Miscarriage : Types, Symptoms, Causes, Sign, Treatment, Prevention and General Home Care of Early Miscarriage
A miscarriage is the loss of a pregnancy during the first 20 weeks. Of all diagnosed pregnancies, between 15% and 20% end in a miscarriage in the first trimester or early in the second trimester.It is also common for a pregnancy to miscarry so early that a woman does not even know that she is pregnant. Miscarriage is more common as a woman gets older, because the quality of eggs deteriorates with age. It is more common in smokers and with multiple pregnancies, such as twins
Exercising, a minor fall, or sexual intercourse does not typically cause a miscarriage. The fetus is well protected by the mother's bones and muscle as well as by the amniotic fluid in which it floats. There is also no evidence that conceiving while taking birth control pills increases the risk of miscarriage. Becoming pregnant while using an IUD, however, does make you more likely to miscarry or develop an infection.
After a miscarriage a woman might experience headaches or have trouble sleeping. She may also experience lack of appetite and fatigue. Many women feel anger and sadness after a miscarriage, while many others experience a strong sense of guilt, even though it is not their fault. These are all natural reactions.
Types of Miscarriage
By feeling the cervix (neck of the womb) the stage of miscarriage can be assessed.
Threatened miscarriage - this is used to describe bleeding in early pregnancy, where the cervix is found to be tightly closed. The pregnancy is most likely to continue.
Inevitable miscarriage - this describes bleeding in early pregnancy where the cervix is found to be open, suggesting that the pregnancy will be lost.
Incomplete miscarriage - miscarriage has definitely started, but there is still some pregnancy tissue left in the uterus. The cervix is usually found to be open.
Complete miscarriage. When you've had the miscarriage and none of the tissue from the pregnancy remains in your uterus, it's called a complete miscarriage. Miscarriages that occur before 12 weeks are usually complete.
Missed miscarriage - when the pregnancy stopped growing some weeks ago, but there was no bleeding at this time. This type of miscarriage usually causes a slight, dark-brown blood loss and the sudden end of normal pregnancy symptoms. It is sometimes called a blighted ovum.
Cause of early miscarriage
There is seldom an adequate explanation for why a woman experiences a miscarriage. Studies inform us that approximately 50 per cent of lost pregnancies have failed to develop normally, either due to chromosome or genetic problems or because of structural (bodily) problems.
A miscarriage is caused by problems that occur during the delicate process of early development - for example, when an egg doesn't implant properly in the uterus or an embryo has structural defects that don't allow it to continue developing. It's usually impossible to tell why the pregnancy was lost. And even when a detailed evaluation is.
Other possible causes include:
Exposure to 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.
Sign and Symptoms of Miscarriage
Vaginal spotting or bleeding is usually the first sign of miscarriage.
Possible symptoms include:
Low-back pain or abdominal pain that is dull, sharp, or cramping
Vaginal bleeding, with or without abdominal cramps
Tissue or clot-like material that passes from the vagina
However, about 20% of pregnant women have some vaginal bleeding during the first trimester. Approximately half of these women have a spontaneous abortion.
Risk Factor of Miscarriage
The most common risk factors:
The number of times you've been pregnant also affects your risk of miscarriage. Women who have had two or more pregnancies are at greater risk.
Your risk of miscarriage increases if you've had three or more miscarriages in the past.
Caffeine. Daily consumption of caffeine may also cause miscarriage.
Some prenatal genetic tests, such as chronic villas sampling and amniocentesis, carry with them an increased risk of miscarriage.
Older women are more likely to conceive babies with chromosomal abnormalities, and to miscarry them as a result. In fact, 40-year-olds are about twice as likely to miscarry as 20-year-olds.
Women who have had two or more miscarriages in a row are more likely than other women to miscarry again.
Certain chronic diseases or disorders like diabetes, certain inherited blood clotting disorders, certain autoimmune disorders and certain hormonal disorders may also lead to miscarriage.
Uterine or cervical problems: Having certain uterine abnormalities or a weak or abnormally short cervix (known as cervical insufficiency).
A history of birth defects or genetic problems: Having had a child with a birth defect, or a family history (or a partner with a family history) of genetic problems.
Smoking a lot, drinking too much alcohol, and using drugs like cocaine and ecstasy during pregnancy can all increase your risk for miscarriage.
Your risk of miscarriage also rises with each child you bear and if you get pregnant within three months after giving birth.
Diagnosis of Miscarriage
The doctor will perform a pelvic exam to see if your cervix has begun to dilate. The following tests may be performed:
Blood count this is to make sure the bleeding hasn't caused anaemia.
Blood group Women who have a rhesus negative blood group may need to have an injection to prevent problems for subsequent pregnancies.
HCG (qualitative urine) or HCG (qualitative blood serum) to confirm pregnancy
Ultrasound scan: Your doctor may also order an ultrasound to assess the status of your pregnancy. With this test, your doctor can check for the presence of an embryo that has a heartbeat and determine if it's growing according to schedule and is the appropriate size in relation to its yolk sac and amniotic sac. If pregnancy is not very far on (less than six to seven weeks) it is sometimes not possible to tell if everything is normal, and another scan is needed in seven to 10 days time.
Treatment of Miscarriage
Treatment for miscarriage in early pregnancy includes a procedure to remove the fetus and other tissues if they have not all been naturally passed. The procedure is called a surgical evacuation of the uterus, or a dilatation and curettage (D&C). Anesthesia is used, as the procedure can be painful to the mother. The cervical opening is dilated (opened) and either suction or an instrument called a curette is used to remove all the pregnancy tissues inside the uterus (called products of conception). These tissues may be sent to the laboratory for culture or testing for genetic or chromosomal abnormalities.
If you smoke, give up.
Rest and avoid sexual intercourse.
Get prenatal care and follow the advice of your health care provider (family doctor, obstetrician, midwife).
Avoid alcohol, nicotine, and street drugs, especially cocaine, during pregnancy.
Avoid or cut down on caffeine.
Control high blood pressure and diabetes.
Identify and treat any bacterial and certain viral infections
General Care after Miscarriage
Get plenty of rest.
Journal writing is an excellent method for people to air out their emotions. Writing in a journal can actually speed up the recovery period during sad times.
Talk with other women and couples who are also dealing with the aftermath of a miscarriage.
Speaking with a professional therapist one-on-one can help you come to terms with your loss.
It is important to be honest with your friends and family, let them know when you do and when you don't want to talk about your miscarriage.
Take some time off of work to focus on yourself. If you can, arrange for your partner to also have some free time so you can be together.
Find a special way to commemorate your child can turn a negative situation into a positive one, helping you to let go of your grief like plant a tree in a local park or backyard.
Call the doctor now
Call the doctor in the following conditions:
If the woman feels weak or faint. These are both signs that she is losing too much blood.
If the woman experiences severe stomach pain, this may be a symptom of an ectopic pregnancy.
If the woman experiences fever, shivering or a smelly vaginal discharge, this can be a sign of an infection or inflammation
You know or suspect you are pregnant and have heavy vaginal bleeding.
You are passing something that looks like tissue (place what you have passed into a jar or container and take it with you to the hospital).
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