How early on can you miscarry
Miscarriage | NHS inform
A miscarriage is the loss of your baby before 24 weeks. Early miscarriages happen in the first 12 weeks of pregnancy. Late miscarriages happen between 12 and 24 weeks.
Most of the time there’s no clear reason why it happens, but it’s very unlikely to be caused by anything you did or didn’t do.
About 1 out of 5 pregnancies miscarry. Since many miscarriages aren't recorded the figure might be higher.
When to get medical help
Always get medical help if:
- you're bleeding from your vagina
- you've got strong, cramping pain
- your waters break
- your baby's movements have changed, or you haven't felt them move for a while
If you're registered, contact your midwife or local maternity unit. If you’re not registered, contact your GP or the NHS 24 111 service.
What causes a miscarriage?
Doctors think most miscarriages are caused when the building blocks controlling the development of a baby (the chromosomes) aren’t right. Babies with too many or not enough chromosomes won't develop properly. This leads to a miscarriage.
Miscarriages can also be caused by:
- issues with your placenta
- cervical weakness - when your cervix (neck of your womb) starts to open
Early miscarriages
An early miscarriage happens in the first 12 weeks of pregnancy. Most women who miscarry do so in the first 12 weeks of their pregnancy.
Many women have a miscarriage before they even know they’re pregnant. If this happens it can feel like a late period with heavy bleeding.
Symptoms of an early miscarriage
You might be having an early miscarriage if:
- you're bleeding from your vagina
- you've cramps in your lower abdomen – these can feel like bad period pains
- there's fluid or tissue coming from your vagina
- your breasts are no longer tender and any morning sickness has passed
Bleeding
Having some light bleeding's fairly common in the first 12 weeks of pregnancy and doesn't necessarily mean you're having a miscarriage.
If you start bleeding, you should always contact your GP or midwife and get advice about what to do.
What happens during an early miscarriage
If you’re in the early weeks of pregnancy:
- you’ll probably be asked to go to the early pregnancy unit at your local hospital straight away
- you’ll have some tests and usually an ultrasound scan
- your body usually completes the miscarriage naturally
Depending on your stage of pregnancy, you may deliver a small baby. That can be a shock and is an understandably upsetting time.
Late miscarriages
A late miscarriage happens after 12 weeks and before 24 weeks.
For many parents who lose their baby after a late miscarriage, the word ‘miscarriage’ doesn't properly express the impact of their loss. The loss of a baby at any time's a terrible shock and a late miscarriage can be especially hard.
Symptoms of a late miscarriage
You might be having a late miscarriage if:
- you're bleeding from your vagina – this can be heavy and you might have blood clots
- you've strong, cramping pains
Always get medical help if:
- you're bleeding
- your baby’s movements have changed or you haven’t felt any movements for a while.
- your waters break and your baby's born very quickly
Contact your midwife or local maternity unit if you’re registered with them. If you’re not registered, contact your GP or phone the NHS 24 111 service.
What happens during a late miscarriage
If you’re later on in pregnancy:
- you may be asked to go to the maternity ward
- you’ll have some tests and usually an ultrasound scan
- you're likely to go through labour in hospital and might have your labour induced
While you deliver your baby you're likely to have heavier bleeding and labour-like pains.
Making difficult decisions
If you're having a miscarriage, your doctor or midwife will:
- talk to you about what will happen next
- help you, and your partner if you have one, decide what you’d like to do
You may have many difficult decisions to make at this time and will have overwhelming emotions. Take your time. Your midwife or doctor can help, and there are many organisations that can support you, your baby’s father and your family.
Get support from SANDS
Get support from SiMBA
After a miscarriage
Depending on your circumstances and stage of pregnancy, your midwife or doctor may ask if you'd like to see or hold your baby.
Some parents decide they don't want to see their baby, and others choose not to for faith or cultural reasons. This is a decision only you can make. It can be very hard when you're feeling overwhelmed. Whatever you decide is okay.
If you’re worried about what your baby looks like, your midwife or doctor can describe them to help you decide.
If your symptoms continue
You’ll probably have some bleeding for a week or two. If you continue to have symptoms after your miscarriage, it may mean that some of the pregnancy tissue's still in your womb.
Some women may need medicine or a short operation to treat this.
If you’re worried about seeking treatment, maybe a friend can come with you. Having support's really important at this difficult time.
Taking time off work
Many women will want to take time off work after having a miscarriage.
If you have a miscarriage before the end of the 24th week, you’re entitled to:
- take sick leave
- any sick pay you'd normally qualify for
If you lose your baby after the end of the 24th week, you’re entitled to:
- take maternity leave
- any maternity pay you qualify for
Speak to your employer about which choices may be right for you and your family.
Working Families has more about your rights at work after a miscarriage
Repeated miscarriages
Most women go on to have a successful pregnancy and a healthy baby after a miscarriage. But unfortunately, some women have repeated miscarriages.
If you've had:
- 1 or 2 miscarriages - you're not more likely than anyone else to have another one
- 3 or more miscarriages - your GP can refer you to a specialist to see whether there’s a specific cause
Miscarriage Rates by Week: Causes and Risks
Miscarriage Rates by Week: Causes and RisksMedically reviewed by Holly Ernst, PA-C — By Rena Goldman on October 3, 2018
Overview
Miscarriage is a word used to describe the early loss of a pregnancy before 20 weeks of pregnancy. It usually happens in the first trimester.
Unfortunately, between 10 and 15 percent of known pregnancies end in miscarriage.
You may have heard of couples waiting to announce a pregnancy until the risk of having a miscarriage is lower. The further you are into the pregnancy, the less likely you are to miscarry.
Read on to learn about what causes miscarriages and the risk for miscarriage during pregnancy.
Causes
Dr. Kaylen Silverberg, a Texas-based fertility specialist, says miscarriages are very common.
“Women think that when they have one miscarriage, they are doomed to miscarry again,” he says. However, the likelihood of having recurrent miscarriages (at least 2 or 3) is low, only occurring in about 1 percent of women.
Studies have shown an increased risk for miscarriage in women who have had recurrent miscarriages in the past. Conversely, some studies indicate that having a successful pregnancy before a current pregnancy may decrease the risk for miscarriage in the current pregnancy.
Several factors have to be accounted for in these cases, however. This includes maternal age and other medical conditions present. Most doctors will begin to investigate for a cause after you have had two to three losses. This will include reviewing your medical history in detail and performing certain tests.
Here are the five most common miscarriage causes.
Genetics
When the sperm and egg meet, the cells come together. They then begin to divide to start forming the genetic material that makes up a person.
Each of us is supposed to have 46 total chromosomes. That’s 23 from one parent and 23 from the other. If something goes wrong when the cells are dividing, a chromosome may be missing or repeated.
About 50 percent of all first trimester miscarriages are because of chromosomal abnormalities. This can occur more frequently in women who are considered advanced maternal age, or greater than 35 years old at pregnancy term.
Infections
Uterus or cervix infections can be dangerous to a developing baby and lead to miscarriage. Other infections that may pass to the baby or placenta can also affect a developing pregnancy and may lead to loss.
Some of these infections include:
- listeria
- parvovirus B19
- toxoplasma gondii
- rubella
- herpes simplex
- cytomegalovirus
Anatomic problems
This refers to defects of the uterus cavity. If a woman’s uterus didn’t form correctly when she was developing, it may be unable to support a healthy pregnancy.
Clotting disorders
Clotting disorders are conditions that cause your body to form more blood clots than normal. Examples include lupus anticoagulant and antiphospholipid syndrome.
In the case of pregnancy, blood clots can form in the placenta. This prevents nutrition and oxygen from getting to the baby-to-be, and prevents waste from being carried away.
Risk rates
The first trimester of pregnancy is considered weeks 0 to 13. About 80 percent of miscarriages happen in the first trimester. Losses after this time occur less often. March of Dimes reports a miscarriage rate of only 1 to 5 percent in the second trimester.
Weeks 0 to 6
These early weeks mark the highest risk of miscarriage. A woman can have a miscarriage in the first week or two without realizing she’s pregnant. It may even seem like a late period.
Age plays a role in a woman’s risk factor. One study indicated that compared to women younger than 35:
- Women ages 35 to 39 have a 75 percent increase in risk
- Women ages 40 and older are at 5 times the risk
Weeks 6 to 12
Once a pregnancy makes it to 6 weeks and has confirmed viability with a heartbeat, the risk of having a miscarriage drops to 10 percent. According to a 2008 study, the risk for miscarriage falls quickly with further gestational age. However, this was not specifically studied in patients with other risk factors for miscarriage.
Weeks 13 to 20
By week 12, the risk may fall to 5 percent. But keep in mind that it doesn’t really fall below that because complications can happen during pregnancy.
Signs and symptoms
The most common signs of a miscarriage are bleeding and cramping that are felt in the abdomen, pelvis, or lower back.
Some women have spotting (light bleeding) during pregnancy. A few drops or light flow of brown or dark red doesn’t necessarily mean trouble. But call your doctor right away if you see bright red blood, particularly in large amounts.
Cramping can also happen in normal pregnancies. But if it’s severe or occurring more on one side of the pelvis, you should call your doctor.
Prevention
The majority of miscarriages are the result of genetic abnormalities or other health factors that are beyond our control. For that reason, there isn’t a whole lot you can do for prevention.
The best thing you can do is to keep yourself as healthy as possible before trying to conceive and throughout your pregnancy. Here are some tips to staying healthy during pregnancy:
- Eat a well-balanced diet.
- Exercise regularly.
- Avoid alcohol, recreational drugs, and cigarette smoking.
- Reduce caffeine to 200 mg or less per day.
- Get regular prenatal visits.
If you’re worried about your risk of having a pregnancy affected by chromosomal issues, you can speak to your doctor about genetic testing before trying to conceive. A blood sample will be taken from one or both partners, and then sent to a laboratory to be evaluated for major genetic disorders. This testing and other evaluation are generally done after someone has recurrent losses.
The takeaway
The experience of a miscarriage can be physically and emotionally painful. But it’s important to remember that it’s not your fault. Talk to trusted friends and family, and ask for help when you need it.
Your doctor may be able to recommend a support group or therapist in your area. There are also many online organizations and support groups like March of Dimes that offer a safe place to share your story and grieve with others.
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Rena Goldman is a journalist and editor who lives in Los Angeles. She writes about health, wellness, interior design, small business, and the grassroots movement for campaign finance reform. When she’s not glued to a computer screen, Rena likes to explore new hiking spots in Southern California. She also enjoys walking in her neighborhood with her dachshund, Charlie, and admiring the landscaping and architecture of LA homes she can’t afford. Follow her on Twitter: @ReeRee_writes
Last medically reviewed on October 3, 2018
- Parenthood
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- Pregnancy Complications
How we reviewed this article:
Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Chromosomal conditions. (2018).
marchofdimes.org/baby/chromosomal-conditions.aspx - Early pregnancy loss: FAQs. (2015).
acog.org/Patients/FAQs/Early-Pregnancy-Loss - Early pregnancy loss: Practice bulletin. (2015).
acog.org/Resources-And-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Early-Pregnancy-Loss - Ford HB, et al. (2009). Recurrent pregnancy loss: Etiology, diagnosis, and therapy.
ncbi.nlm.nih.gov/pmc/articles/PMC2709325/ - Maconochie N, et al. (2007). Risk factors for first-trimester miscarriage—results from a UK-population-based case-control study.
obgyn.onlinelibrary.wiley.com/doi/full/10.1111/j.1471-0528.2006.01193.x - Miscarriage. (2017).
marchofdimes.org/complications/miscarriage.aspx - Regan L, et al. (1989). Influence of past reproductive performance on risk of spontaneous abortion.
uptodate. com/contents/definition-and-etiology-of-recurrent-pregnancy-loss/abstract/19 - Repeated miscarriages. (2016).
acog.org/Patients/FAQs/Repeated-Miscarriages - Tong S, et al. (2008). Miscarriage risk for asymptomatic women after a normal first-trimester prenatal visit.
ncbi.nlm.nih.gov/pubmed/18310375 - Tulandi T. (2018). Patient information: Miscarriage (beyond the basics).
uptodate.com/contents/miscarriage-beyond-the-basics
Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
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Oct 3, 2018
Written By
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Medically Reviewed By
Holly Ernst, PA-C
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Medically reviewed by Holly Ernst, PA-C — By Rena Goldman on October 3, 2018
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A miscarriage is always associated with serious 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, turning to doctors to find out the causes of the problem is the very first and correct step towards the birth of a child.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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 started.
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 were detected already 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 identifying the reasons 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.
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Spontaneous miscarriage and miscarriage
Over the past 10 years, the number of spontaneous miscarriages has been growing rapidly. The International Histological Classification Organization (FIGO) has declared an epidemic of the situation with an increase in the frequency of miscarriages.
Spontaneous miscarriage is the termination of pregnancy before the fetus reaches a viable term (up to 22 weeks of pregnancy and fetal weight 500g.).
Most miscarriages (about 80%) occur before 12 weeks of gestation. Moreover, in the early stages up to 8 weeks of pregnancy, the cause of miscarriage is chromosomal abnormalities in 50% of cases. It turns out that nature eliminates the defective product of conception. And these causes are difficult to prevent, especially in the presence of hereditary diseases. Fortunately, accidental breakdowns are much more common than genetically determined ones. Therefore, subsequent pregnancies usually end happily. But the remaining 50% of miscarriages have completely real and removable causes. They can be easily identified at the stage of preparation for pregnancy by a gynecologist.
What are the reasons?
- chronic diseases: inflammatory diseases of the uterus and appendages, polycystic ovary syndrome, uterine fibroids, endometriosis, malformations of the genital organs.
- infections: toxoplasmosis, listeriosis, genital tuberculosis, sexual infections - chlamydia, mycoplasma, ureaplasma, syphilis.
- antiphospholipid syndrome.
- endocrine diseases: diabetes, thyroid disease.
- metabolic disorders in the body: obesity, folic acid deficiency, iron deficiency, vitamin D deficiency.
- male factor.
Of course, these causes are identified and eliminated before the planned conception.
There are harmful factors that can affect the development of the fetus in the early stages of pregnancy and lead to miscarriage:
- alcohol consumption.
- use of caffeine (4-5 cups of coffee per day).
- smoking (more than 10 cigarettes per day).
- drug use.
- taking medications with a teratogenic effect (for example: aspirin, nise and others from this group of drugs; antifungals; antidepressants; some antibiotics and a number of other drugs).
- toxins and occupational hazards: ionizing radiation, pesticides, inhalation of anesthetic gases.
What are the signs of possible pregnancy loss?
These are complaints of pain in the lower abdomen and lower back, bloody discharge from the genital tract. It is necessary to consult a doctor to rule out an ectopic pregnancy and conduct an additional examination (hCG test, blood test for progesterone, ultrasound).
In early pregnancy, with dubious ultrasound data or suspected non-developing (missing) pregnancy, expectant management is chosen with a repetition of a gynecologist's examination, ultrasound, tests after 7-10 days. If a the diagnosis was made and the fact of uterine pregnancy was confirmed, with a threatened miscarriage, preservation therapy is carried out in an outpatient day hospital. A miscarriage that has begun requires hospitalization in the gynecological department. In the case of a non-developing pregnancy, an abortion is performed.
In accordance with the clinical treatment protocol approved by the Ministry of Health of the Russian Federation dated 07.06.2016. Preference is given to drug therapy aimed at terminating pregnancy with prostaglandin analogues (misoprostol) with or without prior use of an antiprogestin (mifepristone). In case of need for surgical treatment (with incomplete miscarriage with infected miscarriage), it is recommended to use aspiration curettage (with an electric vacuum source or a manual vacuum aspirator). What has a significant advantage over curettage of the uterine cavity because it is less traumatic and can be performed on an outpatient basis.
All women who have had a miscarriage need treatment to prevent complications and prevent recurrent miscarriages. Why is rehabilitation therapy necessary?
According to the decision of the XVIII World Congress of Obstetricians and Gynecologists , the diagnosis of chronic endometritis should be made to absolutely all women who have had an undeveloped pregnancy. Two out of three miscarriages according to Professor V.E. Radzinsky are caused by this disease. When examining the material from the uterine cavity, infectious pathogens were isolated: ureaplasmas, mycoplasmas, streptococci, staphylococci, Escherichia coli, viruses (herpes, HPV). Therefore, it is very important to carry out treatment immediately after the termination of pregnancy.
If time is lost, it is necessary to carry out additional diagnostics: a pipel biopsy of the endometrium with a histological examination and a study for infections, including tuberculosis. Then, taking into account the results obtained, symptomatic anti-inflammatory therapy is carried out (immunomodulators, antibacterial drugs, physiotherapy, gynecological massage, mud therapy). In parallel, an examination is prescribed to identify other causes of miscarriage (male factor, chronic maternal diseases, genital infections, antiphospholipid syndrome).
In the medical center "Mifra-Med" at the level of modern requirements of medicine, all the possibilities of a complete adequate examination have been created: all types of tests, ultrasound, hysteroscopy, aspiration biopsy, consultations of narrow specialists (endocrinologist, therapist, neurologist, urologist).