Pregnancy - the happiest time in my life of almost every woman. But unfortunately, sometimes pregnancy is overshadowed by the problems. And one of the worst problems is missed abortion. After all, what could be worse for a woman who was preparing to become a happy mother than to know that her child was not to be born? In the morning a woman was pregnant and happy, and the only one receiving physician povergnul it into hell.
About missed abortion heard something every woman, but did not go into details, if she has not been faced with it. But if the doctor ordered this terrifying verdict, a woman - whether she wants it or not - have to learn about more missed abortion. That is why we have gathered all the necessary information, with particular attention to scraping, without which it is simply impossible to do.
What is missed abortion?
First of all you must have an idea of what is missed abortion. And why all pregnant pauses. Physicians so called phenomenon in which, for whatever reasons, stops the development of the embryo and, naturally, he dies. In no event should not be confused with missed abortion lagging behind the development of the fetus - in the second case, the future child, provided timely and correct treatment has a good chance to be born healthy.
Most often, the trouble happens at the very early stages - more than 85% of all cases of missed abortion is necessary on the first trimester (that is, in the first 3 months after conception). The remaining 15% are in the second trimester of pregnancy. Well, if a misfortune happened in the last months, the doctors do not speak about the fading of pregnancy, and for fetal death.
Of course, self-understood that the pregnancy came to a standstill, beyond the power of any woman - even doctors will take some time and a number of studies. But a woman can smell a rat if it finds at the following symptoms:
If you have morning sickness, and place it sharply for a couple of days, was gone - it is an occasion to think about whether everything is OK with your pregnancy. Toxicosis develops under the influence of hormones responsible for normal pregnancy. In most cases, morning sickness to start the second trimester of pregnancy weakens, but it happens gradually, day after day.
If one fine morning you just yesterday suffer from strong toxicity, stood up and realized that feel great and there is no hint of nausea, immediately tell your gynecologist. It is unlikely but still there is a risk that the pregnancy stopped, hormone levels fell sharply, as a result, in fact, stopped and toxemia.
Almost all women's breasts undergo changes in early pregnancy - nagrubayut slightly increased in size - the action of the same hormones. And if the pregnancy will cease development and hormone levels drop, breasts quickly return to their doberemennomu state.
In no case is inadmissible to ignore bleeding from the vagina, whatever intensity they may be. Of course, in most cases, doctors remove the cause of the bleeding and keep the baby, but not the case with non-viable pregnancy.
Diagnosis of missed abortion
"By eye" missed abortion is not diagnosed - to make such a diagnosis, a gynecologist closely examine the woman, because in this case, the error is simply unacceptable. For this purpose, the following diagnostics:
Most often, the stood in early pregnancy is detected by accident - during normal scheduled inspection gynecologist notes that the size of the uterus does not match the expected term of the pregnancy. But this factor alone is not enough to say with confidence is a missed abortion - is necessary to eliminate the backlog in the development of the fetus.
Many doctors consider it necessary to appoint a study of blood levels of certain hormones - often it helps to clarify the situation.
And mandatory diagnostic procedure - ultrasound examination of the uterus. The doctor will examine the uterus, the fertilized egg, to adequately assess their size and find out whether the fetal heartbeat. Reliability of ultrasound is very high - the probability of error is no more than one percent.
Removal of the embryo
If a missed abortion confirmed, it is necessary to save the woman - if the fertilized egg in the uterus will very soon begin complications - inflammation of the strongest to general blood poisoning - sepsis. Therefore, it is first necessary to remove the fertilized egg from the uterus - to hope for a spontaneous miscarriage is not necessary, and it does not guarantee that everything will go smoothly. Doctors usually in the case of non-viable pregnancy are as follows:
Medical termination of missed abortion
If the period of pregnancy was very small, your doctor may try to get rid of the ovum without surgery, using special drugs - similar to medical abortion. Woman taking pills with a high content of hormones that trigger a miscarriage. However, there is no guarantee that the fetus will come out completely and do not have the need to clean the uterus.
The most common and reliable way to remove the embryo - curettage. The doctor surgically cleanse the uterus of the embryo and the placenta. That's about it, we'll tell more detail.
Despite the fact that the scraping - the procedure is not new, and is very widespread, many women are afraid of her panic. As a rule, the fear arises from the lack of knowledge of what will happen and expectations of pain.
No special preparation prior to the procedure does not exist. All that is required from a woman - is not there the day before the procedure and to remove pubic hair. As a rule, almost always scraping is done under general anesthesia, so a woman will talk in advance anesthesiologist.
In addition, a woman is required to once again carefully examine gynecologist fact that the usual scraping has a number of contraindications, such as some acute inflammation of the uterus and appendages, infectious diseases, suspected violation of the integrity of the lining of the uterus. Of course, in these cases, the ovum is necessary to get rid of, but the technique of scraping in this case is slightly different.
As mentioned above, most of the doctor spends curettage under general anesthesia - a woman lies in a gynecological chair, the anesthesiologist introduces a drug ... and wakes up a woman in the ward. But if, for whatever reasons, the use of general anesthesia is not possible, resort to the local anesthesia - the cervix and uterine body cut away specific medications, resulting in lose sensitivity.
Before the procedure, the doctor will treat mandatory vulva special iodine solution, as the vagina and cervix - rubbing alcohol to eliminate the possibility of infection. In some cases, if the doctor treating overboard with a few days a woman may experience mild discomfort.
After that, the doctor puts a special device in the vagina, with which expands the cervix. Then, using expanders opening of the cervix is fixed in this position and the doctor proceeds to the removal of the ovum. For this he using a curette, is more reminiscent of a spoon, scrape the mucous membrane of the uterus. This procedure lasts an average of 15 - 20 minutes if everything goes smoothly, without complications.
Complications after curettage
Despite the fact that the technique of scraping the uterus is well established and familiar to all doctors without exception, we must not forget that it is still surgery. So, there is always the risk of development of certain complications.
Perforation of the uterine wall
Perforation - is damage to the integrity of the uterine wall. A very serious complication that can lead to serious problems, up to the need for major surgery. Fortunately, this happens very rarely - less than 1% of all cases of curettage.
Sometimes when scraping missed abortion may lead to bleeding. Leave a phenomenon ignored in any case impossible - immediately report it to your doctor, even if the bleeding is not severe. Otherwise, a high risk that blood clots will begin to accumulate in the uterine cavity. This may result in having to re-curettage. Yes, and iron deficiency anemia you to anything.
After scraping the uterine mucosa is one big gaping wound. Therefore, it is very easy to get any infection. Carefully watch your state of health - if the temperature rises, there will be pain, immediately inform your doctor.
A more long-term complication that can give itself felt in just a few years - adhesions in the pelvis. Pain, menstrual disorders, and sometimes even secondary infertility - not the most pleasant consequences of adhesions.
The postoperative period
So after scraping missed abortion behind - it was the turn of the postoperative period. That is how it will proceed, depends on the probability of various complications - so doctors give him so much attention. On the special control must have the following characteristics:
On the first day after scraping may increase the temperature to 37 - 37 and 5 degrees. But in the second and subsequent days the body temperature should be normal. Even the slightest increase it is alarming bell, talking about what is possible inflammation.
Scraping in the missed abortion - the procedure is quite traumatic, so no blood can not do. But remember that heavy bleeding should not be, so if your pad soaked through in less than an hour, there is reason for concern. In addition, you must pay attention to the smell of discharge - if it becomes unpleasant, can be suspected infitsirovanie.Kak rule, if all goes according to plan and without complications, a woman for a long time in the hospital will not keep - a few days she'll be home.
But there should not relax - at least two to three weeks keep their health under strict control. At 14 days after curettage mandatory visit a gynecologist. Firstly, the necessary examination, which will allow to understand whether the uterus is reduced. Second, do not do without ultrasound - the doctor should make sure that the uterus is left pieces of the gestational sac or fetal membranes.
In addition, in some cases, women may need treatment, which will result in the order of hormones. And most importantly, you need to do - come to terms with this tragedy and learn to live on.
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