Patient's question:
A month passed without her coming, and I knew I was pregnant. On day 34, she bled, and I went for an ultrasound that same day! The doctor said it was very small and not very clear to see. I had another blood test, which confirmed the pregnancy, so they prescribed me Western medicine and told me to rest at home for a week! Two days later, the bleeding stopped! On day 43, I had another ultrasound, and they said the fetus couldn’t be seen inside the uterus! The test paper still showed positive, so I had another blood test, and my blood pressure was lower than before. They said it was indeed gone! I asked what happened, and the doctor said it had already necrotized! They said it would naturally come down in a week! No surgery was needed. If it hadn’t come down in a week, I should go back to see the doctor! I really don’t trust foreign doctors.Doctor's answer:
Hello, based on what you mentioned, it is likely that a stillbirth has occurred. The possibility of a coagulation disorder may arise if the stillbirth has been in the uterus for more than four weeks. The causes of stillbirth include: genetic defects, such as heart malformations or chromosomal abnormalities; infections; maternal conditions, such as diabetes or measles; and placental dysfunction. Most hospitals can treat this condition. The key points of treatment are:(1) Determine the time of fetal death based on the gestational age, the cessation of fetal movement, and the disappearance of pregnancy-related symptoms. If the stillbirth has occurred for more than two weeks, coagulation function should be checked, such as bleeding and clotting times, platelets, fibrinogen, prothrombin time, etc. If there is a tendency toward bleeding, the 3P test should be performed.
(2) Promptly remove the dead fetus and its, which can be done through induced abortion or fetal extraction. Induced abortion can involve methods such as intramembranous injection of medication, placement of a probe or water bag in the uterine cavity, intravenous administration of oxytocin or prostaglandins, etc.
(3) Blood should be prepared before surgery. If a coagulation disorder occurs, it can be treated according to DIC (Disseminated Intravascular Coagulation) protocols, and the uterine contents should be cleared simultaneously.
(4) After the stillbirth and placenta are delivered, the cause of fetal death should be identified as much as possible. If necessary, a pathological examination should be sent for further analysis.
(5) Prevent postpartum hemorrhage and infection.