This article is published on the personal website of Dr. Guo Mingchuan. Click "Reading the original text" to enter the website and directly consult.
There are all kinds of novels and TV series, and there is always a bridge: the female pig’s feet who have just been pregnant, because of various reasons, the lower body is bleeding, and then screamed "My child"The end diagnosis was abortion.
There are many such plots, and the pregnancy numbers are more or less afraid of bleeding during pregnancy.No, the obstetrics and gynecology doctor encountered such a patient …
Vaginal bleeding, pregnant mother nervous to seek medical treatment
I met a patient a few days ago, 50+ days of pregnancy, vaginal bleeding, and medical treatment nervously.The specific situation at the time was like this–
Patient: "Doctor, I have been pregnant for more than 50 days now, and I have been bleeding from vagina. What should I do?"
Me: "Is there a lot of bleeding? How many days are it?"
Patient: "It’s been four or five days! Every time there are brown things on the underwear!"
Me: "Is there a feeling of tightness and swelling?"
Patient: "A little two days before, that is, the small belly is faintly on both sides, and it feels a lot."
Me: "What about now? Is there any pain?"
Patient: "Occasionally there is a little bit, but it is not obvious."
Me: "Have you done a B -ultrasound?"
The patient handed the B -ultrasound. I looked at the B -ultrasound of the emergency department of the foreign hospital 3 days ago. There are fetal heart buds, blood HCG has more than 30,000, and progesterone is more than 20.
Normal pregnancy may also bleed vagina
Me: "No problem, your situation is quite common in early pregnancy."
Patient: "What? Isn’t there a threatened abortion?"
Me: "Some vaginal bleeding in the early pregnancy may indeed be a threatened abortion …"
Patient: "But my progesterone is low?"
Me: "Don’t worry, normal pregnancy is also possible bleeding. You can look at the article" Normal pregnancy will bleed? "When you go back."
In fact, in the early days of normal pregnancy, the endometrium has just changed, and the cervix and uterine body growth is uneven, and the cervical tubular decaying bleeding will occur.
Generally, the bleeding of this situation is similar to the patient, and a small number of people will be bloody.
There is also a possibility that when the gestational sac is just formed, there will be some mucus and blood between the two layers of the miles outside the gestational sac. This is how the "double -ring symbol" said after the imaging examination is formed.(Xiaobian’s words: "Double Ring Expedition" is just a way to describe the B -ultrasound, not a child with a problem!)
Will vaginal bleeding affect children?
The patient seems to understand: "That’s normal, don’t you need to keep your fetus?"
Me: "No need to guarantee, as long as the bleeding does not increase, it will be good."
Patient: "But I have been blood for so long. What if I have an impact on my children?"
I realized that so few brown bleeding can be encountered even if it is a normal menstrual period. For example, after two days of clean menstruation, there is a little more brown thing.
This is also very common in clinical practice, but most women do not seek medical treatment because of this.They don’t worry about their bleeding because of this bleeding, they are worried about children.
I told her: "It doesn’t matter. This bleeding is the uterus bleeding. Besides, it is more accurate. It is the bleeding of the cervical tubular decoling. In detail, it is the mothers’ cervical tube decay of the mother’s uterus in bleeding.
"In other words, this is not a child’s bleeding, and this bleeding has nothing to do with the child. Even if the child really has any problems, it is not caused by the mother’s bleeding. The two are not necessarily related.
"Mom bleeding does not affect the child, but it will be different in turn. If the child has a problem, such as serious defects in congenital chromosomes, then this embryo is not good, and sooner or later will have a miscarriage.
"The embryo will cause mother bleeding during the miscarriage. At this time, the amount of bleeding will be much larger, and there will be symptoms of corresponding abortion such as abdominal pain and cervical duct expansion."
After I was annoying, the patient finally understood.In the end, I didn’t give any fetal medicine, and I went home.
Bleeding from vagina may also be caused by the disease
Bleeding from vaginal bleeding during pregnancy is a very common symptom, and it is also a symptom of alert mother and obstetrics and gynecology.
Common threatened abortion, ectopic pregnancy, hydatidal, and placental prefix status, etc., will take vaginal bleeding as the first symptom in the early days.
Therefore, when the obstetrics and gynecology doctors explain this problem to the patient, starting from clinical thinking, they will first exclude the diseases mentioned above.
However, these diagnosis is often not a one -time diagnosis at a time, and a symptom can be diagnosed early. It is often in the process of the condition. It can be diagnosed by sufficient examination basis and corresponding treatment measures.
Therefore, when doctors communicate with patients, most of their ideas are based on the above possible diseases.
For example, most doctors will tell patients that "you ‘possibly’ is a threatened abortion", "maybe ‘is ectopic pregnancy" and so on.
Although in most cases, maybe the doctor feels unlikely, but it doesn’t say that.Now the contradiction between doctors and patients is so fierce. If you do n’t talk about the problem, would n’t it be possible in case you encounter it?
However, such a communication method has actually brought anxiety to many patients.
The problem -problem embryo is destined to be eliminated
Regarding the diagnosis of "threatened abortion", I personally think it is a controversial diagnosis.
If the cervical function is indeed incomplete, in the middle of pregnancy, there should be no contractions that should not have under normal circumstances. At this time, the diagnosis of "threatened abortion" is not controversial.
However, many pregnant women have abdominal pain and vaginal bleeding in the early stages of pregnancy, especially a little vaginal bleeding and mild abdominal pain like normal pregnancy. In this case, it is difficult to define whether it is normal pregnancy or a real "threatened abortion".
The natural abortion rate in the early pregnancy itself is relatively high. Most of these abortion embryos itself have problems. It can be considered that these pregnancy is actually destined to have a miscarriage. No matter what the mother, it will be eliminated.
Rather than "threatened abortion", it is "destined to have a miscarriage".Early pregnancy that diagnosed "threatened abortion" and successfully treated in the treatment of tire protection. God knows whether there is no problem with pregnancy, or is there no problem for doctors?
A small amount of vaginal bleeding in the early pregnancy is the mother’s cervix and uterus bleeding, not the child is bleeding.
No matter how many bleeding during pregnancy, as long as it is not a large amount of bleeding caused by other severe diseases, it will not affect the child.
Even if it is necessary, it will affect the adults first. The blood circulation of adults is not enough, and the blood supply to the fetus is not enough to affect the child.
However, at that time, the life of adults was first threatened, and the doctor’s attention would be concentrated on adults instead of children.
Doctor Guo concluded:
It is the key to find that bleeding is not nervous, and it is the key to seeing the diagnosis in the hospital in time!
This article was originally from the author’s personal WeChat public account, and was strictly forbidden to reprint without authorization.
More small suggestions for experts are reliable and practical!
Follow "Good Doctor Online" WeChat public account: haodf_wx