A Guide to Understanding Miscarriages

Pregnancy is probably the most cherished period in a woman’s life. However, not all pregnancies result in a baby. Miscarriage refers to the termination of pregnancy within the first 20-24 weeks of gestation. Miscarriages are not uncommon and may happen for a number of reasons.

Symptoms of Miscarriage
Bleeding with mild cramps, abdominal pain and back ache (more intense than normal menstrual pain) are the first symptoms of miscarriage. With time, the pain intensifies and the bleeding becomes heavy; some women also observe white or pink vaginal discharge. Women who are in their first few weeks of pregnancy must immediately report these symptoms to their OB/GYN. In some cases, a silent miscarriage happens where there are no signs of a miscarriage and the pregnant woman learns about the death of the foetus only during the regular scan session.

Types of Miscarriages
While miscarriage is the common term used to refer to the early termination of pregnancy, they are of different types.

Incomplete Miscarriage: In this type of miscarriage, the cervix dilates and the membranes are ruptured, thus causing bleeding. However, the embryo is not completely emptied from the uterus.

Complete Miscarriage: This is less painful than the incomplete miscarriage as all products of the conception are removed completely from the uterus.

Recurrent Miscarriage: About 1% of couples face three or more consecutive miscarriages, and this is mainly due to the physical condition of the mother.

Missed Miscarriage: Miscarriages can also happen without any symptom. While the embryo dies in this type of miscarriage, it is not expelled outside and there is no bleeding either.

Causes of Miscarriage
The reasons for miscarriage are varied. The most common reasons during the first trimester (0-14 weeks) are chromosomal abnormality of the foetus, problems with the egg or the sperm, improper zygote formation, intense exercises or accidents. Other significant reasons are infections in the mother, hormonal imbalance, physical problems for the mother, exposure to drugs, medical conditions like diabetes or thyroid, and uterine abnormalities.

Risks Leading to Miscarriage
Women who are expecting a child must practice certain precautionary steps, especially during the first trimester. Maternal age also plays a significant role for a healthy pregnancy with the risks being greater when the mother is over 35 years of age. In some cases, the woman faces 2 or 3 consecutive miscarriages, thus increasing the risk for next time too. Proper care must be taken in such cases.

Ways to Prevent Miscarriage
The complete prevention of miscarriages is not yet a guarantee. Mothers who have experienced miscarriages previously or faced the possibility of miscarriages may opt to take ample rest to keep risks at bay. Though usual activities or sexual intercourse will not interfere with the pregnancy, it is better to avoid strenuous work-outs especially during the early weeks of pregnancy. Expectant mothers must be alert and any symptoms of miscarriage must be immediately reported. Regular intake of folic acid supplements is recommended.

Treatment After Miscarriage
Dilation and curettage (D&C) is the most common procedure performed to remove the remnants of the embryo from the uterus. In this process, the cervix is gently opened up and the foetal tissues are removed. Sometimes, the doctor suggests placing medicines in the vagina to facilitate the passage of tissues. The earlier the miscarriage, the faster the recovery, and when the miscarriage occurs after 20 weeks of gestation, labour may be induced. In the case of incomplete miscarriage, the doctor waits for the remnants to pass off by themselves.

Miscarriages may be a difficult period emotionally as well as physically. Mothers must be offered appropriate help and support to cope up with the ordeal.

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