Deferred Abortion

Deferred abort. There is talk of deferred abortion when the pregnancy ends suddenly, but the fetus continues to grow for unexplained reasons. It is usually unnoticed and the fetus is still present for several weeks, due to the lack of symptoms. Aborting in this way puts the woman’s life at risk .

Summary

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  • 1 Etiology
  • 2 Treatment
    • 1 Psychological treatment
    • 2 When we need help
  • 3 sensitive periods
    • 1 Temporary symptoms
    • 2 Positive Note
  • 4 Sources

Etiology

Women maintain the symptoms of a pregnancy for several weeks, despite the fact that the fetus is no longer viable, it is due to the presence of these symptoms that it is difficult to detect the death of the fetus . Most of the time it is discovered when the woman goes for a routine check-up. A series of tests are recommended when the doctor has a suspicion that the fetus is not viable, since this I abortion can only be detected by an ultrasound and confirmed when no beating of the is not displayed heart , this detection only gives if the gestational age of the fetus is more than 12 weeks.

Diagnosis When there is a suspicion that a delayed abortion is occurring but the fetus is less than 12 weeks old, the tests to be performed include the measurement of human chorionic gonadotropin -hCG-, that is, the glycoprotein hormone that is produced during the pregnancy , hCG levels are a key indicator when pregnancy is at risk or when the egg is dead.

Treatment

Once the deferred abortion has been detected, the necessary measures are taken to expel the fetal tissue from the body, sometimes some medications are prescribed to help the expulsion of the remains of the pregnancy, if this is unsuccessful, then it is carried out perform the dilation and curettage method to dilate the uterus, scrape and expel the residual matter. This method is the most effective way to successfully expel fetal tissues, as the body generally partially expels fetal remains. This is vitally important as fetal remains can cause serious infections and can even lead to loss of the uterus or loss of life for the woman. The doctor will be in charge of prescribing the necessary medications to the woman after a delayed abortion, since the body is weakened by severe hormonal changes, in addition, if necessary, she will be channeled to psychological therapy, since many women have manifested this experience as truly traumatic.

Psychological treatment

The pregnancy after an early loss caused by a spontaneous abortion is perhaps one of the moments of the life cycle of women in the most anxiety, fear, insecurity and lack of control will feel. Paradoxically, the women who live this reality are very little covered and accompanied, both by their families and by the health system and the social environment. It is something frequent, but it is not talked about. It is a taboo subject .

When we get pregnant for the first time, we put all our energy into it. We live it with hope and some uncertainty; Knowing that we are harboring a baby in our womb fills us with an overflowing vitality and joy that we have practically never experienced before.

Usually, this first pregnancy is experienced like climbing a cloud. We believe that at first glance we can see the smile of happiness knowing that a new life is brewing within us. Achieving it may have been easy and fast, or on the contrary, a long and sometimes hard process (such as pregnancies achieved thanks to assisted reproductive techniques), but when they confirm it, it is almost impossible not to get carried away by these feelings of happiness and fullness. David Chamberlain calls it “the wonder of bonding”: “When conception occurs, parents naturally direct their thoughts to the future baby.

Even when they are initially surprised by the pregnancy (quite common), they usually adapt quickly to the new situation, hug the baby emotionally, celebrate it and begin to organize their lives around this great event. The scientific term used for this process is to create links ”

Although it is not usually thought that anything bad will happen, it is possible, especially in people who have been slow to achieve this first pregnancy, that the pregnancy is lived with caution and alert at the same time. But when you have had a loss due to an early abortion, which we normally had not counted on, a subsequent pregnancy becomes something totally different. It changes the perception of security, of control over ourselves, and is characterized by increased anxiety, which can continue after birth, manifesting itself in overprotective behaviors with the new child.

It is very likely that nothing she has done has influenced the fatal outcome, but generally the woman lives and feels that she has failed at something. Suddenly you believe that your body is not working because it has not managed to reach the end of a natural, spontaneous and easy process.

It seems that everyone can have children without problems, and asks: “Why not me?”

Having a new pregnancy after a loss is a tremendous physical and emotional strain. The feelings of fear, anxiety, anger and lack of control will alternate with those of happiness, hope and joy. It is possible that the woman does not dare to let herself be carried away by that happiness for fear that the same thing will happen to her again. These feelings can spread to the rest of the family.

Without a doubt, the woman is the involuntary protagonist of this highly stressful situation. Unintentionally, thoughts will come to mind that relate the current pregnancy to the previous one. There will be dates that you will live with anguish. For example, if the first time you learned about the loss in the 12-week ultrasound, when you are going to have it in the second pregnancy, you will feel tremendous anguish, you will relive what happened, including the activities you did at that time ( if he worked, if he did sports, if he ate cheese…). Absolutely everything will be cause for concern. For this reason, “in 50% of cases, prenatal control is carried out by professionals other than those of the previous pregnancy, not because of dissatisfaction, but to avoid associations with previous experience.”

Until recently, early pregnancy losses were treated as spontaneous, natural, and hidden. Many women hear phrases like: “You calm down, it’s normal. If your body has rejected it, it will be for something ”. Or even more terrible, the famous “curettage, new pregnancy”. This, at least, is changing.

The specialist must act with tact: “Susceptibility and fear are on the surface. A woman with an Ed2P (pregnancy after two losses) cannot go through the torture of the sonographer making faces, saying nothing or commenting ‘Let’s see where the heartbeat is, I can’t find it …’. It’s too unbearable. ”3 For a few minutes the mother feels that her baby may be like a snowflake that can disappear at any moment. The woman needs to know, not to have dead times without an answer.

Pregnancy tests become an ordeal because you feel like you are continually being tested. They are very painful situations. Things are changing, but much remains to be done.

When a pregnancy is truncated, the way it is aborted medically influences not only how the woman feels her body and assimilates the experience, but also how she will live her next pregnancy. When the ultrasound reveals that the baby has already left (delayed abortion or no heartbeat), one way to approach it is to explain to the woman what to expect, that an urgent curettage is not necessary, unless there are serious complications : infection with fever, bleeding and severe pain. In most cases, there is nothing to prevent giving the woman the opportunity to choose, to let her body act and to start contractions at a natural rate, thus allowing the generation of endorphins and natural oxytocin, without hospitalization, although with medical supervision. Under these circumstances, the woman is going to mourn that much more healing baby. In this way, the mother can say goodbye to her baby, feel that her body does work, that it does what it should do. This “empowerment” process will give you great self-confidence that will make future pregnancy easier.

When we need help

Each woman has different life circumstances, a particular family support, and her own possibilities and tools to overcome the grief over that first loss. A woman may come to a new pregnancy with her own survival arsenal or she may lack one. It is vital that you are aware of your situation and assess whether you need professional support.

Sensitive periods

Much has been said about postpartum depression, but it is now known that depression is more common during the last trimester of pregnancy due to the increase in certain substances (pro-inflammatory cytokines). If we add to this the anxiety and added stress that one experiences in pregnancy after a loss, it is recommended to remain alert for a while, since depression is a serious illness.

Temporary symptoms

The studies by Schiwebert and Kirk describe the appearance of severe physical fatigue and the presence of other symptoms such as pressure in the chest, need to breathe deeply, palpitations, gastric discomfort, loss of appetite and sleep disorders (insomnia, nightmares …) , as normal responses in this grieving process. This allows the body to experience pain and loss, but this symptom must be temporary and disappear with time. Otherwise, it would be advisable to consult a perinatal psychologist.

Positive note

Although it is a hard, difficult, and sometimes misunderstood period, we can try to mitigate these effects and enjoy the pregnancy and our baby: Try to bond with your baby during pregnancy. Joining a life that we perceive as fragile can be scary, but then he will know that you are there. Talk to him, explain how you feel and why. Sing to him, go for a walk alone or with someone. Look for company, protection, and professionals who understand you and know how to assess your situation. Surround yourself with friends and family who support and understand you. Love yourself, enjoy yourself, acknowledge and accept your pain as something logical and normal. You can give it a color, a shape, draw it, or make a clay sculpture. All this will help you to understand how you are inside. When your baby is born, soak up it, of its smell, of its touch, spend a lot of time skin to skin. Let yourself be carried away by an aging without watches. Get help with food and with the house. And remember that breastfeeding has a protective effect against anxiety, since it decreases cortisol and favors bonding.

 

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