What condition is miscarriage? What are the causes of miscarriage?【supervised by doctor】

Introduction

When a pregnant woman discovers she is pregnant, she is happy, but at the same time she may experience a number of anxieties. One of these is the fear of miscarriage. In this article, we will look at the causes of miscarriage.

What is a miscarriage?

A miscarriage is the death of a baby before 22 weeks’ gestation for any reason. The death of a baby after 22 weeks’ gestation is now called a stillbirth.

How often do miscarriages occur?

15-20% of pregnancies result in miscarriage. Other miscarriages may occur before the pregnancy is known and go unnoticed. About 85% of miscarriages occur before the 12th week of pregnancy.

It is estimated that one in six women will have experienced a miscarriage, and many women do.

Miscarriage is also said to be one of the most common conditions in women with high-risk pregnancies.

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What is a high-risk pregnancy?

• Younger and older births
• Physical characteristics such as short stature, obesity, etc.
• Social characteristics (e.g. marital status, special occupation)
• Problems during previous pregnancies (miscarriages, stillbirths, illnesses during pregnancy)
• Diseases present before conception
• Illnesses developed during pregnancy
• Exposure to harmful substances and drugs during pregnancy

What is NIPT

NIPT is a non-invasive prenatal genetic test.

A blood sample is taken from the mother between the 10th and 16th week of pregnancy to check for chromosomal abnormalities in the baby. The test is optional for pregnant women who have had an older birth, miscarriage or stillbirth, and for pregnant women who have not had an older birth, miscarriage or stillbirth, but are concerned about their baby’s condition.

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What causes miscarriages?

Most miscarriages that occur before about 11 weeks’ gestation are due to causes on the part of the baby, genetic disorders or congenital abnormalities. Therefore, in most cases, the moment of conception determines whether the miscarriage is a miscarriage or not. In early miscarriages, it can be said that the pregnancy was unnoticed and not due to drinking, smoking, taking medication, work or exercise.

It is also said that psychological shocks and minor injuries (such as slips and falls), which are often feared, have nothing to do with miscarriage.

The causes of many miscarriages after 12 weeks are not yet known with current medical care, but problems on the mother’s side include

• Uterine structural abnormalities (fibroids, duplicated uterus, cervical incompetence)
• Drinking, smoking, therapeutic drugs, cocaine and other drugs
• Severe injuries
• Infectious diseases (e.g. cytomegalovirus, rubella)
• Severe thyroid dysfunction
• Severe diabetes mellitus
• Untreated chronic kidney disease, systemic lupus erythematosus, hypertension, etc.
• RH blood group incompatibility (maternal Rh-, foetal Rh+)

The probability of a second or subsequent miscarriage increases for those who have experienced a miscarriage. The more frequent the miscarriages, the higher the risk of another miscarriage, and repeated miscarriages may indicate infertility, so testing and treatment should be started at an early stage.

※ Failure to thrive refers to repeated miscarriages, stillbirths and premature births, when a pregnancy can be achieved but the baby does not grow

Types of miscarriages

There are different types and names for miscarriages. The terms are explained below.

Spontaneous miscarriage

All miscarriages that occur non-humanly.

Abortifacient miscarriage

‘Abortion’. Surgery performed by a doctor designated under the Maternal Protection Act for the purpose of protecting the mother.

Threatened miscarriage

A condition in which the cervix is not open by 20 weeks’ gestation and there is bleeding or cramping pain and the baby may be lost.

What condition is miscarriage? What are the causes of miscarriage?【supervised by doctor】

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Progressive miscarriage

A condition in which there is bleeding and cramping pain by 20 weeks’ gestation, the cervix (uterine opening) opens and the uterine contents begin to drain spontaneously with bleeding and abdominal pain.

Complete miscarriage

A condition in which the baby and placenta have all left the womb.

Incomplete miscarriage

A condition in which only part of the baby and placenta are outside the uterus. A small amount of blood remains in the uterus.

Residual miscarriage

A condition in which the baby has died but still has no bleeding, abdominal pain or other symptoms. It is first confirmed during a medical examination.

Contagious miscarriage

Miscarriage with bacterial infection in the uterus.

Recurrent miscarriage

Two repeated miscarriages.

Habitual miscarriage

A miscarriage repeated three or more times.

Chemical miscarriage

A miscarriage at a very early stage of pregnancy. It is defined as a pregnancy that is not confirmed by ultrasound, although a urine or blood test shows a pregnancy response. It is a condition that has become more noticeable due to the widespread use of over-the-counter pregnancy tests and is often thought of as a normal menstruation if no test is done.

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What are the symptoms of miscarriage?

Prior to miscarriage, a small amount or clear bleeding of a fresh or dark red colour occurs, and the uterus contracts, causing cramp-like pain in the abdomen. Abdominal pain becomes more severe and bleeding increases with each successive week of pregnancy.

The baby may die in the womb and not cause abdominal pain or bleeding. In this case, the baby waits for spontaneous expulsion, but may be surgically removed because infection may occur from the tissue in the uterus.

Bleeding and abdominal pain in early pregnancy can also occur in normal pregnancies. It is therefore difficult to judge for yourself whether you have a miscarriage or a normal pregnancy from the symptoms alone. If there is a small amount of bleeding or mild abdominal pain, it is advisable to consult a doctor at the next check-up. However, if there is heavy bleeding or abdominal pain, there is a risk of an ectopic pregnancy (pregnancy outside the uterus) and you should visit a medical institution, even at night or after hours.

How can miscarriages be prevented?

Miscarriages up to 11 weeks’ gestation are caused by genetic disorders or congenital abnormalities in the baby. Preventing miscarriage in the early stages is therefore very difficult.

However, there are things that can be done before a pregnancy is desired. Stop smoking, complete vaccinations against rubella, measles and other diseases, and make sure that any underlying medical conditions are checked and treated. Mothers need to be physically and mentally healthy to be able to welcome their baby. Abstinence from alcohol should be done in a stress-free manner.

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What is the diagnosis and treatment of miscarriage?

Miscarriage is diagnosed by internal examination, ultrasound and blood tests.

If the cervix is open before 20 weeks’ gestation, miscarriage is inevitable.

Current medical treatment does not offer any prophylaxis for an imminent miscarriage before 12 weeks’ gestation.

It has been reported that exercise, resting as much as possible and abstaining from sexual intercourse are effective in the case of an imminent miscarriage, but there is no clear scientific evidence to support this. Any restrictions on activity should be directed by your doctor and regular check-ups are necessary.

No treatment is required for complete or chemical miscarriages.

In the case of a comitting or incomplete miscarriage, if the woman does not have a fever or physical condition, wait for her to bleed out spontaneously. If it does not come out spontaneously, surgical procedures or labour-inducing drugs are used.

In case of infected miscarriage, the foetus and placenta should be removed as soon as possible and injections of antibacterial agents should be administered.

In the case of a repeat or habitual miscarriage, the baby may not grow in the womb for some reason. You may need to discuss this with your doctor and see a fertility specialist for treatment.

What to look out for after a miscarriage?

Women who experience a miscarriage are more likely to experience feelings of anger, guilt and anxiety about the next pregnancy due to hormonal imbalances and grief at the loss of the baby.

The loss of a baby is a natural reaction. It is necessary not to suppress or deny these feelings, but to talk to someone about how you are feeling, shed tears and grieve to help you sort through your emotions. The mother may feel guilty that it is her fault that the baby miscarried, but it is important to know that miscarriage at less than 11 weeks’ gestation is rarely caused by the mother. If you are worried about your next pregnancy, you can talk to your doctor and get tests if necessary. It is important to know that although miscarriage increases the risk of another miscarriage, most women are able to conceive again and continue with their pregnancy.

Conclusion

For women who have experienced a miscarriage, it is no exaggeration to say that miscarriage is one of the most difficult things in life.

With the right knowledge, you can eliminate the many anxieties caused by pregnancy and have a better maternity life.