Spontaneous abortion (SAB), or miscarriage, is the term used for a pregnancy that ends on it’s own, within the first 20 weeks of gestation. The medical name spontaneous abortion (SAB) gives many women a negative feeling, so throughout this article we will refer to any type of spontaneous abortion or pregnancy loss less than 20 weeks as miscarriage.
[ Hindi version ]
Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage. Chemical pregnancies may account for 50-75% of all miscarriages. This occurs when a pregnancy is lost shortly after implantation, resulting in bleeding that occurs around the time of her expected period. The woman may not realize that she conceived when she experiences a chemical pregnancy.
Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but with the great number of recognized miscarriages that occur, it is beneficial to be informed about miscarriage, in the unfortunate event that you find yourself or someone you know faced with one.
Miscarriage is a term used for an unplanned expulsion of the fetus, which takes place spontaneously before the time of the life that is able to survive independently. This situation is a terrible blow to individual mother as well as entire family members linked to the child. Since, it is an emotional shock to everyone in the family, especially mother, the lady suffering from miscarriage may even stay in shock for a couple of months. Any time before 24 weeks of pregnancy if the baby is lost, this can be termed as miscarriage. Generally in the first trimester, the chances of miscarriage remain maximum. But, there are cases when the lady is losing baby even after this time, which is known as late miscarriage.
Why do miscarriages occur?
The reason for miscarriage is varied, and most often the cause cannot be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality – meaning that something is not correct with the baby’s chromosomes. Most chromosomal abnormalities are the cause of a damaged egg or sperm cell, or are due to a problem at the time that the zygote went through the division process. Other causes for miscarriage include:
- Hormonal problems, infections or maternal health problems
- Lifestyle (i.e., smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
- Implantation of the egg into the uterine lining does not occur properly
- Maternal age
- Maternal trauma
What are the warning signs of miscarriage?
If you experience any or all of these symptoms, it is important to contact your health care provider or a medical facility to evaluate if you could be having a miscarriage:
- Mild to severe back pain (often worse than normal menstrual cramps)
- Weight loss
- White-pink mucus
- True contractions (very painful happening every 5-20 minutes)
- Brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)
- Tissue with clot like material passing from the vagina
- Sudden decrease in signs of pregnancy
Probable reasons behind miscarriage
When lady’s face early miscarriage, it is probably due to underdevelopment of the embryo. Another cause can be due to the effect of chromosomes. Sometimes even after maintaining great cautions people hardly get the guarantee that she won’t lose her baby.
Every baby developing within your uterus would require right variety of normal chromosomes. Exactly, 23 chromosomes each from both his mother and father would be ideal. But sometimes a baby doesn’t get exactly 23. Rather the split becomes 30 and 16. This is the situation when a lady might lose her child or even if the child is born, he will be born with certain abnormalities.
The reason behind late miscarriages can be due to health problems of the mother who is holding the fetus in her embryo. There are situations when a single lady is getting several miscarriages. This can be due to improper lifestyle of the lady. Since you are holding a life inside yourself, you cannot continue with your reckless lifestyle habit. Smoking a cigarette, drinking alcohol within the pregnancy period can definitely give rise to miscarriages.
Treatment for miscarriage
The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage, known as a D&C. Drugs may be prescribed to help control bleeding after the D&C is performed. Bleeding should be monitored closely once you are at home; if you notice an increase in bleeding or the onset of chills or fever, it is best to call your physician immediately.
Once your miscarriage is done, there is nothing to do instead of waiting. In a number of cases, the pregnancy tissue will pass naturally. Sometimes ladies also go through the situation of incomplete miscarriage. This is a situation when the fetus as well as embryo has stopped growing, but the pregnancy tissue has not passed yet. With just a small amount of pregnancy tissue remaining, this might not be very risky. Thus, you can wait for some time to see whether the pregnancy tissue passes away.
In some cases, tissue might not pass away naturally and would also develop the signs of infection. In such case, you must go for dilatation and curettage.
Dilatation and curettage
This generally becomes a treatment procedure when a pregnant woman has gone through a partial miscarriage. This is a process of removing remaining tissue right from the uterus. Here, the expert would widen your cervix area will remove the tissue with the help of an instrument named as Crete.
Sometimes with the help of medicines only the lady with the problem of miscarriage washes away the unwanted pregnancy tissue from her body. It is much easier way to treat miscarriage for a lady.
Blood is used to determine the amount of pregnancy hormone (hCG) is checked to monitor the progress of the miscarriage. When the bleeding stops, usually you will be able to continue with your normal activities. In this treatment, you may be diagnosed with an incompetent cervix if the cervix is dilated. With a procedure to close the cervix, as performed if the pregnancy is still viable. If your blood type is Rh negative, then the doctor gives a product called Rh immune globulin that helps to prevent you from developing antibodies. It could be harmed for your baby as well as for your future pregnancies.
Blood tests, genetic test, or medication is very important for a woman who has more than two miscarriages in a row which is known as recurrent miscarriage. There are some diagnostic procedures that are used to evaluate the cause of repeated miscarriage such as
- Pelvic ultrasound,
- Hysterosalpingogram which is an X-ray of the uterus and Fallopian tubes,
- Hysteroscopy, which is a test in which the doctor views the inside of the uterus with a thin, telescope like device inserted through the vagina and cervix.
Antiphospholipid syndrome (APS) is an autoimmune imbalance that causes the body’s immune system to react with certain normal substances in the blood which can increase the chance of forming blood clots. APS is the most important test with recurrent miscarriages and is estimated in 10 – 25% of women. This is a positive test that can result for any part of this test that indicates there may be other immune problems.
The adequate progesterone level is the most crucial in pregnancy health care. This is because it can lower the progesterone levels which are linked to the most of miscarriages. You can test around the day 21 – 28 day cycle, within this cycle, you can determine what your progesterone level is at. Even if you can get it to blood test by visiting an RE or by saliva testing through an online lab.
Karotyping test is the most examine chromosomes for any of the genetic issues. It can be performed on both parents, which is known as fetal tissue testing. If you are currently going through a miscarriage and choose to have a D & C, then you can have karotyping which is done on the tissue that is collected to rule out genetic issues. This test can be followed with the samples of blood, amniotic fluid, or placental tissue.
How to avoid miscarriage?
Just go ahead with simple and healthy habits in order to prevent miscarriage. Consume healthy food such as green leafy vegetables, proteins and other mineral rich foods. Your doctor will definitely prescribe you a diet chart which you must follow to keep yourself as well as your baby healthy. Every single physiological change in your body must be reported to your doctor in order to stay away from miscarriages.
Sometimes pregnant ladies may have spotting. This is a condition when the lady loses blood, but that too in very small amount. You can get a few spots of blood over your undergarments or the tissue that you are using the toilet. An early stage of pregnancy, spotting is very common and does not have anything to worry. Many ladies become tensed and think this to be a reason behind miscarriage.
But, when the bleeding becomes more than spotting, you must see your doctor immediately. If your bleeding stops after a day, this might not be so dangerous as your pregnancy would continue. But, if this doesn’t stop, this can even lead to miscarriages. You should be really cautious about the face and immediately report the same to the gynecologist.
Prevention of miscarriage
Since the cause of most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur.
- Exercise regularly
- Eat healthy
- Manage stress
- Keep weight within healthy limits
- Take folic acid daily
- Do not smoke
Once you find out that you are pregnant, again the goal is to be as healthy as possible, to provide a healthy environment for your baby to grow in:
- Keep your abdomen safe
- Do not smoke or be around smoke
- Do not drink alcohol
- Check with your doctor before taking any over-the-counter medications
- Limit or eliminate caffeine
- Avoid environmental hazards such as radiation, infectious disease and x-rays
- Avoid contact sports or activities that have risk of injury
[ Hindi version ]