Septic Abortion
Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy in Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Medical providers caring for pregnant women encounter various types of spontaneous abortions, also referred to as spontaneous miscarriages, and although the treatment and management for many of these spontaneous abortions are similar, it is important to understand when a combination of both medical and surgical intervention is needed to save a patient's life. Table 10.1 lists the different types of spontaneous abortions. In this chapter, we focus on septic abortions because this condition, although fortunately not very common, can lead to a rapid decline in maternal health and ultimately death if intervention is not provided in a timely manner. A septic abortion involves an infection of the placenta and/or fetus, referred to as products of conception, in a pregnancy prior to 20 weeks and 0 days of gestation [1, 2]. Generally, the infection is located within the placenta and can easily spread to the uterus and then enter the maternal vasculature, where the infection can then spread hematogenously, quickly leading to sepsis, septic shock, and ultimately death. In addition, these infections can cause multiorgan failure [3].
The Reproductive System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Abortion applies to both intentional and unintentional termination of an existing pregnancy by expelling the products of conception from the uterus. A spontaneous abortion occurs naturally and may result from either fetal or maternal abnormalities, infection, or other diseases. Induced abortion (also called artificial abortion) may be induced by the administration of an abortifacient drug or surgically by dilating the cervix and scraping the uterine lining, a procedure known as dilation and curettage (D&C). A D&C is also used to remove excess endometrium in several bleeding and endometrial disorders. If the abortion is performed to medically benefit the mother, it is usually termed a therapeutic abortion.
Miscarriage and Pregnancy Loss
Rosa Maria Quatraro, Pietro Grussu in Handbook of Perinatal Clinical Psychology, 2020
The experience of miscarriage is characterized by emptiness and guilt (Adolfsson et al., 2004), and women might experience several feelings and/or psychological conditions such as devastation, grief, trauma, dysphoria, fear, and injustice (Abboud & Liamputtong, 2003; Brier, 1999; Garel et al., 1992). The impact of miscarriage has been extensively studied in terms of psychopathology, and numerous studies have assessed grief, depressive, anxiety, or posttraumatic stress symptoms that may be developed as a result of spontaneous abortion. While the impact of a miscarriage can persist over an extended period of time (Klier, Geller, & Ritsher, 2002; Robinson, Stirtzinger, Stewart, & Ralevski., 1994), it seems that the intensity of emotional pain decreases over time (Cuisinier, Kuijpers, Hoogduin, Graauw, & Janssen, 1996; Janssen, Cuisinier, Graauw, & Hoogduin, 1997; Madden, 1994). Thus, one year after the loss, mental health of women who experienced perinatal loss is similar to those of women who gave birth to an alive baby (Janssen et al., 1996). Swanson, Connor, Jolley, Pettinado, and Wang (2007) have reported a decrease in distress during the first six weeks following miscarriage but not beyond, suggesting a six-week crisis period.
Impact of prolonged use of adjuvant tocolytics after cervical cerclage on late abortion and premature delivery
Published in Journal of Obstetrics and Gynaecology, 2023
Li-Rong Zhao, Shu-Jing Lu, Qing Liu, Ying-Chun Yu, Li Xiao
Spontaneous abortion and premature delivery are major concerns for both obstetricians and pregnant women. Preterm birth affects approximately 10% of pregnancies (Pohl et al. 2018). The reasons for late abortion and premature deliveries could be multifactorial (Goldenberg et al. 2008). Cervical insufficiency is one of the causes of late abortion and premature delivery. A study has shown that acute cervical insufficiency accounts for 10–25% of all mid-trimester pregnancy losses (Park et al. 2021). Cervical cerclage was first performed to treat cervical insufficiency in 1955, and has subsequently become the most commonly performed surgical procedure to prolong the pregnancy time in patients with the loss and premature delivery of second pregnancy caused by cervical insufficiency. Zhu LQ et al. (Zhu et al. 2015) mentioned that cervical cerclage was a feasible choice to prolong the pregnancy. However, cervical cerclage of patients with uterine contractions may lead to abortion and premature delivery. Therefore, we retrospectively analysed the medical data at our hospital to examine the impact of persistent uterine contraction inhibition after cervical cerclage on late abortion and premature delivery.
Expression and mechanism of micro-ribonucleic acid-29a in chorionic villi obtained at curettage with recurrent abortion
Published in Gynecological Endocrinology, 2022
Aining Wu, Rongxin Yu, Debang Li, Ya Tuo
Fifty-two patients with RSA who underwent diagnosis and treatment from January 2020 to January 2022 were enrolled in the present study. The inclusion criteria were patients who (1) met the diagnostic criteria in the Expert Consensus on the Diagnosis and Treatment of Recurrent Spontaneous Abortion [10], (2) had abnormal vaginal bleeding (i.e. in addition to normal monthly menstruation, bleeding manifested by the reproductive system excreted via the vagina), with a clinical diagnosis of inevitable spontaneous abortion and where an ultrasound showed no beating of the primitive heart tube, and (3) had experienced three or more spontaneous abortions. The exclusion criteria were patients with (1) parental chromosomal abnormalities or embryo aneuploidy, (2) abnormalities confirmed via pathogen screening, (3) hereditary, endocrine, or immune disorder complications, (4) abnormal ovarian function, and (5) antiphospholipid syndrome.
Effects of different doses of estrogen on ER expression and ovarian function in patients with unexplained recurrent abortion
Published in Gynecological Endocrinology, 2022
Yamin Qiu, Jie Lin, Qing Xu, Linhua Zeng, Chao Liu
Recurrent abortion refers to two or more consecutive abortions (less than 20 weeks of gestation), which accounts for about 0.8% of the total number of women of childbearing age [1]. In addition to genetic defects, reproductive system abnormalities, endocrine disorders, immune factors, infection, systemic diseases, and environmental factors [2], the occurrence of this disease is related to about 50% of patients with no cause, which is called Unexplained recurrent spontaneous abortion (URSA). Recent studies have shown that the occurrence of URSA may be related to the abnormal expression of estrogen receptor (ER) and progesterone receptor (PR) [3]. Kelly [4] has confirmed that has confirmed that the content of estrogen and progesterone receptors ER and PR in the decidua tissue of patients with recurrent miscarriage is reduced. Supplementing estradiol and progesterone can increase the content of receptors in the endometrium and improve endometrial responsiveness [5]. At present, in clinical treatment, the most widely used estrogen and progesterone sequential regimen is the treatment, but the dosage of progesterone is relatively uniform, and there has been no uniform standard for the use of estrogen. In this study, we used different doses of steroid therapy for URSA patients to observe the clinical efficacy and provide a clinical reference method for URSA's intervention treatment.
Related Knowledge Centers
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- Gestation
- Vaginal Bleeding
- Sadness
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