OBSTETRICS : MISCARRIAGE FAILED - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
Missed miscarriage - the death of the ovum, is not accompanied by release it from the uterine cavity.
Etiology and pathogenesis is not clear. Known value may be small irritability of the uterus-dependent changes in the activity of the Central nervous system and hormonal reasons.
Lost fertilized egg can remain in the uterus from several weeks to several months and even over a year. Menstruation during the stay of the ovum in the uterus absent. Pregnancy symptoms (nausea, vomiting, breast engorgement) disappear. The uterus decreases in size, but does not reach normal. In a small period of pregnancy the fetus can be established in the uterus. In some cases, the fertilized egg is enveloped by blood clots formed blood drift (haematomola) or, if the coloring matter of the blood leached and all education becomes more pale, fleshy drift. The deposition of lime salts - rocky drift.
The recognition is based on the anamnesis, the mismatch value of the uterus to the date of termination monthly and signs of fetal death. In re-examination, you notice a gradual decrease in size of the uterus. With prolonged loss of placental tissue disappears positive response to chorionic gonadotropin (Asheim-COGECA).
The treatment is strictly expectant. Expulsion of the fetus takes place independently. Only for special indications (infection of the fetus inside the uterus, ihoroznom selection, intoxication sick decay products of the fruit, bad taste in the mouth) shows the instrumental emptying of the uterus, if its value does not exceed a three-month pregnant uterus. With a larger value of the uterus - stimulation of the uterus castor oil, enemas, fractional doses of quinine 0.2 5 times in an hour, pituitrin 0.2 5 times in an hour and large doses follikulina or sinistral.
When started miscarriage to act accordingly to the rules of treatment of miscarriage.