Miscarriage is a real risk during pregnancy, but you should not get anxious about it. Instead, know about the chances of having it, the reasons for it, its warning signs and ways to avoid it. This MomJunction post provides you with all that information.
What Is A Miscarriage?
A miscarriage is an unexpected loss of pregnancy before the 20th week of pregnancy. About 10 to 20% of pregnancies end in miscarriages during the first trimester (1). Miscarriage is said to be early if it is before 12 weeks and late if it happens in the second trimester between the 12th and the 24th week.
Also known as spontaneous abortion, miscarriage is a naturally occurring event that could happen due to several medical factors.
Some miscarriages occur even before a woman misses her period.
What Are The Types Of Miscarriage?
- Threatened miscarriage: There is mild spotting or bleeding during the first trimester, but the pregnancy will continue.
- Complete miscarriage: The entire pregnancy tissue, including the embryo, fetus, and placenta, is lost in bleeding.
- Incomplete miscarriage: Only a part of the tissue is passed with bleeding, while a part still remains in the uterus.
- Missed, delayed or silent miscarriage: There is embryonic death, but no expulsion of the tissue or bleeding.
- Recurrent (repeated) miscarriage: Three or more consecutive pregnancies are lost.
- Septic miscarriage: The miscarriage gets infected. There might be abdominal pain, bleeding, and discharge with a foul odor.
- Blighted ovum (embryonic pregnancy): There are a placenta and amniotic sac but the embryo does not grow (3).
- Ectopic pregnancy: The fertilized egg does not implant in the uterus but in other places, mostly the fallopian tubes (4).
- Molar pregnancy: An abnormal pregnancy where a non-viable fertilized egg implants into the uterus and fails to develop (5).
A miscarriage may leave you depressed and sad. Some women might even blame themselves for it. But that is an injustice you do to yourself. A miscarriage is not your fault because it occurs due to various reasons.
What Are The Causes Of Miscarriage?
A miscarriage usually happens if the fetus fails to develop due to a chromosomal abnormality. There are other reasons too as discussed below:
- Chromosomal abnormalities: Several miscarriages in the first trimester happen due to chromosomal disorders. Chromosomes are structures in cells that hold genes. Both the egg and the sperm bring 23 chromosomes each to the embryo, and if any one of the chromosomes turns faulty, it leads to a genetic abnormality and may prevent the embryo from growing (6).
- Hormonal abnormalities: Imbalance in the hormonal levels, such as low levels of progesterone hormone, prevents the fertilized egg from implanting. Also, hormonal problems, such as PCOS, could increase the risk of miscarriages (7).
- Uterine or cervical problems: Some congenital uterine abnormalities (such as the septate or bicornuate uterus), uterine fibroids, uterine adhesions (bands of scar tissue) or an abnormal or weak cervix can keep the egg from implantation or affect the blood flow to the placenta (8).
- Chronic ailments: Untreated or poorly controlled diabetes, thyroid problems, heart diseases, kidney and liver diseases, and autoimmune diseases (such as lupus) create an unfavorable uterine environment for the embryo to develop (9).
- High fever: If you have an abnormal fever with a core body temperature of above 102° during early pregnancy, it could damage the embryo and result in pregnancy loss.
The risk of having a miscarriage is high if you are affirmative to certain factors.
What Are The Factors That Increase The Risk Of Miscarriage?
Your age and lifestyle habits could interfere with embryo (or fetal) development, increasing the risk of miscarriage. Such factors include:
- Advanced maternal age (see the table in the next section)
- Previous miscarriages
- Smoking, drinking and drug use
- Being underweight or overweight
- Poor diet or malnutrition
- Trauma such as accidents
- Certain medications such as NSAIDs (non-steroidal anti-inflammatory drugs)
- Environmental toxins
Your chances of miscarriage are also higher if you conceive within three months of giving birth.
What Are The Chances Of Having A Miscarriage?
Doctors and the elders in the family ask us to be extra careful during the first three months of the pregnancy, and when the pregnancy happens in the 30s or later. This is because the chances of a miscarriage are high in these instances. This section tells you how the risk of having a miscarriage increases with your age (10):
A woman who has a previous miscarriage has 25% chances of having it again.
Signs And Symptoms Of Miscarriage
The symptoms vary depending on the gestational age, and the causative factor. In some cases, you will not even know you had a miscarriage and it just passes like a period. Contact your doctor if you experience any of these symptoms (11):
- Spotting or bleeding from the vagina
- Tissue or blood clots passing from the vagina
- Pain in the lower back or abdomen
- Mild to severe cramps
- Sudden weight loss
- A decrease in pregnancy symptoms, such as nausea and vomiting
Remember that these symptoms could show even without a miscarriage. Your doctor will conduct the required tests, ultrasound scan, and pelvic examination to detect the cause of these symptoms.
What Is The Treatment For Miscarriage?
The treatment depends on the type of miscarriage. If there are no pregnancy tissue remnants in the body, you do not require any treatment, but if there is some tissue, you are likely to have the following treatments (12):
- Expectant management: It involves frequent check-ups to see if the remaining tissue has passed out naturally.
- Medical management: Medications (such as misoprostol) are given to help the pregnancy tissue pass out of the body. It mainly contracts the uterus, letting out the tissues.
- Surgical management: The remaining tissue is surgically removed using dilation and curettage (D&C). Here the cervix is opened and either suction or a curette instrument is used to remove the pregnancy tissue from the uterus.
The complications associated with these above options are minimal; therefore, you can check with your doctor and know the best treatment for you.
How Long Does It Take To Recover From A Miscarriage?
Physically, it might take a few weeks to a month or more for your body to recovery. It depends on how far you have been into pregnancy before the miscarriage. The pregnancy hormones may last in the blood for a couple of months after your miscarriage, and you will get your normal period in four to six weeks. You should avoid using tampons or having sex for around two weeks after miscarriage.
Emotionally, it might take longer to recover. The entire experience could leave you confused or angry. You may need the support of your partner, family, and friends. Avoid being alone and keep yourself busy so that you can deviate from it. Join a community where you can talk with couples who have had a similar experience.
When Can You Get Pregnant After A Miscarriage?
It is good to wait until you heal both physically and emotionally. Though you are likely to get back your periods in four to six weeks, wait until you have a couple of cycles so that you recover completely.
Can You Prevent A Miscarriage?
Since most miscarriages occur due to chromosomal anomalies, there is nothing you can do to prevent them. In general, you may follow the below safety measures to stay healthy and strengthen your pregnancy.
- Have a healthy and balanced diet, and also avoid foods that are harmful to pregnancy.
- Avoid smoking, drinking alcohol or using drugs.
- Maintain a healthy weight before conception.
- Go for regular prenatal check-ups and blood tests, and also check about vaccinations for chronic medical conditions.
- Disclose your medical history to the gynecologist.
- Avoid excessive consumption of caffeinated drinks.
- Do not over-exert yourself.
- Manage your stress levels by practicing deep breathing, yoga or meditation techniques.
- Follow safe sex practices.
- Stay away from environmental hazards such as radiation, x-rays and infectious diseases.
Pregnancy loss can be painful, but you should know that it is not the end. Do not blame yourself for what has happened. Understand the reasons for it, and take care of your health so that the next pregnancy is a healthy one. However, do not be in a haste to get pregnant immediately after a miscarriage. Give yourself time to recover and build confidence that you can hold a baby now.
Do you have any experience to share? Let us know about it in the comments section below.
2. Miscarriage; The Children’s Hospital of Philadelphia
3. Understanding blighted ovum; The University of Chicago Medical Center
4. Ectopic pregnancy; Beaumont Health
5. Molar pregnancy; Miscarriage Association
6. Ljunger E et al.; Chromosomal anomalies in first-trimester miscarriages; Acta Obstet Gynecol Scand (2005)
7. Pluchino N et al.; Hormonal causes of recurrent pregnancy loss (RPL); Hormones (Athens) (2014)
8. Miscarriage: Recurring pregnancy loss; The University of Utah
9. What are the causes of and risks for pregnancy loss (before 20 weeks of pregnancy); NIH
10. Early pregnancy loss; American College of Obstetricians and Gynecologists
11. Katherine J. Sapra et al.; Signs and symptoms of early pregnancy loss; Reprod Sci (2017)
12. J Trinder et al.; Management of miscarriage: expectant, medical, or surgical? Results of randomised controlled trial (miscarriage treatment (MIST) trial); BMJ Publishing Group Ltd (2006)