Miscarriages can occur due to a complication in the fetus (z. B. a hereditary disease or birth defect) or in the expectant mother (z. B. Malformations of the reproductive organs, infections, cocaine, alcohol, and tobacco use, or an injury) occur, and the cause is often unknown.
Bleeding and cramping may occur, especially towards the end of pregnancy.
The doctor examines the cervix and usually performs an ultrasound examination.
Any residue of the pregnancy remaining in the uterus after a miscarriage is removed.
Pregnancy complications are problems that occur only during pregnancy. These can have an impact on the woman and/or the fetus and can occur at different times during pregnancy. However, most pregnancy complications can be successfully treated. Miscarriage, by definition, is associated with fetal death and may increase the risk of miscarriage in future pregnancies.
It is estimated that up to 15 percent of confirmed pregnancies end in miscarriage. Many more miscarriages go unnoticed because the women were not even aware of the pregnancy until this time. About 85 percent of miscarriages occur in the first 12 weeks of pregnancy, and up to 25 percent of all pregnancies end in miscarriage during the first 12 weeks of pregnancy. The remaining 15 percent of miscarriages occur in the 13. to 20. Week of pregnancy.
The likelihood of miscarriage is higher in high-risk pregnancies Learn more, especially if women do not receive appropriate medical care.
Causes of miscarriage
Most miscarriages that occur in the first 10 to 11 weeks of pregnancy are thought to be due to a hereditary condition. Some miscarriages are the result of a malformation.
For many of the miscarriages that occur between 13. and 20. No cause can be determined at the first week of pregnancy.
Risk factors (Conditions that increase the risk of disease) for miscarriage include the following:
Advanced age (over 35)
Malformations of the reproductive organs, z. B. Myomas Myomas are benign tumors (not cancer) made up of muscle and connective tissue fibers. It is located in the uterus. Fibroids can cause pain, abnormal vaginal bleeding, constipation. Learn more , scarred tissue, double uterus, or cervical weakness (cervical insufficiency) Cervical insufficiency Cervical insufficiency is an opening of the cervix without labor that leads to delivery of the baby in the second trimester of pregnancy. Connective tissue disease present at the time of birth. Learn more , wherein the cervix opens (dilates) as the uterus grows
Severe or poorly controlled hypothyroidism Hypothyroidism is underactivity of the thyroid gland, causing inadequate production of thyroid hormones and slowing of vital functions. Learn more ) or hyperthyroidism (hyperthyroidism Hyperthyroidism is an overactivity of the thyroid gland that results in high levels of thyroid hormones and an acceleration of vital functions. Graves’ disease. Learn more ) of the thyroid gland
A sudden emotional shock (e. B. after receiving bad news) and minor injuries (z. B. in slip and fall accidents) are not related to miscarriages.
Miscarriage is more likely if a woman has had a miscarriage in a previous pregnancy.
The more miscarriages a woman has had, the higher the risk of miscarriage again. The risk of another miscarriage also depends on what caused it, but overall, women who have had multiple miscarriages have a 1 in 4 chance of miscarrying again in a subsequent pregnancy.
Some of the causes that are not corrected or. treated seem to be the reason for repeated miscarriages. If a woman has had a series of miscarriages, the cause may be an abnormality in her chromosomes or the father’s chromosomes, or antiphospholipid antibody syndrome.
Understanding the language of loss
In some circumstances, doctors use the term Abortion used when talking about a miscarriage (spontaneous abortion) or even a deliberate termination of pregnancy for medical or other reasons. After 20 weeks of pregnancy, the birth of a dead baby is called a stillbirth.
Other terms for an abortion are:
Abortion induction: Induction of abortion by medical assistance (drugs or surgical intervention), e.g. B. If the life or health of the woman is endangered or the fetus has severe abnormalities
Impending miscarriage: Bleeding or cramping during the first 20 weeks of pregnancy without opening (dilation) of the cervix, indicating possible loss of the baby
Inevitable miscarriage: Pain or bleeding during the first 20 weeks of pregnancy with dilatation of the cervix indicates that loss of the baby is imminent
Complete abortion: Ejection of the entire fetus and placenta in the uterus
Incomplete abortion: Incomplete expulsion of the uterine contents
Behavioral abortion: Remaining of the dead fetus in the uterus
Septic abortion: Infection of the uterine contents before, during, or after an abortion
Symptoms of miscarriage
A miscarriage is usually preceded by bleeding or spotting with light or dark blood. Contractions of the uterus occur, causing cramps. However, bleeding occurs in about 20% of pregnant women at least once during the first 20 weeks of pregnancy. About half of these episodes end in miscarriage.
In early pregnancy, the only symptom that may show up is light vaginal bleeding. In late pregnancy, heavy bleeding may occur due to a miscarriage, and a blood slime or blood clots may form. Convulsions increase until the uterus finally contracts and expels the fetus and placenta.
Sometimes the fetus dies without showing symptoms of miscarriage. In such a case, the uterus does not enlarge. Rarely, infection of the dead tissue in the uterus occurs before, during, or after a miscarriage. Such an infection (called septic abortion) is usually the result of an artificial abortion performed by an untrained person who did not use sterile techniques. Septic abortion can be severe, causing fever, chills, bleeding and palpitations. The women fall into delirium. If necessary, there is a sharp drop in blood pressure.
Did you know .
Many miscarriages go unnoticed because women were not even aware of the pregnancy at the time.
Bleeding occurs in about 20% of pregnant women at least once during the first 20 weeks of pregnancy.
Diagnosis of miscarriage
Examination by the doctor
If bleeding and cramping occur during the first 20 weeks of pregnancy, a doctor will check to see if a miscarriage is imminent. The cervix is examined to find out if it is dilating or retracting (passing). If this is not the case, the pregnancy does not have to be terminated. If it opens before 20. After the 20th week of pregnancy, a miscarriage is most likely to occur.
Usually an ultrasound examination is also performed. This is to determine whether a miscarriage is present or. Whether the fetus is still alive. Ultrasound images also show whether the fetus and placenta have been expelled after a miscarriage.
Usually, the doctor also performs blood tests to measure a hormone produced by the placenta in the first weeks of pregnancy, human chorionic gonadotropin (hCG). The results can be used to determine whether a woman has a pregnancy outside the uterus (ectopic pregnancy) Ectopic pregnancy Ectopic pregnancy is the implantation (implantation) of a fertilized egg in an unusual area. In an ectopic pregnancy, the fetus cannot be delivered. Learn more is present, which can also cause bleeding. This test also allows the doctor to determine if any parts of the fetus or placenta remain in the uterus after a miscarriage.
Doctors can usually diagnose a septic abortion based on the woman’s circumstances and symptoms. If a septic abortion seems likely, a blood sample will be sent to the laboratory, where a culture will be made (in a substance that stimulates the growth of microorganisms). This technique can be used to determine the microorganism causing the infection so that it can be determined which antibiotics would be effective.
If a woman has had several miscarriages, she should first see a doctor before trying to get pregnant again. The doctor may check her for malformations or anatomical abnormalities, as well as other conditions that pose an increased risk of miscarriage. It may include z. B. Perform the following:
Imaging procedures (z. B. Ultrasound, hysteroscopy, or hysterosalpingography) to detect anatomical abnormalities
Blood tests to detect certain conditions, such as z. B. Antiphospholipid antibody syndrome, diabetes, hormonal disorders, and thyroid disorders
genetic testing to detect chromosomal abnormalities
If the cause of miscarriage is determined, it may be possible to treat it and allow for a successful pregnancy.
Treating a miscarriage
If an abortion is imminent, periodically assess the affected woman’s symptoms
In the case of a complete abortion, no treatment
For other abortions, removal of the uterine contents
If the fetus is alive and the cervix is not open (threatened abortion), there is no specific treatment, but the symptoms of the affected woman are regularly assessed by the attending physicians, z. B. by means of ultrasound examinations.
Some doctors advise women not to engage in strenuous activities and to spend as little time on their feet as possible. However, there is no evidence that these restrictions are actually helpful. Also, it has not been proven that abstaining from sexual intercourse is beneficial.
If the fetus and placenta were completely expelled in a miscarriage, no treatment is needed.
If some fetal or placental tissue remains in the uterus after a miscarriage, or if the fetus dies and remains in the uterus, the doctor may do one of the following:
If the patient has no fever and appears to be healthy, she is monitored closely to see if the uterus expels any remaining debris. Whether this procedure is safe depends on how much tissue is left, how the uterus looks on a pelvic ultrasound, and when the miscarriage is estimated to have occurred.
A drug such as z. B. Oxytocin (usually given later in pregnancy) or misoprostol (usually given early in pregnancy) is given, which can induce labor, causing the contents of the uterus to be expelled.
Before surgically removing the fetus in the first or second trimester, natural substances that absorb fluids can first be used to open the cervix (z. B. Seaweed gel). Alternatively, the woman may be given prostaglandin (a hormone-like drug that stimulates the uterus to contract), z. B. Misoprostol. These treatments make it easier to remove the tissue.
If a drug is used, suction curettage or D& may need to be performed afterwards A be performed to remove the remnants of the placenta. It may be that the D& A cannot be performed because it requires special training.
If a woman shows symptoms of a septic abortion, the retained contents of the uterus are removed as quickly as possible and intravenous antibiotics are administered.
Emotions after a miscarriage
After a miscarriage, many women experience feelings of sadness, grief, anger, guilt, or fear of becoming pregnant again.
Grief: Grief over loss is a natural reaction and should not be suppressed or denied. Talking to another person about feelings can help women come to terms with their feelings and gain a new perspective.
Guilt: It is possible that the women believes that they did something that caused the miscarriage. As a rule, however, this is not the case. Women may remember taking a commonly available over-the-counter medicine in the early stages of pregnancy, drinking a glass of wine, or doing any other mundane thing before learning of their pregnancy. These things are almost never the cause of a miscarriage. So the women should not reproach themselves for it.
Anxiety: Women who have had a miscarriage may want to talk to their doctor about the likelihood of miscarriage in later pregnancies and be evaluated. Even though miscarriage increases the risk of having more miscarriages, most of these women are able to conceive again and have a healthy baby born on time.
Doctors offer support to affected women and reassure them, when appropriate, that they are not at fault for the miscarriage. Formal psychological counseling is rarely required, but is made available to women who request it.