Miscarriage Signs, Symptoms & Causes

  • What is Miscarriage ?
  • Signs and symptoms of a miscarriage
  • Types of miscarriage
  • How is miscarriage diagnosed ?
  • Treatment of Miscarriage
  • Pregnancy after miscarriage ?
  • Can miscarriage be prevented ?

Miscarriage

The loss of an embryo or fetus before the 20th week of pregnancy is called miscarriage. The medical term for miscarriage is spontaneous abortion.  Most miscarriages happen during the first 12 weeks of pregnancy. It’s rare for a miscarriage to occur during the 13th to 19th week.
Though every woman he’s treated for a miscarriage blames herself for the loss and feels like she did something wrong to cause it.




But it’s hardly a woman’s fault: The majority of miscarriages are due to an abnormal number of chromosomes in the embryo.
Men and women thought lifting a heavy object is the main cause in pregnancy loss. Lifting something heavy does not cause miscarriages.
Common causes for a woman having a miscarriage include cigarette smoking, older maternal age, radiation exposure, previous miscarriage, maternal weight, and illicit drug use, trauma or anatomical abnormalities to the uterus.

Signs and symptoms of a miscarriage

Vaginal bleeding and passing blood clots are the most common symptoms of miscarriage. A woman may also have cramping that feels worse than menstrual cramps, or mild to severe lower back pain.
Sudden decrease in pregnancy signs, such as nausea is also possible indication of miscarriage.
The warning signs of a miscarriage:

  • Bleeding which progresses from light to heavy
  • White-pink mucus
  • Severe cramps
  • Abdominal pain
  • Fever
  • Weakness
  • mild/severe back pain
  • expulsion of tissue with clots from the vagina
  • heavy spotting

If you experience any or all of these symptoms contact your health care as early as possible.

What Causes Miscarriage?

Most miscarriages happen by genetic problems within the embryo that would prevent a baby from developing normally and surviving after birth. These fatal genetic errors are not usually related to genetic problems in the mother.
A miscarriage sometimes happens because there is a weakness of the cervix, called an incompetent cervix, which cannot hold the pregnancy. A miscarriage from an incompetent cervix usually occurs in the second trimester.
Mothers who have diabetes or thyroid disease are at increased risk of miscarriage. Certain illnesses or medical conditions can cause miscarriage or may increase the risk of miscarriage.
Causes of miscarriage

  • Infection
  • Hormone problems
  • Cigarette smoking (>10 cigarettes/day)
  • Moderate to high alcohol consumption
  • Trauma to the uterus
  • Radiation exposure
  • Previous miscarriage
  • Maternal weight extremes (BMI either below 18.5 or above 25 kg/m2)
  • Anatomical abnormalities of the uterus
  • Illicit drug use
  • Use of non steroidal anti-inflammatory drugs  (NSAIDs) around the time of conception may increase the risk of miscarriage

Abortion

Types of miscarriage

There are many different stages or types of miscarriage depending on the cause and stage of your pregnancy. Names of miscarriage such as:

  • Missed Miscarriage: the fetus has not developed, so there is no viable pregnancy, but there is placental tissue and/or fetal tissue contained within the uterus
  • Blighted Ovum: A fertilized egg implants into the uterine wall, but fetal development never begins. Often there is a gestational sac with or without a yolk sac, but there is an absence of fetal growth.
  • Incomplete Miscarriage: Abdominal or back pain accompanied by bleeding with an open cervix. Miscarriage is inevitable when there is a dilation or effacement of the cervix and/or there is rupture of the membranes. Bleeding and cramps may persist if the miscarriage is not complete.
  • Complete Miscarriage: A completed miscarriage is when the embryo or products of conception have emptied out of the uterus. Bleeding should subside quickly, as should any pain or cramping. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage (D&C) performed.
  • Threatened abortion: a woman may experience vaginal bleeding or others signs of miscarriage, but loss of the pregnancy has not yet occurred
  • Septic abortion: a miscarriage in which there is infection in the presence of retained fetal and/or placental tissue.
  • Ectopic Pregnancy: A fertilized egg implants itself in places other than the uterus, most commonly the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If not treated rapidly, this could end in serious maternal complications.
  • Recurrent Miscarriage: Defined as 3 or more consecutive first trimester miscarriages. Recurrent miscarriages typically have no problem getting pregnant, and they often seem to be having a healthy, normal pregnancy. The reason for repeat miscarriages, a woman suffering from the condition needs to undergo testing and see a specialist, who will try to determine a possible cause?

How is miscarriage diagnosed?

If a woman has symptoms of a miscarriage an ultrasound examination is required. The ultrasound can determine if the pregnancy is intact and if a fetal heartbeat is present. Ultrasound examination can also reveal whether the pregnancy is an ectopic pregnancy (located outside of the uterus, typically in the Fallopian tube), which may have similar symptoms and signs as miscarriage.  On the other hand blood tests for pregnancy hormones, blood counts to determine the degree of blood loss or to see whether infection is present, and a pelvic examination. During miscarriage the mother’s blood type should also be checked, so that Rh-negative women can receive an injection of rho-D immune globulin to prevent problems in future pregnancies.

How are miscarriages treated? 

There are three ways to treat miscarriages, and each choice has its own risks and benefits:

  1. Woman need to wait until the pregnancy loss passes naturally on its own. The advantage of this method is that less medical intervention is needed. But one disadvantage is that it can take up to two weeks for the pregnancy loss to occur. Also, bleeding can be very heavy, and important genetic information from the fetal tissue can’t be tested to possibly understand why the miscarriage happened.
  2. A second treatment is the use of a medication that causes the pregnancy to pass within 6 to 12 hours. The benefit of this treatment is that the timing of the pregnancy loss is known because the cramping can be severe. One disadvantage is that it is hard to recover the fetal tissue to test it afterward.
  3. A third treatment option is a surgical approach known as a D&C. In this procedure, a doctor will remove any remaining fetal tissue from the lining of a woman’s uterus, and the tissue can be tested. However, there will be bleeding with this approach, and it carries a slight risk of infection or scarring to the uterus.

Bleeding should be monitored closely once you are at home; if you notice an increase in bleeding or the onset of chills or fever, it is best to call your physician immediately.

Pregnancy after miscarriage

Having a miscarriage does not necessarily mean you have a fertility problem. At least 85% of women who have miscarriages have subsequent normal pregnancies and births. Some health care providers recommend waiting a certain amount of time (from one menstrual cycle to 3 months) before trying to conceive again.

Medical thinking on this question has changed over time. It used to be that women were told to wait a year before becoming pregnant again following a miscarriage; then it became six months, and now its three months.

It is depend on when the miscarriage took place during the pregnancy. If the pregnancy loss happened in the early weeks of pregnancy, a couple can wait one menstrual cycle. Most women get their period again four to six weeks after a miscarriage. But if it occurred after 20 weeks it is suggested waiting at least three months.

Most women will have their menstrual period within 4 to 6 weeks after a miscarriage. While it is possible to conceive again after your menstrual period has returned, some doctors advise waiting a bit longer, such as another menstrual cycle or more, to provide enough time for physical and emotional recovery.

It’s important for her human chorionic gonadotropin (hCG) levels to return to zero. That’s because if a woman who has miscarried has fluctuating levels of hCG in her blood and tries to conceive too soon, it’s hard to know if her levels of the so-called pregnancy hormone are elevated as a result of fetal tissue from the old pregnancy or because of a new one.

On the other hand, about 1%-2% of women may have repeated miscarriages (three or more). Some researchers believe this is related to an autoimmune response. Ask your health care provider to perform diagnostic tests to determine the cause of the miscarriages. To prevent another miscarriage, your health care provider may recommend treatment with progesterone, a hormone needed for implantation and early support of a pregnancy in the uterus.

Can miscarriage be prevented?

You need have a conception plan after miscarriage and before you attempt another pregnancy. Women who have vaginal bleeding during pregnancy are often advised to rest and limit sexual activity until there are no more potential signs of miscarriage. It is possible that some risk factors for miscarriage can be minimized by maintaining a healthy weight and avoiding the use of alcohol, illicit drugs, or tobacco. Screening for, and treatment of, any sexually-transmitted diseases (STDs) can also reduce the risk of a miscarriage. Prenatal vitamins can help support even the healthiest of diets to ensure that you and your baby get all of the nutrients needed.

Your doctor will likely recommend tests to detect any problems that may have caused your previous miscarriage. These may include:

  • blood tests to detect hormone imbalances
  • chromosome tests (done through blood and/or tissue samples)
  • pelvic and uterine exams
  • ultrasounds

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