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Miscarriage is the unintentional termination of a pregnancy before the 20th week. Miscarriage occurs in 10 to 20% of known pregnancies. However, the actual figure is likely greater because many miscarriages occur early in pregnancy – before you even realize you're pregnant.
The phrase "miscarriage" may imply that something went wrong throughout the pregnancy's carrying. However, this is rarely the case. The majority of miscarriages occur because the fetus is not developing normally.
Miscarriage is a fairly regular occurrence, but that doesn't make it any less painful. Take the first step toward emotional recovery by learning what causes miscarriages, what raises the risk, and what medical care may be required.
WHAT ARE THE SYMPTOMS OF MISCARRIAGE?
The majority of miscarriages happen before the 12th week of pregnancy.
Miscarriage signs and symptoms may include:
Spotting or bleeding in the cervix
Cramping or pain in your abdominal or lower back
Fluid or tissue exiting your vagina
If you have passed fetal tissue from your vagina, place it in a clean container and bring it to the office or hospital of your health care practitioner for analysis.
Most women who experience vaginal spotting or bleeding during their first trimester have successful pregnancies.
WHAT ARE THE CAUSES OF MISCARRIAGE?
Issues with genes or chromosomes
The majority of miscarriages occur because the fetus is not developing normally. Extra or missing chromosomes are responsible for approximately 50% of miscarriages. Most chromosome issues are caused by flaws that occur by chance when the embryo divides and grows, rather than by problems inherited from the parents.
Chromosome issues may result in:
- Blighted ovum: A blighted ovum happens when no embryo develops.
- Intrauterine fetal demise: In this case, an embryo develops but then stops developing and dies before any signs of pregnancy loss appear.
- Partial molar pregnancy and molar pregnancy: Both sets of chromosomes are inherited from the father in a molar pregnancy. A molar pregnancy is characterized by aberrant placental growth; there is usually no embryonic development.
When the mother's chromosomes remain but the male gives two sets of chromosomes, a partial molar pregnancy results. A partial molar pregnancy is frequently accompanied with placental anomalies and a malformed fetus.
Pregnancies that are molar or partially molar are not viable. Molar and partial molar pregnancies can sometimes be related with placental cancer.
Maternal health issues
A mother's health condition may cause miscarriage in a few circumstances. Here are several examples:
- Diabetes that is uncontrolled
- Infections
- Hormonal issues
- Problems with the uterus or cervix
- Thyroid disorder
What is NOT a cause of miscarriage?
Routine activities like these do not result in a miscarriage:
- Exercise, which includes high-intensity exercises like jogging and cycling.
- Sexual encounters
- Working as long as you are not exposed to hazardous substances or radiation. If you are concerned about workplace hazards, consult your doctor.
WHAT ARE THE RISK FACTORS FOR MISCARRIAGE?
Miscarriage is increased by a number of factors, including:
- Age: Women over the age of 35 are more likely to miscarry than younger women. At the age of 35, you have a 20% chance. At the age of 40, the risk is approximately 40%. At 45, it's almost 80%.
- Miscarriages in the past: Women who have experienced two or more losses in a row are at a higher risk of miscarriage.
- Uterine or cervical issues: Miscarriage risk may be increased by certain uterine diseases or weak cervical tissues (incompetent cervix).
- Tobacco, alcohol, and illegal drugs: Women who smoke during pregnancy are more likely to miscarry than nonsmokers. Miscarriage is also increased by heavy alcohol and illicit substance usage.
- Weight: An increased risk of miscarriage has been linked to being underweight or overweight.
- Invasive prenatal tests: Some invasive prenatal genetic tests, such as chorionic villus sampling and amniocentesis, are associated with a small risk of miscarriage.
- Chronic illnesses: Women with chronic conditions, such as untreated diabetes, are more likely to miscarry.
WHAT ARE THE COMPLICATIONS OF MISCARRIAGE?
Some women who miscarry get uterine infections. This is known as a septic miscarriage. This infection's signs and symptoms include:
- Fever
- Chills
- Tenderness in the lower abdomen
- Vaginal discharge that smells bad
HOW IS MISCARRIAGE DIAGNOSED?
Your doctor may do the following tests on you:
- Pelvic examination: Your doctor may examine you to see if your cervix has begun to dilate.
- Ultrasound: During an ultrasound, your doctor will look for a fetal heartbeat and evaluate if the embryo is developing normally. If a diagnosis cannot be reached, you may need another ultrasound in about a week.
- Blood tests: Human chorionic gonadotropin (HCG) levels in your blood may be measured and compared to prior measurements by your health care practitioner. A problem could be indicated if the pattern of variations in your HCG level is abnormal. Your doctor may check to see whether you're anemic — which could happen if you've had a lot of bleeding — and may also check your blood type.
- Tissue tests: If you have passed tissue, it can be sent to a lab to establish that you had a miscarriage — and that your symptoms aren't due to something else.
- Chromosomal tests: If you've had two or more miscarriages, your doctor may prescribe blood testing for you and your partner to see if your chromosomes are a cause.
Among the possible diagnoses are:
- Threatened miscarriage: There is a risk of miscarriage if you are bleeding but your cervix has not begun to dilate. Such pregnancies frequently end without complications.
- Inevitable miscarriage: A miscarriage is deemed inevitable if you are bleeding, cramping, and your cervix is dilated.
- Missed miscarriage: The placental and embryonic tissues remain in the uterus after a missed miscarriage, but the embryo has perished or was never created.
- Complete miscarriage: It is called a complete miscarriage if you have passed all of the pregnancy tissues. This is prevalent in miscarriages that occur before 12 weeks.
- Incomplete miscarriage: An incomplete miscarriage occurs when you pass fetal or placental material yet some remains in your uterus.
- Septic miscarriage: A septic miscarriage occurs when you have an infection in your uterus. This is a serious infection that necessitates prompt medical attention.
HOW IS MISCARRIAGE TREATED?
Threatened miscarriage
In the case of a threatened miscarriage, your doctor may advise you to rest until the bleeding or pain stops. Although bed rest has not been proven to prevent miscarriage, it is sometimes suggested as a precaution. You may also be instructed to refrain from exercise and sex. Although it has not been proven that these methods minimize the risk of miscarriage, they may increase your comfort.
In some situations, it's also a good idea to postpone travel, particularly to locations where fast medical care is difficult to obtain. Inquire with your doctor about postponing any forthcoming travels you have planned.
Miscarriage
Ultrasound has made it much easier to identify whether an embryo died or was never developed. Either discovery indicates that a miscarriage is unavoidable. You may have numerous options in this situation:
- Expectant management: If there are no signs of infection, you may choose to let the miscarriage run its course. This usually occurs within a few weeks of determining that the embryo has perished. Regrettably, it could take up to three or four weeks. This can be an emotionally challenging moment. If ejection does not occur naturally, medical or surgical treatment will be required.
- Medical treatment: If you want to speed up the process following a diagnosis of certain pregnancy loss, medicines can cause your body to remove the pregnancy tissue and placenta. The drug can be given orally or through vaginal insertion. Your doctor may advise you to administer the drug vaginally to boost its effectiveness and reduce adverse effects such as nausea and diarrhea. This treatment is effective in 70 to 90 percent of women within 24 hours.
- Surgical treatment: Suction dilation and curettage, a small surgical technique, is another possibility (D&C). Your doctor will dilate your cervix and remove tissue from the interior of your uterus during this surgery. Complications are uncommon, although they may include damage to your cervix's connective tissue or the uterine wall. If you experience a miscarriage that is accompanied by excessive bleeding or evidence of infection, surgical treatment is required.
Physical recovery
Physical healing from miscarriage usually takes only a few hours to a few days. In the interim, if you develop significant bleeding, fever, or abdominal pain, contact your doctor.
Ovulation can occur as soon as two weeks following a loss. Your period should return in four to six weeks. After a miscarriage, you can begin taking any sort of contraception. However, for the first two weeks after a miscarriage, avoid having sex or inserting anything into your vagina, such as a tampon.
Pregnancies in the future
It is possible to conceive during the menstrual cycle immediately following a miscarriage. If you and your partner decide to try again, make sure you're both physically and emotionally prepared. Inquire with your doctor about the best time for you to try to conceive.
Miscarriage is typically a one-time event. Most miscarried women go on to have a healthy pregnancy after their miscarriage. Only 5% of women experience two consecutive miscarriages, and 1% have three or more consecutive miscarriages.
If you have two or three miscarriages in a succession, you should undergo testing to rule out any underlying problems. Problems with the uterus, blood clotting, or chromosomes are examples of such causes. Don't give up if the cause of your miscarriages cannot be determined. Approximately 60 to 80 percent of women who experience unexplained recurring miscarriages have healthy pregnancies.
HOW CAN MISCARRIAGE BE PREVENTED?
There is often nothing you can do to avoid a miscarriage. Simply concentrate on taking care of yourself and your child:
- Seek routine prenatal care.
- Smoking, consuming alcohol, and using illicit drugs are all established miscarriage risk factors.
- Take a multivitamin every day.
- Limit your caffeine consumption. According to a recent study, drinking more than two caffeinated beverages per day seems to be connected with an increased chance of miscarriage.
If you have a chronic ailment, collaborate with your health care team to manage it.