Miscarriage is often regarded as the most dreaded situation in women’s life that brings with itself a lot of plethora of emotion. Though it brings a lot of anxiety and depression in the family, also it brings guilt and shock in women’s life. In this article certain basic points have been explained, what is a miscarriage, its symptoms, causes, risk factor, diagnostic tests, types, prevention, and management.
What is Miscarriage?
Miscarriage is a loss of pregnancy. The term is commonly used when there is damage/loss of pregnancy before 20 weeks of gestation. Other terms used for such loss include miscarriage and early pregnancy failure.
About 15% to 20% of known pregnancies end in miscarriage. Most miscarriages occur simultaneously before 12 weeks of pregnancy. During the first few weeks of pregnancy, abortions sometimes occur because the fertilized egg has not formed the fetus properly. In many cases, the fetal heart activity stops for days or weeks before the onset of miscarriage symptoms.
What are the symptoms of miscarriage?
Symptoms of a miscarriage include:
- Vaginal bleeding, which can begin as brown discharge. When the bleeding is heavy, blood clots or other tissue may pass from the vagina. However, not all bleeding during pregnancy means abortion. Many pregnancies remain healthy, particularly when only small amounts of bleeding (“spotting”) occur.
- Other pain in the pelvis or pelvis, in the lower back or abdomen, commonly called a cramp.
- A decrease in the early sign of pregnancy, such as nausea and breast tenderness. However, such symptoms usually disappear in a healthy pregnancy. So, their disappearance rarely means abortion.
In addition to the possibility of miscarriage, pain, or vaginal bleeding during pregnancy, other problems such as tubal (ectopic) pregnancy can be caused. These symptoms should always be called to your doctor, midwife, or nurse immediately.
What are the causes of miscarriage?
About half of all miscarriages occurring in the first trimester are due to a chromosomal abnormality – which can be inherited or spontaneous – in the father’s sperm or the mother’s egg. Chromosomes are small structures inside body cells that carry many genes, the basic units of heredity.
Genes determine all physical characteristics of an individual, such as sex, hair and eye color, and blood type. Most chromosomal problems occur by accident and are not related to the health of the mother or father.
Spontaneous abortions are also caused by various unknown and known factors, such as:
- Exposure to environmental and workplace hazards, such as radiation or toxic agents at high levels.
- Hormonal irregularity.
- Improper implantation of a fertilized egg in the lining of the uterus.
- Mother’s age.
- Uterine abnormalities.
- Disable cervix. (The cervix begins to expand and opens very quickly, in mid-pregnancy, with no signs of pain or childbirth).
- Certain lifestyle factors such as drinking alcohol, smoking, or using illegal drugs.
- Lupus, immune system disorders including autoimmune disease.
- Severe kidney disease.
- congenital heart disease.
- Uncontrolled diabetes.
- Thyroid disease
- Some medicines, such as the acne medicine isotretinoin (Accutane®).
- Severe malnutrition.
- Group B streptococcus infection.
What are the risk factors?
The risk of miscarriage is increased by several factors, including:
- Ages : Women over the age of 35 have a higher risk of miscarriage than younger women. At age 35, the risk is about 20%. At 40, the risk is around 40%. And at age 45, it is about 80%.
- Previous miscarriage : Women who have had two or more consecutive miscarriages have an increased risk of miscarriage.
- Critical situation : Women with chronic conditions such as uncontrolled diabetes have an increased risk of miscarriage.
- Uterine or cervical problems : Certain uterine abnormalities or weak cervical tissue (incompetent cervix) may increase the risk of miscarriage.
- Smoking, Alcohol, Illegal Drugs : Women who smoke during pregnancy are at greater risk of miscarriage than nonsmokers. Sometimes, heavy alcohol use and illegal drug use also increase the risk of miscarriage.
- Weight : Being overweight or overweight increases the risk of miscarriage.
- Invasive prenatal examination : Some invasive prenatal genetic tests, such as chorionic villus sampling and amniocentesis, have little risk of miscarriage.
What is the diagnostic test for miscarriage?
The health care provider will perform a pelvic exam, an ultrasound examination, and a blood test to confirm abortion. If the miscarriage is complete and the uterus is empty, no further treatment is usually required. Because the uterus cannot empty, dilation and curettage (D&C) are performed. This procedure dilutes the cervix and gently removes any remaining fetal or placental tissue from the uterus. As an alternative to D&C, some medications may be given to excrete uterine contents from the body. This option is more ideal if you want to avoid surgery or are otherwise stable.
Blood tests are done to monitor the progress of abortion to determine the amount of hormone (hCG) during pregnancy.
Once the bleeding stops, normal activity can usually continue. If the cervix is thin, a disabled cervix can be diagnosed, and if the pregnancy is still present, a procedure to close the cervix (called the cervix) can be performed. If the blood group pregnant lady is negative for Rh, then the doctor may give a blood product called Rh immunoglobulin (Rhogam). This will prevent the development of antibodies that may harm a fetus or future pregnancy.
If a woman may require more than one miscarriage (called a repeated miscarriage), blood tests, genetic tests, or medications. Some diagnostic methods used to assess the cause of miscarriage include hysterosalpingography (X-rays of the uterus and fallopian tubes), pelvic ultrasonography, and hysteroscopy (with a doctor with a thin telescope). An examination to inspect the inside of the uterus) involves a device inserted through the vagina and cervix).
What are the types of miscarriage?
There are many types of miscarriages and they occur at different stages of pregnancy. We do not yet know why abortion occurs, but doctors may use certain conditions when doing so. The type of abortion allows you and your doctor to get more information about why this happened.
Premature miscarriage is the loss of a pregnancy during the first three months of pregnancy (early pregnancy). It is the most common abortion.
If pregnancy is lost after 12 weeks (early pregnancy) and before 24 weeks, miscarriage is delayed. About 1-2% of pregnancies end with a delayed miscarriage.
Stillbirth is a loss of pregnancy after 24 weeks. It occurs in about 0.5% of births in the UK.
A complete miscarriage occurs when the pregnant tissue is completely separated from the uterus and does not require medical intervention.
An incomplete abortion occurs when the abortion has begun but not all pregnancies have been resolved. Examine the signs of incomplete abortion and how to manage this type of abortion.
Miss abortion (also called silent or delayed abortion)
Occasionally, some women have no signs of miscarriage but are diagnosed with routine prenatal ultrasound. This is called abortion failure or delay.
A chemical pregnancy is a miscarriage that ends five weeks before pregnancy. Pregnancy can be confirmed by a blood test or home pregnancy test but is not yet visible on an ultrasound scan. Find out more about chemical pregnancy.
Molar pregnancy is a very rare complication of pregnancy which is an improper formation of the fetus in the womb.
A repeated miscarriage occurs when an abortion occurs three or more times in a row. It is extremely rare and affects 1% of joints.
An ectopic pregnancy is one in which the baby is outside the womb, usually in one of the fallopian tubes. It occurs in about 1% of pregnancies.
What are the treatments and management options for miscarriage?
Not all abortions can be stopped. However, you can take steps to maintain a healthy pregnancy. Here are some recommendations:
- Get regular antenatal care during pregnancy.
- Avoid alcohol, drugs, and smoking during pregnancy.
- To cautious about healthy weight before and during pregnancy.
- Avoid infection. Wash your hands thoroughly and stay away from people who are already ill.
- By limiting caffeine intake to 200 mg/day or less.
- Take prenatal vitamins to help ensure that you and your developing fetus receive adequate nutrients.
- Eat a healthy, diet with many fruits and vegetables.
The treatment for a miscarriage depends on the type of miscarriage. If no pregnancy tissue remains in the body (complete abortion), no treatment is required.
If you still have issues in your body, there are several treatment options:
Expected management, a place to wait for the rest of the organization to come out of your body naturally
Medical management helps in taking medicines that help to pass through the rest of the tissue.
Surgical management, surgical removal including residual tissue
The risk of complications from any of these treatment options is so low that you can work with your doctor to determine what is best for you.