Threatened abortion refers to a small amount of vaginal bleeding before 28 weeks of pregnancy, which is usually dark red or bloody leucorrhea, without discharge of pregnancy products, followed by paroxysmal lower abdominal pain or back pain. Gynecological examination shows that the cervix is not open, the membranes are not ruptured, and the size of the uterus is consistent with the number of weeks of amenorrhea. After rest and treatment, the symptoms disappear and the pregnancy can continue; if the amount of vaginal bleeding increases or the lower abdominal pain worsens, it may develop into inevitable abortion. Proper rest and abstain from sexual intercourse. Patients with luteal insufficiency can receive intramuscular injection of 20 mg of progesterone once a day. Or oral progesterone preparations; patients with hypothyroidism can take small doses of thyroid tablets orally. After treatment, if vaginal bleeding stops and ultrasound examination indicates that the embryo is alive, the pregnancy can continue. If clinical symptoms worsen, ultrasound examination shows that the embryo is poorly developed, and blood hCG continues to not rise or decrease, it indicates that miscarriage is inevitable and the pregnancy should be terminated. Proper rest and abstain from sexual intercourse. Patients with luteal insufficiency can receive intramuscular injection of 20 mg of progesterone once a day. Or oral progesterone preparations; patients with hypothyroidism can take small doses of thyroid tablets orally. After treatment, if vaginal bleeding stops and ultrasound examination indicates that the embryo is alive, the pregnancy can continue. If clinical symptoms worsen, ultrasound examination shows that the embryo is poorly developed, and blood hCG continues to not rise or decrease, it indicates that miscarriage is inevitable and the pregnancy should be terminated. If threatened abortion progresses to inevitable abortion, the embryo and placental tissue should be completely expelled as soon as possible. Early abortion should be promptly treated with curettage, and the pregnancy products should be carefully examined and sent for pathological examination; if conditions permit, chorionic villus karyotype analysis can be performed to help clarify the cause of the abortion. In late abortion, the uterus is large and bleeding is heavy. Oxytocin 10-20U can be added to 500ml of 5% glucose injection and intravenously dripped to promote uterine contraction. After the fetus and placenta are expelled, check whether they are complete. If necessary, perform curettage to remove the pregnancy products remaining in the uterine cavity. Antibiotics should be given to prevent infection. |
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