Miscarriage

From this article you will learn about miscarriage before 20 weeks of pregnancy.

What is a miscarriage?

A miscarriage is the loss of a pregnancy during the first 20 weeks. After 20 weeks, the loss of the baby is called a stillbirth. A miscarriage can end within a few days or weeks. Common symptoms include vaginal bleeding, pain in the lower abdomen, lower back, or pelvic organs, or the passage of fetal tissue. Bleeding may be light, heavy, constant, or intermittent. It is often not immediately clear whether light bleeding is a sign of miscarriage. When it is accompanied by pain, the likelihood of miscarriage increases.

Risk factors for miscarriage

• Age 35 years and older.
• History of previous miscarriages.
• Polycystic ovary syndrome, which is accompanied by problems with ovulation, obesity, increased levels of male hormones and an increased risk of developing diabetes.
• Certain bacterial and viral infections during pregnancy.
• Antiphospholipid syndrome.
• Anomaly in the development of the shape of the uterus.
• Physical trauma.
• Exposure to harmful chemicals such as benzene and formaldehyde.
• Father's age, especially before 35 years.

Other factors that increase the risk of miscarriage include:

• Use of nonsteroidal anti-inflammatory drugs (ibuprofen or naproxen) during conception or early pregnancy.
• Use of alcohol or drugs, as well as smoking during pregnancy.
• Snake bite.
• Consuming large amounts of caffeine.
• Chorionic villus sampling or amniocentesis (puncture of the amniotic sac) to detect congenital defects or genetic diseases of the fetus. If this procedure is performed by highly qualified specialists, the risk of miscarriage is 1:400. In other cases, it increases slightly - 2-4:400 and is associated with unprofessional performance of the procedure.

It is normal to try to find the cause of a miscarriage. It is important to note that most miscarriages occur because the fertilized egg does not develop properly, and not because the woman has made a mistake. Miscarriages are not caused by stressful situations, physical exertion, or sex.

Symptoms of Miscarriage

• Vaginal bleeding: light or heavy, constant or intermittent. Bleeding is considered a sign of miscarriage, but it is also common during normal pregnancy, so the possibility of miscarriage increases when pain occurs at the same time.
• Pain. You may experience contractions of the uterus, abdominal pain, or constant, recurring lower back pain. The duration of pain varies from a few hours to a few days after the bleeding begins.
• Vaginal discharge in the form of blood clots or grayish fetal tissue. It is not always possible to say with certainty that a miscarriage is occurring. It is usually accompanied by a chain of symptoms that last for several days, and each woman experiences them differently.

If a miscarriage has already begun, you will not be able to help yourself in any way, since this process can neither be stopped nor prevented. A miscarriage is a spontaneous termination of pregnancy as a result of pathological development of the fetus at an early stage of cell division.

It is important to remember the symptoms of a miscarriage and immediately contact a doctor at the first signs. Until the doctor has examined and diagnosed you, avoid intimate relations and physical activity. Call an ambulance immediately if there is heavy bleeding and symptoms of shock.

Symptoms of shock:

• dizziness or a feeling that you are about to lose consciousness;
• anxiety, confusion, or fear;
• slow or rapid breathing;
• weakness;
• thirst, nausea or vomiting;
• strong heartbeat.

Contact your doctor immediately if you are pregnant and experience vaginal bleeding, or have cramping pain in your abdomen, pelvic organs, or lower back. Your doctor will ask you to collect any tissue discharge in a container for analysis.

Complications after miscarriage

The most common complications after a miscarriage are excessive bleeding and inflammation. Light to moderate vaginal bleeding (but not heavy) should subside within two weeks after a miscarriage. Call emergency services immediately if you have heavy vaginal bleeding after a miscarriage and are in shock.

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Recurrence of miscarriage

If you have had three or more miscarriages, your doctor will try to determine the cause.

• Blood testing for antibodies (antiphospholipid syndrome).
• Blood test for abnormalities of chromosomal cells.
• Determination of hormone levels to detect polycystic ovary syndrome.
• Conducting a hysteresoscopy or ultrasound of the abdominal cavity to identify developmental abnormalities of the uterus.

How to recognize a miscarriage?

• A vaginal examination reveals that the cervix is opening and blood clots and fetal tissue are coming out.
• Blood test: determination of the level of pregnancy hormone (human chorionic gonadotropin). The test is done several times to determine the progression of pregnancy.
• Ultrasound helps determine the integrity of the amniotic sac, the heart rate and the age of the fetus.
• If you have not had a Rh factor test done before, your doctor will also recommend doing it.

What to do in case of miscarriage?

If you notice symptoms of a miscarriage, see a doctor immediately. Failure to do so increases the risk of complications. The doctor must make sure that:

• You haven't lost too much blood and the inflammatory process hasn't started;
• there are no signs of an ectopic pregnancy, which is life-threatening and requires immediate surgical intervention;
• You do not have a negative Rh factor, which may negatively affect your next pregnancy.

Measures to be taken in case of miscarriage

Although it is impossible to stop or prevent a miscarriage, treatment is prescribed to prevent complications. Depending on the woman's condition, the doctor:

• monitors the progress of the miscarriage over the course of days or weeks;
• prescribes medications for complete cleansing of the uterus and prevention of the inflammatory process;
• will perform curettage or vacuum abortion (up to 12 weeks of pregnancy).

If the doctor confirms that the uterus has cleared, you can expect the bleeding to stop in a week or so. In the absence of symptoms of complications (high temperature and heavy bleeding), drug treatment is not prescribed. But if the above symptoms are observed (an increase in temperature to 38 or more, and the need to change the pad twice an hour), you should immediately see a doctor, since there is a risk of life-threatening blood loss and infection.

Miscarriage Treatment Overview

There are no medications that can stop a miscarriage. If there are no symptoms of complications such as large blood loss, weakness, high fever or other signs of inflammation, you can allow your body to cope with the miscarriage and cleanse itself, which usually takes a few days. If you have a negative Rh factor, you should get an Rh antibody shot to prevent future problems.

In case of severe bleeding and pain that persists for a long time, the doctor may recommend curettage of the uterine cavity in order to completely cleanse the uterus.

Threat of termination of pregnancy

If you have vaginal bleeding, but tests show that the pregnancy has not yet been terminated, your doctor will usually advise:

• rest: temporarily abstain from intimate relations and physical activity, and sometimes even bed rest (although there is no data indicating the effectiveness of bed rest in the case of threatened miscarriage);
• take progesterone: the hormone progesterone helps maintain pregnancy, although it has been proven that it only delays the time of miscarriage, but does not prevent it (it is effective at a later stage of pregnancy to prevent premature birth);
• Do not take nonsteroidal anti-inflammatory drugs (you can only take acetaminophen - Tylenol).

Incomplete miscarriage

Sometimes some fetal tissue remains in the uterine cavity. This is called an incomplete miscarriage. If the doctor confirms this diagnosis after examination, the following treatment is possible:

• observation: the doctor decides to wait and see if the woman's body can cope on its own, while closely monitoring the woman's health and, in the event of complications, taking certain measures;
• use of medications: mifepristone (and/or misoprostol) causes contraction of the uterus and its cleansing;
• Curettage of the uterine cavity or vacuum aspiration are aimed at completing the miscarriage and cleansing the uterus.

Additional treatment

In case of severe bleeding, you should have a blood test for hemoglobin, and in case of anemia, undergo a course of treatment. If you have a negative Rh factor, you should have a Rh antibody vaccination to prevent problems in the future. In very rare cases, a hysterectomy is required - when there is very severe bleeding or the inflammatory process cannot be removed with antibiotics.

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After a miscarriage

If you are planning to become pregnant again, consult your doctor. Most experts agree that you should wait until at least your first normal menstrual cycle. The chances of a healthy pregnancy are quite high even after one or two miscarriages. In case of several miscarriages (three or four in a row), you should undergo testing and diagnostics to determine the cause of the termination of pregnancy. But, as statistics show, 70% of married couples manage to give birth to a child without special treatment after several miscarriages.

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Rehabilitation after miscarriage

Naturally, regardless of the pregnancy period, a woman will mourn her newborn child. Guilt, anxiety, and sadness will haunt her for some time, and there will also be a burning desire to know the true reason for what happened. But in most cases, a miscarriage is a spontaneous termination of pregnancy that cannot be prevented. To cope with grief, experts recommend that a woman and her family members find support groups and talk to other people who have already experienced this ordeal.

There is a lot of literature available today on how to survive a miscarriage. Look for it in bookstores, the library, or the Internet. The severity and duration of grief depends on the woman herself and varies from case to case, but most women who have experienced a miscarriage still find the strength to return to work within a fairly short time. The feeling of loss and hormonal changes often provoke the development of depression. Therefore, you need to be on guard and consult a psychologist if the symptoms of depression do not go away within 2 weeks.

Most women can still have a healthy pregnancy and give birth to a baby after one or more miscarriages. But if you are planning to get pregnant again, consult your doctor first, as experts recommend waiting until at least your first menstrual period after a miscarriage.

What should you think about?

Scientists suspect that some miscarriages occur because a woman's immune system fails. But experimental immunotherapy has not yet produced the desired results.

Contact your doctor immediately if, after a miscarriage, you experience:

• severe bleeding, but no symptoms of shock. If you cannot contact a doctor, ask your loved ones to take you to the nearest hospital.
• the inflammatory process has begun: high temperature (38 and above), moderate or severe pain in the abdominal cavity, and vaginal discharge has a specific odor.