Habitual Abortion
The term abortion refers to the expulsion of the fetus
from the uterus before the complete formation of the placenta. It is also
commonly known as miscarriage. This may occur any time before 28 weeks of
gestation but is most common during the first 12 weeks of pregnancy. Once in
five to ten pregnancies terminates in this way. When miscarriage occurs
repeatedly at a certain period of pregnancy, it is termed "habitual abortion".
It is one of the most perplexing problems of gynaecology and a major cause of maternal
mortality. A woman who has suffered two or more terminations of this sort consecutively
is said to be a case of habitual abortion.
Symptoms
Pains of the same character as labour pains and
bleedings are the two main symptoms of possible abortion. Bleeding may lead to
the detachment of the ovum from the uterus. It now acts as a foreign body in
the uterus which stimulates uterine contraction. This generates a lot of pain and
the fetus is thrown out of the body. In later weeks when the fetus is well
developed, if it dies in the uterus, it leads to maceration of the body. The
abdomen is filled with blood and the skin colour appears red. Sometime after a
few more days, the fetus gets dehydrated and the fluid surrounding the fetus
gets dried away.
Causes
One of the most important causes of habitual abortion
is a congenital malformation of the uterus. A hysterogram, before the woman
becomes pregnant, will be useful in detecting any abnormality, so that she is
made aware of her case. Deficient functioning of the thyroid is another
important cause of habitual abortion.
Most cases of habitual abortion, however, result from
an inadequate secretion of the female hormone progesterone. This hormone is
responsible for the development of the placenta. In the early stage of
pregnancy, the gonadotrophin secreted by the cytotrophoblast of the chorion,
one of the fetal membranes, stimulates the corpus lotemum to produce more estrogen
and progesterone, both essential female hormones. At a later stage, by about
the 12th week of pregnancy, the placenta takes over the production and
secretion of the hormones. Any deficiency of these hormones at this stage is
detrimental to the growth of the fetus. It is, therefore, during this critical
period, when habitual abortion mostly occurs. Lack of progesterone is
especially instrumental in expelling the fertilised ovum and it results in an
abortion.
Another important
cause of habitual abortion may be chronic constipation which leads to putrefaction
of morbid matter and wastes in the large intestines. This in turn causes auto-intoxication
and inflammation of the reproductive organs, which can lead to a miscarriage. Abortion
may result from the excessive use of certain drugs. Drugs enter the fetus
through the placenta. They may act quite differently on the fetus from the
mother. Drugs which have adverse effects on the fetus are called "tera-togenestic
drugs" and may include painkillers, antibiotics, tranquillisers and
hormones. A high dosage of such drugs may produce contraction in the uterus and
induce abortion.
Other causes of habitual abortion are excessive
physical exercise, mental excitement, sexual intercourse, syphilis infections
fibroid tumours, blood incompatibly of husband and wife, systemic disorders in
the mother like hypertension, chronic nephritis, diabetes and even her mental condition. Thorough examination of the pregnant woman’s blood,
urine, blood pressure and their related parameters help in detecting maternal
disorders. Serological tests, for example, prove the presence or absence of
syphilis infection. Pelvic examinations help to diagnose uterine displacements,
fibroids or ovarian tumours. A hysterogram also helps to detect uterine malfunctions.
The exact cause must be ascertained for prescribing correct treatment.
Treatment
Conditions such as hormonal imbalance, infections of
the uterus and chronic constipation can be remedied by natural methods of
treatment. For congenital uterine malformation, however, recourse may have to
be taken to surgery. On appearance of the first symptoms of possible abortion,
the patient should be put to bed immediately and the bottom end of the bed
raised. Cold compresses at 60 o F temperature should be applied
continuously to the inner portion of the thighs, the perinium, the vagina and the
lumbar region. Compresses should be changed every 15 to 20 minutes. When the
compress is removed for renewing, the surface should be rubbed with a warm dry
flannel for half a minute or until reddened, before applying the compress
again.
Simultaneously, a hot application should be made to
the feet. A neutral or warm water enema is an effective remedy for a
constipated colon which is a major cause for the toxemic condition of the
uterus. This will relieve the bowels and thus reduce any excessive pressure on
the uterus and other pelvic organs. A regular cold hip bath for a duration of
10 minutes twice every day is very helpful in relieving congestion and
inflammation of the uterus. Wet girdle packs, twice every day, on an empty
stomach, also relieve congestion’s and infections in the uterus and other
pelvic organs. It is advisable that women with a history of repeated abortions
should adopt these techniques before conception and continue them during the
first two months of pregnancy.
Hormonal imbalances can be set right by practicing
yogic exercise. Yogic asanas such as sarvangasana, vajrasana, bhujan-gasana,
shalabhsana, dhanurasana, paschimottashana, and trikonasana are especially
useful in improving thyroid, pituitary, adrenal and gonaidal endocrine functions
and should be practised regularly by women who suffer from imbalances of this
sort, up to the first two months of pregnancy. Dietary control is of utmost
importance in the prevention of habitual abortion. Pregnant women should avoid
refined carbohydrates, sugars, non-vegetarian food, coffee and tea. They should
also avoid oily and fried foods as such foods lead to constipation, which is
very detrimental to pregnancy. Smoking or chewing tobacco and drinking alcohol
must be strictly avoided. The pregnant woman’s diet chart should be on the
following lines:
Breakfast: Fresh
fruits and a glass of milk mixed with a teaspoonful of honey.
Lunch: Steamed
vegetables, boiled rice or whole wheat chappatis and soup or buttermilk.
Midafternoon: A glass of fruit juice or a whole fruit.
Dinner: Cooked
diet similar to the afternoon meal may be taken till the seventh month. After that,
fruits, nuts, germinated seeds and sprouts, milk, buttermilk and soups must
form her diet because they reduce the workload on the digestive system and thus
help avoid indigestion, constipation and related disorders.
Indian gooseberry, known as amla in the vernacular,
is considered useful in preventing abortion. A teaspoonful of fresh amla juice
and honey mixed together should be taken every morning during the period of
pregnancy. It will also prevent infections and help in the absorption of iron.
A brew made from safflower foliage is also said to prevent abortion. Pregnant
women with a history of repeated abortions should take all other precautions necessary
to prevent miscarriage. They should avoid sexual intercourse, during early pregnancy.
They should go to bed early and rise early and take regular exercise, but avoid
fatigue. They should sleep on a hard mattress with their heads low, and remain
calm and cool. All these measures will greatly help in correcting the
phenomenon of habitual abortion.
Source: www.healthlibrary.com through www.scribd.com
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