Rehmanniae Preparata, Radix Dipsaci, Semen Cuscutae each 65438±05g, and Colla Corii Asini 65438±00g.
Reference Chinese patent medicine: Baochan Pill.
③ Blood-heat: a small amount of vaginal bleeding after pregnancy, bright red color, thick texture, upset mouth, constipation, red urine, red tongue, thin yellow fur and slippery pulse.
Methods: Clearing away heat, nourishing yin and preventing miscarriage.
Medicines: Radix Rehmanniae Preparata, Radix Rehmanniae, Radix Dipsaci, Radix Hemerocallis, Fructus Ligustri Lucidi and Herba Hedyotidis Diffusae each 65438±05g, Radix Scutellariae and Colla Corii Asini each 65438±00g.
Reference Chinese patent medicine: Huo Qing Pill for Pregnant Women.
④ Trauma: a small amount of vaginal bleeding, abdominal pain, backache, red tongue, thin white fur and slippery pulse during pregnancy.
Methods: Supplementing qi and blood, tonifying kidney and preventing miscarriage.
Medicine: Codonopsis pilosula, Radix Astragali, Radix Angelicae Sinensis, Radix Dipsaci, Semen Cuscutae, Herba Taxilli each 65438 05g, Colla Corii Asini 65438 00g.
(2) Habitual abortion: repeated pregnancy abortion, weak waist and knees, dull complexion, dizziness, tinnitus, palpitation and shortness of breath, or irregular menstruation, frequent urination, pale tongue, thin and white fur and weak pulse.
Methods: tonify kidney and spleen, and regulate chong and ren.
Medication: Cuscuta chinensis, Taxilli, Dipsacus, Codonopsis pilosula, Atractylodes macrocephala, Radix Rehmanniae Preparata and Radix Paeoniae Alba each 65,438 05g, Angelica sinensis and Colla Corii Asini (Yang) each 65,438 00g. This prescription should be taken before pregnancy.