Habitual abortion refers to spontaneous abortion 3 or more times in a row. Its clinical characteristics are the same as those of ordinary miscarriage, but the cause is very complex and involves many factors such as genetics, immunity, infection, uterine lesions, and endocrine factors. The incidence rate is 1% to 2% of normal pregnancies. Repeated miscarriages bring great pain to patients, and the cause should be identified and treated symptomatically to ensure a successful pregnancy for the next pregnancy.
(1) Immune abnormalities: The relationship between immune factors and habitual abortion has attracted more and more attention. Habitual abortions that were previously thought to have unexplained causes are now believed to be related to immune factors. About 20% of habitual abortions are caused by immune factors. The fetus has genes from both the father and the mother, and is a natural transplant of the same species. The vast majority of fetuses can develop normally until full-term delivery. This is because many factors participate in immune regulation after pregnancy to maintain immune coordination between the mother and fetus. For example, in early pregnancy, trophoblast antigens are shed into the maternal blood as syncytiotrophoblast cells continue to shed, leading to immune recognition and immune response. This process is important to protect the fetus from rejection and maintain pregnancy. Any factor that causes an imbalance in immune coordination between mother and fetus can lead to miscarriage.
(2) Uterine lesions:The classification of uterine lesions is: ① Congenital uterine developmental abnormalities; ② Uterine adhesions; ③ Uterine fibroids; ④ Cervical insufficiency.
(3) Infection: Infections during pregnancy not only harm the mother, but some infections can also have serious effects on the fetus and newborn. In addition to causing miscarriage, premature birth or stillbirth, it can also cause various malformations and mentally retarded children, thus affecting the quality of the population.
(4) Luteal insufficiency: ① Poor ovarian follicle development, defective luteal formation, insufficient or deficient follicle-stimulating hormone in the blood and an excessive ratio of estrogen and progesterone in the blood High, related to the lack of a high enough luteinizing hormone peak in the blood. ② Delayed changes in endometrial secretion in the luteal phase or incomplete secretion phase, and insufficient progesterone receptors in the endometrium will result in poor endometrium response to progesterone. ③ Endocrine abnormalities, such as hyperprolactinemia, hypothyroidism, etc. ④Endometriosis; ⑤Others, such as post-abortion and iatrogenic ligation.
(5) Chromosomal abnormalities: The chromosomal abnormality rate of couples with habitual abortion is 3.2% to 4.9%, which is significantly higher than the normal population (0.5%). Mainly manifested as embryonic cessation in early pregnancy, habituationChronic miscarriage. About 60% of miscarried embryos have chromosomal abnormalities within 12 weeks of gestation, and about 7% of miscarriages after 24 weeks of gestation have a significantly reduced rate of chromosomal abnormalities. This shows that spontaneous abortion caused by chromosomal abnormalities is a way of natural selection in human evolution. With the development of genetic probes and recombinant technology, the relationship between chromosomal abnormalities and infertility will be further clarified.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao