What is a Miscarriage?
A miscarriage refers to the loss of a baby within the first 20 weeks of pregnancy. A miscarriage can be described medically as spontaneous abortion. It is not abortion, as the common term implies. Half of all pregnancies result in miscarriage. This is most common before the woman has missed a period or knows she's pregnant. A miscarriage is a common outcome in 15%-25% of all pregnancies.
More than 80% of miscarriages occur within the first three months of pregnancy. After 20 weeks, miscarriages are much less common. Doctors call them late miscarriages when they occur.
If they miscarry, many couples blame themselves and their behaviour. However, in most cases, there is nothing you can do that will prevent it. According to the American Pregnancy Association, the most common reason is a genetic abnormality in an embryo. Hormonal imbalances, uterine issues, chronic illness, high fever, and other factors could also be responsible. Your risk of developing cancer may be increased by certain factors, such as excessive drinking, drug use, and advanced maternal years.
It is a good thing that miscarriages are often followed by successful pregnancies. According to statistics, at least 85 per cent of miscarriages women will have a full-term, healthy pregnancy the second time around. Do you want to know how to distinguish between miscarriage symptoms and standard-issue pregnancy issues? Continue reading to find out what is normal and what should be considered a concern.
Miscarriage Symptoms
There are fewer signs of pregnancy. A miscarriage can be characterized by:
- Bleeding that is light to heavy
- Grave cramps
- Belly pain
- Weakness
- Severe or worsening back pain
- These symptoms can be accompanied by fever
- Weight loss
- White-pink mucus
- Contractions
- The tissue that looks like blood is passing from your genital area.
These symptoms should be reported to your doctor immediately. You'll be told by your doctor whether you should go to the hospital or the office.
Miscarriage Risk Factors and Causes
Miscarriages are most common when the unborn baby is suffering from fatal genetic conditions. These problems are usually not related to the mother.
A risk factor is any trait or behaviour that increases the chance of a person developing a disease. Risk factors for miscarriage include:
- Maternal age. Research shows that miscarriage rates range from 12% to 15% for 20-year-olds to 25% to 40% for those 40 years old. The increased incidence of chromosomal anomalies exacerbates age-related miscarriage risk.
- Certain conditions that can cause miscarriage in the mother are listed in the section "What causes miscarriage?"
The following are other problems that could increase your risk of miscarriage:
- Infection
- Thyroid disease or diabetes are medical conditions that can affect the mother.
- Hormone problems
- Immune system responses
- Mothers with physical problems
- Anomalies of the uterine system
- Smoking
- Consuming alcohol
- Using street drugs
- Radiation or toxic substances exposure
The chances of miscarriage in a woman are high if:
- You are over 35
- Thyroid problems or diabetes are two examples of diseases that you might have.
- You have had at least three miscarriages
- Cervical insufficiency. Sometimes, a miscarriage occurs when the mother's cervix is weak. This is called cervical insufficiency by doctors. This means that the cervix is unable to hold the pregnancy. This type of miscarriage is most common in the second trimester.
A miscarriage due to cervical insufficiency usually has few symptoms. There may be sudden pressure, and your water might burst. Your body could also lose tissue and placenta from the baby without any pain. A "circling" stitch is used to treat insufficient cervix in the next pregnancy. This usually happens around 12 weeks. This keeps your cervix shut until you have it removed by the doctor. The stitch can be added to prevent miscarriage if you have never had one.
Causes
There are many reasons why a miscarriage may occur.
- Problems with the placenta: The blood supply from the mother and baby can be disrupted if the placenta develops in an abnormal way.
- Problems with chromosomes: A fetus may receive an insufficient number of chromosomes. This can lead to abnormal development. The first trimester is the most common time miscarriages occur. This is due to chromosomal abnormalities.
- Anomalies in the womb structure: An abnormal shape of the womb and fibroids (noncancerous growths) can pose a risk to a developing foetus.
- Polycystic Ovarian Syndrome (PCOS: This is when the ovaries become too large, leading to hormonal imbalance.
- A weakened cervix: The cervical is the neck of your womb. If the muscles of your cervix become weak, miscarriage can occur.
- Lifestyle factors: Miscarriage can be caused by smoking, alcohol consumption, and illegal drug use.
Being Overweight or Underweight
Obesity has been shown to increase the likelihood of miscarriages, both first and second. Low body mass index women who are pregnant before the age of 30 have a higher chance of miscarriage. According to research published in the International Journal of Obstetrics and Gynaecology, women who are underweight were 72%.
Women who are overweight are more likely to have a miscarriage in the first three months of their pregnancy than women who are healthy.
Keep track of all current medications
It is important to discuss with your doctor whether you are allowed to take certain medications during pregnancy. Avoiding medications while pregnant is a good idea.
- retinoids
- Non-steroidal anti-inflammatory drugs (NSAIDs),
- methotrexate
- misoprostol
- antidepressants
Limit caffeine
A meta-analysis published by the European Journal of Epidemiology gathered data from 60 studies to produce this conclusion: Increased caffeine intake is associated with spontaneous abortion, stillbirth, low weight, and SGA but not preterm births.
The World Health Organization
The WHO advises women who consume more caffeine than 300 mg per day to reduce their intake.
What could I feel during a miscarriage?
Many women experience a miscarriage at an early stage of their pregnancy, often without realizing it. It is possible that they think they are experiencing a heavy period. You might experience cramping, heavy bleeding, weakness, or pain in your stomach, pelvis, or back if this happens. Spotting is a normal part of many pregnancies. Talk to the physical experts and doctor if you are concerned.
You might experience cramping pains, bleeding, or fluid and blood clots in your vagina later on in your pregnancy. Depending on how long you have been pregnant, you may experience tissue that looks more like a baby or a fetus.
Some types of miscarriage may not cause any symptoms. The miscarriage might not even be apparent until the next ultrasound. You might notice that your breast tenderness and morning sickness have disappeared.
When you discover you are having a miscarriage, it is normal to feel upset and emotional. It may take some time to fully understand what is happening.
Types of Miscarriage
There are many types of miscarriages.
- Threatened miscarriage. Your cervix isn't dilation, and you're bleeding. You can expect your pregnancy to continue normally without any issues.
- Inevitable miscarriage. You are bleeding and cramping. Your cervix has dilated. In such cases, miscarriages can happen.
- Incomplete miscarriage. You may lose some tissue from the baby's placenta or from the placenta, but the rest will remain in your uterus.
- Complete miscarriage. Your body will lose all pregnancy tissues. This type of miscarriage typically occurs before the 12th week of pregnancy.
- Missed miscarriage. The embryo is lost or never formed. However, the tissues remain in your uterus.
- Recurrent miscarriage (RM). Three or more pregnancies are lost in one trimester. This type of miscarriage affects only 1% of couples who are trying to have babies.
Miscarriage Diagnosis
Your doctor can check if you have had a miscarriage.
- A pelvic exam. They will check to make sure your cervix is not dilated.
- An ultrasound test. This test uses sound waves in order to detect a baby's heartbeat. You may return for another test within a week if the results aren't clear.
- Blood tests. They are used by the doctor to check for pregnancy hormones and to compare them with past levels. If you have been bleeding heavily, they may test you for anaemia.
- Tissue tests. The doctor might send the tissue to a laboratory to confirm that there was a miscarriage. This can help to confirm that there was no other cause of your symptoms.
- Chromosome testing. Your doctor may perform these tests if you have had multiple miscarriages.
What happens if there is a miscarriage?
Once a miscarriage has begun, there is no way to stop it. The only way to stop heavy bleeding is to avoid infection.
You might be advised by your doctor that no treatment is required. This is known as "expectant management," and you can just wait to see what happens. The natural passage of the pregnancy tissue (the placenta, fetus, and pregnancy sac) is possible. This process can take several days or even up to four weeks.
It can be difficult to wait for a miscarriage, as you never know when it will occur. You will begin to feel cramps and spotting. Then, it will be quite quickly followed by heavy bleeding. You will eventually feel the contractions, and your cramps will become worse.
Women may choose to take medicine to accelerate the process. The pregnancy tissue will likely pass in a matter of hours. If you are experiencing infection or tissue that is not passing naturally, you might need a small operation called a "dilatation & curettage" (D&C). Your hospital appointment may take some time. You will be able to go home in 5-10 minutes after the operation under general anaesthesia.
It's best to wait for the miscarriage to end before you go back to work. You can do what is best for you. Paracetamol can be used for pain of any kind. You should use sanitary pads instead of tampons if you are bleeding.
What could I possibly see in a miscarriage situation?
The developing embryo is about the same size as a grain of rice in the first month of pregnancy. It is difficult to see. There may be a blood clot, or multiple clots, from your vagina. The clots may also contain white or grey tissue. Although the bleeding will stop within a few days, it may take up to two weeks.
At 6 weeks
When a miscarriage occurs, most women don't recognize it. You may notice small fluid-filled sacs that appear during bleeding. You might see the embryo (about the same size as your fingernail) and possibly a placenta inside the sac. It is possible to also see something that looks similar to an umbilical cord.
At 8 weeks
It may appear dark and shiny. Some women say it looks like liver. A sac containing an embryo may be found approximately the same size as a small bean. You might be able to see the formation of the eyes, arms, and legs if you look closely.
At 10 Weeks
Clots that have been passed look dark red and almost jelly-like. The membrane that appears inside the clots could be part of the placenta. One of the clots will contain the sac. The developing baby is often fully formed at this stage, but it can still be difficult to see.
Between 12 and 16 weeks
You might feel the water in your vagina if you miscarry. Then you may notice bleeding and clots. The fetus is small and fully formed. It might not be inside the sac yet if you look closely. It could also be attached to both the umbilical cord and the placenta.
Between 16 and 20 weeks
This is sometimes called a "late miscarriage". Large, shiny red clots may appear similar to the liver. Other tissue pieces that feel and look like membranes might also be present. You might feel it as painful as labour and may need pain relief at the hospital. You will find your baby fully formed and can comfortably fit in the palm of your hands.
After the Miscarriage
After a miscarriage, you will experience some cramping and bleeding. This is similar to a period. The pain will get less frequent over time and usually stops within two weeks. In the days following the miscarriage, the signs of pregnancy such as nausea or tender breasts will disappear. Your breasts may produce milk if you have a late miscarriage. Your next period will likely be in 4 to 6 weeks. It's normal to feel upset and emotional at this point.
Miscarriage Treatments
At least 85% have normal pregnancies and children after miscarriage. A miscarriage doesn't necessarily indicate that you have a fertility issue. However, around 1% to 2% of women have had multiple miscarriages (three or greater). Researchers believe that this could be due to an autoimmune reaction.
You won't likely need any further treatment if the miscarriage has ended and your uterus remains empty.
Sometimes, all of the tissue isn't removed. Your doctor may recommend a dilation-and-curette (D&C), procedure if this happens. Your doctor will dilate your cervical cavity and remove any excess tissue. You can also take medications that will cause any uterine tissue to be removed from your body. If you don't want to have surgery, this may be an option.
The doctor may induce labour and delivery if the bleeding is more advanced in the pregnancy or the fetus is dead in the womb. You should be able to go back to normal activities once the bleeding stops. Incompetent Cervix is a condition where your cervix has dilated naturally, but you are still pregnant. The doctor may perform a procedure called cerclage to close it.
Rh immunoglobulin (Rhogam) may be prescribed to you if your blood type is Rh-positive. This will prevent you from creating antibodies that could cause harm to your baby or future pregnancies.
If you have had multiple miscarriages (recurrent miscarriages), your doctor may order blood tests and genetic tests. Your doctor may use the following tests to diagnose this condition:
- Pelvic ultrasound
- Hysterosalpingogram: An X-ray of your uterus and fallopian tube.
- Hysteroscopy. To examine your uterus, the doctor inserts a thin telescope-like device through your vagina.
Talk to your doctor if you have had two miscarriages consecutively.
Symptoms After a Miscarriage
After a miscarriage, mild discomfort and bleeding are common signs. Contact your doctor immediately if you experience severe bleeding, fever, chills, or pain. These could be symptoms of an infection.
You may feel physical symptoms, but you might also experience a variety of emotions. These could include sadness, guilt, grief, and concern about the future. It's normal to feel what you are feeling. Allow yourself to grieve.
Talk to your family, friends, and partner if you feel up to it. Talk to a professional counsellor for mental health. You and your partner may find support groups for pregnancy loss valuable. For more information, consult your doctor. Remember that every person heals at their own pace and in different ways.
Pregnancy After a Miscarriage
After a miscarriage, you can still get pregnant. A minimum of 85% of miscarriage victims go on to have normal pregnancies. A miscarriage does not necessarily mean that you have a fertility issue. However, around 1% to 2% of women might have had multiple miscarriages (three or more).
If you have had two miscarriages, it is time to stop trying to conceive. Instead, use birth control and ask your doctor for tests to determine the cause.
Myths about Miscarriage
Many misconceptions surround miscarriage. Although many people believe that exercising and having sex can cause miscarriage, there is no evidence. A woman eight months pregnant should not do certain types of exercise. Ask your doctor if you are pregnant to determine which exercises are suitable.
A miscarriage can often be unavoidable.
How to Conceive After a Miscarriage
Talk to your doctor about the timing of your next baby. Experts recommend waiting a while (from one to three months) before trying again. The doctor might recommend progesterone treatment to prevent another miscarriage. This hormone helps the embryo implant and supports early conception in the uterus.
It is important to take the time to heal emotionally and physically after a miscarriage. Don't let yourself down. Counselling in such cases can be an option to help you deal with your loss.
Miscarriage Prevention
Most miscarriages occur because of a pregnancy problem. They can't be prevented. There may be treatment options available if your doctor performs testing. Treating an illness can increase your chances of a successful pregnancy. You can start to feel as healthy as possible before you attempt to have a child.
- Get regular exercise.
- A healthy and balanced diet is important.
- Keep a healthy weight
- Avoid infection.
- Do not smoke, have any addictive things like alcohol, or use drugs.
- Cut back on caffeine.
After a miscarriage, can you still get pregnant?
Yes. 87 per cent of miscarriages are followed by normal pregnancies. A miscarriage doesn't necessarily mean that you have a fertility issue. A mere 1% of people have had multiple miscarriages, three or more times. It is possible to prevent miscarriages, but it can often occur because the pregnancy is abnormal. Researchers believe that this may be due to an autoimmune reaction.
There is no time that you need to wait for trying to conceive. However, your healthcare provider may recommend that you discuss the timing of your next baby with him. Your healthcare provider may recommend progesterone treatment to prevent another miscarriage. This hormone is necessary for the implantation of the embryo in the uterus. Treating an illness can increase your chances of having a successful pregnancy.
It is important to take time to heal emotionally and physically after a miscarriage. Don't take responsibility for your miscarriage. Counselling can help you deal with the loss. You and your partner might find a support group for pregnancy loss helpful. For more information on counselling or support groups, ask your healthcare provider.
If you have had three consecutive miscarriages, it is time to stop trying to conceive. Instead, you can use birth control and talk to your doctor about diagnostic tests that will help determine the cause.
References
