What can you eat after a miscarriage. Early miscarriage: symptoms. Treatment for incomplete abortion

Incomplete miscarriage, what is it and why is it dangerous? This event is said in the case when the termination of pregnancy, spontaneous or with the help of doctors, did not lead to the complete cleansing of the uterus from the membranes.

Incomplete miscarriage symptoms are usually noticeable to a woman. First of all, it is spotting, which does not end in a week or two. And the longer the remnants of the membranes remain in the uterus, the worse the woman's condition becomes. So, there are such signs of an incomplete miscarriage in the early stages as general malaise, weakness, nausea, and fever. All this provokes an inflammatory process, which, if too long, can lead not only to infertility due to the formation of adhesions in the fallopian tubes, but also to the removal of the uterus. The consequences of an early miscarriage can be very severe. How to proceed?

If a woman's pregnancy was terminated when she was in the hospital, then for sure she will undergo curettage of the uterus. In this case, there is a minimum percentage that something extra will remain in the uterus. Another thing is if a woman refuses this procedure, or even happens spontaneous interruption pregnancy at home. But in this case, you need to see a doctor. He will conduct a gynecological examination, assess the size, density, soreness of the uterus, direct to ultrasonography. If very little time has passed after the detachment of the fetal egg, the cervix is ​​ajar, the doctor can simply prescribe a drug that reduces the uterus and, if necessary, hemostatic, if bleeding after a miscarriage is profuse.

If the cervix is ​​closed, there is a big risk inflammatory process, then the doctor can direct you to clean the uterus with the appointment of antibiotic therapy after it.

If everything is in order on ultrasound, cleaning or vacuum aspiration is simply “for prevention” is not prescribed. Usually they wait for the next menstruation, and then they do a control ultrasound. It should be noted that many women do not even think about the topic “spontaneous miscarriage incomplete, what to do”, because at the time when this happens, they still do not know that they are in a position. And everything ends happily without medical intervention.

Every woman after a miscarriage feels oppressed and morally crushed. In addition, spontaneous abortion negatively affects the entire body and inhibits the reproductive system. During the recovery period, it is important to take responsibility for your health and spend proper treatment after a miscarriage.

It will directly depend on the correctness and completeness of therapy whether in the future a woman will be able to feel the joy of motherhood, or not. It must be understood that if such a problem arose, then you should definitely contact a gynecologist. Only a doctor will be able to carry out a full treatment after an early miscarriage and restore reproductive function.

If we consider the concept of miscarriage with medical point of view, then when such a situation arises, experts say that a spontaneous abortion or rejection of the embryo by the body has occurred. Often, shortly after conception, membranes completely out of the cavity reproductive organ, but may stay there partially.

A miscarriage can be early or late. Source: melnitsa-asb.ru

The fastest recovery after an early miscarriage, that is, up to 12 weeks of fetal development. However, the occurrence of this condition in the second trimester is not excluded. So, for example, if the 25th week has already come, then it is not about arbitrary termination of pregnancy, but about premature birth.

Regardless of the period in which the problem arose, a woman must definitely contact a medical institution to determine her state of health, as well as confirm the absence of complications. Let us consider in more detail what to do if a miscarriage happened at home, what to do, whether cleaning and reception is necessary medicines.

Causes

If a woman has a spontaneous abortion, then, first of all, it is necessary to establish what caused such a problem. Accordingly, it is not surprising that girls are wondering how to do this, and whether this is even possible. It should be noted that the maximum diagnostic information can be obtained only after cleaning.

During the procedure, the doctor takes a small amount of biological material and sends it to the next histological examination. In certain cases, the results can determine what caused the abortion. However, this is not always enough, so a woman is prescribed tests after an early miscarriage.

It is imperative to donate blood for general clinical diagnostics and determination of the level of concentration of sex hormones in the blood. A biological fluid is also given to determine the presence or absence of genital infections, inflammatory processes, and genetic predispositions.

Examination after a miscarriage also involves visiting doctors of a narrow specialization, including a urologist, endocrinologist, cardiologist, therapist. During the examination, doctors can identify pathologies according to their specialization, which are often an indirect or direct cause of spontaneous abortion in the early stages.

Cleaning

Recovering from a miscarriage is different for every woman. IN young age, especially if this is a long-awaited child and the first pregnancy, often girls close in on themselves and experience severe psychological trauma. It is important to understand that if the fetus did not take root, and it was rejected by the body, you should not become depressed, but you need to understand why this happened and try to eliminate the cause.

So, first of all, you need to know if a miscarriage has occurred, what to do, in particular, this question concerns the cleaning of the uterine cavity, how to understand that this procedure cannot be dispensed with. First of all, the woman should go to the gynecologist, who will advise her to undergo an examination on the chair, and also to do ultrasound screening pelvic organs.

Cleansing procedure after spontaneous miscarriage. Source: gloriamed.ru

Thanks to such a study, the diagnostician will be able to understand the state of the uterus and its mucous membrane. In those situations where the organ is clean, cleaning is not prescribed. However, even in the presence of the smallest inclusions (remnants of the fetal egg), the procedure must be carried out. It should be performed immediately, because if you miss the time, then serious consequences can develop, including sepsis.

How to recover from a miscarriage will be told by a leading specialist. As for curettage, it is almost always performed by women who have had a spontaneous interruption after 7 weeks of gestation. Since the procedure is performed on an outpatient basis, the natural question arises of how long they stay in the hospital after a miscarriage.

Time in the walls medical institution depends on many factors. Often, the cleaning itself takes no more than 15 minutes, while it is done with intravenous anesthesia. If everything went without complications, then they stay in the clinic for several hours until the condition stabilizes, and then go home.

A complete miscarriage at an early stage without cleaning is possible. But in the second trimester this procedure is mandatory, while the woman after it will need to be in the hospital for several days.

Preparations

If in the early period of gestation spontaneous interruption contributed to the complete removal of the embryo, then the doctor does not prescribe pills after a miscarriage. However, after gynecological curettage, there is an urgent need to take medications.

Specialists in therapeutic practice use the following medicines:

1. Be sure to prescribe an antibiotic after a miscarriage (preference is given to the penicillin group). Taking these drugs is necessary to prevent infection of the reproductive organs. They should be drunk in a course, the duration of which is from 3 to 10 days.
2. Pills are also prescribed to reduce the uterus after a miscarriage (in most cases, Oxytocin is used). After the introduction of the drug, the contractility of the muscular layer of the uterus increases, so there is a rapid rejection of the endometrium, thereby preventing the opening of severe bleeding.
3. Definitely shown drugs after a miscarriage to increase immunity (it is best to take Izoprizon or Derinat). Thanks to them, the protective abilities of the body are improved, it is better able to resist viral and infectious diseases.

The doctor will definitely tell the patient after a miscarriage what to do and how it is preferable to restore the reproductive abilities of the reproductive system. It is categorically unacceptable to independently choose medicines and drink pills on the advice of friends and acquaintances. Medical therapy is selected by a leading specialist based on the characteristics of the clinical picture.

Recovery

Many girls who are faced with the problem of spontaneous abortion are interested in how to recover from an early miscarriage. The main reproductive organ after the rejection of the embryo returns to normal quite quickly, even if the embryo has developed well.

During the recovery period, it is forbidden to enter into intimacy. Source: sixtumed.ru

Within a few days, the uterus acquires normal sizes. However, if this did not happen, then the doctor will tell the woman which pills to drink after a miscarriage to improve the contractile abilities of the reproductive organ. Concerning intimacy, then it should be completely excluded until the first natural menstruation begins.

If you do not follow this recommendation, then infection of the genital organs, the development of an inflammatory disease, as well as the occurrence of other, more severe consequences for the body, for example, severe bleeding may open. When the doctor talks about what to do after an early miscarriage, he focuses the patient's attention on the fact that for several cycles you can not have sex without a condom.

Menstruation

When a miscarriage occurs, the leading gynecologist explains what to do. Be sure to ask a specialist what will be the nature of the first menstrual bleeding. It is important to understand that discharge after curettage and menstruation are two completely different concepts.

Recovery after a miscarriage and cleansing is complicated by a protracted period, since this manipulation led the doctor to perform in a few minutes what happens for several days, that is, rejection of the endometrium. From this moment, it is already possible to begin to control the stability of the menstrual cycle, but the first natural (physiological) discharge will begin only after 3-5 weeks.

After the onset of bleeding, it is better to use pads, since tampons can cause pathogenic bacterial flora to enter the genital tract. As for the nature of menstruation, they can be equally meager and abundant, which is due to serious changes hormonal background.

A special role is played by the period at which spontaneous abortion occurred. If this happened before eight weeks, then the body has not yet had time to adapt to the fact that a new life has arisen in it, and the balance of hormones has not changed much. In this case, rehabilitation after an early miscarriage and the restoration of the cycle will occur quickly and without consequences.

First aid for a miscarriage for a period of 12 weeks or more is to hospitalize the woman as quickly as possible. Self-termination of pregnancy at this time is complicated by the fact that the placenta has already begun to function, so qualified medical care is needed. As for the cycle, it takes longer to recover, and if the situation happened at a later date, then the patient may develop endometriosis, mastopathy and tumors.

If a woman is faced with such a problem as spontaneous abortion, then after a miscarriage, the recommendations of doctors will be as follows:

1. First of all, you should go for an ultrasound examination of the pelvic organs to determine if there are any particles of the fetal egg left in the uterus;
2. If there are medical indications, then it is necessary to undergo a curettage procedure so that there are no complications in the future;
3. The gynecologist will definitely tell you what to drink after a miscarriage, in what dose and for what period of time;
4. It will be necessary after a miscarriage to undergo a complete medical examination, thanks to which there is a chance to establish the cause of spontaneous interruption;
5. Planning for the next pregnancy can only begin after the approval of these desires by the leading specialist.

The first time is better to drink after a miscarriage contraceptives, which will help to avoid unwanted fertilization during the first months. The body needs to recover as fully as possible. Be sure to treat all associated pathologies. During recovery period It is also recommended to take vitamins after a miscarriage.

Sports can be replaced by walking.

Miscarriage - spontaneous termination of pregnancy in its first half (up to 20 weeks). According to statistics, every fifth pregnancy ends with an early termination. In some cases, the expulsion of a non-viable embryo can occur already in the first days of its implantation attempt, when the woman is not yet aware of the changes that have occurred in her body. Such an abortion is often mistaken for a delayed period.

Most spontaneous abortions occur in the first three months of pregnancy. The statistics allow us to conclude that main reason pathological condition are chromosomal abnormalities that "weed out" defective embryos. Thus, nature is fighting for the health of future offspring.

Causes of miscarriage

It is impossible to answer with absolute accuracy why a miscarriage occurs. There are many prerequisites that can lead to or the abortion itself. Among them are:

• Genetic and chromosomal disorders and mutations that make the development of the fetus impossible. Such embryos die no later than 6-8 weeks of gestation.
• Anomalies of the genital organs (, hypoplasia of the uterus).
• Infectious diseases. Elevated temperature, general intoxication of the body negatively affect the fetal membranes and the fetus itself.
• Chronic diseases of the mother (diabetes mellitus, thyroid pathology, disorders in the blood coagulation system).
• Hormonal disorders, in particular associated with a lack of progesterone.
• Previous abortions or curettage of the uterus, which lead to trauma and inability to hold the fetus. Abortion during the first pregnancy is especially dangerous.
• Autoimmune failures, in which the body begins to "attack" the embryo with antibodies, leading to its death.
• mother and fetus. It occurs when an Rh-negative mother develops a fetus that inherits a positive Rh from the father. The woman's body perceives it as a foreign body and tries to get rid of it.
• Poisoning and severe physical injury. These reasons can provoke a miscarriage, but not as often as they say. Regular contact with certain chemical elements can, to a certain extent, adversely affect the development of pregnancy. In a healthy woman, minor injuries very rarely lead to miscarriage, since the fetus is well protected in the uterus.

Contrary to common misconceptions, a pregnancy up to 12 weeks is not interrupted by air travel, computer and copier work, minor physical or sports activities, sexual activity, or emotional distress.

The risk of miscarriage is slightly higher if previous pregnancies ended in spontaneous abortions, or if the age is over 40 years. However, in the presence of only the listed indicators, most women successfully carry the pregnancy to term.

Relative danger is represented by the use of alcohol and smoking, coffee abuse, the father's age is over 40 years. There are a number medications And medicinal herbs, the abuse of which can lead to fetal intoxication and spontaneous abortion. As soon as a woman is convinced of her pregnancy, she should change her attitude towards taking medications and use them only after consulting a doctor.

Symptoms

How does a miscarriage happen? Spontaneous abortion begins with the gradual detachment of the fetal egg from the walls of the uterus. Under the influence of its contractions, the embryo is expelled in whole or in part.

The first signs of a miscarriage are bleeding and cramping pains in the lower abdomen, reminiscent of painful sensations during menstruation, but differing in greater intensity. The discharges accompanying the process can be both bright red and plentiful, and scanty brown.

Also observed:

• lower back pain of varying degrees of intensity;
• secretion of mucus and blood clots;
• a sharp disappearance of the signs that were observed during pregnancy earlier (nausea, drowsiness, enlargement of the mammary glands);
• weight loss.

There are several types of miscarriage.

At an early stage

• Threatened abortion

There is a detachment of the fetal egg in only one area. In this case, bleeding may be absent, and the pain may be insignificant. There is a high chance that the pregnancy will continue.

• Incipient abortion

It is characterized by partial detachment of the fetus, which is accompanied by slight pain and bleeding. Pregnancy is more difficult to maintain, but possible.

• Abortion in progress

The fertilized egg has exfoliated and is on its way out of the uterus. A woman has severe cramping pains, heavy bleeding, sometimes chills. It is not possible to save the pregnancy.

• incomplete abortion

After the death of the fetus, only part of it is expelled from the uterus, other elements continue to reside in the uterine cavity.

• Missed miscarriage

After the death of the fetus, it is not expelled from the uterus. The dead embryo may remain in the cavity for some time. This condition is very dangerous, since the entry of pathogenic microorganisms into the uterus can cause infection.

• medical abortion

A medical miscarriage is caused for medical reasons for up to 7-8 weeks. After taking the drug Mifepristone, the woman stays in a medical facility for several hours and then goes home. After 2-3 days, you need to make another visit to the doctor to re-take the drug. After two weeks, a control ultrasound is performed to make sure that there are no fetal particles left in the uterus.

Contraindications for medical abortion:

• age over 35;
• active smoking;
• problems with blood clotting;
• severe forms of hypertension;
• kidney or liver failure;
• sexual infections.

As already mentioned, often fetal rejection can occur for a very long time.

How to distinguish a miscarriage from menstruation?

This can be quite difficult, and in some cases even impossible. The basis for suspicion of spontaneous abortion may be a delay in menstruation for several days (weeks), a sharp onset of bleeding, accompanied by more intense pain than usual, nausea, dizziness.

Can help determine the fact of a miscarriage. Many women at the planning stage of pregnancy monitor its indicators. At conception, an increase in temperature is characteristic, and in the event of an abortion, its normalization.

If a woman suspects a miscarriage, it is necessary to contact a gynecologist.

At a late date

After 20 weeks, the threat of termination of pregnancy decreases, but the risk cannot be completely eliminated. Termination of pregnancy in the second trimester can occur with low hemoglobin, placenta previa, isthmic-cervical insufficiency, infectious diseases, .

Signs of a threatened abortion are similar to those that occur in the first half of pregnancy. There may also be uterine hypertonicity, fast fatiguability, intestinal disorders, pallor of the skin, pain in the lumbar region.

Treatment and diagnosis

What to do if you experience abdominal pain and bleeding? How to determine a miscarriage? These symptoms are a serious reason to seek medical help. When diagnosing, pay attention to:

• analysis of complaints of a pregnant woman (the onset of pain and discharge, their intensity);
• study of medical data (the course of previous pregnancies, abortions, infectious or gynecological diseases);
• gynecological examination to determine the size of the uterus, the nature of the discharge, the degree of cervical dilatation;
• Ultrasound of the pelvic organs;
• blood test (determination of the Rh factor);
• HCG - is carried out at a very early stage, when ultrasound diagnostics is not yet effective enough.

Most of the symptoms of spontaneous abortion are identical to those of other gynecological pathologies. So, pain and bleeding can occur with cervical injuries, malignant tumors. A set of diagnostic measures will distinguish possible miscarriage from other pathologies.

The main question to which treatment will be subordinated is how much it is possible to maintain pregnancy. A woman is prescribed strict bed rest for several weeks with limited physical activity and a ban on sexual activity. In order to relieve uterine contractions, antispasmodics are prescribed. Hemostatic therapy is also indicated.

Until 9-16 weeks, hormone treatment with progesterone is prescribed, which lasts up to two months. is an indication for suturing to narrow the isthmus of the uterus. The sutures are removed at 36-37 weeks of gestation.

Need for scraping

If a miscarriage cannot be avoided, the uterine cavity is scraped to remove the remnants of the embryo and placenta. Many women choose not to brush, believing that scraping can be harmful. It is impossible to determine on your own whether the fetal egg is completely expelled, especially when the miscarriage occurs outside the medical facility. Only a doctor can decide how much cleaning is necessary after a spontaneous abortion. To refuse this procedure means to risk your well-being and the further possibility of having children.

Doctors do not advise getting pregnant earlier than six months later. The most optimal interval between spontaneous abortion at an early stage and a new pregnancy is a period of one year. If the miscarriage occurred in the second trimester, conception should occur no earlier than two years later.

When planning a new pregnancy, a woman must observe the following rules:

1. Completely give up bad habits (alcohol and smoking).
2. Avoid taking strong drugs, do not take untested drugs without consulting a doctor, replace them as much as possible with folk remedies.
3. Provide yourself with a favorable psychological atmosphere, avoid severe stress, physical overvoltage, grueling sports training.
4. Timely detect and treat various chronic, viral or infectious diseases.
5. Organize proper nutrition, follow a diet rich in vitamins and other beneficial substances.
6. Avoid crowded places during outbreaks of viral diseases.
7. Regularly take vitamin complexes, folic acid, iron preparations.

It must be remembered that a new pregnancy after a miscarriage also carries a certain risk. She must strictly follow all the recommendations of the doctor, and at the slightest sign of feeling unwell, seek medical help. This will help to avoid other problems that often occur in pregnant women with previous miscarriages: delays in its development, premature birth.

The consequences of a miscarriage can be emotionally painful for both you and your partner, as well as negatively affect your body. A miscarriage is the loss of a fetus before 20 weeks of gestation that occurs spontaneously or otherwise. Start with Step 1 below for helpful tips on how to take care of yourself physically and emotionally after a miscarriage.

Steps

Taking care of yourself physically

Rest as much as possible during the first 24 hours. It is obviously essential to rest as much as possible within the 24 hours immediately following a miscarriage, as this gives your body time to adjust to the new state and recover from the loss.

• Get as much sleep as possible - if you're having trouble falling asleep, try drinking a glass of warm milk. The warm liquid will relax your body and help you fall asleep.
• While resting, try to stretch your arms and legs every ten minutes. Every day you can walk for 20 minutes - this exercise will benefit you and help you sleep better.

1. Take painkillers to relieve crampy abdominal pain. Spasmodic pain in the abdomen very often occurs after a miscarriage and is usually accompanied by bleeding. At different women this pain manifests itself in different ways and may depend on whether the miscarriage was natural or the fetus was removed surgically.

   • Take medications like ibuprofen to relieve back pain, while stronger drugs like Cyclopam and Buscopan are antispasmodics that relieve pain by reducing the intensity of uterine muscle contractions.
   • The pain and cramps should subside on their own over time. If over time the pain only increases, it is recommended to immediately consult a doctor, as there may be tissue left in the uterus that should be removed.

2. Take your temperature, as it serves as an indicator of infection. In the first five days after a miscarriage, it is recommended to check the temperature daily. At any temperature above 37.60 ° C, see a doctor, as a high temperature may be a sign of an infection in the uterus or outside it.

3. Use sanitary pads or tampons to control bleeding. After a miscarriage, heavy, moderate bleeding from the vagina is characteristic, as the uterus pushes out the tissues left after pregnancy. For heavy bleeding, use sanitary towels, and as soon as they decrease, switch to tampons. Sanitary pads and tampons should be changed at least every 8 hours.

   • You should also take a shower at least once a day (twice is better). This helps maintain a normal level of hygiene and reduces the risk of infections.
   • Do not douche or use any strong chemical disinfectant or soap around the vaginal area. This can cause irritation and lead to infection.

4. Apply hot and cold compresses to relieve cramps and headaches. Hot and cold compresses are good for headaches, along with stomach cramps and back pain. Alternating between hot and cold compresses is a good idea, as the heat helps relax the muscles, while the cold helps dull any pain.

   • You can buy special hot and cold compresses for this, or you can make your own by soaking a washcloth in hot or cold water and squeeze it out before use. You can also use a bag of frozen peas for a cold compress and a bottle of hot water for a hot compress.
   • Press a hot compress on the affected area and hold for 20-25 minutes, then change to a cold one, or vice versa.

5. Follow a healthy diet as it will help your body recover. Eating a healthy diet is the most important thing after a miscarriage, as eating healthy will help the body heal and restore normal functioning. It will also give you more energy and help you feel better overall. Poor nutrition will only make you feel worse.

   • Eat a balanced diet that contains a healthy portion of protein, carbohydrates, fiber, and fat. Try to drink at least 8 glasses of water a day.
   • Get more calcium - up to about 200 mg per day. During pregnancy, the fetus absorbs all of the calcium, so you may not have enough after a miscarriage. Drink milk, eat dairy products and fish such as sardines and salmon.
   • Increase your folic acid intake. Folic acid is essential for blood compounds and you tend to lose a lot of blood after a miscarriage. Get more folic acid by adding more green leaves, vegetables, and fruits to your diet.

6. Give up sexual activity during the first 1-2 months after a miscarriage. It is advisable to avoid sexual intercourse in the first 1-2 months after a miscarriage - this time will be required for the healing of the vagina.

   • After you return to sexual activity, it is recommended to use contraceptives, as there is an increased risk of becoming pregnant again before your normal menstruation returns (usually one month to six weeks after a miscarriage).
   • This is especially important if you and your partner don't want to get pregnant so soon.

   Taking care of yourself emotionally

   1. Mourn the loss of your child. Different people react to miscarriage in different ways, but everyone, regardless of the circumstances of not carrying a pregnancy, needs time to heal the wounds. It is important that you have the opportunity to grieve the loss of your child for as long as you need to, as this helps you come to terms with the loss and begin the healing process.

      • If you're constantly feeling down and can't seem to recover from your miscarriage, seeking the help of a therapist is a good idea. He will help you deal with your feelings and explain the meaning of what you have gone through.
      • It is very important to find a psychologist with whom you feel comfortable, and you can tell him about your sorrows, fears and anxieties.

   2. Share your feelings with a close friend or family member. The hormonal changes that occur in a mother's body after a miscarriage can increase feelings of sadness or anger, which your partner may or may not fully understand. Therefore, finding a friend, close relative, or even a support group to express your feelings to is very important. It helps to heal and prevent depression.

      • However, it is important to be aware of the fact that miscarriage is a depressing experience for both the mother and her partner. Both experience emotional stress after losing a child, so don't close yourself off from your partner - it's important to support each other throughout the mourning period.
      • Also try to keep in mind that both partners may experience loss in different ways. For example, you may cry out loud while your partner continues to keep his or her grief in. This does not mean that his pain of loss is less, so try to be understanding.

   3. Do simple exercises and meditations. Once you've overcome the initial physical symptoms of a miscarriage, it's a good idea to work on yourself as much as possible. Any kind of physical activity will do you good, as it reduces the level of androgens (stress hormones) in our body and releases endorphins (joyful, relaxing hormones) instead.

      • Start with a daily 20 minute walk to get your blood pumping - Fresh air will do you good. After that, you can move on to more challenging activities like running, cycling or rowing.
      • Choose the type of physical activity that you like best - anything from dancing to rock climbing and horseback riding. The first months after a miscarriage are very difficult time so it's important to engage in activities that make you happy

   4. Take up yoga. For women who are recovering from a miscarriage, it is recommended to practice yoga every day, as it consists of light physical exercises and helps to calm the mind and relieve tension.

      • Yoga includes a series of breathing exercises that help you feel calm and relaxed, as well as getting more oxygen into your bloodstream, relaxing your muscles, and helping you feel better physically.
      • Yoga can be practiced in the comfort of your home using a yoga mat and DVD, or you can find classes in your area. For more detailed instructions on how to perform certain yoga breathing exercises, see this article.

   5. Ask your doctor to prescribe antidepressants if needed. Anti-anxiety medications and antidepressants help manage depression and anxiety when these feelings become overwhelming. These drugs work by inhibiting the serotonin receptors that cause major depression and grief.

      • It may take about 3 weeks before you feel a noticeable difference while taking these medicines. But over time, they tend to give good results.
      • Talk to your doctor to get you a prescription.

   6. Return to work when you feel ready for it. It will take some time to return to work and normal daily activities after a miscarriage. For each person, this time will be different.

      • Some people will try to get home from work early to deal with the emotional trauma of losing their child. Others, on the other hand, will put more time into work because they don't feel ready to face a problem in the real world.
      • How long it takes you to recover from a miscarriage is completely your personal choice, which depends on how you feel - both psychologically and physically. Spend as much time as you need - no need to rush into a decision.

   7. Plan your future pregnancy with an obstetrician. After a miscarriage, it is recommended to plan any future pregnancies only with an obstetrician.

      • Your OB/GYN will advise you on any precautions you can take to avoid future miscarriages. These may be recommendations for rest during pregnancy and a balanced diet.
      • He or she may also prescribe you drugs that minimize the risk of miscarriage. This will help you feel calmer and safer during your next pregnancy.
      • For more information on how to prevent miscarriage, see this article.

   Understanding miscarriage

   1. Remember that there are different types miscarriages. A miscarriage is defined as the loss of a fetus before 20 months of pregnancy. However, within this definition, there are several terms used to describe the exact nature of a miscarriage:

      • Spontaneous abortion: occurs when a pregnancy is terminated naturally, before 20 weeks, due to factors such as genetic abnormalities, drug or alcohol abuse, infections, or hormonal problems that prevent the fetus from surviving.
      • Incomplete abortion: this is when the pregnancy is terminated, but some of the tissue is still in the womb. The doctor must remove this tissue, otherwise it can lead to infection.
      • Complete abortion: this is when the fetus is removed with all accompanying tissues (also known as products of conception).
      • Inevitable abortion: this is a type of abortion where the symptoms cannot be prevented or stopped, and eventually lead to a miscarriage. Symptoms include bleeding from the vagina and dilatation of the cervix.

   2. Find out if you are at risk. Some women are at a higher risk of miscarriage than others. In some cases these risks can be avoided, but in others they are unavoidable. Women at risk:

      • Who smoke, drink or take drugs during pregnancy. This lifestyle is known to reduce the level of amniotic fluid in the body, which causes premature labor and may lead to miscarriage.
      • Who are older than 35 at the time of conception of their first child.
      • Who already had a bitter experience of miscarriage.

   3. Learn to recognize the symptoms and signs of a possible miscarriage. If you are pregnant, it is important to learn to recognize the early signs and symptoms of a miscarriage. If you notice any of the following symptoms, you should call your doctor and get tested.

      • Vaginal bleeding: bleeding from the vagina (often accompanied by sharp pains) is one of the most obvious signals that you are about to have a miscarriage (or that you have already had one). Please visit your nearest doctor if you notice any vaginal bleeding. Bleeding occurs when the placenta begins to separate due to various factors, such as a decrease in the level of hCG in the blood or the use of drugs and alcohol, which leads to spontaneous labor.
      • Isolation of clots: in some cases, there may not be any bleeding (at least at first), but you may notice a clot of tissue from the vagina. This is due to the low level of hCG in the blood, which means that the mother's body is not able to carry the child to full term and, naturally, a miscarriage occurs.
      • Pain in the abdomen or back: any form of abdominal pain or lower back pain should make you suspect a miscarriage. These types of pains are often the first sign that the uterus is contracting due to lower levels of estrogen and hCG in the blood.

   4. Understand how your doctor determines if you've had a miscarriage. In some cases, this is not immediately clear, even if there are symptoms such as vaginal bleeding and cramping. In such situations, doctors must perform several tests to see if the pregnancy is still valid. These tests include:

      • Ordinary AS ( clinical analysis blood) - testing is done to determine the level of hemoglobin in the blood, and how much blood has been lost.
      • Determination of the blood type - is carried out to find out Rh compatibility. Rh compatibility indicates whether the blood type of the mother and fetus will be the same or different.
      • You may be advised to do an ultrasound of the organs abdominal cavity and/or pelvis.
      • The level of hCG in the blood is tested to see if it is low or normal. Short hCG level increases the chance of miscarriage.

   5. Learn how tissue is removed in an incomplete abortion. An incomplete abortion is when the fetus is removed, but the products of conception remain inside the uterus. These products of conception must be removed to prevent infection of the uterus. This is done through a procedure known as dilatation and curettage.

      • During dilation and curettage, the patient is anesthetized and put to sleep so that she does not feel any pain. The cervix is ​​then dilated and an instrument called a curette removes the contents of the uterus through the cervix.
      • After the tissues are removed, the uterus is cleaned with an antiseptic betadine solution, which helps prevent infection.
   • wear comfortable bra to relieve chest discomfort.
   • Get a massage to relieve tension in your neck, back, and shoulders.
   • Any bleeding from the vagina before 20 weeks is called a miscarriage. Anything after 20 weeks is called preterm labor.

   Sources

   • Barrett, E. E. (2010). What was lost: A Christian journey through miscarriage. Louisville, Ky: Westminster John Knox Press.
   • Rehmann-Sutter, C., & Müller, H. (2009). Disclosure dilemmas: Ethics of genetic prognosis after the "right to know/not to know" debate. Farnham, England: Ashgate Pub.
   • Perkins, S., & Meyers-Thompson, J. (2007). Infertility for dummies. Hoboken, NJ: Wiley Pub.
   • Katz VL. Spontaneous and recurrent abortion: etiology, diagnosis, treatment. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 16.
   • Laurino MY, Bennett RL, Saraiya DS, et al. Genetic evaluation and counseling of couples with recurrent miscarriage: Recommendations of the National Society of Genetic Counselors. J Genet Couns. June 2005;14(3). Reaffirmed April 2010.
   • Simpson JL, Jauniaux ERM. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 26.

If a woman has a miscarriage, it is important to take competent measures to restore health. This will help to cope with the pathology morally and prepare the ground for a new pregnancy. Medical statistics state that 15-20% of pregnancies end in spontaneous abortion. different reasons. The symptoms of what happened rarely go unnoticed.

This makes it possible for a woman to diagnose what happened in time, contact a gynecologist, undergo adequate treatment and plan the birth of a child for the future. Spontaneous abortion experts classify into three categories:

1. Termination biochemical pregnancy - the embryo leaves the uterine cavity in the first - third week after conception. A woman during this period most often does not suspect that she is carrying a child. Pregnancy becomes known only when testing for the content of hCG in the urine and blood, which is why it is called "biochemical". The failed mother perceives the blood that has left the body as menstruation, which for unknown reasons began outside the scheduled time. Units who carefully monitor their own health go to the doctor.
2. Spontaneous abortion or miscarriage in early pregnancy - up to 22 weeks, when the weight of the embryo does not reach 0.4 kg.
3. preterm birth when the pregnancy ended at 22-37 weeks. If medical assistance is provided on time, efforts are made to ensure the life of the child, the baby in most cases can be saved. In medicine, an early born is called premature.

After the birth of the child, they are connected to life-supporting equipment, which helps him adapt to new conditions.

What is a miscarriage - an overview of options

A miscarriage that occurs is complete when all parts of the embryo come out of the uterine cavity along with the membranes and amniotic fluid. In the event that parts of the fetus remain in the uterus, they speak of an incomplete miscarriage, which occurs more often in the early stages of pregnancy. For neutralization negative consequences, preventing the development of an infectious process in the tissues, the product of conception is evacuated from the uterine cavity by methods of medical interruption, gynecological curettage, vacuum aspiration. Therapy may include the use of drugs aimed at contracting the uterus and pushing the contents out. Ultrasound examination is considered to be the control method of diagnostics. Negative consequences entail a miscarriage during the first pregnancy. After the event, conception is possible after a thorough examination and treatment.

The most dangerous for spontaneous miscarriage is the first month of pregnancy. Doctors distinguish the so-called critical periods of development, in which the embryo (fetus) is especially exposed to harmful factors:

• 2-3 weeks from conception;
• 8-12 weeks;
• 18-22 weeks;
• 28-32 weeks.

During this period, most of the accidents associated with the loss of a child occur. Therefore, the expectant mother should be extra careful.

Why does the body reject the embryo

When a new life is born in a woman's body, the causes of miscarriage often lie in the presence of chromosomal abnormalities at the fetus. Therefore, it is highly undesirable to correct the pathological condition before 12 weeks. Among the factors provoking rejection of embryos are:

• hereditary factor and genetic failure at the stage of fertilization of the egg by the sperm. A non-viable fetus appears as a result of the action of various risk factors - the environmental situation, occupational hazards, and a viral disease of the parents. It is impossible to neutralize these factors. The only way out of the situation is to reduce the likelihood of their manifestation by protecting the mother from dangers during the gestation period. If a defect incompatible with life develops in the child's body, the embryo does not undergo natural selection. The body performs a spontaneous abortion, getting rid of a non-viable fetus;
• Hormonal imbalance caused by malfunction endocrine system. The situation can be affected by an insufficient amount of progesterone in the mother's body or an excess of testosterone. With early detection of a failure of the hormonal system, a woman undergoes specially organized therapy before pregnancy, which eliminates the possibility of a miscarriage;
• The presence of tumors, neoplasms in the pelvic organs;
• Isthmic-cervical insufficiency(ICN), when the isthmus and cervix open prematurely, unable to cope with the increasing pressure caused by the fetus growing in the body;
• There is a risk of miscarriage in the presence of anomalies in the work of the cardiovascular, renal systems;
• Addiction, alcohol addiction , substance abuse of mother and father;
• Depressive states, stress, nervous stress of a pregnant woman;
• Mechanical loads, impacts, bruises, excessive physical labor of the future woman in labor;
• X-ray examination- Irradiation can cause miscarriage.
• The use of medicines. In the first trimester, the use of potent medicinal formulas is prohibited. Drugs can cause the development of defects in the embryo. Some decoctions of herbs are also contraindicated. These are parsley, tansy, cornflower, nettle, St. John's wort. Self-medication is prohibited. Each drug is agreed with the attending physician.
• Infectious and viral process in the body of a pregnant woman. Any sexually transmitted infection can provoke a miscarriage, which must be treated before pregnancy, otherwise there is a high risk of infection of the fetus in the womb. A great threat of miscarriage in the early stages exists due to viral infections and inflammation of internal organs. Dangerous symptom- high temperature of the mother, accompanied by intoxication of the body. At the stage of pregnancy planning, it is important to stop chronic diseases, get vaccinated against dangerous infections.
• History of abortion, unsuccessfully performed surgery, unprofessionalism of the doctor and unfortunate circumstances can lead to fetal loss.
• Immunological factors.

The list of causes of miscarriage in early pregnancy and in the later period can be more extensive, in each specific case doctors identify pathology individually. Impact of all harmful factors future mother not able to prevent, however, much in her power.

A little about a frozen pregnancy

Having studied what are the symptoms of a miscarriage, recovery time and treatment methods, one cannot ignore the issue of a missed pregnancy. The condition is characterized by the death of an embryo in the womb, often occurring in the first trimester of pregnancy. Among the reasons, similar factors were noted - maternal infections, genetic failure, hormonal imbalance, bad habits, potent drugs, stress.

If, with a spontaneous miscarriage, the clinic is expressed by severe pain and blood loss, then a frozen pregnancy is often asymptomatic. There are no pulling and throbbing sensations of pain, no contraction-like urges, no blood is released from the vagina. The uterus may not reject the dead embryo, leaving it inside itself. At the initial stage of pregnancy, the condition is difficult to detect; in the second and third trimester, the mother is alarmed by the prolonged absence of movements in the abdomen. The next visit to the doctor reveals a mismatch in terms of the size of the uterus, the absence of a heartbeat in the mother's womb. Ultrasound makes an accurate diagnosis.

If the fetus is dead, and tissue rejection does not occur, curettage or extraction of the deceased embryo with a vacuum is prescribed. If this is not done, there is a high probability of poisoning by toxic decay products that have entered the bloodstream from the uterus. A thorough examination will help to establish the causes of the anomaly, prescribe effective therapy.

Both spouses should be tested. On the basis of the seized material, a histology of the tissues of the embryo is carried out. Diagnostics of diseases is carried out, adequate treatment of the root causes of fetal loss is prescribed. Comprehensive diagnostics includes microbiological, ultrasound, hormonal, immunological examination.

The existing threat of miscarriage during pregnancy is a reason to carry out therapy in a specialized medical institution if it is established that the pregnancy is progressing. The hospital will provide a calm regime, timely administration of drugs. Hospitalization of a woman with recurrent miscarriage is an adequate response to the risk of fetal loss.

Isthmic-cervical insufficiency (ICI)

One of the most common causes of spontaneous miscarriage during pregnancy is ICI - the opening of the cervix and isthmus of the uterus in response to the increasing pressure of the growing fetus. Pre-pregnancy manipulations with the uterus (cervical dilation due to abortion, childbirth or curettage) affect the condition of the muscle ring. Damaged areas are tightened by scar tissue that does not have elasticity, is not amenable to stretching and contraction. ICI also has a functional nature, when there is a hormonal imbalance - the level of testosterone in the blood rises, there is a lack of progesterone.

ICI occurs in the period from 11 to 27 weeks after conception, when the embryo begins to produce androgens in the mother's body with the launch of the adrenal glands. Taking into account the mother's hormones, their indicator may be exceeded - this softens the cervix, opens it, shortens it. Harmful bacteria and microorganisms penetrate into the formed channel, infecting the fetal egg. Overt symptoms initial stages They do not have ICI, since they do not entail the tone of the uterine muscles. With the loss of strength of the membranes, amniotic fluid pours out. Pain during miscarriage is absent.

If a woman has experienced a spontaneous abortion, which began with an outpouring amniotic fluid, when monitoring a subsequent pregnancy, she should indicate this fact to the doctor.

Treatment of isthmic-cervical insufficiency

Endocrine disorders that lead to an increase in testosterone are corrected by prescribing hormonal drugs. An assessment of the condition of the uterus is done by a doctor a couple of weeks after the start of taking medications. Positive dynamics is said when the opening is suspended and no further expansion of the neck is observed. If therapy does not give the planned effect, surgical intervention is prescribed. Similar measures are used for the traumatic nature of cervical deformity. You should not be afraid of the operation, the doctor acts delicately, without causing additional injuries to the patient, without causing discomfort to the expectant mother and the baby growing in the womb. Greater efficiency of the procedure is noted in the early stages. Suturing can significantly reduce the risk of infection of the embryo through the lower edge of the cavity.

Surgical intervention is carried out in stationary conditions. Before the operation, the pregnant woman is examined. After the procedure, the vagina is sanitized, for which the area of ​​suturing is treated with antiseptics for 3 days. For this purpose, chlorhexidine and furacillin are used. Then every week the patient needs to undergo a follow-up examination by the attending physician, where he assesses the situation, making adjustments to the therapeutic protocol if necessary. The stitches are removed at 38 weeks of gestation. During this time, the cervix matures, preparing the birth canal for the passage of the fetus. Many women in labor worry that sutures require caesarean section. This is not true. In most cases, women give birth on their own.

Emergency action is recommended if the fetal bladder prolapses into the cervix from 16 to 24 weeks. The operation of suturing the cervix obliges the woman to observe bed rest, strictly follow the daily routine, avoid physical exertion, and do not skip taking medications. In rare cases, complications occur after suturing. Among them, the cutting of sutures through the tissues, provoked by the frequent tension of the muscles of the uterus. To prevent tone, tocolytics are prescribed. The expectant mother should be prepared to conduct intensive examinations, taking smears to check the vagina. This is due to the likelihood of accumulation of pathological microflora on the threads of the seams.

It is also important to conduct psychological therapy, where a woman is taught the techniques of self-soothing, relaxation. The behavior of the mother is a decisive factor in the successful bearing of the fetus with complications. Panic and fuss create an unfavorable prognosis in stabilizing the situation. Careful health monitoring is carried out in a newborn baby to eliminate the risk of infection in the womb. If a spontaneous abortion has occurred for reasons of ICI, when can you get pregnant after a miscarriage, the doctor will say. Ideally, the period should be at least two years. The doctor must take measures to prevent a repeated situation of losing a child.

Now, in addition to the suture, ICI correction is also carried out with the help of an obstetric pessary. Alternative method is the imposition of a special ring of hypoallergenic materials on the cervix. Silicone is the most commonly used. The ring creates additional support, preventing the opening of the neck.

Uterine hypertonicity - risk prevention

Contractions of the uterus until the moment of natural childbirth are called organ hypertonicity. The condition is not an independent disease, it signals a malfunction in the body of the expectant mother, often manifests itself in the early stages of pregnancy. The causes of the pathological phenomenon are:

• Hormonal disorders caused by insufficient function of the placenta, ovaries, impaired activity of the adrenal glands, causing imbalance.
• Genital infantilism, defects of the body;
• Neoplasms, tumors in the uterus, not necessarily of a malignant nature (myoma);
• Transferred during pregnancy infectious processes, viral diseases;
• ICI - cervical dilatation under increasing pressure created by the growing embryo;
• Immunological trouble;
• Chronic diseases of the body(cardiovascular disorders, renal failure);
• Previous spontaneous miscarriages at an early stage, the symptoms of which may recur, artificially induced abortions.

Except physiological reasons psychological factors are of no small importance. Residing in depressed state a woman can provoke uterine hypertonicity.

A woman can feel the tension of the muscles of the uterus herself, without the help of a specialist. This is evidenced by the heaviness that appeared in the lower abdomen, pulling pains in the lumbar region. Symptoms are similar to painful menstruation. Arising in the first trimester, the condition provokes spontaneous abortion, missed pregnancy, death of the fetal egg. In the subsequent period, premature birth is likely due to uterine hypertonicity.

Why does the tension of the walls of the uterus cause terrible consequences? The point is the disturbed blood supply to the placental tissues, the occurrence of hypoxia of the embryo, and the slowing down of the development of the developing child. Following the contraction of the muscles of the uterus, there is no contraction of the placenta. This causes its detachment, provoking the release of the fetal bladder.

Uterine hypertonicity is detected during a scheduled visit to a specialist. Stabilization of the situation requires the appointment of sedative drugs and antispasmodics. A strengthening effect is provided by therapy with the inclusion of vitamin B6, magnesium. In most cases, the measures taken are sufficient to neutralize the risks. Self-medication is strictly prohibited. This can cause irreversible consequences. With hypertension, the main rule for a pregnant woman is calmness and lack of physical activity. Some moms who have had a successful birth say they “didn't get up” the whole pregnancy. This is true, but the result is worth the sacrifices spent on it. With hypertonicity, sexual contacts and sexual life are excluded.

If the threat cannot be neutralized, hospitalization of the pregnant woman in a hospital setting is recommended. It is especially dangerous when severe cramping pain is complemented by spotting. To lie down "for preservation" is an adequate measure in the struggle for the birth of a healthy and strong baby. In the hospital walls, a pregnant woman is prescribed a vaginal examination, ultrasound. On the computer monitor when scanning the fetal bladder and uterus, a doctor with a high degree accuracy determines their condition. If necessary, the expectant mother is sent to assess the level of hormones, take urine and blood tests, and be examined for STIs.

At the onset of labor activity before 34 weeks, they try to stabilize the condition with tocolytics. The most dangerous period is from 25 to 28 weeks, the woman is recommended the maximum possible bed rest. After that, the fetus has every chance of survival. In order for the pulmonary system of the embryo to form faster, allowing it to survive under early appearance into the world, hormones are prescribed. Having an unfavorable prognosis for miscarriage and the threat of miscarriage, it is necessary to prevent this situation at the stage of conception planning.

Stages of spontaneous abortion

There are certain signs of a miscarriage that attract attention and divide the course of a miscarriage into specific stages:

• Threat - noticing threatening pregnancy factors, measures can be taken to restore the situation, normalize the mother's well-being.
• The beginning of an abortion - adequate therapy can work wonders. At this stage, the doctor can apply life-saving manipulations and give recommendations to a pregnant woman who plans to become a mother.
• A miscarriage is in progress - the condition is irreversible, it is impossible to stop the pathology. The death of the fetal egg begins, leaving the uterine cavity.
• completed abortion- the uterus gets rid of the residual tissues of the embryo, cleanses, restores its original parameters. It is important to prevent the remnants of foreign fibers inside, otherwise the organ becomes infected with decaying residues, toxins go into the bloodstream.

An effective diagnostic method is an ultrasound examination of the uterus and pelvic organs.

Miscarriage symptoms - how not to miss the threat

If there is a threat of miscarriage in the early stages, then the following symptoms may occur:

• Pullers appear, incessant pain in the lower abdomen. The pain may be monotonous or come in waves.
• Opens sluggish bleeding, the signs of which are reduced to smearing brownish discharge. Bright scarlet blood can stand out, it is often confused with menstruation.
• Tone of the uterus.

A woman who does not know how a miscarriage occurs in the early stages should listen to her inner state. Should be alert:

• spasmodic pain impulses;
• drawing pain in the lumbar region.

In the later stages, the above symptoms are added:

• liquid discharge from the vagina, which may signal damage to the amniotic sac;
• pain when urinating;
• internal bleeding, which worsens general condition, fainting, dizziness, pallor of the skin
• These conditions are indications for emergency hospitalization of a pregnant woman.

The stage of the onset of an abortion is characterized by more pronounced symptoms of a miscarriage - contraction-like pain, severe dizziness, and loss of strength. Instead of smearing discharges, clot-like ones appear, abundantly manifested during movement. At this point, in some cases, it is possible to save the pregnancy if the area of ​​detachment of the fetal egg is small, the pregnancy progresses, the fetal heartbeat is determined.

The third stage is useless for saving the fetus. There is girdle pain in the lower back and abdomen. Together with abundant blood loss, a fetal egg comes out of the uterus. Incomplete miscarriage requires curettage of the uterine cavity if parts of the embryo or membranes of the fetal egg remain in the cavity, otherwise there is a high risk of complications that will threaten the life of the mother.

In an early miscarriage, the symptoms are similar in many respects to a late abortion - pain and bleeding. The intensity and duration of symptoms may vary. The fetal egg going through the birth canal damages the small vascular network, injuring the tissues. This causes bleeding. Normally, the blood will stop being released after a spontaneous miscarriage after a few days. A period exceeding these indicators confirms the infection of the uterus, the preservation of the remains of the embryo in the cavity. Therapy is based on drug treatment, surgical intervention.

After a spontaneous miscarriage, complications and serious health consequences are likely. These are rare cases, in the majority of situations the body independently copes with what happened, expels the parts remaining in the uterine cavity by natural contraction of the muscles. Early spontaneous miscarriage does not always occur, dangerous state may wait at a later date. Some women try to provoke the release of the fetus, decoctions of herbs and medications. This is fraught with complications, including sepsis, dysfunction of the reproductive organs, after which pregnancy in the subsequent period becomes impossible.

Diagnostic methods

If there is a threat of miscarriage at an early date, the doctor will help determine the symptoms during a visit antenatal clinic. The specialist will check the size of the uterus, determine the tone of its muscles, the condition of the cervix, and examine the discharge from the genital organs. A reliable method to identify the existing threat is transvaginal ultrasound diagnostics. The doctor draws attention to segmental muscle contractions of the uterus, detachment of the fetal egg. Analyze probable causes miscarriage pregnancy will help genetic testing. The patient's history is carefully collected, Clinical signs spontaneous abortions

Medical therapy

In order to maintain pregnancy, any methods are good. A qualified doctor develops an individual treatment protocol based on the available diagnostic data. Among the drugs used:

• sedatives;
• restorative therapy;
• drugs that stabilize the hormonal background;
• antispasmodics that reduce the tone of the uterus;
• vitamin and mineral supplements.

The specialist eliminates the threat of miscarriage in the early stages, tells how to prevent a woman who has lost a child from relapse. In the later stages, the cervix is ​​fixed with a special suturing (usually in the period of 16-25 weeks, if there is an ICI).

At failed attempt stopping spontaneous abortion, the following treatment tactics are used:

• Waiting - an organism that has independently freed itself from an embryo does not require specialized treatment.
• Medical therapy- the patient is discharged medical preparations that complete the removal of foreign tissues from the body. By causing severe spasms of the muscular walls of the uterus, the tablets provoke the expulsion of residues from the cavity.
• Surgery - is used for complications or inconvenient for the independent exit of the fetus, the bend of the uterus.

The control conclusion is made by the doctor after the ultrasound.

Surgery (curettage)

Having diagnosed the symptoms of a miscarriage in the early stages of pregnancy, and faced with the need for curettage, a woman worries about the state of the reproductive system. It is not worth doing this, the operation takes place in a gentle mode, with maximum delicacy in relation to the patient's childbearing ability. Curettage is performed when there is a risk of incomplete exit of the embryo from the uterine cavity and the development of infection in the pelvic organs due to the elements remaining in it. Ignoring the procedure can lead to blood poisoning and the formation of a pathology that prevents re-conception.

The specialist conducts an examination, fills out the patient's health card, sends the woman for an enema. Before the operation, hair removal from the pubic surface is mandatory. Considering individual characteristics female patient, an anesthesiologist selects a drug for pain relief. The doctor expands the cervix, cleans the internal cavity with a curette, freeing it from the remnants of the fetal egg. The uterus is scraped from the inside, which prevents the development of infection. However, vacuum aspiration is more commonly performed, as it is a more gentle method of removing debris from the uterus.

After a miscarriage, the materials obtained during scraping are sent for histological analysis. The rules recommended by the doctor should be strictly followed. A woman will be able to resume sexual activity no earlier than 1.5-2 months after the procedure. During this period, damaged tissues will be restored. By this time, menstruation will resume, it will be possible to use the usual methods of contraception.

Scraping - what and why

Cleaning is carried out after an early miscarriage in most cases in order to prevent the development of infection in the uterine cavity from the remaining tissues of the deceased fetus. It is pointless to be afraid of the negative consequences of cleaning. Gynecological curettage is a procedure for removing the upper layer of the inner cavity of the uterus. After removing the excess, the endometrium begins a natural recovery, returning the ability to function normally. To facilitate access to the cavity after local anesthesia, the neck expands. This is facilitated by special medicinal formulas or medical instruments. Gynecological cleaning is carried out in diagnostic and medicinal purposes for different indications:

• after childbirth;
• with a frozen pregnancy, miscarriages;
• with failures of the menstrual cycle;
• for accurate diagnosis of gynecological disorders.

The complex application of the method with hysteroscopy allows you to carefully examine the internal contents of the uterus in order to prevent poorly cleaned areas on the mucous membrane. The essence of the technology makes it similar to abortion, but the purpose of the procedures varies significantly.

Preparing for a gynecological cleaning

Scraping is recommended a few days before the onset of menstruation. In this case, blood loss decreases and a favorable prognosis is given for rapid tissue recovery. The operation requires a preliminary examination, testing. This:

• a study on the ability of blood clotting;
• smear for examination of the bacteriological environment;
• analysis for STIs.

Before curettage, you stop taking any medications, dietary supplements that have not been discussed with a specialist. Even plant components that can affect blood clotting and provoke blood loss during surgery can be dangerous. It is important that your healthcare provider is aware of the medications you are taking so that they know what risks may arise. The rules for preparing for the procedure are simple:

• 3 days before the operation, refuse sexual contact;
• exclude from everyday use the use of intimate hygiene products (gels, creams, ointments, liquids), candles, tablets and vaginal sprays;
• do not douche;
• 10 hours before surgical intervention do not take food, water. This is necessary for high-quality anesthesia, which allows the patient not to feel discomfort.

Carrying out cleaning

Curettage is carried out in a hospital, the woman is placed on the gynecological chair of the operating room. The doctor removes the upper layer of the mucous lining the uterine cavity from the inside. The exclusion of pain involves anesthesia. If there were signs of miscarriage in the early stages of pregnancy or at a later period, after which it spontaneously terminated, the dilated cervix allows for curettage without anesthesia. For anesthesia, intravenous administration of a drug selected in individually taking into account the characteristics of the patient's body. A few seconds after the injection, the woman falls into a shallow sleep, the discomfort disappears, which makes the doctor's actions painless.

The dilator inserted into the cervix straightens the walls of the organ, facilitating access to the internal cavity. Holding the neck, the specialist inserts a rounded probe with a small diameter, after which he replaces it with a more voluminous analogue. A special video camera attached to the end of the probe allows for hysteroscopy - examination of the cavity before curettage. Cleaning is carried out with a curette, shaped like a small spoon on a long handle. Carefully collected tissues are stored in a specialized sterile tube, which is later sent to the laboratory for histological examination.

The procedure rarely goes beyond one hour, usually the doctor takes 20 minutes. Together with the uterine cavity, the cervical canal is cleaned. Manipulations are called RDV - separate diagnostic curettage. Collected samples are placed separately. Histology is used to identify the structure of tissues in order to exclude the presence of atypical cells in them, indicating cancerous lesions, precancerous conditions. The study is carried out within two weeks, after receiving the results, the woman revisits the gynecologist for a follow-up examination.

Curettage is often carried out for diagnostic purposes to clarify the symptoms of pathological conditions in the organs of the reproductive system. It can be:

• menstruation with an irregular cycle;
• bulky discharge and painful menstruation;
• bleeding during menopause;
• difficulty conceiving without visible reasons pathology;
• suggestion of developing uterine cancer.

A gynecological cleaning is carried out in order to obtain materials for histological analysis.

Curettage after miscarriage - possible complications

Complications can arise, as after any surgical intervention. A serious consequence is the discovery uterine bleeding due to insufficient blood clotting. In order to prevent oxytocin is used - injections stimulate the cessation of abnormal blood flow. Oxytocin will help if the bleeding is due to the uterus not contracting well. In violation of coagulability, it is not effective.

Another complication is hematometra, when blood clots accumulate in the uterine cavity, which can cause the development of an inflammatory process in the tissues. The spasm of the cervix contributes to the hematometer, which prevents the blood from coming out, which occurred immediately after the cleaning. Experts recommend the use of antispasmodics that relax the muscles of the body, contributing to the normal outflow of blood. A woman should be alerted by pulling pains in the lower abdomen, a sharp cessation of discharge.

After cleaning, endometritis may occur when inflammation affects the uterine mucosa. An adequate measure of therapy for a dangerous diagnosis is a course of antibiotics. Pain in the abdomen and a sharp increase in body temperature speak of a pathological condition. Any dangerous change in condition should be reported to the doctor immediately. In this case, countermeasures will be taken in a timely manner, which will eliminate the risks of developing more formidable complications.

How to behave after a miscarriage

A miscarriage that has occurred requires the failed parents to follow a certain tactic of behavior. Among the measures recommended by doctors:

1. It is advisable to postpone a new pregnancy attempt for 3-6 months. Otherwise, the risk of repeating the undesirable development of events is high. If pregnancy occurs before the expiration date, you should not panic. The main thing is the supervision of a specialist. Then there is a chance to give birth safely.
2. If you are waiting for the term, consult about the method of effective contraception.
3. Follow the recommendations given by your doctor. Having understood what threats of miscarriage exist, it is easier to neutralize them.
4. Pass the recommended examinations, pass the necessary tests. Possible studies for both parents are the detection of infections of the reproductive system, hormones in the blood, hemostasis, and immune status. Identified failures are subject to mandatory correction.

Consult what effect the drugs taken will have on the fetus if you become pregnant during therapy. Find out after what period of time you can fearlessly try to conceive a child. In most situations, in addition to the therapeutic course, it is necessary to change habitual image life - daily routine, nutrition, habits.

The psychological state of a woman during the recovery period

Spontaneous abortion is a severe stress for a woman. Faced with this situation, many lose the meaning of life, they are afraid to plan a new pregnancy after a miscarriage, fearing a repetition of what happened. The condition of a woman during this period is unstable, emotions are negative and unstable. Often, a failed mother begins to bully herself with negative thoughts, revel in contemplating other people's children on the street, communicating with bereaved mothers on forums, visiting children's stores and looking at small things in windows. A likely tactic of behavior is blaming yourself for what happened. Against the backdrop of such thoughts, families are destroyed, divorces occur.

Psychologists advise to show perseverance, endurance, purposefulness. For this you need:

Over time, negative thoughts will fade into the background, there will be a desire full life. A new pregnancy will not scare and disturb.

How to detect genetic pathologies during repeated pregnancy

If there was a miscarriage of the first pregnancy due to a genetic factor, it is especially scary to decide on a second one. You should not be afraid of this, with a well-designed therapy, the chances of success are more than great. Diagnostic procedures today they are highly accurate and allow to detect pathology at an early stage. Among the deviations are Edwards syndrome, Down syndrome, Patau and other pathologies. IN without fail examination is recommended for women with repeated miscarriages, as well as:

• over 35 years old;
• having changes detected during screening;
• with markers of chromosomal pathologies and malformations of the embryo;
• with previously born children with chromosome anomalies.

Ultrasound diagnostics is able to detect malformations in 80-85% of cases. However, the technology is not impeccably reliable, as it misses pathologies in 20% of situations. Biochemical screening, invasive examinations have valid data. The last version of the study allows you to identify up to 99% of anomalies. No less popular is the high-precision PANORAMA test for determining DNA pathologies.

When planning a new pregnancy, you should definitely visit a geneticist. Screening diagnostics for the detection of abnormal genes will help eliminate risks possible pathologies, a factor of heredity and genetic failure at conception. Sometimes the threat of miscarriage in the early stages exists in almost healthy carriers. The examination will allow you to find out about the anomaly in advance and undergo adequate treatment of a possible pathology.

Planning for a new pregnancy

The medical community is unanimous on the issue of planning a new pregnancy after a spontaneous abortion has occurred. Conception is not recommended for at least 3-6 months after the accident. During this period, the woman's body will recover and gain strength to bear the fetus. Observation by a doctor, harmonization of hormonal levels, examination of parents to identify possible pathologies is important. In order not to become pregnant after a miscarriage in the first months, it is recommended to use contraceptive methods recommended by your doctor.

Examination after a miscarriage includes blood and urine tests, a study of the microflora of the vagina with a smear, the identification of overt and latent genital infections, an analysis of glucose and hormones, and an examination of the biological compatibility of partners. Planning is an important step towards birth healthy baby. After the studies, the woman is prescribed strengthening therapy. It is important to completely reconsider eating habits, to exclude factors that are harmful to well-being. Vitamins, folic acid are used. Fast foods containing carcinogens and preservatives are excluded from the diet. Subject to the rules recommended by the doctor, a successful pregnancy with a favorable outcome is likely.

It is not uncommon for situations in which, after a miscarriage, a pregnancy test shows two strips. This is due to the restructuring of the body, the organs of the reproductive system. It is important to report the incident to your doctor. Provoke positive result test may be the presence of remnants of embryonic tissue in the uterus. In this case, immediate curettage is necessary, which neutralizes the risk of inflammation and infection. To accurately determine her condition, a woman needs to undergo an ultrasound diagnosis, take tests to determine hCG in the blood.

The question of whether it is possible to get pregnant after a miscarriage worries many parents. The answer is unequivocal - yes, if you follow the recommendations of experts, carefully plan a new conception, monitor your well-being and state of your health.

Components of success after a miscarriage

The state of health of the patient does not always lead to a miscarriage; in many respects, non-compliance with simple rules becomes a threat. To reduce the risk of losing a child during pregnancy, you must:

1. keep calm- It is important for a mother to exclude from her life all the factors that make her nervous. Irritation is not the best The best way normalize the state. In order to stabilize the emotional background, rest is recommended, the use of soothing teas with the permission of the doctor. Good results are given by herbal teas from chamomile, lemon balm, mint.
2. Avoid taking unnecessary medications and drugs. Self-cessation of the therapy prescribed by the doctor is unacceptable. Each step must be discussed with the gynecologist.
3. Eliminate harmful professional factors. Working in the chemical industry and other hazardous facilities can create an undesirable background in the body, which prevents the normal bearing of a child. It is important to understand what is of great value to the mother - the birth of a healthy baby or a career factor. Many women refuse to work in hazardous conditions in order to increase the chance of having a baby.
4. Eliminate bad habits. It is unacceptable for a mother who has experienced miscarriage to practice bad habits in ordinary life- drink alcoholic beverages, smoke. It is forbidden for the father to do this. Harmfulness negatively affects the quality of spermatozoa, which provokes difficulties with conception and risks of deviations in the development of the embryo.
5. Take vitamin complexes specially designed to prepare the body for pregnancy, the formation of basic conditions for its favorable course.
6. healthy eating. A complete, balanced diet works wonders. With a lack of weight, a nutritionist will develop an adequate diet for a woman with the inclusion of a large amount of protein foods rich in vitamins and trace elements of vegetables, fruits, and cereals. Fatty foods are allowed when it comes to the “right” fat found in fish, seeds, nuts, avocados, and olives.
7. Get rid of extra pounds. Obesity adversely affects the development of pregnancy. Science has proven that enhanced nutrition during pregnancy, consisting of a plentiful meal, is not required. The main thing is its balance.

Important psychological readiness to conception and observation by a gynecologist until a successful birth. Science knows the facts happy pregnancy even after multiple failed attempts.

Repeated pregnancy makes a woman worry about every little thing. Fears scare, tune in to a negative wave. It is important to suppress pathological condition psyche - emotional background passed on to the baby. Try to treat pregnancy as a miracle granted by heaven. Prepare yourself for childbirth physically, with the permission of the doctor, attend trainings and seminars for pregnant women, courses for expectant parents.

It happens that a woman, having become pregnant again, does not want to share her experiences with loved ones. Doing this is not worth it. At work, upon confirmation of conception, provide the employer with a certificate of the need to transfer to light labor. Perhaps the gynecologist will completely protect you from visiting the workplace by writing out a sick leave.

infections during pregnancy

Infectious processes transferred before pregnancy develop immunity in the mother to similar agents of influence. Primary infection poses a great threat, so vaccination will not be superfluous when planning conception. Perinatal diagnosis makes it possible to detect an infectious process at an early stage and prevent its harmful effects. This is possible if a pregnant woman is registered from an early date.

Infection of a pregnant woman can develop due to an infection transmitted by airborne droplets. This is the most dangerous species, since it is almost impossible to prevent it. This applies to mumps, measles, rubella. HIV and hepatitis infect the body through sexual contact, similar to chlamydia. Listeriosis is transmitted with poor-quality products. A pregnant woman can transmit infections developing baby. This pathology is determined by profile tests of latent infection.

Planned monitoring of the development of pregnancy involves regular testing. Sexual infections are determined using a smear, ultrasound shows deviations in the development of the baby, and KGT is aimed at listening to the work of the fetal heart muscle. If there is a suspicion of a serious infection of the embryo, blood sampling from the umbilical cord and amniotic fluid analysis are practiced.

Infection of the child also depends on concomitant factors. The speed of diagnosis, the literacy of the treatment, the type of pathogen, the duration of the pregnancy are taken into account. The following infectious processes deserve special attention:

1. Viral etiology - a huge number of viruses creates a danger to a pregnant woman. It is enough for a virus to capture one cell for the pathological process to begin. The carrier carries the infection, spreading it to internal organs, fabrics. The threat is genital herpes, rubella, infectious type erythema, cytomegalovirus, hepatitis B, measles, mumps, chickenpox.
2. Attention should be paid to bacterial infections detected during the analysis of biological materials (feces, urine, blood), examination of individual organs of the body. Active reproduction provokes a rapid growth in the number of bacteria in the vagina. Not all microorganisms pose a threat to the child. Antibiotic therapy is used to destroy harmful microflora. Dangerous candidiasis, streptococcus, chlamydia, bacterial vaginosis, cystitis.

Pregnancy is threatened intestinal infections, often active in the summer. Carriers of infection can be animals that are poorly treated before eating food. Of particular danger are listeriosis, salmonellosis, toxoplasmosis.

Prevention of infections during pregnancy

Infection of the mother provokes a threat to the life of the fetus. From 3 to 12 weeks, the infected organism responds with a miscarriage or the formation of malformations in the child. From 11 to 28 - developmental delay. At a later date, it deforms already formed organs and creates conditions for premature birth. In order to prevent intrauterine infection It is recommended to apply a number of rules:

• Examine the mother for the detection of STIs.
• examine the blood, to determine the presence of antibodies to carriers of infection, pathogens.
• avoid contact with sick people, visits to crowded places where there is a possibility of infection by airborne droplets.
• conduct a pet survey for the presence of dangerous infections, if necessary, treat or remove them from the house until the threat is eliminated.
• exclude fast food from the diet, shop semi-finished products, subject meat, fish to thorough heat treatment.
• remove exotic foods from the diet- sushi and other culinary delights purchased in restaurants, cafes.
• wash hands thoroughly, fruits, vegetables with special disinfectants that are not capable of harming a pregnant woman and a child.
• scheduled to visit a gynecologist, undergo examinations recommended by the doctor, take tests, take vitamins.
• register at the first sign of pregnancy to be under medical supervision.
• when planning a pregnancy prepare for conception, cure infections, vaccinate.

It is important for the father of the child to comply with most of the recommended rules. If only the mother undergoes treatment, a relapse is likely during sexual intercourse, neutralizing the beneficial effect of therapy.

A woman who has had a miscarriage in the past should be alarmed by any deviations from the norm in well-being. It is important to pay attention to ailments, pain, weakness, dizziness. Accounting for an early consultation will create conditions for the bearing of the fetus and the birth of a child. There is no need to be afraid that a miscarriage will forever deprive the joy of motherhood.

After completing a course of examinations, passing tests and following the measures prescribed by the doctor to treat imbalances in the body, you will create all the conditions for a favorable outcome of pregnancy. Tune in to the positive, protect yourself from worries, worries, stress. Feel the support of loved ones, hope for the best. Get advice from good specialists to rule out any unfavorable prognosis before conception or take steps to neutralize them. Health and prosperity to you, your families and loved ones!