Overview of Miscarriage
Symptoms and Diagnosis of Spontaneous Abortion
Unfortunately, approximately 20% of all pregnancies end in spontaneous abortion, otherwise known as a miscarriage. Here are the different types of miscarriage:
Chemical Pregnancies—These equal approximately 50-75% of all miscarriages. A chemical pregnancy occurs when the pregnancy is lost shortly after the embryo has implanted, and bleeding occurs around the time the woman’s period would have arrived. Therefore, many women are unaware that they have had a chemical pregnancy.
Threatened Miscarriage—There is a degree of bleeding along with cramping or lower backache, but the cervix is closed and no tissue has passed. The pregnant woman has a 50-50% chance of carrying a baby to term in this instance.
Inevitable Miscarriage—The bleeding and cramping is more severe, and the cervix has opened. It is "inevitable" that the fetus will miscarry.
Incomplete Miscarriage—There is severe bleeding and abdominal pain, along with expulsion of some, but not all, of the fetal tissue.
Complete Miscarriage—This is when the embryo and all of the "products of conception" have been emptied, either naturally or through surgery. After this point the bleeding and cramping should subside.
Missed Miscarriage—This is when a fetus passes away without the woman knowing it.
Recurring Miscarriages—Three or more consecutive miscarriages. At this point your doctor may order genetic counseling.
Risk Factors for Miscarriage
While most miscarriages occur without known causes, there are a few types of identified reasons for miscarriage. First trimester miscarriages are often a result of chromosomal abnormality with the egg or sperm. Other factors that may play a part in causing a miscarriage are:
- Maternal infections or hormone imbalances
- Fibroids, abnormal womb or placenta
- Maternal diabetes, high blood pressure, kidney disease, or lupus
- Maternal German measles or pneumonia
- Alcohol or drug use
- Malnutrition
- Excessive exposure to radiation
- Advanced maternal age
It is known that miscarriages are not due to sex, working, or moderate exercise.
Symptoms of Miscarriage
Symptoms of miscarriage may include any of the following, and should be investigated by a health care professional:
- Mild to severe back pain
- Abdominal pain or cramping
- Brown or bright red vaginal bleeding, with or without cramps
- Tissues or clots passing from the vagina
- Sudden absence of pregnancy symptoms
- Contractions every 5-10 minutes
- Weakness or dizziness
Diagnosing a Miscarriage
Diagnosing a miscarriage usually takes several steps. First, a woman's health care provider may order urine or blood tests to check for anemia, blood type, and the levels of pregnancy hormone in her system. If the hormone levels are too low the pregnancy may be abnormal. This test may be repeated in two to three days to see if hormone levels are increasing or decreasing.
Next, a physician will give a vaginal exam to feel whether the woman's cervix is open or closed, and to estimate the size of her uterus. If she has already miscarried, her uterus would most likely already be back to its normal size. Lastly, he will most likely perform an ultrasound to look for evidence of pregnancy or to make sure all tissue has passed.
Treating Miscarriage
If a woman has expelled all fetal tissue naturally, no further treatment is necessary. If she has not, she may be given three choices: to wait to pass the fetus on her own, to take medication to aid in the passing of the fetus, or to undergo a dilation and curettage (D&C). A dilation and curettage is a surgical procedure under general anesthesia, which involves cleaning the uterus completely.
After a miscarriage, a woman should get plenty of rest and avoid douching or sexual intercourse. If she experiences more severe bleeding, pain or dizziness, she should return to the emergency department.
Miscarriage is physically and emotionally draining. It can be hard to come to terms with the loss of a baby, especially if a woman was excited and anticipating a healthy child. Miscarriage is not only hard on the mother, but on all the members of the family. Women and their loved ones should seek support through a counselor, friend, online chat room or clergyman.
References:
Feeling Miscarriage
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