Uterine contractions are the most important cause of miscarriage and recurrence from the 4th to 6th month of pregnancy.
Uterine tummy is a phenomenon where the joint between the cervix and the uterus is exposed due to the unbearable pressure of the amniotic sac when the fetus develops. This leads to the cervix being opened before the mother elects labor to make the pregnant mother vulnerable to miscarriage or premature birth.
The uterus of the uterus cannot identify itself because it has no symptoms in the first months of pregnancy. When the fetus is more than 16 weeks old, the pressure of the amniotic fluid increases and presses on the cervix to dilate the cervix, rupture of the membranes leading to premature women, miscarriage.
Typically, a 24-year-old pregnant woman has a cervical waist. The second pregnant woman, has registered to monitor pregnancy at the obstetrics department. Recently, antenatal care, doctors found that the patient had an uterus that had to have a waist to the uterus. The method of cervical cerclage is usually done at 16 – 20 weeks and lasts for about 38 weeks.
More complicated than the above case, pregnant woman H.O., 38 years old, suffers from uterine obstruction, so 3 previous pregnancies she could not keep. There were 2 times she had miscarriage and 1 time of fetal heart failure. The last 9 years have been an extremely difficult journey for her husband and wife, each time they were pregnant, they hoped and collapsed because of their disappointment. She said, one year after getting married, she was pregnant with her first child. When pregnant at 26 weeks, she gave birth prematurely and could not keep her baby. 2 years later, she was pregnant again but for 8 weeks, the doctor found no fetal heart.
By the third time she was pregnant with a baby girl, but O. also lost her body after 26 weeks. This time, at the age of 38, O. was pregnant for the fourth time. This time, she and her husband were worried about going to medical facilities for examination and monitoring soon. After the examination, the doctor discovered that she had a double uterus, two horns, a uterus, because she had many miscarriages and premature birth, so the doctors decided to have a uterus waist for pregnant women in the 16th week of pregnancy. to prevent premature birth.
These are just two of many cases of uterine atony that leads to repeated miscarriage.
Causes of uterine atony
There are many causes of uterine obstruction which may be due to: Congenital; Because the cervix is damaged by cervical dilatation for abortion at previous pregnancies; Due to cervical tear at birth. Due to surgery to remove the tip or cut the cervical segment.
Why is it easy to miscarry due to uterine?
From the 16th week of pregnancy onwards, pressure in the amniotic fluid increases, presses on the cervix, dilates the cervix, leading to amniotomy and miscarriage. Characteristics of miscarriage due to uterine obstruction: pregnancy often abruptly occurs during pregnancy about 4 – 6 months, asymptomatic abdominal pain or vaginal bleeding forewarned. Pregnant women are living normally, suddenly rupture of membranes and after a few strong attacks, the fetus is born very quickly. Pregnancy is usually very preterm, dying after birth. The following pregnancy tends to be premature earlier than the previous one with a smaller pregnancy weight.
The pathophysiology of cervical obstruction is still unknown. Many factors increase the risk of cervical openness such as cervical sphincter, cervical biopsy, abortion or cervical tear during birth, congenital anomaly abnormalities, lack of collagen and elastin, Diethylstilbestrol exposure … However, these factors are not a clear cause of cervical ligation and are not indicated for cervical waist closure.
Watch closely for the first 3 months
Uterus is a clinical diagnosis. Think of the uterus when the cervix is open but there is no uterine contraction at week 16-24 and is detected by vaginal examination by hand (or on ultrasound). If there is uterine contraction, diagnosis of incidence of preterm labor.
On ultrasound, diagnosis of uterine atony when: Cervical length <2.5 cm. It is possible to have an amniotic fluid in the cervical canal to form a Y, V or U. Part of the gestational age may be present for 16 – 20 weeks (preferably 16 – 18 weeks).
Depending on your previous miscarriage, your doctor will choose the right time (before your last miscarriage in your precursor).
Therefore, it is necessary to have an antenatal check up (first 3 months) of pregnancy, a clear history of your ongoing miscarriage should be reported for treatment instructions. Usually, you will be hospitalized by a doctor to sew your womb.
What should be done after a uterine?
After performing uterine obstruction, pregnant women need to stay in bed. Doctors will give medication to reduce uterine mounds and antibiotics. If stable, you will be discharged after 48 hours. After going home from the hospital in the first week you should limit your travel or heavy work.
Pregnant women need to be checked periodically and need to be examined immediately when there are signs such as: abdominal pain, vaginal bleeding.