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Signs of early miscarriage: Symptoms and causes

What is a miscarriage?

Miscarriage is the loss of a pregnancy in the first 20 weeks. In medical language, the term "spontaneous abortion" is often used in place of miscarriage. When it happens in the first trimester, miscarriage is also called early pregnancy loss.

About 10 percent of known pregnancies end in miscarriage, and more than 80 percent of these losses happen before 12 weeks. The risk of miscarriage drops significantly as pregnancy progresses. In one study, researchers found a miscarriage rate of 9.4 percent at 6 weeks of pregnancy, 4.2 percent at 7 weeks, 1.5 percent at 8 weeks, 0.5 percent at 9 weeks and 0.7 percent at 10 weeks.

This doesn't include situations in which you lose a fertilized egg before a pregnancy becomes established. Studies have found that 30 to 50 percent of fertilized eggs are lost before or during the process of implantation – often so early that a woman goes on to get her period at about the expected time or up to a week late. This is called a chemical pregnancy.

Signs of miscarriage

If you have these signs of miscarriage, call your doctor or midwife right away so they can determine whether you have a problem that needs to be dealt with immediately:

• Bleeding or spotting. Vaginal spotting or bleeding is usually the first sign of miscarriage. Keep in mind, though, that up to 1 in 4 pregnant women have some bleeding or spotting (finding spots of blood on your underpants or toilet tissue) in early pregnancy, and most of these pregnancies don't end in miscarriage.
• Abdominal pain. Abdominal pain usually begins after you first have some bleeding. It may feel crampy or persistent, mild or sharp, or may feel more like low back pain or pelvic pressure.

If you have both bleeding and pain, the chances of your pregnancy continuing are much lower. It's very important to be aware that vaginal bleeding, spotting, or pain in early pregnancy can also signal an ectopic or a molar pregnancy.

Also, if your blood is Rh-negative, you may need a shot of Rh immune globulin within two or three days after you first notice bleeding, unless the baby's father is Rh-negative as well.

Some miscarriages are first suspected during a routine prenatal visit, when the doctor or midwife can't hear the baby's heartbeat or notices that your uterus isn't growing as it should be. (Often the embryo or fetus stops developing a few weeks before you have symptoms like bleeding or cramping.)

If your practitioner suspects that you've had a miscarriage, they'll order an ultrasound to see what's going on in your uterus. They may also do a blood test.

What causes miscarriage?

There are a lot of myths about what causes miscarriage. But things like stress, exercising, having sex, and having used birth control pills before getting pregnant don't cause miscarriage. Neither does morning sickness, a fall, or a blow to the stomach. Don't blame yourself. Miscarriage usually happens because the fertilized embryo can't develop normally.

Between 50 and 70 percent of first-trimester miscarriages are thought to be random events caused by chromosomal abnormalities in the fertilized embryo. Most often, this means that the egg or sperm had the wrong number of chromosomes.

Sometimes a miscarriage is caused by problems that occur during the delicate process of early development. This would include an egg that doesn't implant properly in the uterus or an embryo with structural defects that prevent it from developing.

Since most healthcare practitioners won't do a full-scale workup of a healthy woman after a single miscarriage, it's usually impossible to tell why the pregnancy was lost. And even when a detailed evaluation is performed – after you've had two or three consecutive miscarriages, for instance – the cause still remains unknown half the time.

When the fertilized egg has chromosomal problems, you may end up with what's sometimes called a blighted ovum (now usually referred to in medical circles as an early pregnancy loss or missed abortion). In this case, the fertilized embryo implants in the uterus and the placenta and gestational sac begin to develop, but the resulting embryo either stops developing very early or doesn't form at all.

Because the placenta begins to secrete hormones, you'll get a positive pregnancy test and may have early pregnancy symptoms, but an ultrasound will show an empty gestational sac. In other cases, the embryo does develop for a little while but has abnormalities that make survival impossible, and development stops before the heart starts beating.

Risk factors for miscarriage

Though any woman can miscarry, some are more likely to miscarry than others. Here are some risk factors:

• Age: Older women are more likely to conceive a baby with a chromosomal abnormality and to miscarry as a result. In fact, 40-year-olds are about twice as likely to miscarry as 20-year-olds. Your risk of miscarriage also rises with each child you bear.
• A history of miscarriages: Women who have had two or more miscarriages in a row are more likely than other women to miscarry again.
• Chronic diseases or disorders: Poorly controlled diabetes, autoimmune disorders (such as antiphospholipid syndrome or lupus), and hormonal disorders (such as polycystic ovary syndrome) are some of the conditions that could increase the risk of miscarriage.
• Uterine or cervical problems: Having certain congenital uterine abnormalities, severe uterine adhesions (bands of scar tissue), or a weak or abnormally short cervix (known as cervical insufficiency) up the odds for a miscarriage. The link between uterine fibroids (a common, benign growth) and miscarriage is controversial, but most fibroids don't cause problems.
• A history of birth defects or genetic problems: If you, your partner, or family members have a genetic abnormality, have had one identified in a previous pregnancy, or have given birth to a child with a birth defect, you're at higher risk for miscarriage.
• Infections: Research has shown a somewhat higher risk for miscarriage if you have listeria, mumps, rubella, measles, cytomegalovirus, parvovirus, gonorrhea, HIV, and certain other infections.
• Smoking, drinking, and using drugs: Smoking, drinking alcohol, and using drugs like cocaine and MDMA (ecstasy) during pregnancy can all increase your risk for miscarriage. Some studies show that high levels of caffeine consumption are linked to an increased risk of miscarriage.
• Medications: Some medications have been linked to increased risk of miscarriage, so it's important to ask your caregiver about the safety of any medications you're taking, even while you're trying to conceive. This goes for prescription and over-the-counter drugs, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin.
• Environmental toxins: Environmental factors that might increase your risk include lead; arsenic; some chemicals, like formaldehyde, benzene, and ethylene oxide; and large doses of radiation or anesthetic gases.
• Paternal factors: Little is known about how the father's condition contributes to a couple's risk for miscarriage, though the risk does rise with the father's age. Researchers are studying the extent to which sperm could be damaged by environmental toxins but still manage to fertilize an egg. Some studies have found a greater risk of miscarriage when the father has been exposed to mercury, lead, and some industrial chemicals and pesticides.
• Obesity: Some studies show a link between obesity and miscarriage.
• Diagnostic procedures: There's a small increased risk of miscarriage after chorionic villus sampling and amniocentesis, which may be performed for diagnostic genetic testing.
• Short time between pregnancies: Your risk of miscarriage is higher if you get pregnant within three months after giving birth.

If you think you're having a miscarriage

Call your doctor or midwife immediately if you ever notice unusual symptoms such as bleeding or cramping during pregnancy. Your practitioner will examine you to see if the bleeding is coming from your cervix and check your uterus. They may also do a blood test to check for the pregnancy hormone hCG and repeat it in two to three days to see if your levels are rising as they should be.

If you're having bleeding or cramping and your practitioner has even the slightest suspicion that you have an ectopic pregnancy, you'll have an ultrasound right away. If there's no sign of a problem but you continue to spot, you'll have another ultrasound in a couple of weeks.

At this point, if the sonographer sees an embryo with a normal heartbeat, you have a viable pregnancy and your risk of miscarrying is now much lower, but you'll need to have another ultrasound later if you continue to bleed. If the sonographer determines that the embryo is the appropriate size but there's no heartbeat, it may mean that the embryo didn't form or didn't survive.

If you're in your second trimester and an ultrasound shows your cervix is shortening or opening, your doctor may decide to perform a procedure called cerclage, in which they stitch your cervix closed in an attempt to prevent miscarriage or premature delivery. (This is assuming your baby appears normal on the ultrasound and you have no signs of an intrauterine infection.) Cerclage isn't without risk, and you may not meet the criteria for it.

Your caregiver may suggest that you not have sex while you're having bleeding or cramping. Sex doesn't cause miscarriage, but it's a good idea to abstain while you're having these symptoms.

Treatment for miscarriage

If you're miscarrying, discuss the pros and cons of treatment options with your caregiver. If there's no threat to your health, you may choose to wait and let the tissue pass on its own. (More than half of women spontaneously miscarry within a week of finding out that the pregnancy is no longer viable.)

If you wait for the tissue to pass on its own, you may have light bleeding and cramping for a few weeks. You can wear sanitary pads but no tampons during this time and take acetaminophen for the pain. The bleeding and cramping will likely get worse shortly before you pass the "products of conception" – that is, the placenta and the embryonic or fetal tissue, which will look grayish and may include blood clots.

Or you may decide to have a surgical procedure to remove the tissue. This is done by suction dilation and curettage (D&C).

You'll definitely need to have the tissue removed right away if you have any problems that make it unsafe to wait, such as significant bleeding or signs of infection. And your practitioner may recommend the procedure if this is your second or third miscarriage in a row, so the tissue can be tested for a genetic cause.

If you choose to have suction dilation and curettage, the procedure doesn't usually require an overnight stay unless you have complications. As with any surgery, you'll need to arrive with an empty stomach – no food or drink since the night before.

The doctor will insert a speculum into your vagina, clean your cervix and vagina with an antiseptic solution, and dilate your cervix with narrow metal rods (unless your cervix is already dilated from having passed some tissue). In most cases, you'll be given sedation through an IV and a local anesthetic to numb your cervix.

Then the doctor will pass a hollow plastic tube through your cervix and suction out the tissue from your uterus. Finally, they'll use a spoon-shaped instrument called a curette to gently scrape any remaining tissue from the walls of your uterus. The whole procedure may take about 15 to 20 minutes, though the tissue removal itself takes less than ten minutes.

Finally, if your blood is Rh-negative, you'll receive a shot of Rh immune globulin unless the baby's father is Rh-negative, too.

What happens after a miscarriage

Whether you pass the tissue on your own or have it removed, you'll have mild menstrual-like cramps afterward for up to a day or so and light bleeding for a week or two. Use pads instead of tampons and take ibuprofen or acetaminophen for the cramps. Avoid sex, swimming, and using vaginal medications for at least a couple of weeks and until your bleeding has stopped.

If you begin to bleed heavily (soaking a sanitary pad in an hour), have any signs of infection (such as fever, achiness, or foul-smelling vaginal discharge), or feel excessive pain, call your practitioner immediately or go to the emergency room. If your bleeding is heavy and you begin to feel weak, dizzy, or lightheaded, you may be going into shock. In this case, call 911 right away – don't wait to hear from your caregiver, and don't drive yourself to the ER.

The chance of having another miscarriage

It's understandable to be worried about the possibility of another miscarriage, but fertility experts don't consider a single early pregnancy loss to be a sign that there's anything wrong with you or your partner.

Some practitioners will order special blood and genetic tests to try to find out what's going on after two miscarriages in a row, particularly if you're 35 or older or you have certain medical conditions. Others will wait until you've had three consecutive losses. In certain situations, such as if you had a second-trimester miscarriage or an early-third-trimester premature birth from a weakened cervix, you might be referred to a high-risk specialist after a single loss so your pregnancy can be carefully managed.

Conceiving again after a miscarriage

You may have to wait a bit. Whether you miscarry spontaneously, with the help of medication, or have the tissue removed, you'll generally get your period again in four to six weeks.

You can start trying to conceive again after this period, but you may want to wait longer so that you have more time to recover physically and emotionally. (You'll need to use birth control to prevent conception during this time, because you may ovulate as early as two weeks after you miscarry.)

How to cope after a miscarriage

Though you may be physically ready to get pregnant again, you may not feel ready emotionally. Some women cope best by turning their attention toward trying for a new pregnancy as soon as possible. Others find that months or more go by before they're ready to try to conceive again. Take the time to examine your feelings, and do what feels right for you and your partner. For more information see our article on coping with pregnancy loss.

You may find help in a support group (your caregiver can refer you to one) or in our Community's Miscarriage, Stillbirth, and Infant Loss Support group.

If you're feeling overwhelmed by your sadness, call your caregiver. They can put you in touch with a therapist who can help.

If you're wondering how to explain a pregnancy loss to your child, read about how to talk to your preschooler about pregnancy loss.

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.

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 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.

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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).

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