Miscarriages: Early Loss of Pregnancy

Miscarriages are known as loss of pregnancy or abortion or death of an embryo / fetus before it develops completely. Uterus shreds the clot or tissue like a substance through the vagina. Recurrent miscarriage is recommended as a form of infertility .

What causes miscarriages?

  • In 1st trimester (up to 13 weeks)- 50% of miscarriages happens due to chromosomal abnormalities
  • Infection that occurs in uterus, Diseases ( TORCH )
  • Hormonal imbalance (PCOS )
  • Implantation (improper)
  • Uterine abnormalities
  • Cervix incompetent
  • Smoking ,alcohol
  • Lupus
  • CHD
  • Thyroid diseases

What happens in miscarriage?

  • Spotting
  • Pain in abdominal
  • Cramping
  • Secretion of fluids
  • Passing of blood clots & tissuse
  • Bleeding

Types of early pregnancy loss

Missed miscarriage : Loss of pregnancy happening without any symptom when the woman is unware, confirmation is done by an ultrasound. USG confirms absence of heartbeat.

Threatened miscarriages : 1st half of the pregnancy experiences bleeding, but the cervix stays closed , viable & even the pregnancy continues with pelvic cramping.

Recurrent miscarriages : Consecutive miscarriages happens multiple times (more than 3 times), 1% couples are affected by this.
An embryonic pregnancy : In this condition where the gestational sac develops normally, its also known as empty sac or blighted ovum. From early stage the embryonic part of the pregnancy is absent or either stops to grow .

Complete miscarriage : Pregnancy loss happens which may lead to empty of uterus, the uterus expels the conception products ( i,e yolk sac ). Bleeding continues along with pelvic cramping , ultrasound confirms about the miscarriage (empty of uterus).

Incomplete miscarriages : The uterus does not completely shred the conception particles, some remain inside the uterus.

Inevitable miscarriages : When the cervix has dilated and the parts of conception has started to expel this will lead to complete miscarriage. There will be amniotic fluid leakage, even cardiac activity of fetus is also not seen.

Septic miscarriages : When the uterus does not expel the particles of the fetus such as missed miscarriage or incomplete miscarriage then it’s is infected which can spread and causes septicemia which may be fatal.

Diagnosis of miscarriages

  • Ultrasound – used to check fetal heart beat and presence of a yok sac
  • Blood test – beta HCG
  • Pelvic exam – dilation of cervix is seen

What are the risk factors for abortion?

Age : As age increases steadily the risk factor becomes significant , lowered risk in age of 30’s and above 30 risk of miscarriage increases.

Obesity : People with over weight not only have miscarriage also leads to sub fertility problems. Bulimia nervosa & anorexia nervosa are with increased risk

Endocrine disorders : Women with thyroid related problems have high outcomes of miscarriages. After age of 30 women should control the insulin levels in the body or this may lead to loss of pregnancy. Women with deficiency are more prone with miscarriage.

Food poisoning : Women are pregnant should not intake the food that is contaminated with salmonella or other contaminating products.

Amniocentesis & chronic villus sampling : These procedures are done to asses the fetus in which the amniotic fluid in collected for the sampling by the insertion of needle through the abdomen into uterus.

Surgery : Surgery in pregnant women affects the pregnancy, women with ovarian cysts or tumors then are prone to high risk of miscarriage.

Medications : NSAIDs , misoprostol, statins increases the risk of miscarriage.

Treatment for cancer : Women with pregnancy undergone radiation therapy as part of the cancer treatment may lead to miscarriage due the levels of radiation, exposure to this can cause infertility as well.

Smoking : Risk is very high in smokers due to reduced blood supply to the uterus and fetus.

Pre-existing diseases: DM , PCOS, Hypothyroidism, preterm delivery due to mycoplasma infection.

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