Miscarriage

Miscarriage is a devastating event that affects countless individuals and couples around the world. The loss of a pregnancy can have profound emotional and physical effects on those who experience it. Following a miscarriage, women often undergo physical symptoms like bleeding, cramping, and fatigue as their bodies recover.

These tangible reminders of their loss can exacerbate emotional distress, making it challenging to cope. This article will explore what a miscarriage is, its symptoms, causes, risk factors, complications, diagnosis, treatments, prevention, and when to seek medical attention. It is essential to understand that miscarriage is a sensitive and complex topic, and the information provided here aims to offer support and guidance to those who have gone through or are currently experiencing this heartbreaking loss.

What is a Miscarriage?

A miscarriage, medically known as spontaneous abortion, is the loss of a pregnancy before the foetus reaches viability, typically before the 20th week of gestation. It is a heartbreaking experience for expectant parents who have been eagerly anticipating the arrival of their baby. Miscarriages can occur due to various reasons, and it is estimated that up to 25% of known pregnancies end in miscarriage. It is important to note that most miscarriages happen in the first trimester, often before the woman is even aware she is pregnant.

Symptoms of Miscarriage

Miscarriage can present with a range of symptoms, which may vary from person to person. These include:

• Vaginal bleeding: It can range from light spotting to heavy bleeding.  
• Cramping, or abdominal pain, ranges from mild to severe and can be similar to menstruation pain.
• Pain in the back and pelvic area
• Passing of tissue or clots through the vagina 
• A decrease or cessation of pregnancy-related miscarriage symptoms, such as morning sickness or breast tenderness

It is essential to keep in mind that not all bleeding during pregnancy indicates a miscarriage, as some women may experience implantation bleeding or other harmless causes of bleeding. 

Causes of a Miscarriage

Various factors can contribute to miscarriages, and in many cases, the exact cause remains unknown:

• Chromosomal defects: Chromosomal abnormalities, such as aneuploidy, are a common cause of early miscarriage. These abnormalities develop when errors in the number or structure of chromosomes in the embryo or foetus occur. 
• Maternal age: As women age (typically after 35), they become more prone to have eggs with chromosomal abnormalities and will experience miscarriage.
• Chronic health conditions: Pre Existing maternal health conditions like diabetes, autoimmune disorders, thyroid disease, or blood clotting disorders can increase the chance of early miscarriage.
• Other causes: These may include hormonal imbalances, infections (cytomegalovirus, listeria, or toxoplasmosis), immune disorders, and anatomical abnormalities of the uterus. 
• Lifestyle factors, such as obesity, exposure to environmental toxins, smoking, drug use, and excessive alcohol consumption, can also be a reason for miscarriage.

Complications

In some cases, a miscarriage can lead to complications that require medical attention, such as: 

• One such complication is an incomplete miscarriage, where not all the pregnancy tissue is ejected from the uterus. It can result in persistent bleeding and infection if left untreated. 
• Another potential complication is an ectopic pregnancy, where the fertilised egg gets implanted outside the uterus, typically in the fallopian tube. Ectopic pregnancies require immediate medical intervention as they can cause life-threatening complications. 
• When the uterus is not completely empty during miscarriage, the risk of infection increases. Symptoms of infection include high fever, chills, abdominal pain, and foul-smelling discharge. 
• Excessive or prolonged heavy bleeding miscarriage can lead to anaemia, low blood pressure, or other complications.

It is crucial to seek medical attention if you experience prolonged miscarriage bleeding, severe pain, or signs of infection after a miscarriage.

Miscarriage Diagnosis

When a miscarriage is suspected, healthcare professionals employ various diagnostic methods to confirm the loss. These may include:

• Blood investigation: Blood tests are conducted to monitor hormone levels, such as beta-human chorionic gonadotropin (hCG), which may decrease following a miscarriage.
• Pelvic examination: Healthcare professionals conduct a pelvic exam to assess uterine size and tenderness.
• Ultrasound: An ultrasound helps visualise the foetus and confirm the absence of a heartbeat, confirming the diagnosis of miscarriage.
• Genetic testing: In some cases, doctors may recommend genetic testing to identify chromosomal abnormalities that could have contributed to the miscarriage.

 It is important to remember that the diagnosis of a miscarriage can be emotionally challenging, and seeking emotional support during this time is crucial.

Miscarriage Treatments

• The management of a miscarriage depends on several factors, including the gestational age, the presence of complications, and the woman's preferences. 
• Sometimes, the body may naturally expel the pregnancy tissue, and no further intervention is needed. It is known as a spontaneous miscarriage or a complete miscarriage. 
• However, if the miscarriage is not complete, medical or surgical interventions may be necessary. Medications can help the uterus expel the remaining tissue, while a surgical procedure called a dilation and curettage (D&C) may be performed to remove the pregnancy tissue. 
• After a miscarriage, if you have blood type Rh negative, your doctor may also give you a vaccine of medicine called Rh immunoglobulin.
• The healthcare provider will determine the treatment choice based on individual circumstances.

Prevention

While it is not possible to prevent miscarriage every time, there are steps people can take to reduce the risk, including:

• Maintaining a healthy lifestyle, including a nutrient-rich diet, regular exercise, and limiting caffeine intake, can help promote a healthy pregnancy. 
• Avoiding consumption of harmful substances like tobacco and excessive alcohol
• Managing chronic conditions and seeking relevant medical care before and during pregnancy is also crucial. 
• Minimising exposure to environmental toxins, chemicals, and radiation

It is essential to discuss any concerns or queries regarding pregnancy with a healthcare provider to receive personalised guidance and support.

When to See a Doctor

If you suspect you may be experiencing a miscarriage or have any concerns about your pregnancy, seek medical attention promptly. Contact your healthcare provider if you experience: 

• Vaginal bleeding
• Severe abdominal pain and cramping
• Lower back pain that has not improved with rest
• If you pass tissue or clots 

Healthcare providers can evaluate your symptoms, perform necessary tests, and provide appropriate guidance and support during this challenging time. 

Conclusion

Miscarriage is a deeply personal and painful experience that affects individuals and couples both emotionally and physically. Understanding the symptoms, causes, risk factors, and complications associated with miscarriage can help individuals navigate this difficult journey with knowledge and support. It is important to remember that healing from a miscarriage takes time and that seeking emotional support from loved ones, support groups, or mental health professionals can be invaluable. While the pain may never fully dissipate, many individuals go on to have successful pregnancies and find solace in sharing their stories and supporting others who have experienced similar losses.

FAQs

1. How do I know if I'm having a miscarriage?

If you experience abnormal vaginal discharge or bleeding, abdominal pain, or pass tissue or clots during pregnancy, it is necessary to consult a doctor for evaluation. They can analyse your symptoms, perform required tests, and provide appropriate guidance and support.

2. What’s the difference between a miscarriage and stillbirth?

A miscarriage is the loss of a pregnancy before the foetus reaches viability, typically before the 20th week of gestation. Stillbirth, on the other hand, refers to the loss of a pregnancy after the 20th week of gestation. 

3. When can I retry to conceive after a miscarriage?

Deciding when to try to conceive after a miscarriage is a personal decision that may vary from individual to individual. It is generally recommended to wait at least 3 months, which allows the body to heal physically and emotionally.

4. How long do miscarriages last?

The duration of a miscarriage can vary depending on individual circumstances. Some miscarriages resolve quickly, while others may take several days or even weeks. Seek medical guidance if you experience a prolonged heavy bleeding miscarriage.

CARE Medical Team

2