2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21
A failed miscarriage is considered to be the cessation of the development of the fetal egg and the death of the fetus, which occurred due to various reasons, but the dead fetus does not leave the body on its own. The ultrasound method confirms an empty fetal egg or with a dead embryo. This type of miscarriage is diagnosed for a period of no more than 28 weeks.
Miscarriage ICD code 10 has O02.1.
Symptoms
Unfortunately, by its very definition, a missed miscarriage usually means no symptoms of a missed miscarriage prior to diagnosis. In some cases, pregnancy symptoms continue. Although the pregnancy is not viable, the placenta can still produce hormones, and there may also be signs such as breast tenderness, morning sickness, and fatigue. But more often than not, pregnancy symptoms disappear or become dull.
Signs of an early missed pregnancy
Chest falls down and becomes soft, stomach does not increase, womanceases to feel fetal movements. A failed miscarriage is characterized by symptoms such as chills, weakness, poor appetite, and an unpleasant taste in the mouth. From time to time, spotting occurs in a small amount. It can be either a single manifestation or repeated. It is necessary in this case to visit a doctor.
How to recognize?
Miscarriage (in ICD 10 under the code O02.1) is quite difficult to recognize, because most patients do not feel any changes in the state of the body. A dead fetal egg remains in the uterus, causing pulling or contraction-like pains in the lower abdomen. But even these symptoms pass very quickly, and then nothing bothers the woman.
If the fetal egg is in the uterus for too long, it gradually breaks down and is saturated with blood secretions, this phenomenon is called a blood mole. If after this there is no natural or artificial exit of the dead fetal egg, then it forms a fleshy skid.
In a short period of time, about two months, the fetus can dissolve completely. The danger is a fetal egg that has lingered in the uterus for a longer period. Under such conditions, the fruit begins to gradually decompose or rot. The process of decay is hard to miss, it is signaled by discharge with a very unpleasant odor. In medicine, there are cases of complete mummification of the fetus in the uterus. After a long stay in the body, it loses amniotic fluid and shrinks.
Diagnosis
A correct diagnosis canput only a gynecologist after a thorough examination, history taking and some tests. On examination in the gynecologist's chair, special attention is paid to the size and condition of the uterus, the nature of the discharge, the condition of the cervix. With a failed miscarriage, a discrepancy between the size of the uterus and the gestational age will be clearly visible. A woman is prescribed blood and urine tests to clarify the level of hCG, placental lactogen, hormones estradiol and progesterone.
The patient is usually referred for uterine ultrasound and fetal ECG. If the fetal heart sounds cannot be heard, then the diagnosis is confirmed even without additional examinations. If necessary, the patient donates blood for the Rh factor, group and other immunological studies.
Such a diagnosis as a missed miscarriage is not always realistic to put right away. This may require follow-up time, especially in early pregnancy. After the 8th week, the diagnosis is made much faster, because the fetal heart can already be heard.
Reasons
Factors that contributed to a failed miscarriage may be different. Often, fetal death is provoked by bacterial (gonorrhea, streptococcus) and viral infections. Sometimes a miscarriage occurs due to ureaplasma, mycoplasma, chlamydia, toxoplasmosis. But despite the fact that medicine has stepped far forward, it is still impossible to say with accuracy what specific reasons provoke a failed miscarriage.
Genetics
Fruitstops in development due to the genetic characteristics of the woman's body or genetic abnormalities in the fetus. In the early stages of pregnancy, up to 8 weeks, some genetic mutations or malformations can already be detected in the embryo, which ultimately negatively affect its viability. In this case, nature takes care to give life to a better gene pool and eliminate the weak one.
Thyroid
Endocrine causes always play an important role in the development of pregnancy, for example, progesterone deficiency most often causes miscarriage. In more rare cases, the cause is the Rh conflict, the presence of antibodies to hCG.
Pathologies of the cervix
Often a failed miscarriage provokes a pathology of the cervix and isthmus of the uterus, in which these organs cannot withstand the pressure on them. Under the pressure of the fetus or amniotic fluid, the cervix can simply open up. Any uterine anomalies will interfere with the normal attachment of the fetus and contribute to death, among them baby womb syndrome and a uterus split into two cavities.
The same statement is true for uterine fibroids, the fetal egg does not have the opportunity for normal fixation, and its shape becomes deformed due to the myomatous node. Inflammatory processes that occur directly in the uterus or appendages can not only provoke a failed miscarriage, but also permanently disrupt the ability of the female body to conceive. Lack of necessary hormones or, conversely, excesssome types of hormones will contribute to the early death of the fetus, but without expelling it from the uterine cavity. An unstable hormonal background is likely to cause a failed miscarriage.
Blood clotting
If a woman has problems with blood clotting, then she is threatened with complications during the formation and development of the placenta. The vessels of the placenta become clogged with too thick blood, and blood circulation between the placenta, the fetus and the expectant mother can stop, which in 100% of cases leads to the death of the fetus.
Do not exclude the impact of stress on the body of the expectant mother as a reason. Stress, equally along with other factors, becomes the reason why the pregnancy does not continue to develop, but the miscarriage as such does not occur.
Miscarriage in some cases occurs due to acute infectious diseases suffered by the mother or a state of intoxication.
Due to a number of factors, the regulatory functions of the CNS change the neuromuscular sensitivity of the uterus. If for some reason the fetus dies in the uterine cavity, then the body will perceive it as a foreign body and will try to reject it. But for a failed miscarriage, the insensitivity of the uterus to this irritant is characteristic. Its muscular walls lining it from the inside are in a passive state, therefore they do not push out the dead embryo.
The hormonal background of a miscarriage is high progesterone levels along with low estrogen titer levels. Datacircumstances only exacerbate the inert state of the myometrium - the muscular walls of the uterus. If the gestation period was very short, this allows the embryo to quickly dissolve without harming the woman's body.
Treatment
Once the diagnosis is made, it will likely take some time for the miscarriage to occur naturally. This may take from several days to several weeks. Active intervention is carried out only when absolutely necessary, if there are symptoms that threaten the woman's he alth. Bleeding, pain, fever - such indications will serve as a reason for an early hospitalization and taking measures to cleanse the uterus. Depending on the term and other important factors, curettage of the uterus or medical abortion is performed. In some cases, the doctor may prescribe antibiotics after the uterus has been cleansed.
Possible Complications
A dead embryo in a fetal egg can become infected ascending from the vagina. This poses a great threat to women's he alth, so endometritis, chorioamnionitis, chorionepithelioma, metroendometritis can develop.
Even if a woman has not noticed a missed miscarriage, her condition due to complications will clearly make it clear what happened. The patient develops pain in the lower abdomen, subfebrile or high temperature, severe weakness, nausea, and heart rhythm disturbances. Sometimes the uterus gets rid of the fetus on its own, andprofuse bleeding begins.
Often, after suffering complications, the prognosis is quite positive. But much depends on the degree of damage to the uterus by the infection, for example, with metroendometritis, the risk of recurrent miscarriage increases.
Conclusion
Unfortunately, early miscarriage is common, and not all pregnancies end in the birth of a baby. After a missed miscarriage, couples have to wait one to three menstrual cycles before trying to conceive again. The issue of conception must be approached carefully and follow all the measures prescribed by the doctor. Pregnancy planning should include a proper diet, sanitation of all known sexually transmitted infections, smoking and alcohol cessation. According to statistics, the majority of women who have had a miscarriage have been able to become pregnant and bear he althy children in the future.
In addition to gynecological care, a woman may need the help of a psychologist. Since a failed miscarriage, especially if it occurs in the later stages, leaves psychological trauma.
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