Miscarriage

Did you know that about 40% of all pregnancies experience miscarriage? Miscarriage (also called as pregnancy loss) refers to a pregnancy that has end on its own around 20 weeks and under of pregnancy.

Miscarriage occurs when a pregnancy has failed right after the egg has implanted in the uterus.

Types of miscarriage

There are different types of miscarriage, enlisted below are the following:

Threatened miscarriage

Threatened miscarriage usually occurs early in pregnancy which is accompanied by:

  • Lower back ache
  • Uterine bleeding that leads to implantation
  • Closed cervix

Inevitable or incomplete miscarriage

Pregnancy week by week

Inevitable or incomplete miscarriage is when the cervix has dilated, effaced, and is accompanied by:

  • Abdominal and back ache
  • Bleeding with an open cervix

Complete miscarriage

Completed miscarriage is when the embryo has emptied out the uterus which is accompanied by:

  • Bleeding
  • Cramping

This type of miscarriage can be detected via an ultrasound and/or by having a dilation and curettage.

Missed miscarriage

Missed miscarriage is the occurrence of embryonic death sans the expulsion and is accompanied by:

  • Complete or sudden loss of pregnancy symptoms
  • Absence of fetal heartbeat

Recurrent miscarriage (RM)

Recurrent miscarriage is the 3 or more consecutive occurrences of 1st trimester miscarriages.

Embryonic pregnancy

Embryonic pregnancy (also called as blighted ovum) is when the fertilized egg implants in the uterine wall sans the fetal growth. In some cases, there is a gestational sac sans the yolk sac.

Ectopic pregnancy

Ectopic pregnancy is the abnormal implantation of a fertilized egg outside the uterus, most commonly in the ampulla of a fallopian tube.

Molar pregnancy

Molar pregnancy is the genetic error during the process of fertilization which results to:

  • Abnormal tissue growth in the uterus
  • Missed menstrual period
  • Severe nausea and vomiting
  • Positive pregnancy test result

Contributing factors of miscarriage

Enlisted below are the contributing factors which heighten the risk of experiencing miscarriage:

  • Healthy mother s – to – be have 15 – 20% chance of experiencing miscarriage
  • Women in their childbearing years have 10 – 25% chance of experiencing miscarriage
  • Maternal ages 35 below have 15% chance of experiencing miscarriage
  • Maternal ages 35 – 45 have 20 – 35% chance of experiencing miscarriage
  • Maternal ages 45 above have 50% chance of experiencing miscarriage
  • Mothers who had multiple miscarriages have 25% chance of experiencing another miscarriage
  • Listeria – bacteria found in undercooked meats, raw eggs, and unpasteurized dairy goods
  • Being under the influence of drugs
  • Uncontrolled diabetes
  • Lupus

Late miscarriage

Late miscarriage is a pregnancy loss which occurs around 14 – 20 weeks of pregnancy, and only about 2% of all pregnancies experience this. The signs and symptoms of late miscarriage is similar to the early miscarriage.

Causes of miscarriage

Studies and researches have shown the proven, unproven and other causes of miscarriage, enlisted below are the following:

Proven causes

Genetic abnormalities

About 70% of miscarriages are caused by genetic [or chromosomal] abnormalities in the embryo.

Certain chronic health conditions

Miscarriage increases the risk of being affected with certain chronic health conditions such as:

  • Lupus
  • Cardiovascular disease

Thyroid diseases

Thyroid diseases may it be hypothyroidism (too low) or hyperthyroidism (too high) cause infertility and/or intermittent miscarriages.

This is because hypothyroidism triggers hormone production that can quash ovulation. On the other hand, hyperthyroidism [which produces many hormones] hinders the estrogen’s function to make the uterus negative for implantation which may lead to atypical uterine bleeding.

Uncontrolled diabetes

Uncontrolled diabetes is when the levels of blood sugar have exceeded its breech.

Physical problems

Miscarriage also stem from physical problems such as:

  • Uterine abnormalities including its septum and polyps
  • Cervical incompetency

Blood – clotting conditions

Blood – clotting conditions such as the factor V Leiden thrombophilia (atypical blood clots) causes miscarriage.

Hormonal imbalances

Hormonal imbalances, especially the lack of progesterone since this hormone aids in holding the placenta together with the fetus by supporting the uterine lining.

Vices

  • Excessive alcohol drinking
  • Smoking tobaccos, cigarettes, and e – cigarettes
  • Illegal drugs

Various infections

  • Uterine deformities
  • Improper egg implantation in the uterine lining
  • Maternal trauma
  • Immune system reactions
  • Cervical insufficiency

Unproven causes

Excess caffeine consummation

Women who consume 200 milligrams or more caffeine a day are believed to have 2x higher risk of experiencing miscarriage.

Fact: Researches suggest that caffeinated substances intrude the placenta which can affect cell development.

Bad mood

No studies have been proven yet that being in a bad mood can cause miscarriage.

Stress

Some studies have shown that stress can not cause miscarriage.

Immunologic illnesses

Immunologic illnesses are believed to hinder the body from accepting pregnancy.

Other causes

  • Sexual intercourse
  • Mothers working outside their homes (especially in a harmful environment)

Causes of late miscarriage

  • Cervical incompetence – where the cervix is incapable of holding a pregnancy
  • Anti – phospholid anti – bodies syndrome (APS) – a condition of having a lot of anti – phospholid anti – bodies in the bloodstream
  • Fetal structural complications such as spina bifida
  • Congenital heart defects and disorders
  • Maternal anatomical complications such as bicornuate uterus (uterus is almost or split into 2 different cavities)
  • Placenta problems like placental abruption
  • Various infections that will kill the newborn such as Lyme disease, 5th disease, parvovirus, cytomegalovirus, toxoplasmosis
  • Various infections that will cause pre-term birth (amniotic sac leakage)

 Signs and symptoms of miscarriage

Majority of miscarriages occur since the unborn baby suffers from fatal genetic problems. Other than that, enlisted below are the following signs and symptoms that a trying – to – conceive or a mother – to –be is or has experienced miscarriage:

Decreased fetal movements

The decrease [or the cessation] of fetal movements is a sign of miscarriage since this usually occurs during the 1st trimester.

Changes in pregnancy – related symptoms

In line with the abovementioned symptom is the changes in pregnancy – related symptoms such as:

  • Nausea and vomiting
  • Sore breasts

Body pain

  • Abdominal cavity
  • Pelvic area
  • Mild to severe lower back ache
  • Dull to sharp menstrual – like crampings

Other symptoms

  • Weight loss
  • Fever
  • Chills
  • Lack of energy
  • True contractions [which happens every 2 – 3 minutes]
  • Probable signs of pregnancy

How vaginal bleeding is related to miscarriage

Vaginal spotting

Vaginal spotting (also called as vaginal bleeding) ranges from brown to light red color with or without the cramps. Approximately 20 – 30% of all pregnancies experience this in the early weeks, and 50% of which carry on with normal pregnancies.

Prevention, treatment options, and diagnosis

To lessen the instances or prevent miscarriage from re-occurring, below are the following prevention, treatment options, and diagnosis for it:

Ways to prevent having miscarriage

During conception

  • Regular exercise
  • Healthy and nutritious foods
  • Stress management
  • Maintaining a healthy weight
  • Take folic acid per day
  • Stop smoking
  • Schedule a pre – conception visit with an obstetrician – gynecologist
  • Eat a healthy and well – balanced diet
  • Take pre – natal vitamins
  • Quit engaging in illegal drugs
  • Stay relaxed
  • Improve overall mood

During gestation

  • Keep the abdomen safe
  • Stop smoking and avoid second – hand smoke
  • Stop drinking alcoholic beverages
  • Cut or withdraw caffeine intake
  • Avoid environmental hazards like radiation and x – rays
  • Avoid physical activities than are prone to injuries
  • Consult a doctor before taking over – the – counter medicines
  • Quit engaging in illegal drugs

Diagnosis for miscarriage

Ultrasound test

Ultrasound test for miscarriage purposes serve as a confirmation for this type of pregnancy loss.

Dilation and curettage procedure

Dilation and curettage (D&C) is the removal any fetal and placental tissue remains in the uterus.

Bloodwork

Bloodwork checks the amount of human chorionic gonadotrophin (hCG) to determine the progress of miscarriage.

Cerclage

Cerclage is the procedure of closing the cervix while the pregnancy is still sustainable.

Rho (D) immune globulin

For an Rh negative blood type, the doctor will give a blood product called Rho (D) immune globulin (RhoGAM) which hinders the development of anti – bodies that could cause harm on both parties. RhoGAM is of 2 types:

  • Injection route
  • Intramuscular route

Hysterosalpingogram

Hysterosalpingogram is an x – ray specifically designed for the uterus and fallopian tubes.

Hysteroscopy

Hysteroscopy is a test where the doctor checks the inner part of the uterus using a thin, telescope – like device inserted through the vaginal opening and cervix.

The aftermath of miscarriage

For women who experienced miscarriage for the 1st time, here are the following things and events to expect during the aftermath:

Irregular menstruation after miscarriage

Irregular periods prior to pregnancy

For women with a regular menstrual cycle, tendency is she will experience an irregular cycle prior to the succeeding pregnancy and after a miscarriage.

Anovulation

Anovulation (not ovulating) is the continuous growth and thickening of the endometrium sans the produced egg cell. In line with this, an endometrium overgrowth can lead to vaginal spotting or worst, heavy bleeding.

Tissue – like vaginal discharge

Expect a tissue – like vaginal discharge after the 1st few weeks of miscarriage (akin to a regular menstruation). Around 6 – 7 weeks, the discharge is akin to heavy vaginal bleeding. Furthermore, around 10 – 11 weeks, has expelled more tissue and probably some placenta.

Healing after miscarriage

Physical healing

Physical healing depends whether the miscarriage occurred early or late. Early miscarriages do not require any treatment rather than bed rest and recovery. Though in some cases, a D&C is required to expel the tissue remains.

A woman should be able to resume on her regular activities within 1 – 2 days.

Emotional healing

Emotional healing varies from women to women [also from couple to couple].

Conception after miscarriage

Women who are trying to conceive after miscarriage have lower chances of miscarrying again. As a matter of fact, less than 5% of trying – to – conceive women experienced 2 consecutive miscarriages and less than 1% has experienced more than 2 recurrent miscarriages.

Pregnancy after miscarriage

Medical practitioners recommend letting 1 – 2 menstrual cycles pass before attempting to be pregnant again, which allows full body healing and hormonal rebalancing. With that being said, ovulation can occur in as early as 2 weeks after an early miscarriage.