The loss of pregnancy during the first 20 weeks of pregnancy is called as miscarriage or spontaneous abortion.
15-20% of all recognised pregnancies end up in miscarriage. 80% of these occur in first 3 months.
Paras Bliss has a well developed program to address the issues of women suffering from miscarriage and early pregnancy loss. The team is supported by experienced gynaecologists, obstetricians, nutrition experts, psychologists, counsellors, who ensure a perfect transition and support the woman in accepting the decision of nature, They also prepare the woman for future pregnancies mentally and ensure that she and her family are physically fit to try for another bundle of joy.
What causes miscarriage or early pregnancy loss?
Studies highlight that even in fertile couples; there is 40% of chance that a miscarriage may occur. Trends highlight that 50% of pregnancies miscarry before implantation in the womb occurs. Early after implantation (before a pregnancy is clinically recognised) pregnancy loss rate is around 30%. And even after a pregnancy is clinically recognised as many as one quarter of pregnancies miscarry, usually during the first 14 weeks. The most risky time is 6-8 weeks from the last menstrual cycle.
It should also be noted that more than half of the cases where a miscarriage happens, is also due to some chromosomal abnormality in the baby. This is due to the crossover of the genes when the sperm and the egg come together at the time of fertilisation or conception. At this point some genetic information can get lost and the pregnancy may not be successful. This is called a chance event. If the baby has some chromosomal defects, the pregnancy may move ahead, however in the later months the mother may experience bleeding, abdominal pain and other signs of period type pains.
The other reason for the miscarriage is when the baby is not able to implant itself correctly in the womb lining. Due to this the woman may get a positive pregnancy test, however on later levels a miscarriage will happen.
The risk factors that can contribute in increasing the miscarriage risk are- increase in maternal age (above 35 yrs of age), smoking, use of drugs, multiple pregnancies such as twins or triplets, poorly controlled conditions such as diabetes, thyroid disorder, autoimmune diseases, uterine abnormalities and cervical incompetence.
Types of miscarriage
Depending on the situation of the cervix, the doctor is able to highlight the type and the stage of miscarriage.
Threatened Miscarriage – This is when bleeding in experienced in early pregnancy and the cervix is found to be tightly closed. The pregnancy is most likely to continue.
Inevitable Miscarriage – In this condition the bleeding is experienced in the early pregnancy and the cervix is found to be open, suggesting that the pregnancy will be lost.
Incomplete Miscarriage – In this situation, the miscarriage will definitely take place. However there is some pregnancy tissue that is left behind in the womb, which may have to be removed through medical or surgical intervention. In this also the cervix is usually found open.
Complete miscarriage – Here nature has taken its course. The miscarriage has happened and the entire pregnancy tissue has been naturally expelled. The cervix is found closed in this case.
Missed miscarriage – This is when the pregnancy stopped growing some weeks ago, but there was no bleeding at this time. This type of miscarriage usually causes a slight, dark-brown blood loss and the sudden end of normal pregnancy symptoms. It is sometimes called a blighted ovum.
Symptoms of miscarriage:
The following are the signs and symptoms that usually a woman experiences in a miscarriage. If you are experiencing the same, consult a doctor immediately. Women who are expecting should be aware of the listed signs too:
Vaginal bleeding – heavy or light spotting
Blood clots along with other tissues coming of the vagina
Prolonged and heavy bleeding
Back pain or cramp like pain – uncomfortable and rhythmic – similar to contractions in labour
Loss of fluid
Nausea, Breast tenderness, Fatigue – features of pregnancy may stop
Treatment for miscarriage:
A miscarriage means that the body has not been able to accept the baby and the natural termination of the pregnancy has happened. If the same takes place within 10 weeks of pregnancy, then no treatment is required. The doctor may prescribe medical management. The doctor will evaluate the condition of the woman and study the aspects, ti decide the further course for clinical action:
Stage of pregnancy
Risk to health
Amount of bleeding
If drugs or surgical intervention is needed to remove the remaining pregnancy tissue.
Surgical treatment: Studies highlight that if a woman gets the remaining pregnancy tissue removed surgically, it drastically reduces the risk of infection. The surgical procedure takes place under general anaesthesia and usually just takes under 5 minutes. The procedure ensures that the womb is emptied. This procedure is called as evacuation of retained products of conception (ERPOC). A small plastic tube is passed into the womb and by suction the material is removed. If required the surgeons may also perform a procedure called dilation and curettage (D&C) – in which the cervix is widened to enable the removal of the pregnancy tissue. This also includes scrapping away the lining of the womb. Both procedures are safe and are carried out under the strict supervision of the expert gynaecologists and the obstetricians. If blood group of mother is Rh Negative she needs to get the Anti D or Rhogam injection to prevent damage to further pregnancies.
Cervical insufficiency- Usually abortion occurs in second trimester. It can be treated with a circling stitch in cervix around 12 weeks. It can be done electively or on emergency basis if insufficiency is discovered before miscarriage.
Uterine Anomalies- Septum can be treated by a hyteroscopic septoplasty before planning next pregnancy.