Miscarriage or abortion means spontaneous loss of pregnancy before the 20th week of pregnancy. Having a miscarriage can be emotionally overwhelming and deeply distressing. Unfortunately, miscarriages are common during the first trimester of pregnancy. The chances of having a miscarriage increase from 12% to 30%, as age increases from 20 years to above 40 years.
Book an appointment with Dr. Daksha Bakre for any Gynecology related consultations.
Causes of Miscarriage
Miscarriages can happen due to a number of reasons. In most cases it is not possible to determine the exact cause of miscarriage. Some of the common causes of miscarriage are listed below.
Chromosomal Abnormality in the fetus or placenta - This is the most common cause of miscarriage, especially early in pregnancy, and accounts for about 50 to 60% of miscarriages. Chromosomes contain genetic material. The developing fetus receives one set of chromosomes from the mother and another from the father. Damaged egg or sperm can lead to failure in the development of the fetus or placenta leading to a miscarriage.
Maternal Infections like tuberculosis, rubella, urinary tract infections, vaginal infections, viral infections, bacterial infections, etc can cause early pregnancy loss.
Maternal medical problems like uncontrolled diabetes, thyroid disorders, immunological conditions like rheumatoid arthritis, SLE or disorders of blood coagulation can be associated with miscarriages.
Uterine abnormalities like fibroids, endometrial polyps, adhesions or developmental disorders of the uterus like septate uterus, etc. can cause miscarriages.
Exposure to chemicals, drugs, radiation or environmental toxins - Use of alcohol, tobacco, too much caffeine, use of medication like antibiotics, pain killers, acne tablets, etc just before or soon after missed periods increases the risk of miscarriages.
Maternal trauma, fall, injuries, travel or strenuous activities may precipitate miscarriages.
Biochemical Pregnancy Loss means a very early miscarriage that occurs in the first few days of pregnancy. In this scenario, the pregnancy test (either urine test or blood test) is positive but the pregnancy fails to implant or does not develop normally. Ultrasound does not show any features of pregnancy. Eventually the bleeding starts and the HCG values drop to the non-pregnant state.
Blighted ovum or anembryonic pregnancy means that a pregnancy sac is seen on the ultrasound scan but embryo does not form at all.
A complete miscarriage is defined as a vaginal bleeding leading to complete expulsion of pregnancy tissues from the womb, with no evidence of any retained products on the ultrasound scan, in a woman who previously had a pregnancy confirmed on the ultrasound scan.
An Incomplete Miscarriage means vaginal bleeding leading to expulsion of pregnancy tissues from the womb but there is evidence of retained products of conception on the ultrasound scan, in a woman who previously had a pregnancy confirmed on the ultrasound scan.
A Threatened Miscarriage means vaginal bleeding is present but the cervix is closed. About 50% of these cases will proceed to a complete miscarriage.
Inevitable Miscarriage means the pregnancy is in the uterus but the cervix is open and it will not usually be possible to save the pregnancy and fetus.
Missed Miscarriage means a non-viable pregnancy in which the embryo or fetus is present but is dead, but there are no symptoms of miscarriage like vaginal bleeding or crampy pain in lower abdomen. This is usually detected on the ultrasound scan when the pregnancy fails to develop.
Recurrent Pregnancy Loss means occurrence of 3 or more consecutive miscarriages.
Septic miscarriage means a miscarriage associated with development of an infection in the uterus. This can be a severe infection and demands immediate care.
Symptoms of Miscarriage
Symptoms of miscarriage may vary in women and sometimes there may be no symptoms at all. In some cases, miscarriage happens so quickly that you may not even know you’re pregnant before you miscarry. The common symptoms of miscarriage are -
Cramps and severe pain in the lower abdomen
Expulsion of fleshy tissue vaginally
Fever and tiredness
Treatment of Miscarriage
If you are expecting and observe any of the above-mentioned symptoms, consult your Gynaecologist immediately. In case of a complete miscarriage you may not need any further treatment. In case of an incomplete or missed miscarriage treatment with medication or surgery might be necessary.
What can be done to prevent a miscarriage?
Visit your Gynaecologist for a pre-pregnancy check up. If any medical conditions like infections, diabetes, hypertension, thyroid disorders, anaemia or other nutritional deficiencies are diagnosed, they can be corrected before planning pregnancy.
If you are on any medication which is contraindicated during pregnancy, your Gynaecologist will make recommendations to switch to safer options.
Any genetic, hereditary or autoimmune conditions like haemophilia, thalassemia, SLE, etc. should be addressed before planning pregnancy
Both prospective parents should take folic acid supplements from 3 months before planned conception.
Having a healthy lifestyle, consuming a healthy diet, following a proper sleep pattern, regular exercise or walking and taking good care of your physical health from before planning pregnancy is essential for preventing miscarriages.