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Miscarriage

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Miscarriage

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Although miscarriage is an emotionally and physically hurting experience, having detailed knowledge about it will help one to prevent and cope with the situation.

Medically reviewed by

Dr. Veena Madhan Kumar

Published At November 17, 2018
Reviewed AtMarch 26, 2024

Introduction

A miscarriage is the death of the baby within the mother’s womb, and medically it is known as spontaneous abortion. This can either happen during the first three months of pregnancy or later. Most of the time, the cause is not known, but females who have had miscarriages earlier have had a healthy pregnancy later.

What Are the Different Causes of Miscarriage?

If the miscarriage happens during the first trimester, it is primarily due to a problem with the chromosomes of the fetus (baby). The majority of the situations are related to this type.

The second one can be related to the development of the placenta, which is the organ connecting the blood supply between the mother and her baby.

If the miscarriage happens after the first three months, it is mostly related to the mother's health. The major causes associated with such miscarriages include the following:

  • Chronic illnesses like diabetes (raised blood sugar), thyroid disorders, lupus erythematosus (immune disorder), etc.

  • Infections acquired during pregnancy like sexually transmitted diseases, vaginosis, etc.

  • Certain medications consumed. For example, Misoprostol, NSAIDs like Ibuprofen, Methotrexate, and Retinoids.

  • Consumption of contaminated food.

  • Fibroid or any other growth in the womb.

  • The shape of the womb being abnormal.

  • Weak muscles of the cervix due to previous injury or surgery leading to an early opening of the cervix.

  • Hormonal changes in the ovary lead to polycystic ovarian syndrome, ultimately infertility, and miscarriages.

What Are the Various Risk Factors Associated With Miscarriage?

  • Long-term diseases like diabetes, autoimmune conditions, and hormonal disorders.

  • Two or more miscarriages in the past.

  • Smoking habits.

  • Alcohol or drug usage.

  • Excessive caffeine consumption.

  • Exposure to radiation.

  • Injury or accidents or trauma.

  • Advanced maternal age (greater than 35 years).

  • The weight of the mother (overweight).

What Are the Signs and Symptoms of Miscarriage?

The main being vaginal bleeding which can or cannot be associated with cramps. It is important to note that mild bleeding in the initial days can also be due to implantation bleeding and hence, it is essential to consult a doctor to be assured. The following other symptoms can be accompanied:

  • A backache.

  • Decreased or missing pregnancy symptoms.

  • Vaginal discharge, ranging from the blood clot to mucus or fluid which is pinkish in color.

  • Severe and frequent painful contractions.

What Are the Treatment Interventions Available for Miscarriage?

It is not possible to stop miscarriage once it has begun. There can be two things happening, either a complete or incomplete abortion, and in any case, the person should visit the concerned doctor.

When it comes to an incomplete abortion, the lady will be advised of three options. One is a natural way; the other is through medicine and the next being surgical.

  • The natural way is also called as expectant management of miscarriage in which there is a wait-and-watch approach to check for complete passage of the pregnancy products either at home or in the hospital.

  • The medicinal approach includes the prescription of medicines (mainly hormonal) that will help or speed up the process of evacuation or passage of the dead baby and other products. The effect of the drugs can be visible post four to six hours of consumption, and sometimes it may delay too. If this method does not work, you will be advised for surgical management.

  • The surgical approach is a minor procedure which is called dilatation and curettage (D&C). As the name suggests, in this, the cervix is dilated, and the products are excavated from the uterus. This is done under spinal or epidural anesthesia in an operation theatre but does not involve any cutting of tissues.

How to Prevent Miscarriage?

The chromosomal defect of the fetus leading to miscarriage cannot be prevented, but genetic counseling can be done after the mishap and the various things that can be done to ensure the prevention of other causes are as follows:

  • Regular exercises.

  • Avoid any kind of stress.

  • Consumption of nutritional supplements (like Folic acid).

  • Balanced- healthy diet.

  • Avoid smoking. Even passive smoking can be harmful.

  • Do not consume alcohol and limit the usage of caffeinated drinks.

  • Do not consume certain foods during pregnancy like papaya.

  • Stay away from radiation exposure or any kind of drugs or medicines that can prove to be dangerous (consult your doctor for the same).

  • Try to be in normal BMI (body mass index) and weight.

  • Take good care of general body health and be careful about getting any infections.

  • Get treated or manage known chronic illnesses.

Risk factors include

  • The age, risk of miscarriage is about 12 percent to 15 percent

  • at 20 and it increases to about 25percent

  • if the person is in their 40’s. Most of the age-related miscarriage is caused due to hormonal abnormalities.

  • There is a 25 percent chance for a person to have a miscarriage with a history of previous miscarriages.

  • Other health conditions such as diabetes, problems with the uterus, and infection of the cervix or the uterus can enhance the chance of miscarriage.

What Is the Risk of Miscarriage by Week?

The risk of miscarriage is reduced each week the woman is pregnant. About 15 percent of total cases end up in miscarriage. The number of miscarriage which occur in the second trimester is only about one to five percent. The most common risk of miscarriage is age and health. Most people’s miscarriage risk is reduced by each week of pregnancy if the pregnant woman has no other health complications.

Conclusion

Miscarriages are always not under the control of the mother or anyone else. But we can take care of a few possible things to avoid it. It is a traumatic experience for the mother both physically and emotionally, and hence, support, care, and love of the near ones will help her cope up with the loss. Make sure to consult a doctor and discuss pregnancy and miscarriages so that you are aware and updated about it. A miscarriage does not mean infertility or no future pregnancy. So, do not lose hope. Most women can get healthy pregnancies, post encountering miscarriage experiences.

Frequently Asked Questions

1.

What Are the First Signs of a Miscarriage?

The first and foremost sign of miscarriage is vaginal bleeding or spotting. The blood may be light brown. This discharge will have heavy bleeding. There may be severe abdominal pain, back pain, and dizziness.

2.

What Causes Miscarriage?

There are different causes of miscarriage.
- Increased maternal age.
- Environmental hazards.
- Occupational hazards.
- Exposure to harmful toxic substances.
- Hormonal irregularities.
- Improper implantation of a fertilized egg in the uterine lining.
- Infection.
- Pathological conditions of the uterus.

3.

What Happens After a Miscarriage?

After the miscarriage, you will have some abdominal pain and bleeding. This will resemble a period. It will gradually begin to get lighter. It will stop within 2 weeks. The pregnancy signs such as nausea and tenderness in the breasts will subside. If there is a miscarriage in the first trimester, you may wait for seven to fourteen days as the tissues pass out naturally. If the pain and bleeding have stopped completely it means the miscarriage has finished.

4.

How Do Doctors Test for Miscarriage?

A complete blood count may be done to determine the amount of blood loss. Your gynecologist will perform a pelvic examination clinically to look for signs of miscarriage. The changes to the cervix and ruptured membranes will be noted by the doctor.

5.

What Are the Symptoms of Silent Miscarriage?

When the pregnant mother does not experience any symptoms of miscarriage, then it is known as a silent miscarriage. It is very rare. One sign which can be seen is that the symptoms of pregnancy such as nausea, vomiting, and fatigue might disappear.

6.

Can the Fetus Which Is Dead Cause Infection?

Women who retain the dead embryo or fetus have the chance to experience severe blood loss or develop an infection of the womb. These are known to be rare complications.

7.

When to See a Doctor If You Suspect an Early Miscarriage?

When you start experiencing heavy bleeding or if you are having any symptoms of ectopic pregnancy, such as severe pain in the dizziness, fainting or abdominal area you should visit a doctor immediately.

8.

When Will I Get Periods After Miscarriage?

Most of the women get their period again within four to six weeks after their miscarriage.Your body might take a while to recover from a miscarriage. It might take a maximum of one month. Depending on the duration of pregnancy, you may still have the pregnancy hormones residing after the miscarriage.

9.

What Is D&C?

The full form of D&C is dilation and curettage. It is a surgical procedure that is done after the first-trimester miscarriage. In a D&C, dilation involves opening the cervix and curettage involves removing the remaining contents of the uterus.

10.

Is D&C a Safe Procedure?

The dilation and curettage procedure is a very common and safe procedure. But since it is a surgical procedure, there are few risks of other complications. The risks involved are uterine perforation and uterine infections.
Dr. Veena Madhan Kumar
Dr. Veena Madhan Kumar

Obstetrics and Gynecology

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