Why do people have miscarriages

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.

Advanced Maternal Age (Geriatric Pregnancy): Definition & Risks

Overview

What is advanced maternal age?

Advanced maternal age is a medical term to describe people who are over age 35 during pregnancy. Pregnancies have an increased risk for certain complications when the birth parent is 35 or older. Some of these complications are higher rates of miscarriage, genetic disorders, and certain pregnancy complications like high blood pressure or gestational diabetes.

Advanced maternal age pregnancy isn't treated much differently than a typical pregnancy. Your healthcare provider may suggest prenatal testing and monitor you more closely. Being mindful of your pregnancy symptoms and staying healthy becomes even more important when you're over age 35 because your risk for chronic conditions increases.

Despite these risks, people can have healthy pregnancies and healthy babies after 35.

What age are you considered advanced maternal age?

You're considered of advanced maternal age if you will be 35 or older at the time of your due date.

Is advanced maternal age the same as geriatric pregnancy?

Yes, they’re the same. Geriatric pregnancy is an outdated term and most healthcare providers prefer to use the term advanced maternal age.

Is it harder to get pregnant if you are over 35?

Healthcare providers have discovered that the biggest decline in fertility happens in your mid-to-late 30s. A decline in fertility means the quality and quantity of eggs in your ovaries decreases. This doesn't mean getting pregnant after 35 is impossible (it's very possible). It means 35 is the age when fertility starts to decline more rapidly and your chances for complications increase more significantly.

How does advanced maternal age affect my eggs?

You’re born with a set number of eggs. You release an egg at ovulation each menstrual cycle. The older you get, the fewer eggs you have. The eggs you do have are more likely to have chromosomal issues that lead to genetic disorders. A genetic disorder is a condition present at birth.

What are the risks associated with having a baby after 35?

All pregnancies come with risks; however, you or your baby are at increased risk for the following conditions when you are of advanced maternal age:

• Preeclampsia.
• Gestational diabetes.
• Premature birth or low birth weight.
• Expecting twins.
• Miscarriage.
• Down syndrome or other genetic disorders.
• Cesarean section (c-section).
• Stillbirth.

Why are there more complications if you’re over 35 and pregnant?

Advanced maternal age is associated with a decrease in egg quality. This means that as your age goes up, your egg quality goes down. "Older" eggs are more likely to cause chromosomal anomalies. A lot of these chromosomal anomalies are what healthcare providers screen for in the first trimester.

Another reason there are more complications after 35 is that your chances of developing most chronic medical conditions increase as you age. Your body simply responds to these conditions differently once you are older. These chronic medical conditions can affect pregnancy and delivery. For example, even a nonpregnant person is more likely to have high blood pressure at 35 than at 25.

What are the benefits of having a baby after 35?

Starting a family is a personal decision, and many people choose to wait until later in life to have children. One of the benefits of having a baby later in life is having more life experience and financial stability. Couples are getting married later than they were decades ago. Assisted reproductive technologies (like in vitro fertilization or IVF) are getting more successful. This means people may delay starting or expanding their families. Studies show the rate of people having their first baby in their late 30s is rising every year.

Diagnosis and Tests

What tests are recommended for an advanced maternal age pregnancy?

Genetic screening tests are recommended for all pregnancies but are particularly important for people of advanced maternal age. These noninvasive screenings are optional and can detect if your baby is at high risk for certain congenital conditions. Most testing uses blood tests or ultrasound. These tests are screenings, meaning they detect the possibility of a genetic condition.

If a problem is detected in a screening test, invasive genetic testing can be done. These include chronic villus sampling (CVS) and amniocentesis. CVS uses cells from the placenta to diagnose a genetic condition. Amniocentesis involves placing a needle through your abdomen to extract amniotic fluid from inside the uterus. This fluid can help diagnose certain genetic conditions.

Management and Treatment

Are advanced maternal age pregnancies treated differently by doctors?

Not really. Healthcare providers typically don't treat you differently just because you are of advanced maternal age. However, if genetic screening tests indicate your baby may have a congenital disorder, your provider may refer you to a maternal-fetal medicine specialist. This is someone who specializes in higher-risk pregnancies. Other times you may have more frequent prenatal visits with your regular provider or have testing done sooner. For example, an earlier glucose screening test (to check for signs of gestational diabetes) or more ultrasounds or fetal heart rate monitoring to ensure that your baby is doing well. If you have other risk factors for preeclampsia, your doctor may recommend that you take a baby aspirin daily throughout most of your pregnancy to decrease your risk of developing this condition.

Your prenatal care is more important as you age just because your risks for certain conditions increases. So, it's more important than ever to attend all appointments or screenings, eat a healthy diet and maintain a healthy weight through your pregnancy.

Outlook / Prognosis

Can I lower my risk of pregnancy complications if I’m older than 35?

If you are over 35 and pregnant (or think you will be), there may be some steps you can take now to lower your risk for pregnancy complications:

• Make sure all your preventative care is up to date.
• Manage any existing medical conditions. For example, keeping your blood sugar in range if you have diabetes.
• Take a prenatal vitamin that includes folic acid.
• Exercise regularly.
• Quit smoking or using tobacco products.
• Stop drinking alcohol.
• Eat a healthy diet with plenty of fruits, vegetables, lean meats and whole grains.
• Stay within a healthy weight range.

What are my chances of miscarriage if I am of advanced maternal age?

Your chances of having a healthy baby are still much higher than your chance of miscarriage. If you are between the ages of 35 and 40, your chance for miscarriage is about 20% to 30%. Rates start to rise significantly for people who are 40 and older as they continue to age.

Living With

How do I take care of myself if I am over 35 and pregnant?

You can take steps to increase your chances of having a healthy baby.

Some things you can do if you are older than 35 and pregnant are:

• Attend all of your prenatal appointments and screenings.
• Gain a healthy amount of weight during pregnancy.
• Manage any preexisting or new pregnancy conditions.
• Reduce your stress levels and get enough sleep.
• Exercise regularly and eat a healthy diet.

Frequently Asked Questions

Is 35 too old to have a baby?

No, it's not too old to have a baby. The pregnancy rates of people having babies in their late 30s or 40s have increased across all races. Having a healthy pregnancy is dependent on how healthy you are overall, not just how old you are.

Will my baby have a birth condition if I am older than 35?

No, the chance of your baby having a congenital disorder is still small. However, as you get older, the risks of having a baby with a chromosomal disorder increase.

How common are chromosomal problems?

They’re more common as you get older. For example, if you are older than 35, your chances of having a child with Down syndrome increases. According to the American College of Obstetricians and Gynecologists, your chances are:

• 1 in 1,480 at age 20.
• 1 in 940 at age 30.
• 1 in 353 at age 35.
• 1 in 85 at age 40.
• 1 in 35 at age 45.

Can I get pregnant at 42 naturally?

Yes, it's possible to get pregnant naturally if you're 42. However, by about age 40, your chances of getting pregnant naturally is about 5% each menstrual cycle.

Can you reverse menopause and get pregnant?

No, once menopause has started, you can't reverse the process. If you are delaying pregnancy or are worried about preserving fertility, reproductive technologies like IVF or freezing your eggs are an option. Pregnancy using donor eggs is another option. Talk to your healthcare provider about these methods or if you believe you are entering menopause.

A note from Cleveland Clinic

Most pregnancies over the age of 35 are healthy and successful. However, it's important to know the potential complications with advanced-age pregnancies. Talk to your healthcare provider about what genetic screening tests they recommend or what you can do to stay healthy if you are older than 35. In most cases, age during pregnancy is just a number. If you maintain a healthy weight, manage any conditions you have and listen to your healthcare provider, you will likely deliver a healthy baby.

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

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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

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Obstetrician-gynecologist Doctor of the first category Experience: 26 years

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Maksimova Tamara Anatolyevna

Obstetrician-gynecologist Work experience: 7 years

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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. nine0084

Spontaneous miscarriage is the termination of pregnancy before the fetus reaches a viable term (up to 22 weeks of pregnancy and fetal weight 500 g.).
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. nine0083 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. nine0191 - 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. nine0191 - 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? nine0084