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Pregnancy Miscarriage: Causes And Prevention

Posted On: February 13, 2020

Pregnancy Miscarriage: Causes And Prevention

Pregnancy miscarriage, also known as spontaneous abortion, according to some psychologists, seems to be more common today, but one might have said that it is just an impression. When the challenge of being a mother is accepted with an open heart, the fatality of spontaneous abortion, no doubt, is followed by feelings of loss and helplessness not always understood by the woman herself and even by those around her. Although it is considered common in medicine since one in four pregnancies does not go ahead. Thus, there is always a silence with taboo nuances around the involuntary termination of pregnancy. Doctors often dismiss the situation and rarely treat it with due sensitivity. Even family and friends don’t mention it, but suffering is generally experienced in solitude.

The World Health Organization (WHO) classifies miscarriage as the loss of the fetus due to natural causes before the 22nd week of pregnancy. Studies suggest that 20% to 30% of pregnant women experience some bleeding or colic at least once during this period of pregnancy. Approximately 50% of these episodes end in termination of pregnancy due to factors related to chromosomal abnormalities. These have been considered responsible for malformations that the body itself is in charge of eliminating.

Miscarriages according to researches mostly occur at the early period of the pregnancy. At least 15% of women experience a miscarriage during the first weeks of their pregnancy. Of these involuntary losses that occurred between the 13th and the 22nd week (late abortion), approximately two-thirds result from problems with the pregnant woman and one third has an unknown cause.

What Is Miscarriage

Miscarriage according to the American College of Obstetricians and Gynecologists (ACOG) is the most common type of pregnancy loss. This is a gestational loss that occurs before pregnancy is viable. These types of abortions are quite frequent, and it is estimated that approximately half of the gestations end in spontaneous abortion (miscarriage), although only about 15 percent of the gestations are detected. This can appear in any week, but it is more frequent during the shorter period of gestation time, so as it increases, the chances of having a miscarriage decrease.

Statistics show that about 1 in 100 women in the UK experience recurrent pregnancy miscarriages (3 or more in a row). Only in 1996, it was estimated that about 6,240,000 pregnancies resulted in a live birth in the United States, induced abortion, or fetal loss otherwise known as miscarriages or stillbirths. While in France, the number of miscarriages is estimated at around 20,000 each year, or 10 to 15% of pregnancies. Late miscarriages, occurring between 14 and 22 weeks of amenorrhea, are rare (less than 1% of pregnancies). As for early miscarriages, occurring before the 14th week of amenorrhea, they affected 10% of pregnancies. It is noteworthy that the best way to ensure a long-term pregnancy is a regular follow-up, integrating all the offers of pregnancy follow-up care.

Causes and Risk Factors

There can be several reasons for pregnancy miscarriage. Often, several factors come together to result in this ugly situation.

Risk Factors of the Mother

A distinction is made between risk factors that affect the female genital organ and those that come from the rest of the mother’s body. Thus, there are several diseases of the mother that can lead to miscarriage, such as:

  • Diabetes poorly controlled.
  • Hormonal disorders.
  • Diseases of the gland thyroiditis.
  • Celiac Disease.
  • Autoimmune diseases such as lupus.
  • A blood clotting disorder.
  • Abnormalities of the female genital tract, including the cervix, uterine fibroids, and micro polycystic ovaries.

Immune System Risk Factor

There are disorders in the mother’s immune system that encourage pregnancy miscarriage. In the most important, the body’s defense attacks the fertilized egg. The implantation usually does not even take place. If it does, it is faulty and ends in an early abortion.

Risk Factors Smoking, Alcohol, And Drugs

Studies have shown that when mothers smoke, drink alcohol or use drugs during pregnancy, it leads, among other things, to serious developmental disorders or malformations of the embryo or fetus. Excessive alcohol consumption is the most common cause of early abortion.

Stress as A Risk Factor

Mental stress increases the risk of pregnancy miscarriage. An imbalance in the immune system and hormonal balance have the tendencies to disturb the pregnancy. On the one hand, lower hormone levels, especially progesterone are observed, which maintain pregnancy. Also, immune cells that can cause miscarriage have increased. Other psychological components also play a role.

Medication as A Risk Factor

Certain medications, including herbal ones, can put the mother at risk of miscarriage. Radiation, such as in computer tomography, can damage the genetic makeup of the fetus right down to the abortion. Other medication and vaccinations also increase the likelihood of miscarriage. Surgery should also be avoided during pregnancy as the procedure and anesthesia may increase the risk of miscarriage.

Late Pregnancy

A late pregnancy, especially after 40 years and especially if it is the first pregnancy, is recognized as an important risk factor for early miscarriage.

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Types and Signs/Symptoms of Miscarriage

The signs of pregnancy miscarriage depend on how and at what time the pregnancy is aborted. The most common signs are sudden, heavy vaginal bleeding. Contractions or labor-like pain are also signs of miscarriage. Bellow, are signs and symptoms that will guide you on how you can recognize an impending or already occurring miscarriage:

Impending Abortion

In the event of impending abortion, the first symptoms of miscarriage are vaginal bleeding. Contractions can also occur sometimes, while the cervix is ​​closed. The bleeding is usually caused by a bruise (hematoma) in the mother’s placenta. To avoid miscarriage, the pregnant woman should rest strictly in bed.

Beginning Abortion

A starting abortion is medically called “Abortus incipient”. In contrast to the impending abortion, the cervix is ​​already open here. Signs of a pregnancy miscarriage include bleeding and painful contractions. Abortions can usually no longer be prevented at this stage. It mostly merges into miscarriage.

Incomplete or Complete Abortion

The incomplete abortion (Abortus incompletes) is considered the preliminary stage of the complete abortion (Abortus completus). Symptoms similar to those at the beginning of abortion occur. In the former, only part of the fruit is expelled, whereas in the case of a complete miscarriage, however, both the fetus and the egg membranes and placenta are expelled.

Missed Abortion

Here, there are no typical external miscarriage symptoms like bleeding or pain. When the cervix is ​​closed, nothing is expelled. Doctors identify this miscarriage using an ultrasound. An embryo is found in which signs of life such as heart sounds are missing. Also, the uterus stops growing.

Feverish Abortion

This so-called abortus febrilis usually shows a fever between 38 and 39 degrees Celsius and purulent discharge from the vagina. If left untreated, this type of miscarriage can be life-threatening. One then speaks of septic abortion with severe blood coagulation disorders to multi-organ failure.

Wind Egg

The wind egg is an improperly developed fertilized egg. Ultrasound shows an empty amniotic sac without an embryo, usually less than three centimeters. A wind egg dies in the first few weeks. Its occurrences account for 50 to 90 percent of miscarriages in the second month of pregnancy. As with restrained abortion, there are hardly any signs of miscarriage. As a rule, spotting is the only symptom.

Habitual Abortion

Habitual abortion is when a woman has had three or more miscarriages. Habitual abortion makes up 0.5 to one percent of all pregnancy miscarriages. The most common causes include changes in a parent’s genetic makeup or an aggressive immune system in women. In this case of three or more consecutive abortions, the specialist points out that it is appropriate to carry out a complete study of the woman and her repeat abortion partner.

Treatment of a Miscarriage

The treatment of a woman after a miscarriage essentially depends on the form/type and signs of the miscarriage. The therapy depends on how far the abortion has progressed or whether the pregnancy can still be preserved. Most of the time, conservative and bed rest is recommended because it seems to reduce bleeding and pain.

Bed Rest

If a miscarriage is imminent, there are no special treatment options. Experts often request the patient should rest in bed and sometimes that the vagina should not be examined. Also, the unborn child who is still alive must be monitored. This is done using ultrasound, among other things. In the event of an impending late abortion, in which labor has already started, contraceptive drugs may be required or administered.

Luteum insufficiency poses a risk of premature miscarriage. This can be reduced in the first few weeks by taking hormone preparations called progestogens. Improvement is expected when the bleeding stops.

Miscarriage-Curettage

With the remaining miscarriages, scraping (curettage) is usually necessary. In the event of incomplete abortion, the parts of pregnancy (placenta, etc.) that remain in the uterus are removed. Otherwise, there would be the risk of persistent bleeding or serious infections up to life-threatening blood poisoning (sepsis). A miscarriage without scraping is possible after a complete abortion from the 24th week of pregnancy. It is only necessary if there are doubts that all parts of the pregnancy have actually disappeared. Even if the bleeding does not abate after the abortion or the uterus does not regress afterward, an intervention is necessary. This is to avoid complications after a miscarriage.

Medicines Instead of Scraping

With the so-called wind egg, which is an improperly developed fertilized egg, and with slow early abortion until the twelfth week of pregnancy, scraping is necessary. At a later point in time, medication is administered first. These are designed to loosen and widen the cervix and stimulate the uterine muscles. This is how the dead fetus can be expelled. The same drugs are also given before surgical clearance. This is intended to protect the mother’s organs from injuries caused by surgical instruments.

Conclusion

A miscarriage is a gestational loss that occurs before pregnancy is viable. It is a common accident that affects 15% to 20% of pregnancies. It mostly occurs within the early period of the pregnancy, but sometimes very late, occurring between 14 and 22 weeks of amenorrhea. Its most common signs are bleeding and pain, while the treatment depends on the form/type and signs of the miscarriage.

 

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