How can you miscarriage
Causes, Symptoms, Risks, Treatment & Prevention
Overview
What is a miscarriage?
A miscarriage (also called a spontaneous abortion) is the unexpected ending of a pregnancy in the first 20 weeks of gestation. Just because it’s called a “miscarriage” doesn’t mean you did something wrong in carrying the pregnancy. Most miscarriages are beyond your control and occur because the fetus stops growing.
Types of miscarriage
Your pregnancy care provider may diagnose you with the following types of miscarriage:
- Missed miscarriage: You’ve lost the pregnancy but are unaware it’s happened. There are no symptoms of miscarriage, but an ultrasound confirms the fetus has no heartbeat.
- Complete miscarriage: You’ve lost the pregnancy and your uterus is empty. You’ve experienced bleeding and passed fetal tissue. Your provider can confirm a complete miscarriage with an ultrasound.
- Recurrent miscarriage: Three consecutive miscarriages.
It affects about 1% of couples.
- Threatened miscarriage: Your cervix stays closed, but you’re bleeding and experiencing pelvic cramping. The pregnancy typically continues with no further issues. Your pregnancy care provider may monitor you more closely for the rest of your pregnancy.
- Inevitable miscarriage: You’re bleeding, cramping and your cervix has started to open (dilate). You may leak amniotic fluid. A complete miscarriage is likely.
How do I know if I’m having a miscarriage?
You may not be aware you’re having a miscarriage. In people who have symptoms of a miscarriage, the most common signs are:
- Bleeding that progresses from light to heavy. You may also pass grayish tissue or blood clots.
- Cramps and abdominal pain (usually worse than menstrual cramps).
- Low back ache that may range from mild to severe.
- A decrease in pregnancy symptoms.
Contact your pregnancy care provider right away if you’re experiencing any of these symptoms.
They will tell you to come into the office or go to the emergency room.
Symptoms and Causes
What causes miscarriage?
Chromosomal abnormalities cause about 50% of all miscarriages in the first trimester (up to 13 weeks) of pregnancy. Chromosomes are tiny structures inside the cells of your body that carry your genes. Genes determine all of a person’s physical attributes, such as assigned sex, hair and eye color and blood type.
During fertilization, when the egg and sperm join, two sets of chromosomes come together. If an egg or sperm has more or fewer chromosomes than normal, the fetus will have an abnormal number. As a fertilized egg grows into a fetus, its cells divide and multiply several times. Abnormalities during this process also leads to miscarriage.
Most chromosomal problems occur by chance. It’s not completely known why this happens.
Several factors may cause miscarriage:
- Infection.
- Exposure to TORCH diseases.
- Hormonal imbalances.
- Improper implantation of fertilized egg in your uterine lining.
- How old you are.
- Uterine abnormalities.
- Incompetent cervix (your cervix begins to open too early in pregnancy).
- Lifestyle factors such as smoking, drinking alcohol or using recreational drugs.
- Disorders of the immune system like lupus.
- Severe kidney disease.
- Congenital heart disease.
- Diabetes that isn't managed.
- Thyroid disease.
- Radiation.
- Certain medicines, such as the acne drug isotretinoin (Accutane®).
- Severe malnutrition.
There is no scientific proof that stress, exercise, sexual activity or prolonged use of birth control pills cause miscarriage. Whatever your situation is, it’s important to not blame yourself for having a miscarriage. Most miscarriages have nothing to do with something you did or didn’t do.
How painful is a miscarriage?
Miscarriages are different for every person.
Some people have painful cramping, while other people have cramps similar to their menstrual period. The type of miscarriage you have may also affect your pain level. For example, if you have a complete miscarriage at home, you may have more pain than a person who has a missed miscarriage and has a surgical procedure to remove the pregnancy.
What happens first during a miscarriage?
It’s hard to say what happens first during a miscarriage because everyone’s symptoms are different. Sometimes there are no signs of miscarriage, and you find out at a prenatal ultrasound that you’ve lost the pregnancy. Most people will experience some degree of cramping and bleeding, but what happens first varies.
How long does a miscarriage take?
It depends. Some people have painful cramping and heavy bleeding longer than others. Your pregnancy care provider can tell you what to expect and give you advice on how to manage pain and cramps during your miscarriage.
What are the risk factors for a miscarriage?
A risk factor is a trait or behavior that increases a person’s chance of developing a disease or condition.
Risk factors for miscarriage include:
- Your age: Studies show that the risk of miscarriage is 12% to 15% for people in their 20s and rises to about 25% for people by age 40. Most age-related miscarriages happen because of a chromosomal abnormality (the fetus has missing or extra chromosomes).
- Previous miscarriage: You have a 25% chance of having another miscarriage (only slightly higher than someone who hasn’t had a miscarriage) if you’ve already had one.
- Health conditions: Certain health conditions like unmanaged diabetes, infections or issues with your uterus or cervix increase your chance of miscarriage.
Talk to your pregnancy care provider about the risk factors for miscarriage. They can discuss your risk after they’ve reviewed your medical history.
How many people have miscarriages?
Between 10% and 20% of all known pregnancies end in miscarriage. Most miscarriages (80%) happen within the first three months of pregnancy (up to 13 weeks of pregnancy).
Less than 5% of miscarriages occur after 20 weeks’ gestation.The rate of miscarriage may be higher if you consider miscarriages that happen shortly after implantation. A person may not realize they’re pregnant because bleeding happens around the time of their menstrual period. This is called a chemical pregnancy.
What is my risk of miscarriage by week?
Your risk of pregnancy loss declines each week you’re pregnant. Around 15% of pregnancies end in miscarriage. Miscarriage risk in the second trimester (13 to 19 weeks) is between 1% and 5%. Many factors affect your risk of miscarriage such as your age and health. However, everyone’s risk of miscarriage declines each week of pregnancy if the pregnant person has no other health conditions.
Diagnosis and Tests
How is a miscarriage diagnosed?
Your pregnancy care provider will perform an ultrasound test to confirm a miscarriage. These tests check for fetal heartbeat or the presence of a yolk sac (one of the first fetal structures your provider can see on ultrasound).
You may also have a blood test to measure human chorionic gonadotropin (hCG), a hormone produced by the placenta. A low hCG level can confirm a miscarriage.
Finally, your provider may perform a pelvic exam to check if your cervix has opened.
Management and Treatment
What are the treatments for a miscarriage?
If you experience the loss of a pregnancy, the fetus must be removed from your uterus. If any parts of the pregnancy are left inside your body, you could experience infection, bleeding or other complications.
If the miscarriage is complete and your uterus expels all the fetal tissue, then no further treatment is usually needed. Your pregnancy care provider will conduct an ultrasound to make sure there’s nothing left in your uterus.
If your body doesn’t remove all the tissue on its own or you haven’t started to bleed, your pregnancy care provider will recommend removing the tissue with medication or surgery.
Nonsurgical treatment
Your pregnancy care provider may recommend waiting to see if you pass the pregnancy on your own.
This may be the case if you have a missed miscarriage. Waiting for a miscarriage to start could take several days. If waiting to pass the tissue isn’t safe or you wish to remove the tissue as soon as possible, they may recommend taking a medication that helps your uterus pass the pregnancy. These options are typically only available if you’ve miscarried before 10 weeks of pregnancy.
If a miscarriage wasn’t confirmed, but you had symptoms of a miscarriage, your provider may prescribe bed rest for several days. You might be admitted to the hospital overnight for observation. When the bleeding stops, you may be able to continue with your normal activities. If your cervix is dilated, they may diagnose you with an incompetent cervix, and they may perform a procedure to close your cervix (cervical cerclage).
Surgical treatment
Your provider may perform a dilation and curettage (D&C) or dilation and evacuation (D&E) if your uterus hasn’t passed the pregnancy or if you’re bleeding heavily.
Surgery may also be the only option if your pregnancy is beyond 10 weeks’ gestation. During these procedures, your cervix is dilated, and any remaining pregnancy-related tissue is gently scraped or suctioned out of your uterus. Your provider performs these surgeries in a hospital, and you’ll be under anesthesia.
What are some of the symptoms after a miscarriage?
Spotting and mild discomfort are common symptoms after a miscarriage.
Contact your healthcare provider immediately if you have any of these symptoms as it could be signs of an infection:
- Heavy bleeding or worsening bleeding.
- Fever.
- Chills.
- Intense pain.
Don’t put anything inside your vagina for at least two weeks after a miscarriage. This includes tampons, sexual intercourse and fingers or sex toys. Your provider will schedule a follow-up appointment with you to discuss your recovery and any complications.
What tests should I have after repeat miscarriages?
Blood tests or genetic tests might be necessary if you’ve more than three miscarriages in a row (called repeated miscarriage).
These include:
- Genetic tests: You and your partner can have blood tests, like karyotyping, to check for chromosome abnormalities. If tissue from the miscarriage is available, your provider may be able to test it for chromosome irregularities.
- Blood tests: You may have a blood test to check for autoimmune or hormone conditions that could be causing miscarriages.
Your provider may also look at your uterus using one of the following procedures:
- Hysterosalpingogram (an X-ray dye test of your uterus and fallopian tubes).
- Hysteroscopy (a test during which your provider views the inside of your uterus with a thin, telescope-like device).
- Laparoscopy (a procedure during which your provider views the pelvic organs with a lighted device).
Prevention
How can I prevent another miscarriage?
It’s usually not possible to prevent a miscarriage. If you have a miscarriage, it’s not because you did something to cause it.
Taking care of your body is the best thing you can do. Some examples of ways to care for yourself include:
- Attending all your prenatal care appointments.
- Maintaining a weight that's healthy for you.
- Avoiding risk factors for miscarriage like drinking alcohol and smoking cigarettes.
- Taking a prenatal vitamin.
- Getting regular exercise and eating a healthy diet.
Outlook / Prognosis
Can I get pregnant after I’ve had a miscarriage?
Yes. Most people (87%) who have miscarriages have subsequent normal pregnancies and births. Having a miscarriage doesn’t necessarily mean you have a fertility problem. Remember, most miscarriages occur because of a chromosomal abnormality, not because of something you did.
How soon can I get pregnant after a miscarriage?
The decision on when you should begin trying to get pregnant again is between you and your pregnancy care provider. Most people can get pregnant again after they’ve had one “normal” menstrual period.
Taking time to heal both physically and emotionally after a miscarriage is important. Counseling is available to help you cope with your loss. A pregnancy loss support group might also be a valuable resource to you and your partner. Ask your healthcare provider for more information about counseling and support groups. Above all, don’t blame yourself for the miscarriage. Take the time you need to grieve.
If you’ve had three miscarriages in a row, ask your provider about performing tests to figure out an underlying cause. You should use birth control until you receive the results. After your provider reviews the test results, they may suggest going off birth control and trying to conceive again.
Living With
How can I cope with my miscarriage?
Losing a pregnancy can be devastating and leave you with a range of emotions and lots of questions. Healing emotionally from a miscarriage is often harder and longer than the physical healing. Take the time you need to grieve your loss.
Talk to your partner, friends and family about your feelings or find a pregnancy loss support group online. Surround yourself with supportive people or seek professional counseling to help you cope with the loss.
A note from Cleveland Clinic
A miscarriage is a very emotional moment for expectant parents and it’s natural to grieve the loss. Remember that a miscarriage can’t be prevented, and it’s not caused by something you did wrong. It doesn’t mean that you can’t have children or that you’ll have another miscarriage. If you’re planning to become pregnant, reach out to your healthcare provider to discuss the timing of your next pregnancy and ask any questions you have. It’s OK to be sad. Find support from family, friends online support groups or a licensed counselor.
Causes, Symptoms, Risks, Treatment & Prevention
Overview
What is a miscarriage?
A miscarriage (also called a spontaneous abortion) is the unexpected ending of a pregnancy in the first 20 weeks of gestation.
Just because it’s called a “miscarriage” doesn’t mean you did something wrong in carrying the pregnancy. Most miscarriages are beyond your control and occur because the fetus stops growing.
Types of miscarriage
Your pregnancy care provider may diagnose you with the following types of miscarriage:
- Missed miscarriage: You’ve lost the pregnancy but are unaware it’s happened. There are no symptoms of miscarriage, but an ultrasound confirms the fetus has no heartbeat.
- Complete miscarriage: You’ve lost the pregnancy and your uterus is empty. You’ve experienced bleeding and passed fetal tissue. Your provider can confirm a complete miscarriage with an ultrasound.
- Recurrent miscarriage: Three consecutive miscarriages. It affects about 1% of couples.
- Threatened miscarriage: Your cervix stays closed, but you’re bleeding and experiencing pelvic cramping. The pregnancy typically continues with no further issues.
Your pregnancy care provider may monitor you more closely for the rest of your pregnancy. - Inevitable miscarriage: You’re bleeding, cramping and your cervix has started to open (dilate). You may leak amniotic fluid. A complete miscarriage is likely.
How do I know if I’m having a miscarriage?
You may not be aware you’re having a miscarriage. In people who have symptoms of a miscarriage, the most common signs are:
- Bleeding that progresses from light to heavy. You may also pass grayish tissue or blood clots.
- Cramps and abdominal pain (usually worse than menstrual cramps).
- Low back ache that may range from mild to severe.
- A decrease in pregnancy symptoms.
Contact your pregnancy care provider right away if you’re experiencing any of these symptoms. They will tell you to come into the office or go to the emergency room.
Symptoms and Causes
What causes miscarriage?
Chromosomal abnormalities cause about 50% of all miscarriages in the first trimester (up to 13 weeks) of pregnancy.
Chromosomes are tiny structures inside the cells of your body that carry your genes. Genes determine all of a person’s physical attributes, such as assigned sex, hair and eye color and blood type.
During fertilization, when the egg and sperm join, two sets of chromosomes come together. If an egg or sperm has more or fewer chromosomes than normal, the fetus will have an abnormal number. As a fertilized egg grows into a fetus, its cells divide and multiply several times. Abnormalities during this process also leads to miscarriage.
Most chromosomal problems occur by chance. It’s not completely known why this happens.
Several factors may cause miscarriage:
- Infection.
- Exposure to TORCH diseases.
- Hormonal imbalances.
- Improper implantation of fertilized egg in your uterine lining.
- How old you are.
- Uterine abnormalities.
- Incompetent cervix (your cervix begins to open too early in pregnancy).
- Lifestyle factors such as smoking, drinking alcohol or using recreational drugs.
- Disorders of the immune system like lupus.
- Severe kidney disease.
- Congenital heart disease.
- Diabetes that isn't managed.
- Thyroid disease.
- Radiation.
- Certain medicines, such as the acne drug isotretinoin (Accutane®).
- Severe malnutrition.
There is no scientific proof that stress, exercise, sexual activity or prolonged use of birth control pills cause miscarriage. Whatever your situation is, it’s important to not blame yourself for having a miscarriage. Most miscarriages have nothing to do with something you did or didn’t do.
How painful is a miscarriage?
Miscarriages are different for every person. Some people have painful cramping, while other people have cramps similar to their menstrual period. The type of miscarriage you have may also affect your pain level. For example, if you have a complete miscarriage at home, you may have more pain than a person who has a missed miscarriage and has a surgical procedure to remove the pregnancy.
What happens first during a miscarriage?
It’s hard to say what happens first during a miscarriage because everyone’s symptoms are different. Sometimes there are no signs of miscarriage, and you find out at a prenatal ultrasound that you’ve lost the pregnancy. Most people will experience some degree of cramping and bleeding, but what happens first varies.
How long does a miscarriage take?
It depends. Some people have painful cramping and heavy bleeding longer than others. Your pregnancy care provider can tell you what to expect and give you advice on how to manage pain and cramps during your miscarriage.
What are the risk factors for a miscarriage?
A risk factor is a trait or behavior that increases a person’s chance of developing a disease or condition. Risk factors for miscarriage include:
- Your age: Studies show that the risk of miscarriage is 12% to 15% for people in their 20s and rises to about 25% for people by age 40.
Most age-related miscarriages happen because of a chromosomal abnormality (the fetus has missing or extra chromosomes). - Previous miscarriage: You have a 25% chance of having another miscarriage (only slightly higher than someone who hasn’t had a miscarriage) if you’ve already had one.
- Health conditions: Certain health conditions like unmanaged diabetes, infections or issues with your uterus or cervix increase your chance of miscarriage.
Talk to your pregnancy care provider about the risk factors for miscarriage. They can discuss your risk after they’ve reviewed your medical history.
How many people have miscarriages?
Between 10% and 20% of all known pregnancies end in miscarriage. Most miscarriages (80%) happen within the first three months of pregnancy (up to 13 weeks of pregnancy). Less than 5% of miscarriages occur after 20 weeks’ gestation.The rate of miscarriage may be higher if you consider miscarriages that happen shortly after implantation.
A person may not realize they’re pregnant because bleeding happens around the time of their menstrual period. This is called a chemical pregnancy.
What is my risk of miscarriage by week?
Your risk of pregnancy loss declines each week you’re pregnant. Around 15% of pregnancies end in miscarriage. Miscarriage risk in the second trimester (13 to 19 weeks) is between 1% and 5%. Many factors affect your risk of miscarriage such as your age and health. However, everyone’s risk of miscarriage declines each week of pregnancy if the pregnant person has no other health conditions.
Diagnosis and Tests
How is a miscarriage diagnosed?
Your pregnancy care provider will perform an ultrasound test to confirm a miscarriage. These tests check for fetal heartbeat or the presence of a yolk sac (one of the first fetal structures your provider can see on ultrasound).
You may also have a blood test to measure human chorionic gonadotropin (hCG), a hormone produced by the placenta.
A low hCG level can confirm a miscarriage.
Finally, your provider may perform a pelvic exam to check if your cervix has opened.
Management and Treatment
What are the treatments for a miscarriage?
If you experience the loss of a pregnancy, the fetus must be removed from your uterus. If any parts of the pregnancy are left inside your body, you could experience infection, bleeding or other complications.
If the miscarriage is complete and your uterus expels all the fetal tissue, then no further treatment is usually needed. Your pregnancy care provider will conduct an ultrasound to make sure there’s nothing left in your uterus.
If your body doesn’t remove all the tissue on its own or you haven’t started to bleed, your pregnancy care provider will recommend removing the tissue with medication or surgery.
Nonsurgical treatment
Your pregnancy care provider may recommend waiting to see if you pass the pregnancy on your own. This may be the case if you have a missed miscarriage.
Waiting for a miscarriage to start could take several days. If waiting to pass the tissue isn’t safe or you wish to remove the tissue as soon as possible, they may recommend taking a medication that helps your uterus pass the pregnancy. These options are typically only available if you’ve miscarried before 10 weeks of pregnancy.
If a miscarriage wasn’t confirmed, but you had symptoms of a miscarriage, your provider may prescribe bed rest for several days. You might be admitted to the hospital overnight for observation. When the bleeding stops, you may be able to continue with your normal activities. If your cervix is dilated, they may diagnose you with an incompetent cervix, and they may perform a procedure to close your cervix (cervical cerclage).
Surgical treatment
Your provider may perform a dilation and curettage (D&C) or dilation and evacuation (D&E) if your uterus hasn’t passed the pregnancy or if you’re bleeding heavily. Surgery may also be the only option if your pregnancy is beyond 10 weeks’ gestation.
During these procedures, your cervix is dilated, and any remaining pregnancy-related tissue is gently scraped or suctioned out of your uterus. Your provider performs these surgeries in a hospital, and you’ll be under anesthesia.
What are some of the symptoms after a miscarriage?
Spotting and mild discomfort are common symptoms after a miscarriage.
Contact your healthcare provider immediately if you have any of these symptoms as it could be signs of an infection:
- Heavy bleeding or worsening bleeding.
- Fever.
- Chills.
- Intense pain.
Don’t put anything inside your vagina for at least two weeks after a miscarriage. This includes tampons, sexual intercourse and fingers or sex toys. Your provider will schedule a follow-up appointment with you to discuss your recovery and any complications.
What tests should I have after repeat miscarriages?
Blood tests or genetic tests might be necessary if you’ve more than three miscarriages in a row (called repeated miscarriage).
These include:
- Genetic tests: You and your partner can have blood tests, like karyotyping, to check for chromosome abnormalities. If tissue from the miscarriage is available, your provider may be able to test it for chromosome irregularities.
- Blood tests: You may have a blood test to check for autoimmune or hormone conditions that could be causing miscarriages.
Your provider may also look at your uterus using one of the following procedures:
- Hysterosalpingogram (an X-ray dye test of your uterus and fallopian tubes).
- Hysteroscopy (a test during which your provider views the inside of your uterus with a thin, telescope-like device).
- Laparoscopy (a procedure during which your provider views the pelvic organs with a lighted device).
Prevention
How can I prevent another miscarriage?
It’s usually not possible to prevent a miscarriage. If you have a miscarriage, it’s not because you did something to cause it.
Taking care of your body is the best thing you can do. Some examples of ways to care for yourself include:
- Attending all your prenatal care appointments.
- Maintaining a weight that's healthy for you.
- Avoiding risk factors for miscarriage like drinking alcohol and smoking cigarettes.
- Taking a prenatal vitamin.
- Getting regular exercise and eating a healthy diet.
Outlook / Prognosis
Can I get pregnant after I’ve had a miscarriage?
Yes. Most people (87%) who have miscarriages have subsequent normal pregnancies and births. Having a miscarriage doesn’t necessarily mean you have a fertility problem. Remember, most miscarriages occur because of a chromosomal abnormality, not because of something you did.
How soon can I get pregnant after a miscarriage?
The decision on when you should begin trying to get pregnant again is between you and your pregnancy care provider. Most people can get pregnant again after they’ve had one “normal” menstrual period.
Taking time to heal both physically and emotionally after a miscarriage is important. Counseling is available to help you cope with your loss. A pregnancy loss support group might also be a valuable resource to you and your partner. Ask your healthcare provider for more information about counseling and support groups. Above all, don’t blame yourself for the miscarriage. Take the time you need to grieve.
If you’ve had three miscarriages in a row, ask your provider about performing tests to figure out an underlying cause. You should use birth control until you receive the results. After your provider reviews the test results, they may suggest going off birth control and trying to conceive again.
Living With
How can I cope with my miscarriage?
Losing a pregnancy can be devastating and leave you with a range of emotions and lots of questions. Healing emotionally from a miscarriage is often harder and longer than the physical healing. Take the time you need to grieve your loss.
Talk to your partner, friends and family about your feelings or find a pregnancy loss support group online. Surround yourself with supportive people or seek professional counseling to help you cope with the loss.
A note from Cleveland Clinic
A miscarriage is a very emotional moment for expectant parents and it’s natural to grieve the loss. Remember that a miscarriage can’t be prevented, and it’s not caused by something you did wrong. It doesn’t mean that you can’t have children or that you’ll have another miscarriage. If you’re planning to become pregnant, reach out to your healthcare provider to discuss the timing of your next pregnancy and ask any questions you have. It’s OK to be sad. Find support from family, friends online support groups or a licensed counselor.
Miscarriage, how to avoid - Planning and management of pregnancy in the gynecology of the Literary Fund polyclinic after a miscarriage
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A miscarriage is always associated with severe consequences for the whole body of a woman and for her reproductive organs in particular, it also affects the family situation, disrupts the woman's work schedule.
An unfavorable outcome of pregnancy requires great mental and physical costs on the part of parents. Therefore, contacting doctors to find out the causes of the problem is the very first and correct step towards the birth of a child. nine0033
Any competent gynecologist will tell you that the problem of miscarriage can be solved. With proper preparation for pregnancy and its management, the next time you will have a successful pregnancy. Most girls after a miscarriage go to extremes: they try to get pregnant again as soon as possible. And if this succeeds, then the miscarriage is very often repeated. And you need to give the body a rest for 2-3 months, then identify and eliminate the cause. And only then try.
Causes of miscarriage
Many are convinced that miscarriages are due to a fall, bruise, or some other physical shock. Any woman who has had a miscarriage can remember that not long before she either fell or lifted something heavy. And I am sure that she lost her unborn child precisely because of this.
However, those women whose pregnancy was normal also fall and lift heavy things. Most sudden miscarriages do not occur for this reason. The reason is in violations of the pregnancy itself. Approximately half of miscarriages are due to abnormal genetic development of the fetus, which can be hereditary or accidental. Merciful nature, following the principles of natural selection in everything, destroys the defective and unviable fetus. But you should not be afraid of this. The fact that there is a defect in one embryo does not mean at all that all the others will be the same. nine0033
The woman's body is almost always to blame for the other half of miscarriages. They are caused by various known and unknown factors, such as: acute infectious diseases suffered in the first trimester of pregnancy, poor environment or difficult working conditions, excessive psychological or physical stress, abnormal development of the uterus, radiation, alcohol, smoking and certain types of drugs.
The causes of early and late miscarriage may differ, although they may overlap.
The most important thing is to find out and eliminate or compensate for your own cause of miscarriage. Having discovered the cause, the gynecologist will tell you how to avoid another loss. nine0033
Miscarriage
Miscarriage statistics also include “missed pregnancy”. Sometimes it happens that the embryo dies and lingers in the uterine cavity. Most often, this fact is detected by ultrasound. The dead fetus may begin to decompose, and this, thereby, will lead to poisoning of the mother's body.
Doctors resort to surgical curettage, which is associated with a risk of inflammation and complications. With such a miscarriage, the next pregnancy is planned after the body is fully restored - not earlier than a year. During this year, you will have to find out the cause of the missed pregnancy and treat it. nine0033
Miscarriage up to 6 weeks
The main causes of miscarriage on this line are malformations of the embryo itself. Statistics say that from 70-90% of embryos had chromosomal abnormalities: they are random and will not occur in other pregnancies.
You may have been ill, taken medication, or were under the influence of other harmful factors. Fate saved you from a child with malformations.
The human body is perfect and finds a way to correct the situation by miscarriage. Today is a tragedy for you. The real tragedy would be the preservation and birth of a sick, non-viable child. So don’t cry and understand: everything is for the best, you won’t help grief with tears ... And after three months, try again - it will almost certainly turn out to be successful. nine0033
It should also be noted that the fact of a miscarriage does not mean that you have lost something. So for a period of 7-8 weeks, the absence of an embryo in the fetal egg is found - "anembryony". It is believed that in 80-90% of cases, miscarriages are undiagnosed non-developing pregnancies.
Miscarriage between 6 and 12 weeks
Miscarriage in this period is also considered early. Its most common causes are:
Endocrine disorders
Endocrine disorders, when the ovaries do not synthesize enough hormones to keep the fetus in the womb, or the amount of male sex hormones is increased, is one of the most common causes of miscarriage and miscarriage.
nine0033
Imbalance of hormones in a woman's body is very likely to lead to an early termination of pregnancy. With a lack of the main hormone progesterone produced by the ovaries, this happens most often. Another hormonal problem is an increase in the tone of the uterus, which provokes the expulsion of the fetus.
Progesterone prepares the uterine mucosa for implantation and is the hormone for maintaining pregnancy in the first months. If conception occurs, the fetus cannot properly establish itself in the uterus. As a result, the fertilized egg is rejected. But pregnancy can be saved with the help of progesterone preparations if this problem is detected in time. nine0033
An excess of male sex hormones that suppress the production of estrogen and progesterone can also be the cause of an early miscarriage. Often, the cause of recurrent miscarriages are androgens that affect the formation and development of pregnancy; as well as thyroid and adrenal hormones. Therefore, a change in the function of these glands can lead to miscarriage.
Undertreated sexual infections
This problem must be solved before conception. Often the cause of miscarriage is sexually transmitted infections: syphilis, trichomoniasis, toxoplasmosis, chlamydia, cytomegalovirus and herpetic infections. Their effect on the fetus and the course of pregnancy is different for each woman and depends on the timing of infection, the activity of the microorganism, the degree of immune protection and the presence of other adverse factors. Depending on the situation, they can lead to the formation of fetal malformations, intrauterine infection, feto-placental insufficiency, early miscarriage or premature birth. Infection of the fetus and damage to the membrane of the fetus leads to miscarriage. To avoid this, infections should be treated before pregnancy. The use of therapy is possible during pregnancy as prescribed by a doctor. nine0033
Viral infections and other diseases
Any disease accompanied by intoxication and fever above 38 about C can lead to a miscarriage.
Rubella, influenza and viral hepatitis occupy a leading position in this list. At a period of 4-10 weeks for pregnancy, ordinary tonsillitis can also become tragic, pneumonia carries a more serious risk. Pyelonephritis and appendicitis can cause early labor. When planning a pregnancy, it is imperative to undergo a medical examination in order to identify and treat foci of infections. nine0033
Extremely dangerous during pregnancy rubella - it leads to severe fetal malformations, so infection during pregnancy is an indication for medical abortion.
Any disease during pregnancy can lead to non-viability of the fetus. And the body, through a miscarriage, insures you against unwanted offspring. With such a miscarriage, the next pregnancy has every chance of going well.
Immune causes of miscarriage
Sometimes antibodies that are hostile to the fetus are formed in the blood of a pregnant woman. This cause can be predicted and eliminated in advance.
Most often, the conflict occurs when the embryo inherits the positive Rh factor of the father, and the negative Rh factor, the mother's body rejects the embryonic tissues that are alien to it. Constant monitoring of antibody titer and the introduction of anti-Rhesus immunoglobulins allows you to maintain and maintain pregnancy. In case of an immune conflict, progesterone preparations are also used to prevent miscarriage, which in this case has an immunomodulatory effect. nine0033
Reduced immunity
Reduced immunity during pregnancy also refers to immune causes. The body is simply not able to grow a new life in itself. You need to take care of yourself and recover before the next conception.
Anatomical causes of miscarriage
Anatomical causes of miscarriage are the most intractable. Malformations of the uterus are a serious reason for miscarriage. Sometimes you just have to deal with it.
Miscarriage between 12 and 22 weeks
Such a miscarriage is considered late.
Its causes coincide with the causes of miscarriages in the early stages (anatomical, immune, infectious, endocrine).
At this time, miscarriage also occurs due to isthmic-cervical insufficiency - a weak cervix cannot hold the fetus and opens. For this reason, a miscarriage can occur in the 2nd or 3rd trimester. Isthmic-cervical insufficiency is observed in 15.0-42.7% of women suffering from miscarriage. Careful monitoring of the pregnant woman allows you to identify the problem in time and make surgical correction of the cervix before the onset of childbirth. nine0033
In isthmic-cervical insufficiency, there is only one method of treatment - mechanical narrowing of the cervical canal. To do this, the neck is either sewn up or a special ring is put on it. However, the latter method is less efficient, because the ring can easily slide off the neck, then it will no longer hold back the process of opening it.
After suturing, if necessary, it is possible to use antibiotics and drugs that normalize the microflora of the vagina.
The treatment of the vagina and the control of the state of the seams are carried out daily for 5 days. Stitches are removed at 37-38 weeks and with premature onset of labor. nine0033
Isthmic-cervical insufficiency may be primary (for no apparent reason), may be the result of abortion or hormonal disorders (increased levels of androgens - male sex hormones or their precursors).
Miscarriage after 22 weeks
Such a loss is hard to forget. Obstetricians talk about premature birth after the 28th week of pregnancy. Traditionally, a child born after this period is considered viable. But medicine knows many cases when it was possible to save the life of earlier children. nine0033
We recommend that you be carefully examined for miscarriage, check the above factors. In addition to them, the cause of a miscarriage can be antiphospholipid syndrome, while the woman's body perceives the child as something alien and rejects it. This disease, like the others listed, can be corrected; you have a very real chance of bearing a child.
Miscarriages due to hemostasis disorders
All of the above causes account for only 30-40%. Up to 70% of miscarriages are caused by disorders in the blood coagulation system (hemostasis). nine0033
Blood coagulation disorders leading to pregnancy loss can be divided into thrombophilic (increased clotting) and hemorrhagic (bleeding tendencies). Both of these extremes are dangerous to the fetus. Various disorders leading to the formation of small blood clots lead to the fact that the fetus loses sufficient blood supply, development is disturbed and the fetus is rejected.
The main hemorrhagic changes can appear even in childhood in the form of increased bleeding during cuts, tooth extractions, the onset of menstruation. But sometimes they declare themselves only during pregnancy and are the cause of a miscarriage. Bleeding in the early stages and detachment of the chorion is difficult to stop. nine0033
You may not guess, but incomprehensible headaches, weakness, fatigue, temporary loss of smell or hearing may be symptoms of disorders in the blood coagulation system.
When planning a pregnancy, a genetic examination should be carried out and, if necessary, treatment should be initiated.
It is advisable to be examined for hidden hemostasis defects even for those who consider themselves healthy. This will allow you to predict the occurrence of complications and prevent loss. Early therapy can prevent miscarriage at 98% of cases. If defects in hemostasis are already detected during pregnancy, it can be difficult to maintain it.
What to do after a miscarriage?
Find the cause! The ideal option is to be examined by future parents: it is much more reasonable to postpone conception and spend two or three months to identify the causes than to risk getting pregnant again, spend two months waiting, and then lose everything again and still go to the doctors.
Until you understand the reason, it will not evaporate. In most cases, the answers lie on the surface. Take care of your health and your future baby. nine0033
Sign up for a consultation with an obstetrician-gynecologist by phone +7 (495) 150-60-01
Tyan Oksana Alexandrovna
Head of the department, obstetrician-gynecologist Doctor of the highest category Work experience: 26 years
Volkova Polina Dmitrievna
Obstetrician-gynecologist, doctor of ultrasound diagnostics Doctor of the highest category Experience: 35 years
Postnikova Nadezhda Anatolyevna
Obstetrician-gynecologist, ultrasound specialist Work experience: 35 years
Moiseeva Alla Vitalievna
Obstetrician-gynecologist, doctor of ultrasound diagnostics Doctor of the first category Work experience: 37 years
Zabolotnova Olga Valentinovna
Obstetrician-gynecologist Doctor of the first category Experience: 26 years
Shchelokova Elena Nikolaevna
Obstetrician-gynecologist Doctor of the highest category Experience: 38 years
Maksimova Tamara Anatolyevna
Obstetrician-gynecologist Work experience: 7 years
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Why is it so important for us to talk about the loss of a child
Why is it so important for us to talk about the loss of a child?- Health »
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- Why is it so important for us to talk about the loss of a child
Why is it important for us to talk about the loss of a child
WHO/M.
Purdie
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The loss of a child during pregnancy due to miscarriage or stillbirth is still a taboo topic around the world, which is associated with condemnation or a sense of shame. Many women who lose a child during pregnancy or childbirth continue to receive neither the proper care nor the respect they deserve. nine0084 In this material we want to share stories told by women from different countries.
Miscarriage is the most common cause of pregnancy loss. Estimates of the prevalence of this phenomenon vary somewhat, although according to the March of Dimes Foundation, an organization dedicated to maternal and child health, the prevalence of miscarriage in women who knew they were pregnant is 10-15%. Different countries around the world use different definitions of pregnancy loss, but as a rule, the death of a child before 28 weeks of gestation is considered a miscarriage, and death at or after 28 completed gestational weeks is considered a stillbirth.
There are 2.6 million stillborn babies born each year, and many of these deaths could have been prevented. However, even in developed countries, miscarriages and stillbirths are not systematically recorded, so the actual figures may be even higher. nine0033
Worldwide, women's access to health services varies by country of residence, with hospitals and outpatient facilities very often under-resourced and understaffed in many countries. As varied as the experience of bereaved women, stigma, guilt and shame are common themes around the world. Women who have lost their children have shared personal experiences that they felt they had to keep their grief quiet, either because miscarriages or stillbirths remain common or because people perceive them as inevitable. nine0033
Jessica Zucker, Clinical Psychologist and Writer, USA
“I am a clinical psychologist specializing in mental health issues related to reproduction and motherhood. I have been doing this for over ten years. But when I myself had a miscarriage at 16 weeks, only then could I truly feel that heartache, that re-experienced feeling of grief and loss that my patients have been telling me about for so many years.
Jessica's story
All this has a very hard effect on women. Many women who lose a child during pregnancy may develop mental health problems that last for months or years, even if they later have healthy children.
Cultural and social views on the loss of a child in different parts of the world can be very different from each other. Thus, in sub-Saharan Africa, the prevailing opinion is that a baby can be born dead because of witchcraft or the machinations of evil spirits. nine0191
Larai, 44, pharmacist, Nigeria
“I took everything that happened after my miscarriage very hard. This was greatly facilitated by the medical workers themselves, despite the fact that I am also a doctor. Another issue is cultural representations. Here, the loss of a child brings disgrace on the woman, because there is a perception that if a woman has lost a child several times, something is wrong with her, and that she may have had extramarital affairs, and the loss of a child in that case, God's punishment.
nine0033
Larai's story
There are many possible causes for miscarriages or stillbirths, from fetal abnormalities to maternal age to infections, many of which (such as malaria and syphilis) are preventable, although identifying the exact cause is often difficult.
General recommendations for preventing miscarriage include a healthy diet, physical activity, avoidance of smoking, drug and alcohol use, limiting caffeine intake, managing stress, and maintaining a normal body weight. This approach focuses on lifestyle factors, and in the absence of specific explanations for what happened, this can lead to women feeling guilty that it was their behavior that caused the miscarriage. nine0033
Lisa, 40, Marketing Manager, UK
“I've had four miscarriages. Every time this happens, a part of you dies. The first time was the hardest. It was my very first pregnancy. We were so happy that we will soon have a baby. But when we went to our local hospital in the southeast of England at week 12 for a routine ultrasound, I was told that I had a miscarriage, or miscarriage, which meant that my baby had died long ago, although I did not feel no signs.
" nine0033
Lisa's story
As with some other medical topics, such as mental health, which remain a huge taboo, many women report that, regardless of their cultural background, education and upbringing, their friends and families don't want to talk about their loss. Apparently, this is due to the general tradition to surround any grief with a veil of silence.
Susan, 34, writer, USA
“I've been dealing with infertility for almost five years now. After I decided to try IVF, I actually managed to get pregnant, but after a few weeks the baby stopped growing. It took doctors two and a half weeks to confirm this. It took another two weeks before I had a miscarriage that lasted 19days. I could not imagine that it could be so painful, for so long and with such heavy bleeding.
Susan's story
Stillbirths occur later in pregnancy, namely after 28 gestational weeks, as defined by WHO. About 98% of stillbirths occur in low- and middle-income countries.
Lack of proper care and supervision during labor results in one in two stillbirths occurring during delivery, many of which could have been prevented with quality care and proper supervision of the woman in labour. nine0033
Better care during pregnancy and childbirth could prevent more than half a million stillbirths globally. Even in high-income countries, non-compliance with standards of care is an important cause of stillbirths.
There are clear ways to reduce the number of children who die during pregnancy, namely: improving access to antenatal care (in some parts of the world, women do not see a health worker until they are several months pregnant), introducing continuous care models, provided by midwives, as well as community care where possible. Integrating infection management during pregnancy, fetal heart rate monitoring and birth monitoring into a comprehensive care package could save 1.3 million lives of otherwise stillborn babies. nine0033
Emilia, 36, shopkeeper, Colombia
“When my baby was stillborn at 32 weeks, we already gave him a name.
The doctor referred me for an ultrasound examination, during which he told me that the child was not showing signs of life. I knew right away that my baby was dead. I know this could have been avoided. If from the very beginning I had been told everything about my condition in more detail, if the doctors had treated me more attentively during the critical periods of my pregnancy, my child could have been saved. nine0033
Emilia's story
The attitude towards women during pregnancy is related to the extent to which their sexual and reproductive rights are generally realized; many women around the world do not have the ability to make autonomous decisions in this area.
In many parts of the world, the pressure of public opinion is forcing women to become pregnant when they are not yet physically or psychologically ready for it. Even in 2019, 200 million women who want to avoid pregnancy do not have access to modern methods of contraception. And when pregnancy does occur, 30 million women are forced to give birth outside of health facilities, and 45 million women do not receive adequate antenatal care or no antenatal care at all, greatly increasing the risk of complications and death for both the mother and the mother.
child. nine0033
Cultural practices, such as ritual female genital mutilation and child marriage, cause great harm to girls' sexual and reproductive health and the health of their children. Having children at a young age can be dangerous for both mother and child. Adolescent girls (aged 10–19) are significantly more likely to have eclampsia or intrauterine infections than women aged 20–24, increasing the risk of stillbirth in this age group. In addition, babies born to women younger than 20 are more likely to have low birth weight, prematurity, or severe health problems in the first month of life, which also increases the risk of stillbirth. nine0033
Female genital mutilation increases a woman's risk of protracted or difficult labour, bleeding, severe tears and increases the frequency of instrumental use in childbirth. At the same time, children of such mothers are much more likely to need resuscitation during childbirth and increase the risk of death during childbirth or after birth.
Putting women at the center of care is critical to creating a positive pregnancy experience—the biomedical and physiological aspects of health services need to be complemented by social, cultural, emotional and psychological support. nine0033
However, many women, even those living in developed countries with access to the best health care systems, do not receive adequate care after the loss of a child. Even the language used by medical professionals in relation to miscarriage and stillbirth can be traumatic in itself: the use of terms such as "cervical failure" or "dead gestational sac" can be painful.
Andrea, 28, stylist and singer, Colombia
“When I was 12 weeks pregnant, I went to a scheduled appointment with the doctor, where I had an ultrasound. The doctor told me that I was not doing well, but did not specify what exactly was wrong. The next day, when I woke up, I noticed blood stains on the sheets. I didn't get any information about why I had a miscarriage.
My doctor was very kind to me, but he didn't explain anything to me. But the nurses were completely indifferent and unfriendly and behaved as if I had undergone an ordinary medical procedure, and nothing more. No one gave me any support." nine0033
Depending on the rules of the particular medical facility, stillborn bodies may be treated as clinical waste and incinerated. It happens that when a woman learns that her baby has died, she is forced to continue carrying the dead baby for several weeks before she can give birth. Even if this delay may be clinically justified, this situation is excruciating for both the woman and her partner. Even in developed countries, women may be forced to give birth to their dead babies in maternity wards, surrounded by women who have healthy children, which is very difficult from a psychological point of view and reminds the woman of her loss. nine0033
Not all inpatient or outpatient facilities can adopt a new care strategy or provide more services.
