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Miscarriage: Causes, Symptoms Risk Factors, Diagnosis, Treatment & Prevention
Miscarriage is the most common type of pregnancy loss, and it can be a heartbreaking experience for a woman. There are many reasons that can cause a miscarriage. Miscarriages occur so early in pregnancy that sometimes a woman isn't even aware that she is pregnant.
In this article, we will explain what causes a miscarriage, its symptoms, risk factors and what medical care or support may be needed.
What Is A Miscarriage? [1]
Miscarriage, medically termed spontaneous abortion, is the loss of pregnancy (the loss of a foetus before it is developed enough to survive) before 20 weeks of pregnancy.
Studies show that about 10 to 26 per cent of all recognised pregnancies end in miscarriage. A miscarriage is most likely to occur within the first three months of pregnancy, which is estimated to be around 80 per cent. After 12 weeks of pregnancy, the risk of miscarriage reduces.
What Causes A Miscarriage?
• Chromosomal abnormalities - During the first three months, the most common cause of miscarriage is chromosomal abnormalities. Chromosomes are the tiny structures inside the body cells that carry genes. A miscarriage can occur when there is some abnormality in the chromosomes of a foetus, which causes the foetus to not develop normally. Chromosomal abnormalities might lead to intrauterine foetal demise, blighted ovum, molar pregnancy and partial molar pregnancy. According to the American Pregnancy Association, most chromosomal abnormalities occur due to a damaged egg or sperm cell or when a zygote divides [2].
• Problems with the placenta - A placenta is a temporary organ that develops inside the uterus during pregnancy. It develops during pregnancy and sheds after the pregnancy ends. If a placenta grows abnormally, the blood supply from the mother to the foetus is stopped [3].
• Weakened cervix - When the cervix (lower part of the uterus) is weakened, it can cause early pregnancy loss.
Other causes of miscarriage include:
•
Infection
[4]
•
Hormonal
problems.
•
Maternal
age
[5]
•
Maternal
trauma.
•
Obesity
[6]
•
High
blood
pressure
[7].
•
Uterine
abnormalities.
•
Implantation
of
the
egg
into
the
uterine
lining
does
not
occur
properly.
•
Exposure
to
radiation
or
toxic
substances.
•
Smoking
and
drinking
alcohol
[8]
•
Severe
kidney
disease.
•
Congenital
heart
disease.
•
Disorders
of
the
immune
system.
•
Uncontrolled
diabetes.
•
Thyroid
disease.
•
Malnutrition
or
poor
diet
[9]
•
Certain
medications.
Performing exercises or sexual intercourse doesn't cause a miscarriage. However, consult a doctor before trying out any exercises and ask which exercises are suitable for you.
Air
Pollution
Can
Increase
The
Risk
Of
Miscarriage,
Studies
Suggest
Types Of Miscarriage
• Threatened miscarriage - If a pregnant woman has bleeding accompanied with cramping and a closed cervix, she may have had a threatened miscarriage [10].
• Inevitable miscarriage - Bleeding and cramping with an open cervix during pregnancy.
• Incomplete miscarriage - The body doesn't pass all the pregnancy tissues and there are some remainings present inside.
• Complete miscarriage - When all the tissues have been passed out of the body.
• Missed miscarriage - When the foetus has died, but the body doesn't expel the foetus or tissues during pregnancy [11].
• Septic miscarriage - An infection in the uterus.
Symptoms Of Miscarriage
•
Light
to
heavy
bleeding
•
Cramps.
•
Abdominal
pain.
•
Mild
to
severe
back
pain.
•
Pelvic
pain.
•
Back
pain.
•
Weakness.
•
Spotting.
•
Fluid
or
tissue
passing
out
from
your
vagina.
•
Weight
loss
[12].
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Risk Factors Of Miscarriage
•
Age
(pregnancy
after
the
age
40)
[13]
•
Two
or
more
consecutive
miscarriages
before.
•
Uncontrolled
diabetes.
•
Underweight
or
overweight
in
pregnant
women.
•
Trauma
to
the
body.
•
Having
a
lot
of
caffeine
[14]
•
Smoking
[15]
•
Alcohol
and
drug
abuse.
•
Exposure
to
radiation.
•
Invasive
prenatal
tests.
•
Uterine
or
cervical
problems.
Women who are pregnant with twins or multiples can increase the risk of miscarriage, preterm birth orpreeclampsia.
Diagnosis Of Miscarriage
The tests used to diagnose a miscarriage are: [16]
•
Ultrasound
test
-
The
test
is
done
to
check
the
heartbeat
of
the
foetus.
•
Pelvic
exam
-
To
see
if
your
cervix
has
started
to
dilate.
•
Blood
tests
-
To
check
whether
the
beta-human
chorionic
gonadotropin
(hCG)
and
progesterone
levels
are
normal.
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Treatment Of Miscarriage
The treatment depends on the type of miscarriage you have had.
•
If
you
have
had
a
complete
miscarriage,
no
further
treatment
is
required.
•
Waiting
for
the
miscarriage
to
happen
naturally
without
treatment
which
is
known
as
expectant
management.
You
will
be
monitored
by
the
doctors
in
the
hospital
for
a
few
weeks.
•
In
medical
management,
medications
are
given
to
help
in
expelling
the
remaining
tissues
out
of
the
body.
•
In
surgical
management,
a
surgical
procedure
called
dilation
and
curettage
(D&C)
is
performed,
wherein
the
cervix
is
dilated
and
any
remaining
foetal
tissue
is
removed
[17].
Prevention Of Miscarriage
•
Eat
a
nutritious
diet.
•
Avoid
smoking
and
drinking
during
pregnancy.
•
Maintain
a
healthy
weight.
•
Do
not
stress.
•
Avoid
contracting
any
infections.
•
Limit
caffeine
consumption.
•
Have
prenatal
vitamins
daily
as
prescribed
by
the
doctor.
•
Get
prenatal
care
when
you
are
pregnant.
After Miscarriage
• Physical recovery - Physical recovery from a miscarriage usually takes only a few hours to a couple of days. In four to six weeks, you should start having normal periods. You may also experience symptoms such as spotting and abdominal discomfort after miscarriage.
• Support - If you have had a miscarriage, give some time for yourself to heal emotionally. You can ask for support from your friends and family when you need it. If you are feeling depressed or guilty seek counselling from a therapist.
• Trying to conceive again - If you are trying to conceive again, it is recommended to give your body some time to heal both physically and emotionally. Ask your doctor how long do you have to wait to get pregnant again.
Common FAQs
Q. How do I know if I had a miscarriage?
A. If you experience bleeding, pain and mild discomfort in the stomach, it may be a sign of miscarriage. Seek medical attention immediately.
Q. Can I get pregnant after a miscarriage?
A.
Yes,
you
can
get
pregnant
after
a
miscarriage.
Check
with
your
doctor
about
the
timing
of
your
next
pregnancy.
Q.
Is
miscarriage
painful?
A. Not all miscarriages are painful, but most pregnant women experience heavy bleeding and cramping which can be painful.
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