Pregnancy after a missed abortion - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Pregnancy And Childbirth

You come and develop desired pregnancy, and suddenly there was something strange and she "froze".As we said in the antenatal clinic, ultrasound and the doctor confirmed.What to do and what will happen next?Do not despair, every woman has the chance to carry and give birth to a baby.And you are no exception.We'll tell you how to properly recover and prepare for the next pregnancy.

missed abortion - a spontaneous fetal death, most often in the first trimester (second trimester is much less common).

missed abortion ends miscarriage, medical or surgical abortion.And spontaneous complete rejection of fetal eggs - the most favorable outcome, as there is minimal damage to the endometrium (the inner lining of the uterus).

When medical abortion, to remove the fetus from the cavity of the uterus of the deceased, taking medications that increase the muscle contractions of the uterus, the endometrium is not directly affected, but there is a risk of delay parts of the fetus in the uterus.

When surgical abortion

performed scraping the uterine cavity and the endometrium is damaged, but at the same time, this is the only way to guarantee almost completely removed from the uterus the fetus.

Rehabilitation after missed abortion:

- Antibiotic treatment

antibacterial drug after scraping appointed in 100% of cases, it helps to avoid the development of infections and profilaktiruet lot of complications.Used antibiotics cephalosporin (ceftriaxone), aminoglycosides (gentamicin, netromycin), antimicrobials (metronidazole).The route of administration (injections, infusions or tablets), type of preparation and duration of reception determined by the physician.In some cases, a combination of drugs.

- reduces uterus preparations

Discharge after curettage procedure should resemble normal menstruation, not abundant, no particular smell, gradually decreasing to 4-7 day.If the discharge stop abruptly, it is a sign of stagnation of blood in the uterus (hematometra).In the hospital for treatment of the condition used uterotonics (drugs that reduce the womb): oxytocin, metilergobrevin (intramuscularly or intravenously).uterotonics Treatment is performed under ultrasound kontol.

Furthermore (after discharge) you recommend to take a decoction of nettle (2 tsp of dry grass pour 1 cup boiling water, let it brew and drink during the day in 4-5 receptions) or tincture of water pepper (30 drops 3 times a daya glass of water) for 7-14 days for the prevention of bleeding.

- Combined oral contraceptives (COCs)

KOC needed to restore normal hormonal rhythm of the female reproductive system.Any pregnancy, childbirth is not finished - a lot of stress to the body.Preparations begin to apply from the 2nd day after curettage, abortion, medical abortion in the first trimester.If you missed abortion and miscarriage occurred during the second trimeter, the administration of drugs to begin 21-28 days.But before that you need to keep the sexual rest or use barrier contraception (condoms).At the moment in pharmacies there are many hormonal contraceptives, the best option to help the doctor.COCs should be at least 3 cycles.
After detailed examination of the preparation can be replaced by the more specific (e.g., possessing antiandrogenic action).If you are wary
hormonal contraception, then we hasten to dispel the doubts, at the moment at the pharmaceutical market there is only those drugs that have been extensive studies.

- Psychological rehabilitation

This is an important aspect in the rehabilitation of women.It is desirable part of the partner, his support and care.

possible herbal remedies reception sedatives: valerian extract 1 tablet 3 times a day, motherwort tincture 30 drops 3 times a day (or motherwort forte 1 tablet 2 times a day).Duration of reception is determined individually.

Contrary to popular belief, it is not necessary to go on a long journey and change climatic conditions dramatically.Instead, you take the recovery forces of the body to acclimatize.Not forbidden to rest in places with a similar climate and humidity.

not hurt chat with women who have experienced the same problem successfully overcame this test.

Preparing for pregnancy after the stood

Training is conducted in three stages:

1) complete clinical-laboratory and instrumental examination,
2) treatment of the identified disease,
3) evaluation of the effectiveness of treatment and pregnancy planning.

survey

1. Preparing for the next pregnancy begins with histologic (microscopic) and cytogenetic studies of fetal tissue zamershego .If you want to you have spent this study, be sure to tell your doctor in consultation and the doctor who performs scraping.Histological examination may reveal some of the causes of this disease: infections, sexually transmitted infections, diabetes, viral infections (rubella, hepatitis), anembrioniyu (in the womb are found only fetal membranes, the fetus also has not developed).In any case, histological examination will help your doctor in diagnosing the causes of missed abortion.

2. Gynecological examination with pap smears on flora (+ gonococci, Trichomonas), and cytology.

3. Screening infections (including sexually transmitted diseases) by ELISA and PCR
- ureaplasma, mycoplasma, human papilloma virus
- TORCH-complex
T - toxoplasmosis
O (OTHER - other) - syphilis, HIVchlamydia, varicella, hepatitis B and C
R - rubella
C - cytomegalovirus
H - herpes

4. Hormonal study. If by the time you came hormonal inspection while on hormonal contraception, the further tactics generated by your obstetrician-gynecologist.In some cases a study in patients receiving HEC, sometimes you want to cancel the drug and begin to hand over to the next cycle.

FSH (follicle stimulating hormone) - 3-8 and 19-21 days of the menstrual cycle (strictly on an empty stomach).
LH (luteinizing hormone) - as well.
Prolactin - twice per cycle, strictly on an empty stomach, 30 minutes prior to the analysis of complete rest, you can not come running to the lab and immediately to be tested for prolactin - will lozhnozavyshenny result (can take on the same days as the FSH, LH).
Estradiol - rented throughout the cycle, on an empty stomach, it is determined by the peak before ovulation.
Progesterone - for 19-21 days of the cycle, on an empty stomach.
Testosterone - any day, on an empty stomach.
DHEA-sulfate - any day, on an empty stomach.
Thyroid hormones (T4, T3, TSH, antibodies against TPO) - any day, on an empty stomach.

5. pelvic ultrasound, monitoring of folliculogenesis .Pelvic ultrasound is usually performed 2 times per cycle, estimated the thickness of the endometrium, changes in the ovaries.Monitoring of follicle genesis - is monitoring the maturation of the follicle, the first ultrasound should be for 4-5 days prior to ovulation (if a regular cycle), then you will be assigned the next visit often enough appearances for the series 2-3.

6. General blood and urine tests.

7. Biochemical analysis of blood.

8. Coagulation (blood clotting test): INR, aPTT, PTI, PTV, D-dimer, SFMC

9. blood test for homocysteine, an antibody to phospholipids and chorionic gonadotropin .

10. Inspections on the testimony of other experts (internist, hematologist, an endocrinologist, infectious disease, hepatology, rheumatology, immunology, and so on)

11. Specialized testing for thrombophilia on the testimony of (a lot of indicators, analyzes the cost is high, so the minimuman informative list of tests must appoint haematologist)

12. Colposcopy (cervix special microscope) on the testimony

13. partner survey

- screening for infection are the same as that of the wife
- examination urologist
-TRUS, semen analysis, hormone research on the testimony

14. Karyotyping spouses, genetics consultation .Karyotyping - a special genetic research showing the ability to couple the data have children (compatibility), inherited genetic abnormality.This research is quite expensive and it is recommended to carry out couples with recurrent pregnancy loss, couples where the spouse is older than 35 years, there is a known hereditary diseases, the birth of children with genetic abnormalities.

treatment revealed pathology is performed by a specialist.

If you have an STI doctor will obstetrician-gynecologist in the case of hormonal disorders treatment is performed together with the endocrinologist, clotting disorders require consultation of a hematologist and so on.

Planning pregnancy after the stood

When can I get pregnant after a missed abortion? planning the next pregnancy is recommended 6-12 months, not before.If you will be tested as recommended to you by your doctor, it is less than 6 months and does not take.Also the timeout period depends on the availability of identified infections, coagulation disorders and other conditions requiring treatment.

willingness to conceive is determined by the sum of factors:

- an optimal state of the endometrium by ultrasound
- availability
ovulation - regular menstrual
cycle - recovery of both partners from infection, including sexually transmitted infections
- no inflammation of the vagina (swab 1,2 purity)

Your lifestyle should include avoiding harmful habits, good nutrition, the optimum drinking regime, dosed physical load.Most of these recommendations may seem trivial, but how difficult it is to comply with them in our business time.Getting used to a new lifestyle, you will suffer a lot easier inevitable limitations during pregnancy (a ban on alcohol, tobacco and energy drinks, excessive consumption of coffee, fast food and other things).

Also recommended:

- if you have not identified antibodies indicating rubella, the do vaccinated at least three months before the alleged conception.Rubella, transferred during pregnancy, triggers abnormalities and fetal death, and is an indication for termination of pregnancy.

- multivitamin complexes , designed specifically for pregnant women (Elevit pronatal, Vitrum Prenatal, komplivit trimestrum, femibion ​​natalkea 1 and 2, a multi-tabs perinatal).

- folic acid preparations .Folic acid supplements and their benefits for pregnant women have long been known, but in recent years they paid special attention to pregravid preparation, especially if there is a history of pregnancy loss, birth of children with developmental disabilities.Folic acid profilaktiruet development of neural tube defects in the fetus.There are a variety of drugs, including folic acid, and the choice can help implement your doctor.

folic acid drugs: folic acid, folic acid, 9 months, folacin, mammafol.
Combination products: angiovit, folio foliber.
now recommends that folic acid both partners.Duration of usually three months before the alleged conception to 12 weeks of pregnancy.

forecast next pregnancy

After all the examinations, you will know what your chances of becoming parents.Missed abortion - this is not a sentence.At the moment, the level of medicine makes it possible to experience the joy of motherhood, even in case of detection of hereditary diseases (thrombophilia), systemic, chronic infectious diseases and other.

survey during the next pregnancy is made according to the order of Ministry of Health of Russia from November 12, 2012 № 572n.Additionally produced:

- medical and genetic counseling,
- a blood test for alpha-fetoprotein, human chorionic gonadotropin after 6 weeks of pregnancy.

With proper inspection, training and supervision during pregnancy you have all the chances to successfully carry and give birth to a healthy baby.

Doctor Petrov AV