What Are the Different Types of Abnormal Pregnancy?

After the second trimester, the uterus is significantly enlarged, can reach the fetal body, feel fetal movement, and hear fetal heart sounds. Easy to diagnose.

Abnormal pregnancy

Menopausal women of childbearing age with a history of sexual life and a menstrual period of 10 days or more should be suspected of being pregnant. Menopause may be the earliest and most important symptom of pregnancy. But note that menopause is not necessarily pregnancy. Abnormal pregnancy means that many abnormalities may occur during pregnancy.

Diagnosis of abnormal pregnancy

After the second trimester, the uterus is significantly enlarged, can reach the fetal body, feel fetal movement, and hear fetal heart sounds. Easy to diagnose.

Abnormal pregnancy symptoms

Have early pregnancy, and gradually feel abdominal enlargement and conscious fetal movement.

Abnormal pregnancy signs

1. Uterus enlargement The uterus enlarges gradually with the progress of pregnancy. When examining the abdomen, measuring the height of the uterine floor by hand and the length of the suprapubic uterus based on a ruler can help determine the number of weeks of pregnancy. The height of the palace floor is different for pregnant women's umbilical distance, fetal development, amniotic fluid volume, single or multiple births, etc., so it is for reference only.

2. Fetal movement The movement of a fetus in the womb against the uterine wall is called fetal movement. Fetal movement is a sign of good fetal condition. Pregnant women begin conscious fetal movement at 18-20 weeks of pregnancy. The more gestational weeks, the more active the fetal movement, but the fetal movement gradually decreases towards the end of pregnancy. The fetal movement is about 3-5 times per hour.

3 Fetal heart sound can be heard at 18-20 weeks of pregnancy through the abdominal wall of the pregnant woman with a stethoscope. Fetal heart sounds are two-tone, like clocks "tick", faster. 120-160 times per minute. Hearing the fetal heart sound confirms the diagnosis and is a live birth. Hear fetal heart sounds with uterine murmurs, abdominal aortic sounds, fetal movements, and umbilical cord murmurs

Identification of abnormal pregnancy phonology

4 After 20 weeks of gestation, the uterus can be reached through the abdominal wall. The fetal head is round and hard. There is a floating ball feeling; the fetal back is wide and flat; the fetal hips are wide and soft with a slightly irregular shape; the fetal limb is small and has irregular movements [3].

Assisted examination of abnormal pregnancy

1. Ultrasound B-mode ultrasound imaging can not only display the number of fetuses, fetal birth pattern, fetal exposure, fetal orientation, fetal heartbeat, and placental position. And can measure the tire head double top diameter and other diameter lines. And can observe the fetal surface deformity. Ultrasound Doppler can detect fetal heart sounds, fetal movements, umbilical cord blood flow sounds and placental blood flow sounds.

2. Fetal ECG At present, indirect detection of fetal ECG is commonly used in China. The success rate is higher after 20 weeks of pregnancy. The advantage of this method is non-invasive. Can be used repeatedly.

Abnormal pregnancy

Abnormal pregnancy means that many abnormal phenomena may occur during pregnancy. Here are the most common abnormal pregnancy problems:

Early pregnancy bleeding and embryo atrophy

In the early stages of pregnancy, bloody vaginal discharge or vaginal bleeding often occurs, and some are accompanied by mild lower abdominal pain, which scares the expectant mothers who are just pregnant. They are afraid that the unborn baby will not be guaranteed. Such a situation is called "threatened abortion".

Early clinical pregnancy, bleeding may occur about 1/4, the reason may be physiological implantation bleeding or pathological cervical lesions. In particular, bleeding after sex should be diagnosed with cervical polyps or cervical bleeding. Most of the bleeding will last for several days or even weeks, and the doctor will instruct the patient to rest in bed and stop sexual life, if necessary, progesterone or treatment for cervical lesions.

If the fetal heart does not appear on ultrasound examination at 6-7 weeks of pregnancy, it is necessary to suspect whether it is "atrophic embryo sac". When patients learn about the abnormal results of embryos, they often feel sad and blame themselves for being too careless to cause this misfortune. In fact, the chance of miscarriage due to natural factors is as high as 15% to 20%. About 60% of embryo atrophy is due to abnormal chromosomes of the fertilized eggs or problems with the fertilized eggs themselves, which are naturally eliminated from the competition. Therefore, expectant mothers and fathers should not be too guilty when encountering such situations. Accepting it frankly and cooperating with the doctor to take appropriate measures is the correct attitude that you should have.

2. Cervical atresia

Cervical insufficiency is a "painless dilatation" of the cervix that cannot be locked, causing the amniotic membrane to rupture and cause abortion. This condition mostly occurs in the second trimester and can cause recurrent miscarriages in the second trimester.

The causes of cervical atresia are mainly congenital cervical dysplasia and acquired cervical injury. Congenitality accounts for about 30% to 50%, including mothers taking drugs such as DES during pregnancy. Acquired causes are mostly related to abortion surgery or cervical cone resections that have experienced the early stages of cervical cancer.

The main treatment for cervical atresia is to perform McDonald's cervical suture at 14 to 16 weeks of pregnancy, but the possible side effects of this surgery are water breakage, bleeding, or infection.

3. Fetal intrauterine growth retardation

When expectant mothers have a checkup, their favorite question is: "Is the baby normal? How heavy is it?" If the doctor's answer is "A little younger!" Expectant mothers will be impatient. In fact, the baby's weight is inherently light, light and large, and as long as the growth curve is normal, there is no need to make a fuss. However, after 37 weeks of gestation, if the fetal weight is less than 10% of the normal weight of the gestational week, and combined with maternal or placental problems, such as oligohydramnios or early placental calcification, it may be fetal growth retardation.

If the fetal head circumference and abdominal circumference are small, it is called "symmetry growth retardation." The main reasons are poor mother's weight gain, intrauterine infections (such as measles, syphilis), congenital abnormalities, and chromosomal abnormalities. However, also It may be because the parents are smaller, and the fetus will naturally be smaller based on genetic factors.

If the fetal head circumference is normal and only the abdomen circumference is small, it is called "uneven growth retardation". The fetus is affected by harmful factors in the third trimester. Common causes are mothers with anemia heart disease or vascular and kidney disease. Causes placental insufficiency, fetuses are multiple births or placenta, umbilical cord abnormalities. In addition, maternal malnutrition or bad habits such as smoking and drinking, as well as pregnant women taking medication indiscriminately, may cause fetal growth retardation.

A stunted fetus has a high rate of fetal distress during delivery, so early diagnosis is important. Once a pregnant woman is found to have fetal growth retardation, in addition to correcting the above-mentioned correctable factors, if necessary, labor induction should be carried out first to prevent accidents.

4. Prenatal bleeding

Prenatal bleeding refers to vaginal bleeding after 28 weeks of pregnancy. The main reasons are:

(1) Abnormal placenta: placenta previa and early placental dissection are the most common.

(2) Cervical and vaginal diseases: such as cervical erosion, uterine polyps or cervical cancer. In addition, vaginal trauma or foreign body implantation can cause bleeding.

(3) Hematuria caused by urinary tract infection.

(4) Hematological diseases, such as abnormal blood coagulation.

When bleeding occurs before giving birth, you should see a doctor as soon as possible and find out the cause of the bleeding. Ultrasound can tell whether there is placenta previa. If it is determined that there is no placenta previa, it should be further diagnosed whether there is cervical or vaginal disease. In addition, urine tests and coagulation tests can provide further information. In some special cases, such as early placental ablation, if conditions for cesarean section are available, it is advisable to produce as soon as possible.

5. malposition

Hip position, lateral position, oblique position, facial pattern and so on are all called fetal malposition, and the proportion of hip position is the highest. Expectant mothers care about the baby's fetal position and often ask the doctor about the fetal position soon after pregnancy. In fact, the embryos 3 months ago were in a planktonic state, changing positions all the time. About six months before the fetus, about half of the fetal position is not correct, until 32 weeks later, the proportion of fetal position is not reduced to 10%. Therefore, the fetal position is not very common before 8 months of pregnancy. Parents do not need to worry because most babies will normalize after 8 months.

Maternal polyhydramnios, laparoscopic abdominal muscle relaxation, uterine fibroids, double-horned uterus, placenta previa, multiple births, etc. are more likely to cause abnormal fetal position. In addition, fetal congenital abnormalities, such as congenital hip dislocation, chromosomal abnormalities , Brain edema, etc., the probability of gluteal position is also higher.

The risk of breech production through the vagina is high. Because the fetus's buttocks cannot fill the mother's pelvis, there is a higher chance of umbilical cord prolapse during delivery, and it is more prone to fetal hypoxia and even cause fetal death. In addition, fetal long bone fractures, spinal cord injuries, or severe lacerations of the mother's birth canal are 10 times higher than the head birth position. Therefore, it is recommended that cesarean section is safer for such women.

6. Premature rupture of membranes

Premature rupture of the membrane means that the amniotic membrane has naturally ruptured before the onset of labor pain, causing amniotic fluid to flow out. Reproductive tract infections, polyhydramnios, multiple births, aspiration of amniotic fluid, insufficiency of the uterus, etc., may cause early water rupture.

Before 6 months of pregnancy, if you unfortunately break the water, the fetal survival rate is not high and there are many complications of premature delivery, it is generally recommended to terminate the pregnancy. If water breaks during 6 to 8 months of pregnancy, conservative anticipatory therapies are considered, and antibiotics, tocolytics or steroids are given according to the situation to improve fetal survival. After water breaks after 34 weeks of pregnancy, the fetal lung maturity is assessed first. If it is immature, it is necessary to have a childbirth and rest in bed.

7. Premature birth

Most of the early uterine contractions may be just pseudo pain. However, if the uterine contraction frequency is more than 4 times every 20 minutes, or more than 6 times per hour, and the cervix has been progressively thinned and dilated, that is Premature labor pain, should rest in bed and cooperate with the doctor to guide the use of anti-fertility drugs.

8. Fetal Distress

Fetal distress is the phenomenon of fetal hypoxia and asphyxia. The normal fetal heart rate is about 120 to 160 times per minute. If the fetal heartbeat rate is too slow or too fast, or if the heartbeat has poor variability, you need to suspect potential fetal distress.

Fetal distress is due to chronic distress caused by placental insufficiency due to expired pregnancy, pregnancy-induced hypertension, or diabetes. In addition, temporary stop of blood circulation caused by contraction of uterine wall muscles can also cause acute distress. Doppler is usually used to measure fetal heart sounds during delivery. The purpose is to determine whether there is potential fetal heart distress. Once an abnormality occurs, the mother will be asked to undergo a 30-minute fetal monitor to determine further treatment.

Most fetal distress can be improved by changing the position of the mother, such as by lying on the left side, or a large number of drip injections or oxygen inhalation can help. If these methods do not work, the ultimate solution is to choose cesarean section.

9. Pregnancy-induced hypertension syndrome

Maternal hypertension is one of the common problems in obstetrics, accounting for about 5% of all pregnant women. Some of them are accompanied by the appearance of proteinuria or edema, which is called pregnancy-induced hypertension syndrome. In severe cases, symptoms such as headache, blurred vision, upper abdominal pain, etc. may cause systemic spasms and even coma if not treated properly.

The cause of pregnancy-induced hypertension is still unclear. At present, it is considered to be a series of disease-derived processes. Fortunately, most pregnancy hypertension only needs to be observed, and there will not be too many sequelae. However, severe blood supply complications, including intracerebral hemorrhage, renal failure, liver failure, respiratory failure, etc., have a higher mortality rate for pregnant women. If the patient's blood pressure cannot be controlled with medication, termination of pregnancy is the only treatment. It is worth mentioning that adequate bed rest can prevent the disease from worsening, which must be remembered by patients with pregnancy-induced hypertension.

10. Gestational diabetes

During pregnancy, due to various hormonal factors, it has the effect of resisting insulin and forms so-called gestational diabetes. The impact of diabetes on mothers is not only difficult to control blood sugar and obesity, but also prone to infectious diseases such as urinary tract infections. In addition, the rate of pregnancy-induced hypertension syndrome can be dozens of times higher than that of the general population.

In addition to the fetus is prone to dystocia due to giant infant disease, long-term high blood sugar can easily lead to uterine placental vascular disease, which can cause fetal growth retardation or even fetal death. Therefore, pregnant women with diabetes should accept the advice of physicians and dietitians to control the diet or control with blood glucose lowering drugs to ensure the safety of mother and child.

The above is a common abnormal pregnancy phenomenon. Learn more about any possible conditions, and you can deal with it in an unpredictable mood when you encounter problems, so that you can become a happy expectant mother.

Causes of abnormal pregnancy

1. When women have lower abdominal pain, be sure to watch out for ectopic pregnancy.

2. Ectopic pregnancy is a more serious disease than abortion. As the fetus grows up, the fallopian tube will rupture and cause large bleeding. Not only the fetus, but more importantly, it threatens the life of the mother.

3. Ectopic pregnancy is also easy to be confused with other abdominal pain problems, and should be distinguished. Intussusception is severe abdominal pain and blood in the stool; the pain of appendicitis is gradually moved from the heart to the right lower abdomen; and ectopic pregnancy, that is, rupture of an extrauterine pregnancy, is severe lower abdominal pain and bleeding.