Miscarriage: Causes, Symptoms, Diagnosis and Treatment
For most women, finding out they are pregnant is one of the happiest news they’ll ever get. Unfortunately not all pregnancies end up with you holding your baby, there are also cases when a miscarriage can occur.
What is a miscarriage?
A miscarriage is the spontaneous loss of a pregnancy until 20 weeks since conception. If your pregnancy is older than 20 weeks, we talk about a stillbirth.
Some also call it a spontaneous abortion, since abortion means ending a pregnancy, whether intentional or not.
Most miscarriages occur in the first trimester of the pregnancy (from 7 to 12 weeks) and, in some cases, women don’t even know they were actually pregnant.
How common is miscarriage?
Experts claim that about half of all fertilized eggs die before implantation or are miscarried.
As already mentioned, there are also women who miscarry, but never knew they were pregnant, this means that, from the known pregnancies, about 10-20% end in miscarriage.
Most miscarriages occur because of genetic problems within the embryo. The resulting baby wouldn’t be able to survive after birth and develop anyway.
The good news is that these fatal genetic errors are not related to genetic problems in the mother.
Certain medical conditions can also cause miscarriage or increase the risks of having a spontaneous abortion.
Mothers with diabetes and thyroid disease are prone to miscarry. Infections that spread to the placenta can also increase the risk.
The most common risk factors for miscarriage include:
- age – older women risk more miscarriages
- cigarette smoking (over 10 a day). Ideally, if you want to get pregnant, you should stop smoking altogether, the risks don’t end here.
- alcohol consumption
- trauma to the uterus
- exposure to radiation
- previous miscarriage – women who had a miscarriage have an incidence of miscarriage of about 20%. If a woman had 3 or more consecutive miscarriages, the risk is as high as 43%.
- weight problems – severely underweight or overweight – BMI of under 18.5 or above 25)
- abnormal uterus
- drug abuse
- the use of NSAIDs (nonsteroidal anti-inflammatory drugs) around the time of conception
What are the types of miscarriage?
Doctors refer to miscarriages by tissue-specific names (reflecting the clinical findings) or the type of miscarriage.
- Threatened abortion – a woman is experiencing vaginal bleeding (or other sign of miscarriage), but hasn’t yet lost the pregnancy
- Incomplete abortion – some fetal and placental tissues have been expelled from the uterus, some remain.
- Complete abortion – all the tissue of the pregnancy has been expelled
- Missed abortion – the fetus has not developed; there is no viable pregnancy in this case. The plancental and fetal tissue are still in the uterus.
- Septic abortion – there is an infection in the retained fetal / placental tissue.
Miscarriage signs and symptoms
Should you experience ANY vaginal bleeding, consult with your OBGYN. While vaginal bleeding doesn’t always mean you are miscarrying, since it’s common in the first trimester, it should be investigated.
Similar to menstrual pain, but higher in intensity. The pain is dull and cramping, can be present constantly or come and go.
In most pregnancies some pelvic pain is normal, since the uterus is growing and it’s painful, but, if you are not sure, always consult with your OBGYN.
Pregnancy symptoms suddenly dissappearing
Morning sickness, tiredness, tender breasts, these are just few of the signs of a normal pregnancy, which are being experienced by most women. These will vane during the second trimester, but, if they suddenly cease, it can be the sign of a miscarriage.
Some vaginal discharge is normal at the beginning of your pregnancy, because of all the hormonal changes in your body, during that time. Should mucus, blood or an unpleasant smell appear, please go see your doctor.
How is miscarriage diagnosed?
- ultrasound examination – the most common way for your doctor to determine if you are having a miscarriage. It can also show if it’s an ectopic pregnancy (outside of the uterus, usually into the Fallopian tube)
- blood tests – for pregnancy hormones, blood counts (to determine the degree of blod loss, or if there is also an infection)
- pelvic examination
- blood type check – for Rh-negative women to receive an injection of rho-D immune globulin (RhoGam), to prevent further miscarriages.
What happens after a miscarriage?
There is no treatment to prevent a miscarriage, although, if the woman has not yet miscarried bedrest is advised. She should also abstain from sexual activity and restrict any physical activity, until the miscarriage signs are no longer present.
Once the miscarriage occurs, there is no treatment for it.
It will take its course and, if there is no severe blood loss or cramping, no treatment is required.
If the pregnancy tissue has not been evacuated entirely, a dilatation and curettage (D&C) procedure will be performed. It’s most common for missed abortions, since the pregnancy material is still present in the uterus.
Women who are Rh-negative will receive a dose of rho-D immune globulin.
If an infection caused the spontaneous abortion, antibiotic treatment will be given.
Having a miscarriage doesn’t necessarily mean you won’t be able to become a mother. Most women recover easily after a miscarriage (as opposed to a molar pregnancy, for instance, when recovery takes longer), so they start trying to conceive weeks after.
Your doctor can advise you to wait for 2-3 menstrual cycles though, so that you are fully recovered. There are high changes of having a normal pregnancy and ending up with the baby you always dreamed of.