A miscarriage is any pregnancy that ends spontaneously before the fetus becomes viable. This term is medically referred to as a spontaneous abortion. Statistic shows that miscarriage occurs in about 15% to 20% of all recognized pregnancies, and usually occurs before the 13th week of pregnancy. In addition, researchers have been able to show that around 60% to 70% of all pregnancies (recognized and unrecognized) are lost. Because the loss occurs so early, many miscarriages occur without the woman ever having known she was pregnant. Prior to the eighth week of pregnancy, 30% have no fetus associated with no embryo inside the sac. This condition is called blighted ovum. There are more causes of pregnancy loss. Here?s a guide for you to know more about miscarriage, its causes and preventions.

What Is The Sign Of Miscarriage?

When the baby stops developing or the mother encounter some factors that precipitate a miscarriage. The uterine lining begins to shed off leading to mild cramping alongside vaginal bleeding (the most common signs and symptoms of miscarriage).

What Are The Causes Of Miscarriage?

First Trimester Miscarriages

The most common known causes of miscarriage during the first trimester are chromosomal abnormalities, collagen vascular disease, diabetes, other hormonal problems, infection, and congenital (present at birth) abnormalities of the uterus.

  • Chromosomal abnormalities of the foetus are the most common cause of early miscarriages, including blighted ovum.
  • Collagen vascular disease is also known as an autoimmune disease wherein a person’s own immune system sees their own organs as foreign bodies and attacks them. Examples: (systemic lupus erythematosus, and antiphospholipid antibody syndrome)
  • Diabetes Good control of blood sugars during pregnancy is very essential. This condition can be well managed during pregnancy, if a woman is compliant with what is advised to her by the health care professional. If diabetes is poorly controlled, not only is the risk of miscarriage is high, but the baby can also have major birth defects.
  • Hormonal factors may be associated with an increased risk of miscarriage, such as abnormality in the pituitary gland that produces large amounts of adrenocorticotropic hormone ACTH, hyper/hypo stimulation of the thyroid gland, inadequate function of the corpus luteum in the ovary, etc. Examples: (cushing?s syndrome, thyroid disease, and polycystic ovary syndrome PCOS).
  • Infections – a lot of different organisms has been associated with an increased risk of miscarriage. Examples: (infections by Listeria monocytogenes, Toxoplasma gondii, parvovirus B19, rubella, herpes simplex, cytomegalovirus, and lymphocytic choriomeningitis virus).
  • Abnormal anatomy of the uterus. For some women, a tissue bridge (uterine septum) may develop. It is believed that the septum usually has a very poor blood supply, therefore, an embryo implanting on the septum would be at increased risk of miscarriage. However, it does not necessarily mean that it caused the miscarriage.
  • Other structural abnormalities. Example: (Fibroid tumors in the uterus – leiomyomata)
  • Ectopic Pregnancy is a normal fertilized egg that gets stuck and implants in the fallopian tube. This type of pregnancy puts the mother at great risk for severe bleeding and possibly cause death as the baby grows and eventually bursts the fallopian tube. If this condition is identified early it can be managed with an anti-neoplastic drug called Methotrexate, which will end the pregnancy safely. If it occurs unexpectedly, a surgical intervention is needed to remove the baby.
  • Other causes. Invasive surgical procedures in the uterus also slightly increase the risk of miscarriage. Example: (amniocentesis and chorionic villus sampling).

Second Trimester Miscarriages

Reasons for miscarriages during the first trimester may also occur as the same manner to second trimester miscarriages. In the event that miscarriage happens, the woman might require a D & C to eliminate the excess contents inside the uterus that might cause maternal sepsis/infection. Late second trimester miscarriages might indicate that the baby dies inside the uterus. If the miscarriage happens after 20 weeks of pregnancy, this loss is technically called a stillbirth.

  • Incompetent cervix – the cervix slowly thins and then the baby can be born too prematurely to survive, even though the pregnancy (age of gestation) is viable. It can be managed by the doctors through a cervical cerclage only if the condition is identified early.
  • Other causes includes drug use, premature rupture of membranes, smoking, teratogen exposure, trauma (e.g., physical abuse)

How To Prevent A Miscarriage?

To prevent a miscarriage is to treat what is believed to be the underlying cause. Treatment and cautious evaluation is not easy. Because the treatment process alone or together with the underlying disease might become potential factors that may be responsible for the pregnancy loss.

If a chromosomal abnormality is detected in one or both couple, then counseling as to future risks is the only option for the couple, since there is currently no means to correct genetic abnormalities.

If the mother has collagen vascular disease or autoimmune disease, such as such as (systemic lupus erythematosus and antiphospholipid antibody syndrome), certain medications are being considered that can be helpful in achieving successful pregnancy results. Blood thinners (aspirin and heparin) are suggested, in some cases, prevent further miscarriages.

If you have diabetes or thyroid abnormality condition, be sure to tell the health care provider who will take care of you during your pregnancy. It’s best if you do this before you become pregnant.

Many doctors use progesterone therapy to women with recurrent pregnancy loss. Though. the effectiveness of this therapy is not confirmed, most physicians report positive outcomes with progesterone therapy. It can be given as vaginal suppositories, gel form or in a tablet.

What You Need To Realise

To prevent the occurrence of miscarriage, it is important for you to know that even though you have followed all the treatments and evaluations given by your doctor, there is still a chance of pregnancy loss, though at least you tried to diminish its chances. This is not to say that prevention attempts should not be considered to correct any abnormalities but there is no absolute treatment can be guaranteed. However, most reports show that even with repeated pregnancy loss, there is still a big possibility of having a successful pregnancy in the future. Early pregnancy and pre-natal counselling can help identify risk factors and allow the doctor to provide any special intervention that may be needed.

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