Patient's question:
So long without getting pregnant, the doctor checked and said I have endometriosis. Isn't this just menstrual pain and irregular periods? It won't affect pregnancy.Doctor's answer:
1. Uterine fibroids: Uterine fibroids primarily occur when the tumor tissue gradually deforms the uterine cavity, leading to degenerative changes. This results in ulcers on the surface of the endometrium, reduced blood flow to the endometrium and myometrium, which is unfavorable for the implantation and development of the fertilized egg, ultimately causing miscarriage. For young women who desire fertility, uterine fibroid enucleation can be performed without hysterectomy to preserve fertility.2. Cervical insufficiency: Pregnant women with cervical insufficiency typically experience miscarriage in the second trimester. This is because, as the fetus grows and amniotic fluid increases, intrauterine pressure rises continuously, causing the fetal membrane sac to protrude from the cervical opening and leading to membrane rupture. Cervical insufficiency is often associated with previous cervical laceration injuries, multiple induced abortions, or poorly developed uterine isthmus. Cervical cerclage during weeks 12-15 of pregnancy or cervical repair during non-pregnancy can achieve good results.
3. Uterine malformations: The human uterus is a muscular organ derived from the development of paramesonephric ducts. Incomplete fusion of the bilateral ducts or incomplete resorption of the septum after fusion can lead to various congenital uterine malformations, such as unicornuate uterus, bicornuate uterus, double uterus, and uterine septum. Uterine septum accounts for about 80% of uterine malformations and is the most common cause of spontaneous abortion and preterm birth. The main reason for miscarriage caused by uterine septum is ischemia in the septal area and poor endometrial development, resulting in insufficient blood supply after implantation and affecting normal fetal development. In recent years, hysteroscopy has played a special role in diagnosing and treating uterine septum. It not only facilitates accurate diagnosis but also allows for septal resection under the hysteroscope, significantly reducing the rate of miscarriage.