Miscarriage MISCARRIAGE by Justina June 3, 2024 June 3, 2024 A+A- Reset 29 Miscarriage, or spontaneous abortion, is a deeply emotional and challenging experience for many women and their families. A miscarriage refers to the loss of a pregnancy before the 20th week. It’s a common occurrence, though its exact frequency is hard to determine because many miscarriages happen before a woman realizes she’s pregnant. Approximately 10%-20% of recognized pregnancies end in miscarriage, but researchers believe the actual rate may be closer to 40%. Causes of Miscarriage Most miscarriages occur due to fatal genetic abnormalities in the embryo or fetus, typically unrelated to the mother. Sometimes, a fertilized egg implants in the uterus but ceases development, known as an anembryonic pregnancy or blighted ovum, leading to miscarriage. Other factors increasing the risk of this spontaneous abortion include: Infections Maternal medical conditions: Such as diabetes or thyroid disease Hormonal issues Immune system responses Uterine abnormalities Lifestyle factors: Smoking, alcohol consumption, and drug use Exposure: To radiation or toxic substances Cervical Insufficiency Miscarriage can also result from cervical insufficiency, where the cervix cannot sustain the pregnancy. This type often occurs in the second trimester, with few prior symptoms. Symptoms may include sudden pressure, breaking of water, and passing of tissue from the baby and placenta with minimal pain. Doctors typically treat cervical insufficiency with a cerclage stitch around 12 weeks into the next pregnancy to keep the cervix closed until delivery. Prevalence of Miscarriage Miscarriage is more common than many realize. Statistics indicate that about 10-20% of known pregnancies end in miscarriage. However, the actual number is likely higher, as many spontaneous abortions occur before a woman even knows she is pregnant. Miscarriages most frequently occur within the first three months of pregnancy. Here’s a breakdown of miscarriage risk by week: First 3 months (Weeks 1-12): Over 80% of miscarriages happen during this period. After week 5: The risk is about 20% (1 in 5). Weeks 8 to 13: The risk drops to 2%-4%. Beyond week 14: The risk decreases to 1% or less. If a pregnancy loss occurs after the 20th week, it is termed a stillbirth. Types of Miscarriages Chemical Pregnancy: Occurs before 6 weeks. Positive pregnancy tests occur, but it’s too early for ultrasound confirmation. Threatened Miscarriage: Bleeding occurs, but the cervix remains closed. Pregnancy often continues without issues. Inevitable Miscarriage: Bleeding and cramping are present, with a dilated cervix indicating a likely miscarriage. Incomplete Miscarriage: Some tissue from the baby or placenta exits the body, but some remain in the uterus. Complete Miscarriage: All pregnancy tissue leaves the body, usually occurring before the 12th week. Missed Miscarriage: It is also known as an asymptomatic or silent miscarriage, where the embryo dies or never forms, but tissue stays in the uterus. Recurrent Miscarriage: Losing two or more pregnancies consecutively affects about 1% of couples trying to conceive. Septic Miscarriage: This is accompanied by a uterine infection, which is rare but can be life-threatening. Symptoms of Miscarriage Spontaneous abortion can sometimes occur without any symptoms. However, potential signs include: Bleeding that ranges from light to heavy Severe cramps Abdominal pain Weakness Severe or worsening back pain Fever alongside any of these symptoms Weight loss White-pink mucus Contractions Tissue resembling blood clots passing from the vagina Decreased signs of pregnancy What to Do If You Experience Symptoms If you experience any of these symptoms, contact your doctor immediately. They will advise whether you should visit their office or go to the emergency room. How Long Does a Miscarriage Last? The duration of a spontaneous abortion can vary based on several factors: Pregnancy Stage: How far along the pregnancy is can influence the duration. Type of Miscarriage: The specific kind of miscarriage (e.g., complete, or incomplete) affects the timeframe. Treatment: The approach taken for treatment, whether natural passage or medical intervention, also plays a role. Typically, a miscarriage can last from a few hours to several weeks. Light bleeding may continue for up to two weeks after the miscarriage is complete. Miscarriage vs. Stillbirth Both miscarriage and stillbirth refer to pregnancy losses, but the distinction lies in the timing of the loss: Miscarriage: Occurs before 20 weeks of pregnancy in the U.S., before 24 weeks in the U.K., and before 22 weeks according to the World Health Organization. Stillbirth: Happens after these respective time periods. Miscarriage vs. Abortion Miscarriage (Spontaneous Abortion): An unplanned end to a pregnancy before the fetus can survive independently, typically before 20 weeks. Induced Abortion: The intentional termination of a pregnancy through medical procedures or medication. Many doctors refer to miscarriage as a “pregnancy loss” to avoid confusion with induced abortion Risk Factors for Miscarriage Certain factors can increase the likelihood of a spontaneous abortion. These include: Advanced Maternal Age: Women over 35 have a higher risk due to age-related genetic abnormalities. Previous Miscarriages: Having two or more consecutive miscarriages increases the risk of future miscarriages. Chronic Diseases: Conditions like hypertension, lupus, diabetes, thyroid problems, and polycystic ovary syndrome (PCOS) can elevate miscarriage risk. Obesity: Excess body weight has been linked to an increased risk of miscarriage. Lifestyle Choices: Smoking, alcohol, and drug use significantly raise the risk of miscarriage. Diagnosis of Miscarriage If miscarriage symptoms occur, a healthcare provider can confirm the diagnosis through: Pelvic Exam: Check if the cervix has started to dilate. Ultrasound Test: It uses sound waves to detect a fetal heartbeat. If results are unclear, a follow-up test may be needed in a week. Blood Tests: Measures pregnancy hormone levels and compares them to previous levels. Tests for anemia if there has been significant bleeding. Tissue Tests: If tissue passes from the body, it can be analyzed in a lab to confirm a miscarriage and rule out other causes. Chromosome Tests: This is conducted if there have been two or more miscarriages to identify potential genetic causes from either partner. Confirming a Miscarriage at Home If you experience symptoms like bleeding and cramping or a sudden loss of pregnancy symptoms (e.g., morning sickness or sore breasts), you can take a home pregnancy test: Negative Result: This may indicate a miscarriage, but follow-up with a doctor is essential as pregnancy hormones do not immediately leave the body. Positive Result: This does not guarantee that everything is okay; further medical evaluation is needed to confirm the pregnancy status. Regardless of home test results, consulting with your doctor is crucial for an accurate diagnosis and appropriate care. They will provide the necessary tests and support to manage your health and understand the cause of the pregnancy loss. Treatments for Miscarriage Treatment for a spontaneous abortion depends on the stage of pregnancy and the woman’s health. Options include: 1. Immediate Treatment If a miscarriage is complete and the uterus is empty, no further treatment may be needed. However, if tissue remains, there are several approaches your doctor might recommend: Natural Passage: Waiting a week or two for the tissue to pass naturally. Dilation and Curettage (D&C): A procedure where the cervix is dilated, and the remaining tissue is gently removed. Medications: Prescribed to help expel any leftover tissue from the uterus. 2. Late Pregnancy Loss If a miscarriage occurs later in pregnancy and the fetus has died in the uterus, the doctor will induce labor to deliver the fetus. 3. Post-Miscarriage Care Once the bleeding stops, you can usually resume normal activities. If the cervix dilates on its own but the pregnancy continues, it may indicate an incompetent cervix. In such cases, a procedure called cerclage can be performed to close the cervix. 4. Rh Factor Considerations If your blood type is Rh negative, your doctor may administer Rh immune globulin (RhoGAM) to prevent the development of antibodies that could harm future pregnancies. Home Care Tips for Miscarriage After a spontaneous abortion, self-care is crucial. Tips include: Rest: Ensure plenty of physical and emotional rest. Hydration: Drink fluids to stay hydrated, especially if you are experiencing bleeding. Pain Management: Use over-the-counter pain relievers like ibuprofen to manage cramping. Support: Seek support from loved ones or counseling services to navigate the emotional aftermath. Prevention of Miscarriage Most spontaneous abortions occur due to issues with the pregnancy that are beyond your control. However, certain steps can potentially improve your chances of a successful pregnancy, especially if underlying health issues are identified and treated. Here’s what you can do: General Health and Lifestyle Regular Exercise: Engage in consistent physical activity to maintain overall health. Balanced Diet: Eat a nutritious diet rich in essential vitamins and minerals. Healthy Weight: Maintain a healthy weight through diet and exercise. Avoid Infections: Practice good hygiene and avoid exposure to infectious diseases. No Smoking or Drugs: Refrain from smoking, drinking alcohol, and using illegal drugs. Limit Caffeine: Reduce your caffeine intake to improve pregnancy outcomes. Medical Interventions Treating Illnesses: Managing pre-existing conditions such as diabetes or thyroid disorders can enhance your chances of a healthy pregnancy. Progesterone Treatment: In some cases, doctors might recommend progesterone supplementation. Progesterone supports the implantation of the embryo and the early stages of pregnancy. Regular Prenatal Care: Early and consistent medical care during pregnancy. Folic Acid Supplementation: Taking folic acid before conception and during early pregnancy can reduce certain risks. Recurrent Miscarriage If you’ve experienced two or more consecutive miscarriages, your doctor may recommend a series of tests and treatments to diagnose and address the underlying causes: Diagnostic Tests Pelvic Ultrasound: To check the reproductive organs. Hysterosalpingogram: An X-ray of the uterus and fallopian tubes. Hysteroscopy: A procedure using a thin, telescope-like device to examine the inside of the uterus through the vagina and cervix. Treatment Options Depending on the identified cause of recurrent miscarriage, treatment options may include: In Vitro Fertilization (IVF): With genetic testing of embryos or using donor sperm or eggs. Surgery: To correct uterine abnormalities. Medical Treatment: For infections or other health issues. Hormone Therapy: To address hormonal imbalances. Immune Therapy: To manage immune system responses. Unexplained Recurrent Miscarriage In about half of recurrent miscarriage cases, doctors cannot determine a specific cause. When this happens, they may recommend: Boosting Overall Health: Through balanced nutrition, regular exercise, and adequate sleep. Reducing Stress: Through stress management techniques and psychological support or therapy. Despite unexplained causes, the prognosis remains positive. Two out of three individuals with recurrent miscarriages eventually have a successful pregnancy. When to See a Doctor Immediate medical attention is essential if you experience: Heavy vaginal bleeding. Severe abdominal pain or cramping. Fever or chills. Signs of infection, such as foul-smelling vaginal discharge. Symptoms After a Miscarriage After a miscarriage, you may experience: Bleeding and Mild Discomfort: These are common post-miscarriage symptoms. Heavy Bleeding, Fever, Chills, or Pain: Contact your doctor immediately if you experience any of these, as they may indicate an infection. Emotional Effects Spontaneous abortion can also have significant emotional impacts, including: Sadness, Guilt, Grief, and Anxiety: These feelings are normal and part of the healing process. Grieving Process: Allow yourself to grieve and recognize that healing takes time. Support and Counseling Support Systems: Talk to supportive individuals, such as your partner, friends, or family members. Professional Help: Consider speaking with a mental health counselor. Support Groups: Join pregnancy loss support groups for additional support and resources. Your doctor can provide information about these resources. Pregnancy After a Miscarriage Fertility Post-Miscarriage Future Pregnancies: At least 80% of women who experience a miscarriage go on to have normal pregnancies and births. Fertility: A miscarriage doesn’t necessarily indicate a fertility problem. However, 1%-2% of women may experience recurrent miscarriages, potentially due to autoimmune responses. Timing for Conception Medical Advice: Consult your doctor about when to try for another pregnancy. While some experts suggest waiting from one menstrual cycle to three months, research indicates there’s no medical necessity for waiting. Healing Time: Prioritize physical and emotional healing before attempting to conceive again. Counseling can assist in coping with the loss. Outlook and Prognosis While experiencing a miscarriage can be devastating, many women go on to have successful pregnancies afterward. The emotional recovery can take time, and seeking support from healthcare providers, counselors, and support groups can be beneficial. Final Notes Seek Medical Advice: Always consult with your doctor for personalized advice and to address any concerns. Self-Care: Prioritize your physical and emotional well-being during and after a miscarriage. Support Networks: Utilize support groups and counseling services to help navigate the emotional aspects of a miscarriage. Sources American College of Obstetricians and Gynecologists (ACOG) Mayo Clinic National Institute of Child Health and Human Development (NICHD) Miscarriage Association Tommy’s: prevention FamilyDoctor.org Cleveland Clinic KidsHealth Merck Manual World Health Organization (WHO) WebMD March of Dimes American Family Physician Stanford Children’s Health StatPearls American Journal of Epidemiology American Journal of Obstetricians and Gynecologists Journal of Human Reproductive Sciences Brigham and Women’s Hospital Obstetrics & Gynecology Australian Government Department of Health and Aged Care MISCARRIAGE 0 FacebookTwitterPinterestLinkedinEmail Justina previous post MISOPHONIA next post MILK ALLERGY
