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25 Aug 2023

Miscarriage: Know the Complications for Your Safe Pregnancy

Miscarriage is the loss of a pregnancy in the first 3 months, before the gestation period of 12 weeks. Most miscarriages take place because the foetus is not developing as expected. Around 10-20%  of known pregnancies generally end up in miscarriage. Whatever the situation, you should never blame yourself for a miscarriage.

Types of Miscarriage

Your gynaecologist may diagnose with the following miscarriage types:

  • Missed miscarriage: You have lost pregnancy but do not know it has occurred. There aren’t any symptoms of a miscarriage however an ultrasound confirms the foetus has no heartbeat.
  • Complete miscarriage: You have already lost the pregnancy and uterus is empty. There are chances of experiencing bleeding and passing of foetal tissue. The gynaecologist will confirm complete miscarriage by means of ultrasound.
  • Recurrent miscarriage: There are three consecutive miscarriages which affects nearly 1% of couples.
  • Threatened miscarriage: The cervix remains closed though you bleed and suffer from pelvic cramps. Your pregnancy continues without any further issues. The gynaecologist may monitor you closely for the rest of the period of your pregnancy.
  • Inevitable miscarriage: You are cramping, bleeding and the cervix has begun to open or dilate. There may be amniotic fluid leaks and chances of a complete miscarriage are very high.

How will you know if you have a miscarriage?

You may not know that you are suffering from a miscarriage. Women who have miscarriage have these common signs:

  • Bleeding that will progress from light to heavy and you may pass blood clots or greyish tissue.
  • Low back ache that might range from mild to severe
  • Abdominal pain and cramps which are worse than menstrual cramps
  • Decrease in the symptoms of pregnancy

Contact your gynaecologist immediately when you suffer from any of these symptoms.

What happens during a miscarriage?

A woman usually has heavy bleeding and she may not even know it is a miscarriage. This is because most of the time she is unaware about her pregnancy. Some women who have a miscarriage suffer from spotting, abdominal pain, cramping, heavier bleeding, back pain, weakness or pelvic pain. But spotting does not mean a miscarriage always and pregnant women can have spotting early during pregnancy yet still give birth to a healthy baby. In the case there is spotting or other symptoms anytime in the pregnancy period, it is advisable to speak with the gynaecologist and remain on the safe side.

Causes of a miscarriage

Chromosomal abnormalities may be the reason for almost 50% of miscarriages during the first trimester of pregnancy. Chromosomes are said to be tiny structures within the body cells carrying your genes. Genes help to know physical attributes which includes – colour of eyes, type of blood, hair and sex.

When the sperm and egg combine together, there will be two sets of chromosomes at the time of fertilisation. In the case sperm or egg has fewer or more chromosomes than usual, there will be unusual number of the foetus. When fertilised egg grows into the foetus, the cells divide and then multiply many times. Abnormalities can cause miscarriage during this process. Most chromosomal problems happen by chance and it is not known why this takes place.

Different factors can lead to miscarriage and some of them are:

  • Your present age
  • Uncontrollable diabetes
  • Incompetent cervix
  • Disorders of immune system like lupus
  • Exposure to any type of illness
  • Inappropriate fertilised egg implantation
  • Hormonal imbalance
  • Chronic kidney disease
  • Infection to your body
  • Congenital heart disease
  • Severe malnutrition
  • Uterine abnormalities
  • Thyroid disease
  • Radiation
  • Lifestyle factors like smoking, drinking alcohol or taking recreational drugs.

Symptoms after a miscarriage

There may be mild discomfort and spotting after a miscarriage. You need to talk to a gynaecologist expert right away when there are any of these symptoms causing an infection:

  • Extreme pain
  • Heavy bleeding or too much bleeding
  • Fever
  • Chills

You should not put anything inside the vagina during the next two weeks after there is a miscarriage. This can include intercourse with your partner, sex toys, fingers and tampons. The provider will fix an appointment for follow up and discuss about recovery process as well as possible complications.

How to diagnose a miscarriage

The gynaecologist performs ultrasound test to confirm whether you have a miscarriage. The tests check for the presence of amniotic sac or foetal heartbeat. You may need to conduct a blood test for detecting human chorionic gonadotropin, a kind of hormone your placenta produces. The lower level of hCG denotes a miscarriage. The health care provider carries out pelvic examination to detect whether the cervix has opened.

Necessary tests to conduct after repeated miscarriage

  • Certain blood or genetic tests are essential when you already had at least three miscarriages in a row. This is known as repeated miscarriage which includes:
  • Genetic tests: Both you as well as your partner need to conduct blood tests like karyotyping, for detecting chromosome abnormalities. When there is tissue from the miscarriage, the health care provider may test it to detect chromosome irregularities.
  • Blood tests: You need to conduct a blood test for checking autoimmune or hormone conditions causing miscarriages.

Your provider may look at the uterus with the following procedures:

  • Hysterosalpingogram: This is an X-ray dye test of the fallopian tubes and uterus.
  • Hysteroscopy: The test enables your gynae expert to see inside part of your uterus with the help of a telescope-like device.
  • Laparoscopy: In this method, your provider sees pelvic organs by using a lighted device.

Different treatments for a miscarriage

Nonsurgical treatment

Your gynae expert may ask to wait and see if you pass pregnancy on your own. This can be the case when you experience a missed miscarriage. Waiting for a miscarriage to begin can take several days. If you think waiting to pass the tissue is not a safe option or you want to remove e tissue quickly, then they may recommend taking a medication for your uterus to pass the pregnancy. These options are available when you have a miscarriage before the 10 weeks of pregnancy. If you do not have a confirmed miscarriage, then the gynaecologist may ask to take bed rest for several days. Once the bleeding stops, you can continue with your routine activities.

Surgical treatment

The health care provider may carry out a dilation and curettage or dilation and evacuation (D&E) when uterus has not passed pregnancy or there is heavy bleeding. Surgery might be the only option when pregnancy goes beyond 10 weeks’ gestation. When undergoing any of these procedures, the cervix gets dilated and any pregnancy-related tissue will be scraped gently. You are given anesthesia and the provider performs these surgeries in the hospital.

Risk factors for a miscarriage

The risk factor is a behaviour that increases chance of developing a disease or condition for a person. Risk factors for a miscarriage include:

  • Your age: As per studies, the risk of miscarriage is generally 12% to 15% in the case of women who are in their 20s. This may increase to almost 25% for women by 40 years. Mostly, age-related miscarriages occur due to chromosomal abnormality where the fetusis missing or there are extra chromosomes.
  • Previous miscarriage: You are having at least 25% chance of another miscarriage in the case you already had one.
  • Health conditions: Certain health conditions such as uncontrolled diabetes, issues or infections with your cervix or uterus may increase the chance of miscarriage.

Consult with your gynae expert about any risk factors related to miscarriage. They may discuss the risk factors after evaluating your medical history.

How much time can a miscarriage take?

Well, this depends from one woman to the other. Some of them may have painful cramps and excessive bleeding than others. Your pregnancy expert will be able to tell what you can expect and give necessary advice on how to deal with pain and cramps during the miscarriage.

How painful a miscarriage can be?

Miscarriages seem to be completely different for every woman. Some of them may get painful cramps while others have cramps which are quite similar to menstrual period. The type of miscarriage you have can affect the level of pain you experience. For example, when you suffer from complete miscarriage at home, you will have more pain than a woman who has missed miscarriage and undergo a surgical procedure to remove pregnancy.

How to prevent another miscarriage

It is not possible to prevent a miscarriage. Make sure you take care of your health condition and some examples include the following:

  • Attend all prenatal care appointments.
  • Maintain a healthy weight
  • Do not take alcohol and smoke cigarettes to avoid miscarriage.
  • Take a prenatal vitamin.
  • Perform routine exercise
  • Eat a healthy diet

You may type in Google search box, “private gynaecologist near me” when finding one in your area. This way, you will know about your health condition during pregnancy and prevent any chances of a miscarriage.