Miscarriage

  

                Miscarriage

Miscarriage (sometimes called "spontaneous abortion") is the loss of a baby in the first 24 weeks of pregnancy. Sadly, it is a common event. Although it's difficult to give an exact figure, about 15 per cent of known pregnancies end in miscarriage. Often, a woman miscarries before she realizes she's pregnant. Perhaps as many as three-quarters of all fertilized eggs are lost in the very earliest stages of pregnancy. About 98 per cent of women who miscarry do so in the first 13 weeks but occasionally, a woman will miscarry much later.

  

 Causes

Most early miscarriages are caused by a chromosomal abnormality. This means that during development the feotus has not grown correctly, this is often due to a faulty egg or sperm. The cause of this is unknown. When the egg starts to divide and develop, (once it has been fertilised by the sperm), it doesn’t develop correctly. The body knows when the foetus is not developing and we then miscarry. These issues are not caused by either parent and do not mean that you are unhealthy or couldn’t have a successful pregnancy in the future. There are other issues which we will look in Infrequent Conditions.

Other Causes

• Lifestyle – Drug Use, Alcohol, Smoking etc
• Hormonal Issues or Immune System Challenges.
• Mothers over the age of 35 years.
• Any deep life or emotional traumas
• Infection or Infectious Diseases
• Underlying uncontrolled disease e.g. Diabetes.
• Any uterine or cervical problems, e.g. a short cervix.
• As mentioned above, women who are 35 years or over are at increased risk of miscarriage, in fact a 20% risk. At 40 years the risk increases to 40% and by the age of 45 years it can be as high as 80%.
• Women who have had 2 or more miscarriages have been shown to have an increased risk of further events. Although having one miscarriage does not put you at any further a risk than a woman who has miscarried at all.
• There is some debate over other possible contributors e.g. caffeine. Again it is best to speak with your Health Care Professional if you think you could be at increased risk.

Warning Signs

There are some general signs and symptoms of miscarriage, if you have any of the below you need to contact a doctor immediately.

Brown or bright red vaginal bleeding, with or without cramping. It is important to use a sanitary pad and not a tampon to be able to assess the amount of bleeding.  Also refrain from sexual intercourse during this time.

Cramps or low back ache, similar to, or more intense than a period. Abdominal pain that is dull, sharp or cramping.

Contractions, these are more painful than period cramping and can last for sometime. You will need to note the frequency for you medical consultation.

A feeling that the signs of pregnancy are decreasing e.g. less nausea or breast tenderness.

Tissues with clots passing from the vagina. This is another reason to use a sanitary pad and the physician may want to assess the contents.

Some women who miscarry can develop an infection in their uterus. If you have any symptoms of fever, chills, body ache or an unusual discharge you must seek medical help.

One of the most obvious and worrisome signs of a possible miscarriage is always bleeding. To put this into perspective, the incidence of vaginal bleeding is quite high in the first 3 months at around 20-30%. As many as 50% of women go on to have a normal birth. Most miscarriages can’t be prevented, as this is the body’s way of recognizing that something is wrong. Bleeding during the first 3 month can be caused by various reasons, from implantation bleeding to types of infection to intercourse.

Treatment

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.