Miscarriage – causes symptoms, stages, risk factor, treatment

A miscarriage is very distressing for a would-be-mother. It denotes end of expectations and even long nurtured dreams. But life does not end with a miscarriage. On the other hand, knowing the causes and symptoms of it can prepare a woman to be cautious and take better care of herself and her future baby.

What is a miscarriage?

A miscarriage or a spontaneous abortion is any pregnancy that abruptly ends by itself within 20 weeks of pregnancy.
Miscarriage is quite common in a pregnancy with over 15-20% of them ending within 13^th week of pregnancy. The actual figure is thought to be as high as 50% of all pregnancies, as they occur without the women actually knowing that they were pregnant.

Miscarriage leaves a woman traumatized

Causes of miscarriage

Miscarriage occurs due to varied reasons and most often the cause cannot be identified.

Most miscarriages that occur in the first trimester are due to chromosomal abnormality. Other possible causes of miscarriage are immune responses, infection, medical conditions of the mother like diabetes and thyroid problems and hormonal factors.

Sometimes miscarriage occurs due to incompetent cervix, a condition in which the cervix cannot hold the baby. This type of miscarriage occurs after 14-16^th week of pregnancy.

Myths about miscarriage

People often believe that sex, working outside and exercise cause miscarriage. But these are fallacies unless there are certain underlying complications.

Symptoms of miscarriage

The most common symptoms of miscarriage are cramping and vaginal bleeding. These may be very mild, moderate or severe also.

Stages of miscarriage

There are several types and stages of miscarriage.

• Blighted Ovum or early miscarriage occurs when an egg is fertilized and embeds in the uterus but no embryo is formed. Often a woman may not know that she is pregnant.
• Threatened miscarriage is vaginal bleeding during pregnancy. The cervix is closed and there are cramps and pains.
• Inevitable or incomplete miscarriage is when the miscarriage has already begun but is not complete yet. The cervix is open and the placenta breaks free from the uterine wall. The body has not completely expelled all the pregnancy tissues. There is much vaginal bleeding and abdominal cramping as tissues pass in clots in blood. There is no way to stop the miscarriage. The woman should be given medical care to ensure that all pregnancy tissues are expelled.
• Complete and spontaneous miscarriage is the one in which the bleeding has completely stopped and an ultrasound confirms that all the pregnancy tissues have been forced out. Once the uterus is emptied the cervix closes down. Those miscarriages that occur within 10^th week of pregnancy generally complete by themselves.
• Missed miscarriage occurs early in pregnancy when the fetus is no longer alive but the pregnancy continues. There are no reliable symptoms for this type of miscarriage and requires a D&C to empty the womb.
• Molar pregnancy is a rare condition wherein due to genetic abnormality abnormal tissue growth happens in the uterus.
• Ectopic pregnancy occurs when the fertilized egg embeds itself in some other area mostly the fallopian tube. This is fatal and requires medical intervention to stop the pregnancy.
• Recurrent miscarriage is defined as three or more miscarriages in the first trimester.

Risk factors of miscarriage

Among all the risk factors of miscarriage late maternal age is the most significant one. For women in the childbearing age the risk of miscarriage is about 15-20%. The chance of miscarriage increases by 20% for women in the age group 35-39. For women above 45 of years of age this risk shots up to 50%.

Other than age, certain conditions of the mother like diabetes and thyroid problems can also lead to miscarriage.

Treatment of miscarriage

Treatment of miscarriage mainly concerns with controlling hemorrhage and infection. In early miscarriages normally the body pushes out all the pregnant tissues and there is no need for D&C (dilation and curettage). Otherwise drugs are prescribed to control bleeding and also D&C is performed to prevent infection.

How to prevent miscarriage

• As the cause of majority of miscarriages are chromosomal abnormalities so there is not much that you can do.
• As a precaution you can improve your health before conceiving to provide a healthy atmosphere for the baby to grow.
• Exercise regularly.
• Have a healthy diet.
• Take folic acids.
• Take calcium.
• Reduce stress.
• Avoid smoking and drinking

Once you conceive try to inculcate healthy habits by

1. Having a balanced and nutritious diet.
2. Exercise regularly.
3. Giving up smoking and alcohol.
4. Shun caffeine.
5. Avoid contact sports or any activity that may cause injury.
6. Keep away from environmental hazards like radiation, x-rays and infectious diseases

Other than these if you had previous miscarriages then the underlying causes can be evaluated and necessary treatment can be done. If miscarriage has occurred due to thyroid or diabetes then these two should be tackled before conceiving.

Miscarriage leaves a woman traumatized. Lot of questions regarding her physical recovery, emotional recovery and conceiving in the future torments her. She needs emotional support from her spouse, doctor and family to handle these.