Vaginal bleeding, which usually occurs in the early stages before the 20th week of pregnancy, is called threatened miscarriage or danger of miscarriage. It is a situation that causes new mothers to be very stressful.
12. The danger of miscarriage seen before the 12th-20th week is considered early. The one seen between weeks of pregnancy is called late type. Although it is very common in the first 3 months, there is a threat of miscarriage in 35-40% of all pregnancies. It usually occurs as a light bleeding and goes away within a few weeks. In only 10% of women who complain of bleeding, the pregnancy ends in miscarriage, that is, it is lost.
In more than 80% of the miscarriages, the reason is a chromosomal disorder of that baby, and it is almost impossible for this baby to continue its vitality. Other reasons may be heavy physical activity, anemia in the mother, goiter, a severe systemic disease, or the ovaries cannot produce enough progesterone hormone for the pregnancy to establish. No cause may be detected
DIAGNOSIS
The most important diagnostic criterion is that the pregnant woman has a bleeding complaint and is not accompanied by pain, that is, the cervix is not open. In early pregnancy, the diagnosis is made by seeing the gestational sac, the presence of the baby and its heartbeat, and the presence of bleeding areas in the uterus. It is important to exclude ectopic pregnancy and grape pregnancy in the differential diagnosis of bleeding during early pregnancy.
The amount of bleeding is generally not too much. Its color may vary from bright red to dark brown. Particularly active red bleeding may require urgent examination, ultrasonography, and vaginal examination. Red bleeding indicates active bleeding, brown bleeding indicates past bleeding. The brighter the color of the bleeding and the greater the amount, the higher the probability that the pregnancy will result in a miscarriage.
TREATMENT
The first thing that can be done in case of a threatened miscarriage is activity restriction. So. It is to lie down and rest.
In the presence of light dark bleeding, severe physical activity restriction is usually sufficient. In such cases, the person should generally spend the day resting in bed; if he is working, he should continue to work until the bleeding stops completely. should give ra. An appropriate approach would be not to lift heavy things and not to get out of bed much except to eat and go to the toilet.
In cases where bleeding is more severe, absolute bed rest is required. In such a case, it would be more appropriate to hospitalize the person and monitor him. The patient does not get out of bed even to eat or go to the toilet. He meets all his needs in bed.
Apart from rest, the most important thing is to consume plenty of fluids. In case of dehydration of the body, uterine contraction increases. In both cases, intercourse should be prohibited.
Treatment is planned according to the severity of bleeding. If there is a problem in the production of progesterone hormone, which is necessary for the continuation of pregnancy in early pregnancy, natural progesterone can be supplemented, especially in the period until the placenta (the baby's partner) develops. Progesterone should only be used in those who are known to be deficient in this hormone and have a history of miscarriage or are at high risk for progesterone deficiency. The best example of this is treatment pregnancies. In these patients, progesterone support is given until the 12th week. Natural progesterone is produced in three ways; It is administered orally as a tablet, vaginally as a tablet or gel, and as intramuscular injections. The risk of losing a pregnancy with a normal chromosome structure and heartbeats is low, despite early bleeding. If the underlying cause is chromosomal, no matter what treatment you apply, the pregnancy will eventually result in loss. After a miscarriage is diagnosed, a curettage decision is made depending on the patient's condition. If the miscarriage is not complete, that is, if there is a piece left inside, curettage should be performed.
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