Miscarriage

From this article you will learn about miscarriages of the fetus before the 20th week of pregnancy.

What is a miscarriage?

Miscarriage - abortion during the first 20 weeks. After 20 - the loss of a child is called stillbirth. Miscarriage can end in a few days or weeks. Usually, the following symptoms are observed: vaginal bleeding, pain in the lower abdomen, lower back or pelvic organs, or fetal tissue secretion. Bleeding can be minor, copious, permanent or intermittent. It is often not immediately clear whether minor bleeding is a sign of miscarriage. When it is accompanied by pain, the probability of miscarriage increases.

Risk factors for miscarriage

• Age 35 years and older.
• History of previous miscarriages.
• Polycystic ovarian syndrome, which is accompanied by the problem of ovulation, obesity, increased content of male hormones and an increased risk of diabetes.
• Certain bacterial and viral infections during pregnancy.
• Antiphosphalipid syndrome.
• Anomaly of development of the form of the uterus.
• Physical trauma.
• Exposure to harmful chemicals, such as benzene and formaldehyde.
• Age of the father, especially up to 35 years.

Other factors that increase the risk of miscarriage include:

• Use of non-steroidal anti-inflammatory drugs (ibuprofen or naproxin) during insemination or at the initial stage of pregnancy.
• Drinking alcohol or drugs, as well as smoking during pregnancy.
• Snake bite.
• Drinking lots of caffeine.
• Chorionic villus sampling or amniocentesis (puncture of the bladder) to identify birth defects or genetic diseases of the fetus. If this procedure is carried out by highly qualified specialists, the risk of miscarriage is 1: 400. In other cases, it slightly increases - 2-4: 400 and is associated with non-professional procedure.

It is normal to try to find the cause of miscarriage. It is important to note that most miscarriages occur because of the abnormal development of a fertilized egg, and not because the woman has committed an oversight. Miscarriage is not provoked by stressful situations, physical exertion or sex.

Symptoms of miscarriage

• Vaginal bleeding: slight or severe, persistent or intermittent. Bleeding is considered a sign of miscarriage, but it is often observed in normal pregnancy, so the possibility of miscarriage increases with the simultaneous appearance of pain.
• Pain. There may be contractions of the uterus, pain in the abdominal cavity or constant continually recurring pain in the lower back. The duration of pain varies from a few hours to several days after the onset of bleeding.
• Vaginal discharge in the form of blood clots or fetal gray tissue. It is not always possible to state with certainty that a miscarriage occurs. It is usually accompanied by a chain of symptoms that last for several days, with each woman feeling them in her own way.

If the miscarriage has already begun, you can not help yourself, because this process can neither be stopped nor prevented. Miscarriage is a spontaneous termination of pregnancy as a result of the developmental pathology of the fetus at an early stage of cell division.

It is important to remember the symptoms of miscarriage and at its first signs immediately consult a doctor. While the doctor does not conduct an examination and diagnosis, give up intimate relationships and physical exertion. Immediately call for help in case of severe bleeding and shock symptoms.

Symptoms of shock:

• dizziness or feeling that you are losing consciousness;
• anxiety, confusion, or fear;
• slow or rapid breathing;
• weakness;
• thirst, nausea, or vomiting;
• a strong palpitations.

Immediately contact the doctor if you are pregnant and observe vaginal bleeding, experience paroxysmal pain in the abdominal cavity, pelvic organs or lower back. The doctor will ask to collect any allocation of tissue in the container for analysis.

Complications after miscarriage

The most common complications after miscarriage are excessive bleeding and inflammation. Minor or moderate vaginal bleeding (but not severe) should pass two weeks after the miscarriage. Immediately call for an ambulance if there is severe vaginal bleeding after the miscarriage and are in a state of shock.

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Recurrence of miscarriage

If you had three or more miscarriages, the doctor will try to determine the cause.

• Testing of blood for antibodies (antiphosphalipid syndrome).
• A study of blood on the anomaly of chromosome cells.
• Determination of the level of the hormone for the detection of polycystic ovary syndrome.
• Conducting a hysteroscopy or ultrasound of the abdominal cavity for the detection of disorders of the development of the uterus. 

How to recognize miscarriage?

• Vaginal examination, as a result of which it becomes clear that the cervix opens and blood clots and fetal tissues leave.
• Blood test: determination of the hormone level of pregnancy (human chorionic gonadotropin). The analysis is done several times to find out the progression of pregnancy.
• The ultrasound helps to determine the integrity of the fetal bladder, the heart rate and the age of the fetus.
• If you did not have to do an analysis of the Rh factor before, the doctor would also recommend that you take it.

What to do in case of miscarriage?

If you observe symptoms of a miscarriage, immediately go to the doctor. If this is not done, the risk of complications increases. The doctor should make sure that:

• You did not lose too much blood and the inflammatory process did not start;
• There are no signs of an ectopic pregnancy that is life-threatening and requires immediate surgical intervention;
• You do not have a negative Rh factor, which can adversely affect the next pregnancy.

Measures taken in case of miscarriage

Although you can not stop or prevent miscarriage, nevertheless prescribe a treatment to prevent complications. Depending on the condition of the woman, the doctor:

• observes the course of the miscarriage for days or weeks;
• prescribes medical preparations for complete purification of the uterus and prevention of inflammation;
• will spend a scraping or vacuum-abortion (till 12 weeks of pregnancy).

If the doctor confirms that the uterus has cleared, you can expect that the bleeding will take place in a week or slightly more. In the absence of symptoms of complications (high fever and severe bleeding), medication is not prescribed. But if the above symptoms are observed (a fever of 38 or more, and the gasket needs to be changed twice per hour), you should immediately see a doctor, because there is a risk of life-threatening blood loss and infection.

Overview of Miscarriage Treatment

There are no medical drugs that could stop the miscarriage. If there are no symptoms of complications such as high blood loss, weakness, fever, or other signs of inflammation, you can let the body cope with miscarriage and cleanse itself, which usually takes several days. If the Rh factor is negative, it is necessary to inoculate Rh-antibodies to prevent future problems.

With severe bleeding and pain, which are observed for a long time, the doctor can recommend scraping the uterine cavity for the purpose of complete cleansing of the uterus.

Threat of abortion

If you have vaginal bleeding, but the tests indicate that the pregnancy is not interrupted, the doctor usually advises:

• vacation: temporarily abandon intimate relationships and physical activity, and sometimes even bed rest (although there is no data indicating the effectiveness of bed rest when a miscarriage threatens);
• to take progesterone: the hormone progesterone promotes pregnancy, although it is proved that it only pushes out the time of miscarriage, but does not prevent it (it is effective at a long gestation period to prevent premature birth);
• Do not take non-steroidal anti-inflammatory drugs (you can only take acetamiphen-tylenol).

Incomplete miscarriage

Sometimes a part of the fetal tissue remains in the uterine cavity. This is called incomplete miscarriage. If the doctor after the examination confirms this diagnosis, the following treatment is possible:

• observation: the doctor decides to wait and see if the woman's body can not cope, while closely monitoring the state of the woman's health and in case of complications, take certain measures;
• use of medications: mifepristone (and / or misoprostol) causes uterine contraction and cleansing;
• scraping of the uterine cavity or vacuum aspiration is aimed at completing miscarriage and purifying the uterus.

Additional treatment

In case of severe bleeding, a blood test for hemoglobin should be done, and in case of anemia, a course of treatment should be performed. If you have a negative Rh factor, you need to vaccinate Rh antibodies to prevent future problems. In very rare cases removal of the uterus is required - when there is very severe bleeding or the inflammatory process can not be removed with the help of antibiotics.

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After a miscarriage

If you again plan to become pregnant, consult a doctor. Most experts agree that you should wait for at least the first normal menstrual cycle. The chances of a healthy pregnancy are high enough even after one or two miscarriages. In the case of several miscarriages (three to four in a row), you should be tested and diagnosed to determine the cause of abortion. But, as statistics show, 70% of married couples manage to have a child without special treatment after several miscarriages.

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Rehabilitation after miscarriage

Naturally, despite the period of pregnancy, a woman will mourn for her newborn child. Wine, anxiety and sadness will persecute for a while, besides there will be a burning desire to know the true cause of what happened. But in most cases, miscarriage is a spontaneous abortion, which is impossible to prevent. To cope with grief, experts recommend that a woman and her family members find support groups and communicate with other people who have already experienced this test.

Today there is a lot of literature about how to survive a miscarriage. Look for it in bookstores, a library or the Internet. The severity and duration of the affliction depends on the woman herself and varies from case to case, but most women who survive the miscarriage still find the strength to return to work for a short time. The sense of loss and the hormonal difference often provoke the development of depression. Therefore, you need to be on call and consult a psychologist if the symptoms of depression do not last for 2 weeks.

Most women after one or more miscarriages can still have a healthy pregnancy and have a baby. But, if you plan to become pregnant again, go first to a consultation with a doctor, since specialists recommend waiting at least the first menstrual cycle after a miscarriage.

What should I think about?

Scientists suggest that a certain number of miscarriages occur as a result of a malfunction of the woman's immune system. But experimental immunotherapy does not yet yield the desired result.

Contact the doctor immediately if you have a miscarriage:

• severe bleeding, but with no symptoms of shock. If contact with a doctor is not possible, ask relatives to take you to the nearest hospital.
• the inflammatory process began: high temperature (38 and above), moderate or severe pain in the abdominal cavity, as well as vaginal discharge have a specific odor.