Miscarriage, simply called as pregnancy loss is the loss or expulsion of the embryo/ fetus before the 20th week of pregnancy. It can be medically divided into ‘spontaneous abortion’ ( which happens by itself) and ‘ induced abortion’ (legal or illegal and medical or surgical as and when indicated ).
If there is bleeding or abnormal vaginal discharge, along with abdominal pain and spasm of lower back muscles in a woman during first trimester or second trimester, then we can suspect for a miscarriage.
It is difficult to know the exact causes of miscarriage. Exercise, sex, mild injuries, certain medications or falls do not usually cause miscarriage. Studies have shown that there are some other reasons for spontaneous abortion.
- If the fertilized egg has an abnormal number of chromosomes, it results in miscarriage.
- Abnormality of the uterus may cause miscarriage.
- Severe injury or abdominal trauma and massive blood loss can result in the death of the fetus.
- Severe infection to the vagina, cervix or uterus may cause loss of pregnancy.
- Some illnesses like Diabetes mellitus, Thyroid disorders can cause pregnancy loss.
Miscarriages are of different types :
1. Threatened miscarriage
2. Inevitable miscarriage
3. Incomplete miscarriage
4. Complete miscarriage
5. Missed miscarriage
Except threatened miscarriage, for other types of miscarriages usually there is no treatment to prevent them. Either the products of conception will expel out spontaneously or it will need complete evacuation of the pregnancy tissues from the uterus. For that purpose few medications are available or Aspiration can be done with a tube which is inserted into the uterus and the remaining tissues are sucked out.
Most dangerous risk factors for miscarriage/pregnancy loss:
- Age: Women older than 35 years have a higher risk of miscarriage. When age increases the risk also increases. If the age is 45 or above the risk increases by 80%.
- Chronic illness: Women having chronic conditions like Diabetes mellitus, tuberculosis, renal diseases, Thyroid disorders, PCOS have a higher risk of pregnancy loss.
- Previous miscarriage: Women who have previously had history of 2 or more consecutive miscarriages have a higher risk pregnancy loss in next pregnancy.
- Uterine/cervical problems: Certain abnormalities of the uterus and incompetent cervix might result in pregnancy loss.
- Smoking, alcohol, and use of drugs: Women who are using alcohol, cigarettes and drugs have more risk of miscarriage than nonuser women.
- Underweight or overweight has significant role in miscarriage.
- Caffeine: Excessive use of caffeine during pregnancy can result in pregnancy loss.
- Trauma: Severe injury may cause miscarriage.
- Use of some medications: Some medications like Misoprostol, Retinoids, Methotrexate, Non-steroidal Anti-inflammatory, anticancerous drugs may cause risk of miscarriage.
- Infections: Some infections during pregnancy, like HIV, Bacterial vaginosis, Cytomegalovirus, Chlamydia, TB, syphilis etc. increases the risk of miscarriage.
There are several misconceptions about miscarriages and their risk factors. One example out of them is like Air travelling considered as one of the risk factor for abortion. But actually, pregnant women are allowed for air travel up to 36 weeks of pregnancy if not contraindicated.
You can reduce the risk factors simply by paying attention to some of your habits and by taking few precautions. Reduction of weight, stop the use of alcohol, smoke, and drugs, avoid contaminated foods and water, avoid exertional activities etc. Recovering from a miscarriage is emotionally painful. Tender, care, love and emotional support require during this period. Because the loss of pregnancy is not rare, you can overcome it by being strong and by emotional support.