Fetus that cannot be delivered

　　The etiology and pathogenesis of a fetus that cannot be delivered are mainly due to deficiency and excess. Deficiency refers to weakness of Qi and blood, which is unable to expel the fetus from the body. Excess refers to blood stasis and dampness and turbidity blocking the fetus's expulsion. Common types include weakness of Qi and blood, obstruction by blood stasis, and obstruction of Qi flow by dampness.

　　1. Weakness of Qi and blood:The pregnant woman is originally weak, with insufficient Qi and blood,空虚的冲任，胎失气载血养，导致胎死胞中；又因气虚运化失职，血虚不润，死胎难以产出，故为胎死不下。

　　2. Obstruction by blood stasis:Injury due to a fall during pregnancy, or cold blood stasis, blocking the Chong and Ren channels, damaging the fetal essence, leading to the fetus dying in the uterus; and due to internal obstruction of blood stasis, the birth canal is not favorable, hindering the expulsion of the fetus, thus causing the fetus to remain in the uterus.

　　3. Obstruction of Qi flow by dampness:The body is originally deficient in the spleen, with insufficient source of transformation. After pregnancy, the fetus loses its nourishment, leading to the fetus dying in the uterus. Deficiency of the spleen causes malfunction in transportation and transformation, leading to internal accumulation of dampness and turbidity, blocking the uterine vessels, and obstructing Qi flow, resulting in the fetus being retained and unable to be delivered.

　　The main complication of a fetus that cannot be delivered is disseminated intravascular coagulation caused by the dead fetus. If the dead fetus remains in the uterine cavity for too long, it is easy to develop coagulation disorders, leading to disseminated intravascular coagulation, which can threaten the life of the pregnant woman. Often, there is a large amount of vaginal bleeding when the dead fetus is present, but if the dead fetus has not been expelled, a combination of traditional Chinese and Western medicine treatment is required. If necessary, a curettage operation should be performed as soon as possible to remove the fetal material, stop bleeding quickly to avoid severe injury to Qi and blood, and prevent the development of other diseases. For women with a uterus smaller than 3 months of pregnancy, direct curettage should be performed; for women with a uterus larger than 3 months of pregnancy, induced labor can be performed. Blood should be prepared before the operation. A fetus that remains for too long is prone to coagulation disorders, so for a fetus that has been dead for more than 3 weeks, a coagulation function test should be performed. If there is an abnormality in coagulation function, surgery should be performed after correction.

　　The symptoms of a fetus that cannot be delivered include the fetus being unable to be delivered, cold pain in the lower abdomen or vaginal bleeding, fullness in the chest and abdomen, foul breath, fatigue, and a thick, greasy, white tongue coating with a soft and slow pulse. The etiology and pathogenesis of a fetus that cannot be delivered are mainly due to deficiency and excess. Deficiency refers to weakness of Qi and blood, which is unable to expel the fetus from the body.

　　The prevention of stillbirth is mainly to prevent stillbirth, which includes the following aspects:

　　1. Be cautious about medication during pregnancy

　　Many drugs can enter the fetus through the placenta. Whether the drugs entering the fetus will affect the fetus and to what extent depends on factors such as the dose, duration, type of drug, route of administration, and susceptibility of the fetus. Taking the time of medication as an example, during the organ formation period of the fetus in the first 4-6 weeks of pregnancy, it is often most susceptible to teratogenic effects. Generally speaking, the earlier the medication time, the longer the duration of medication, and the greater the dose, the greater the harm.

　　2. Avoid viral infection

　　During the early stages of pregnancy (2-3 months), the fetus is very sensitive to viruses. Because some viruses such as herpes simplex virus, measles virus, hepatitis B virus, rubella virus, cytomegalovirus, and influenza virus can cause fetal malformations. If active tuberculosis or hepatitis is present, termination of pregnancy is recommended. Therefore, during the early stages of pregnancy, it is best to avoid public places to prevent viral infection, enhance physical fitness, and strengthen resistance to diseases. Pregnant women should avoid catching a cold.

　　3. Avoid toxic chemicals

　　Excessive contact with detergents can easily cause miscarriage and should also be paid attention to. Ionizing radiation, isotopes, chemical industrial toxins such as benzene, chloroprene, nitrosamines, lead, and highly toxic pesticides all have teratogenic effects. Pregnant women engaged in chemical production or exposed to toxic chemicals should try to change their jobs. Rural pregnant women should not spray pesticides.

　　4. Abstain from smoking, alcohol, and control the intake of strong tea and coffee

　　Tobacco contains more than 400 kinds of harmful compounds, among which nicotine is the main culprit. Pregnant women who inhale or live and work in a smoky environment can suffer from miscarriage, preterm birth, poor fetal development, and even malformations, such as congenital heart disease, cleft lip, cleft palate, and anencephaly. The incidence of hypertensive diseases in pregnancy among smoking pregnant women is also higher than that of non-smoking pregnant women. Smoking or passive smoking after pregnancy can slow down fetal development and can also cause miscarriage, preterm birth, and stillbirth. Alcohol enters the fetus through the placenta, which can make the newborn baby short and have low intelligence. Excessive drinking before conception can cause malformations in developing sperm and eggs. This kind of malformed germ cells combined will pass on the sick genetic genes to the offspring, causing fetal 'alcohol syndrome'. Strong tea and coffee have an exciting effect, which can stimulate the fetus to increase the frequency of fetal movements, and even harm the growth and development of the fetus. In animal experiments on the teratogenicity of drugs, it was found that caffeine can cause malformations in small animals.

　　5. Stick to regular prenatal examinations

　　Prenatal examinations can detect and prevent diseases early, protecting the health of pregnant women. After pregnancy, to adapt to the growth and development of the fetus, the mother's organs undergo a series of changes, which can be physiological or pathological. If the mother has important organ diseases such as heart, kidney, liver, and lungs at the same time as pregnancy, it may endanger the health and even life of both mother and child. Prenatal examinations can detect malformations early, terminate pregnancy in time, and also understand whether the growth and development of the fetus is normal, and provide appropriate guidance on life, hygiene, and health care for pregnant women. Early prenatal examinations can prevent genetic diseases, especially for pregnant women of advanced age, who should have early examinations. Starting from the third month of pregnancy, a check-up should be done once a month..

　　6. How to detect early

　　Fetal heart rate monitors and ultrasound can be used to detect fetal heart rate to discover the condition of stillbirth in the womb before the baby is born. For stillbirth in the second trimester and later, pregnant women themselves may also feel some abnormalities. The most obvious feeling is the disappearance of fetal movement, feeling nothing at all. Other symptoms include the uterus not growing with the number of weeks of pregnancy, and no weight gain or loss..

　　The examination items required for stillbirth include gynecological examination, level Ⅰ prenatal ultrasound examination, six tests of sex hormones, urine routine, blood routine, stool routine, and systematic fetal ultrasound examination.

　　For those with stillbirth, it is advisable to have a light diet, eat more vegetables and fruits, reasonably match the diet, and pay attention to adequate nutrition. Avoid spicy, greasy, and cold foods, and avoid smoking and drinking. Pay attention to maintaining moderate exercise and sufficient sleep every day.

　　The treatment of stillbirth should be specific to the specific condition. The specific methods are as follows:

　　1. Those with incomplete luteal function can be supplemented with progesterone. If there is a possibility of pregnancy, 10-20mg of progesterone per day should be administered from the 3rd to 4th day after the basal body temperature rises. After confirming pregnancy, continuous treatment should be maintained until the 9th to 10th week of pregnancy.

　　2. Those with chromosomal abnormalities must undergo prenatal examination if they become pregnant again. Through amniotic fluid cell karyotype analysis, it is understood whether the fetus has congenital malformations. If any abnormalities are found, pregnancy should be terminated in a timely manner.

　　3. For those with positive bacterial culture of vaginal discharge and seminal fluid, treatment should be given according to drug sensitivity tests until complete recovery. Condoms should be used for contraception during the treatment period.

　　4. For those with small uterine fibroids, medication can be taken; if the fibroids are large and solitary, surgical excision can be adopted for treatment.

　　5. For those with relaxed cervical os, cervical os suture can be performed between 12-20 weeks of pregnancy based on the time of past miscarriage. If there is vaginal inflammation before the operation, it must be cured before surgery. After the operation, progesterone, traditional Chinese medicine, and tranquilizers are used to stabilize the pregnancy, and regular follow-up is required. If there are signs of miscarriage or preterm labor, the suture should be removed in time to avoid serious damage to the cervix. If the pregnancy is successfully preserved, the patient needs to be admitted to the hospital 2-3 weeks before the expected delivery date. The suture can be removed when the signs of labor or cesarean section appear.