Miscarriage

Miscarriage is the spontaneous loss of a pregnancy before the 20th week. It is believed that 10 to 20 percent of known pregnancies end in miscarriage, although the actual number is probably much higher due to the fact that many miscarriages occur so early in pregnancy that a woman doesn't even know she's pregnant.

Miscarriage as a term is frequently misunderstood. It suggests that something was wrong in the carrying of the pregnancy, which is rarely true.

Most miscarriages occur because of abnormal development of the fetus. However, because these abnormalities are rarely understood, it's often difficult to determine what causes them.

In most cases signs and symptoms of a miscarriage include:

• Pain and cramps in your abdomen
• Vaginal bleeding
• Fluid or tissue passing from your vagina

Most miscarriages happen prior to the 12th week of pregnancy.

If you notice parts of fetal tissue, place it in a clean container and bring it to the hospital for analysis.

Bear in mind that most women who experience these symptoms in the first trimester go on to have successful pregnancies.

Most miscarriages are caused by the following reasons:

Gene and chromosome abnormalities

These are the most frequent cause of miscarriage. It mostly happens because of the gene errors that happen during division and growth of the fetal cells.

Maternal health conditions

In rare cases, other maternal health conditions can lead to miscarriage. These include:

• Hypertension
• Infections
• Diabetes
• Hormonal changes
• Problems of the cervix and uterus

If you experience any of miscarriage symptoms, you should see your doctor immediately to receive a diagnosis.

Do not forget to mention to your doctor all the symptoms you are experiencing, history and chronology of their development, other chronic conditions that you have, and all the medications that you are taking. It would be wise if a friend or a loved one followed you along to the hospital.

Your doctor is expected to ask a standard set of questions about your condition and perform certain examinations including:

• pelvic exam,
• blood tests,
• analysis of the passed tissue if there is any.

It is important to determine which type of miscarriage you have, or whether you have a threatened miscarriage.

Threatened miscarriage is a condition when you are bleeding but your cervix hasn’t begun to dilate. Such pregnancies often proceed without any further problems.

Treatment for miscarriage will be determined after the ultrasound finding, and depends on whether the embryo has died or was never formed.

If there are no signs of infection, your doctor might chose to let the miscarriage progress naturally. This can take 3-4 weeks and may be emotionally difficult to handle.

If the expulsion doesn’t happen on its own, medical or surgical treatment will be needed.

Medical Treatment

Medical treatment is consisted of administering medication which should trigger the expulsion of tissue and placenta. Medication may be applied orally or vaginally, and it is effective in 80% of women within 24 hours.

Surgical Treatment

Surgical treatment is required when miscarriage is followed by heavy bleeding or signs of infection. The most widely-used surgical treatment is suction dilation and curettage (D&C).

During this procedure, your doctor dilates your cervix and removes tissue from the inside of the uterus.

Threatened miscarriage

If you are diagnosed with threatened miscarriage, you might be recommended to rest until the bleeding and pain ease. You should avoid sex, exercise and traveling.

There are no known specific measures for prevention of miscarriage.

Do your regular check-ups, take good prenatal care, control your chronic conditions, and avoid as many of known risk factors as possible, such as smoking, diet, and medication side effects. 

Lifestyle modifications are necessary in order to cope with miscarriage.

Physical recovery from the miscarriage requires a few days. Your period is likely to return within 4-6 weeks. Avoid having sex for at least 2 weeks. You can start using contraception immediately after miscarriage.

It is highly unlikely that miscarriage will happen two or more times in a row. If you experience multiple miscarriages, consult your doctor so he or she can identify the underlying cause.

Miscarriage may be difficult to handle emotionally, and can lead to anger, anxiety and depression. Talk to your doctor if you experience any of these feelings.

Don’t lose hope!

Most women with unexplained repeated miscarriages go on to have healthy pregnancies!

There are several risks associated with miscarriage.

Some women who miscarry are at risk of developing a uterine infection, also called a septic miscarriage.

Signs and symptoms of a uterine infection include:

• Pain in lower abdomen
• Fever
• Fetid vaginal discharge

Risks associated with miscarriage include:

• Chronic conditions – diabetes, hypertension, hormone imbalance
• Age - women older than 35 have a higher risk.
• Uterine and cervical abnormalities - such as cycts
• Smoking, alcohol and drug use
• Previous miscarriages
• Being over or underweight