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A miscarriage is the unplanned loss of a baby before the 20th week of pregnancy. At least 10 to 15 of every 100 pregnancies end in miscarriage. Most miscarriages happen during the first 10 to 15 weeks. Some women miscarry even before they know they are pregnant. A menstrual period that is late and heavier than usual may be the only symptom.

Having your pregnancy end in a miscarriage can be very sad and distressing. If you have had a miscarriage, it’s unlikely that you did anything to cause it. There is a good chance that you will be able to have a baby the next time you are pregnant.

Often you will not know what caused a miscarriage. Miscarriage may be your body’s way of ending a pregnancy that is not developing normally. It may happen because there is something wrong with the baby, like a genetic problem.

Other possible causes of miscarriage include infections or problems in the uterus, uncontrolled diabetes, or hormonal imbalances. Cigarette smoking, alcohol, and illegal drugs, such as cocaine, can also cause miscarriage. This is especially true in early pregnancy, when major organs of the baby are developing.

A problem with the cervix sometimes causes a miscarriage. The cervix is the opening of the uterus into the birth canal. During labor the cervical opening gets bigger so that the baby can pass into the birth canal. If the cervix starts opening too early in the pregnancy, there is a risk of miscarriage. Often, if the problem is found early, it can be treated and the pregnancy can continue.

Mild falls, exercise, and sex don’t cause a miscarriage. The baby is well protected in the uterus.

Symptoms may include:

• Bleeding from the vagina. It can range from a few drops of blood to a heavy flow. The bleeding may start with no warning, or you may first have a brownish discharge.
• Cramps in your lower belly
• A gush of fluid from the vagina without bleeding or pain. This may mean that your bag of water has broken. Passing tissue from your uterus. If solid material passes from your vagina, try to keep it so that your healthcare provider can examine it.

It’s possible to have a miscarriage without any bleeding or pain. The baby may have never developed. The only sign of miscarriage may be that you stop having symptoms of pregnancy. This condition is called a missed miscarriage.

You can have signs of miscarriage without actually losing the baby. This is called a threatened miscarriage. If you have signs of a miscarriage but you have not yet lost the baby, there is a chance that your pregnancy will continue normally.

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have tests such as:

• A pelvic exam to check your uterus and cervix
• An ultrasound, which uses sound waves to show pictures of your uterus and organs around it. It can show if the baby is still in your uterus of if the baby started growing outside the uterus. It may show that the pregnancy never developed into a baby.
• Blood tests

If you have a threatened miscarriage, your provider may suggest that you:

• Rest in bed for 1 to 2 days.
• Stop exercise.
• Stay off your feet as much as possible.
• Not have sex until your provider says it’s safe

If the cervix is opening too early, your healthcare provider may stitch the cervix closed until it’s time for your baby to be born. If your uterus or cervix is abnormal, your healthcare provider may prescribe a long period of bed rest and medicines to keep you from having contractions. It may not be possible to stop a miscarriage if you are having bleeding and cramping and the cervix starts to open.

If you miscarry, or have a missed miscarriage, you may need a procedure to remove pregnancy tissue that is still in the uterus. You may have a dilation and curettage (D&C) to gently scrape tissue from the lining of the uterus, or your provider may suction the tissue.

Depending on your blood type, your healthcare provider may want to give you a shot that protects against a problem called Rh incompatibility. This is a problem that might affect future pregnancies. It can happen if your Rh blood type is different from the blood type of the baby.

Recovery usually takes 4 to 6 weeks. You may have a small amount of bleeding and discomfort for a few days. If you were pregnant for more than 13 weeks before the miscarriage, you may look pregnant for a short while and your breasts may leak milk.

Grief, anger, and feelings of guilt are common and completely normal reactions to a miscarriage. Allow yourself to grieve over the loss of the baby. Look for support from friends. You may find it helpful to talk to others who have had miscarriages. You may be afraid that you won’t be able to have a baby, but for most women the next pregnancy is normal.

Some women do have repeated miscarriages. A series of 3 or more miscarriages is called habitual miscarriage. These miscarriages may be caused by an imbalance of hormones or other conditions that can be treated. If you have several miscarriages, you can work with your healthcare provider to try to find and treat the cause.

Ask your healthcare provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-09-17
Last reviewed: 2014-09-17

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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.

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.

Hormone imbalance in a woman's body is 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 is also an immune cause. 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 - a 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 manifest themselves even in childhood in the form of increased bleeding during cuts, extractions of teeth, 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 clotting 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 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.

Sign up for a consultation with an obstetrician-gynecologist by phone +7 (495) 150-60-01

Tyan Oksana Aleksandrovna

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Early miscarriage - symptoms and how to prevent it

The term "early miscarriage" refers to a spontaneous abortion that occurs in the first 6-8 weeks of pregnancy. It can occur before 20 weeks of pregnancy for reasons related to the natural states of the fair sex. According to statistics, the logical outcome of every fifth pregnancy is a miscarriage. However, quite often a woman does not even know that she was pregnant by the time the fetus is rejected by the body.

In addition, a curious pattern was revealed: more often than a natural one, a pregnancy induced artificially ends in a miscarriage. For example, in vitro fertilization, unfortunately, does not always lead to a successful pregnancy and the birth of a baby on time.

Why can an early miscarriage occur?

Here are the most common causes, each of which significantly increases the risk of miscarriage:

• the future mother has certain infectious diseases, as well as STDs;
• intoxication of a woman's body for various reasons, including as a result of her living in an ecologically unfavorable region;
• all kinds of metabolic disorders in the body;
• hormonal failures, including those provoked by a malfunction of the thyroid gland;
• various neoplasms in the uterus and others, as well as the cervix, pathologies;
• future mother leading a life far from a healthy lifestyle. May include drinking alcohol, smoking, taking psychotropic and narcotic drugs, as well as malnutrition;
• obesity;
• immune status disorders;
• cardiac diseases;
• diabetes mellitus;
• too early for pregnancy or, conversely, the patient's overly mature age at times increases the risk of miscarriage;
• all kinds of pathologies of chromosomes and genes;
• prolonged exposure to stress or severe psycho-emotional trauma in a woman.

The timing of a miscarriage may depend, among other things, on the patient's genetic predisposition to miscarriage. Finally, often its specific cause remains unexplained to the end.

Symptoms of miscarriage

A pregnant woman should urgently seek medical help if she has the following warning signs:

• bleeding from the vagina;
• spotting discharge from the genital tract. They can have both light pink and intense red or brownish tint;
• convulsions;
• severe pain in the lumbar region;
• abdominal pain, etc.

All of the above signs can be symptoms of a miscarriage. Timely provision of qualified medical care is the key to maintaining pregnancy.

Life after miscarriage

If a woman could not bear the pregnancy - an early miscarriage crossed out all her plans - then she needs to calm down and take all measures to prevent such complications in the future. Usually obstetricians-gynecologists recommend planning a new pregnancy no earlier than six months after a miscarriage. During this time, a woman needs to be examined and find out if she has any pathology in her body that could lead to an abortion. It can be various STDs and infectious diseases. In the presence of chronic diseases that can provoke spontaneous abortion, it is necessary to throw all your efforts into their treatment.

Gynecologists of the corresponding department of our private clinic in Ryazan will help you find out what could have caused the miscarriage, as well as make recommendations on how to prepare for pregnancy.

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