What is a miscarriage?
A miscarriage is an involuntary loss of a pregnancy that occurs between conception and 20 weeks’ gestation, which is usually during the first trimester of pregnancy. It’s also called a spontaneous abortion. If a fetus dies after 20 weeks’ gestation period, it is referred to as a stillbirth. Miscarriages are very common, most often, they occur so early in pregnancy even before a woman realises she was pregnant. About 10% to 20% of pregnancies end in miscarriages.
What causes miscarriages?
The cause of a miscarriage varies from person to person. Most miscarriages are believed to be caused by genetic problems within the embryo, preventing a baby from developing and growing normally. Other causes include behavioural habits and medical conditions like the following:
- Chromosomal problems: a minor glitch during the fertilization process could result in a genetic abnormality.
- Hormone imbalance: about 15 per cent of all miscarriages are attributed to unbalanced hormones, such as insufficient progesterone levels that prevent a fertilized egg from implanting itself in the uterus.
- Uterine problems: some women are born with a septum, an uncommon uterine defect which could lead to high risks of miscarriage. Also, scar tissue developed from surgery or second-term abortions can keep an egg from implanting itself properly.
- Chronic illness: chronic illnesses like autoimmune disorders, lupus, heart disease, kidney and liver disease, and diabetes cause as high as 6 per cent of recurring miscarriages.
- Older maternal age above 35
- Cigarette smoking
- Moderate to high alcohol consumption
- Trauma to the uterus
- Abnormally shaped uterus
- Radiation exposure
- Previous miscarriages
- Maternal weight extremes: extreme underweight and overweight
- Illicit drug use
- Thyroid diseases and diabetes
- Untreated infections that can spread to the placenta.
- Use of nonsteroidal anti-inflammatory drugs (NSAIDs) around the time of conception.
- High fever: an acute fever of core body temperature over 102 degrees during early pregnancy may result in a miscarriage.
Signs and symptoms of a miscarriage
The symptoms of a miscarriage may vary, depending on the stage of pregnancy. The primary causes include the following:
- Mild to severe back pain
- Heavy spotting
- Vaginal bleeding
- Expulsion of tissue with clots from your vagina
- Severe abdominal pain
- Painful cramps
- Weight loss
- True contractions (agonizing pain happening every 5-20 minutes)
- Brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies.)
- Sudden decrease in signs of pregnancy
Note that, it’s possible to have these symptoms without experiencing a miscarriage. However, if you experience any of the following symptoms, it’s crucial to talk to your doctor.
Types of Miscarriages
Threatened Miscarriage: this where bleeding and cramps point to a possible miscarriage. It may be accompanied by intense cramps and lower backache; bleeding is often the result of implantation.
Inevitable or Incomplete Miscarriage: in the case where the membrane is ruptured or there is a dilation, miscarriage is inevitable. It is usually accompanied by bleeding with an open cervix and lower back pain.
Complete Miscarriage: this is when the embryo/product of conception is expelled from the uterus. Pain or cramping, as well as bleeding experienced during the process, should quickly subside. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage (D&C) performed.
Missed Miscarriage: where the embryo dies without the knowledge of the woman. It occurs early predominantly without any pregnancy symptoms or the absence of the fetal heart tones.
Recurrent Miscarriage (RM): occurs when 3 or more consecutive first trimester miscarriages happen consecutively. It is common with 1% of couples trying to conceive.
Blighted Ovum: here, a fertilized egg implants into the uterine wall, but fetal development never begins. It is also called an embryonic pregnancy.
Molar Pregnancy: caused by a genetic error during the fertilization process that could lead to the growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, but often accompanied by the common symptoms of pregnancy like a missed period, positive pregnancy test and severe nausea.
Ectopic miscarriage: where an egg implants somewhere other than the uterus, usually in the fallopian tubes. This requires urgent medical attention as it could lead to more complicated situations.
What Are The Chances Of Having A Miscarriage?
The average chance of having a miscarriage in childbearing women is from 10-22 per cent. The number increases as a woman ages.
At age 35 and lower, women have about a 15 per cent chance of miscarriage
Between age 35-45, women have a 20-35 per cent chance of miscarriage.
Women over the age of 45 can have up to a 50 per cent chance of miscarriage.
A woman with a history of a miscarriage has a 25 per cent chance of having another miscarriage.
What To Do If You’ve Had A Miscarriage
For women who’ve had a miscarriage, it is normal to experience a range of emotions and conditions like:
- Trouble sleeping
- Loss of appetite
- Low energy
- Frequent crying
These symptoms may become severe and gets worse if left unchecked. It’s critical you seek emotional support from your family or friends if you feel overwhelmed.
It also advisable to keep away baby items, maternity clothing and any other items that might remind you of your loss until you are ready to see them again. Take your time to grieve for your loss. It’s okay to acknowledge the loss and pain you feel.
Before trying to get pregnant again, you need to see your doctor in order to carry out some tests to help detect if there are any existing problems that could have caused your previous miscarriage. These tests may include:
- Blood tests to detect hormone imbalances
- Chromosome tests, using blood or tissue samples
- Pelvic and uterine exams
Depending on your results, your doctor may recommend you wait several months before getting pregnant again. The good news is, the odds of you sustaining a healthy pregnancy after a miscarriage is in your favour. At least 85% of women who have suffered a miscarriage go on to have a healthy, full-term pregnancy.
Can I get Pregnant Again?
Not all miscarriages can be prevented. Still, having a miscarriage or a number of miscarriages doesn’t mean you can’t conceive or carry a baby in the future. The following habits are fundamental to ensuring a healthy pregnancy.
Avoid alcohol, drugs, caffeine and smoking while pregnant and while trying to conceive.
Engage in light regular exercise to improve fetal health.
Maintain a healthy weight before and during pregnancy.
Prevent infections and completely treat any existing trace of infection.
Wash your hands thoroughly and keep your surroundings, and food clean.
Stay away from people who are already ill, particularly diseases that can be easily transmitted.
Limit the amount of caffeine to no more than 200 milligrams per day.
Eat a healthy, nutritious diet with lots of fruits and vegetables.
Ensure your partner is in good health.
Take prenatal vitamins to help ensure that you and your developing fetus get enough nutrients.
The top 7 essential vitamins to boost fertility in women are:
- Folic Acid: Lowers risk of birth defects that lead to miscarriages and increases egg production
- Vitamin D: Boosts progesterone and estrogen levels and regulates the menstrual cycle.
- Vitamin B6: Regulates hormones to promote regular menstrual cycles. Improves egg quality for fertilization and lengthens the luteal phase.
- Vitamin E: Protects cellular growth, promotes free radicals, increases blood flow to thicken the uterine lining and decreases the risk of miscarriages.
- Vitamin C: Protect from free radicals, increases progesterone levels to promote a longer luteal phase.
- Omega-3: Improves egg health
- Vitamin B12: Promotes regular ovulation and helps decrease miscarriage risk.
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