Miscarriage : Miscarriage also called Spontaneous abortion. A miscarriage is the loss of pregnancy from natural causes before the 20th week of pregnancy. Most miscarriages occur very early in the pregnancy, often before a woman even knows she is pregnant. There are many different causes for a miscarriage.
Factors that may contribute to miscarriage include
• A genetic problem with the fetus. This is the most common cause in the first trimester.
• Problems with the uterus or cervix. These contribute in the second trimester.
• Polycystic ovary syndrome
Signs of a miscarriage can include vaginal spotting or bleeding, abdominal pain or cramping, and fluid or tissue passing from the vagina. Although vaginal bleeding is a common symptom of miscarriage, many women have spotting early in their pregnancy but do not miscarry.
Symptoms
Possible symptoms include:
• Low back pain or abdominal pain that is dull, sharp, or cramping
• Tissue or clot-like material that passes from the vagina
• Vaginal bleeding, with or without abdominal cramps
Treatment
When a miscarriage occurs, the tissue passed from the vagina should be examined. This is done to determine if it was a normal placenta or a hydatidiform mole. If the pregnancy tissue does not naturally leave the body, the woman may be closely watched for up to 2 weeks. Surgery (D and C) or medication (such as misoprostol) may be needed to remove the remaining contents from the womb. After treatment, the woman usually resumes her normal menstrual cycle within 4 - 6 weeks. Any further vaginal bleeding should be carefully monitored. It is often possible to become pregnant immediately. It is recommended that women wait one normal menstrual cycle before trying to become pregnant again.
Infertility : .
Endometriosis : Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside or lining the tissue of the uterus, but in a location outside of the uterus. Endometrial cells are cells that are shed each month during menstruation. The cells of endometriosis attach themselves to tissue outside the uterus and are called endometriosis implants. These implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity. They can also be found in the vagina, cervix, and bladder, although less commonly than other locations in the pelvis. Rarely, endometriosis implants can occur outside the pelvis, on the liver, in old surgery scars, and even in or around the lung or brain. Endometrial implants, while they can cause problems, are benign (not cancerous).
TREATMENT AND MEDICATION
Nonsteroidal anti-inflammatory drugs or NSAIDs (such as ibuprofen or naproxensodium) are commonly prescribed to help relieve pelvic pain and menstrual cramping. NSAIDs are commonly used, such as naproxen or ibuprofen, are commonly used.
Gonadotropin-releasing hormone analogs (GnRH analogs)
Gonadotropin-releasing hormone analogs (GnRH analogs) have been effectively used to relieve pain and reduce the size of endometriosis implants.
Oral contraceptive pills
Oral contraceptive pills (estrogen and progesterone in combination) are also sometimes used to treat endometriosis. The most common combination used is in the form of the oral contraceptive pill (OCP).
Progestins
Progestins [for example, medroxyprogesterone acetate, norethindrone acetate, norgestrel acetate ] are more potent than birth control pills and are recommended for women who do not obtain pain relief from or cannot take a birth control pill.
Other drugs used to treat endometriosis
Danazol
Danazol is a synthetic drug that creates a high androgen (male type hormone) and low estrogen hormonal environment by interfering with ovulation and ovarian production of estrogen.,
Aromatase inhibitors
A newer approach to the treatment of endometriosis has involved the administration of drugs known as aromatase inhibitors (for example,anastrozole and letrozole ).