What is a miscarriage?
The loss of a baby within the first 20 weeks of pregnancy is called a miscarriage. When the unborn baby's weight is less than 400 grams and the baby dies, it is also considered a miscarriage. About 10% to 20% of known pregnancies end in a miscarriage; however, the actual figure may be higher. About 75% of women who have had three or four miscarriages will go on to have a successful pregnancy later. A doctor or nurse may refer to a miscarriage as a spontaneous abortion. Abortion is a common medical name for all pregnancies that end before 20 weeks. If a miscarriage occurs in the first 12 to 14 weeks of pregnancy, it’s referred to as an early miscarriage. If pregnancy loss occurs after 14 weeks and up to 20 weeks of pregnancy, it’s referred to as a late miscarriage.
How do I know if I'm having a miscarriage?
Most women, especially during early pregnancy, will experience a miscarriage that is similar to heavy periods with slightly more cramping and bleeding than usual. It’s also common to have vaginal bleeding and pass large blood clots up to the size of a lemon. Heavy miscarriage bleeding can be scary or surprising, but it’s usually normal. Below are the common signs and symptoms of a miscarriage
- Vaginal bleeding or spotting
- Dull lower back pain/pressure
- Changes to vaginal discharge
- Passage of larger-than-usual-size clots
- No longer experiencing pregnancy symptoms such as feeling sick and breast tenderness
What are the common causes of a miscarriage?
As per research, most early miscarriages are caused by abnormal chromosomes (structures that contain genetic information that we inherit from parents) of the developing baby (fetus) in the womb. It is common when the mother is older than 35. This means that women over the age of 35 years old who are having children are more likely to have a miscarriage. If the partner is older thane 45, the mother is more likely to have a miscarriage. Below are few other causes of a miscarriage
- Consuming alcohol
- Using recreational drugs
- Consuming high amounts of caffeine
- Being overweight
- Maternal- or paternal-side reproduction problems
- Having fertility problems or taking a long time to conceive
- Having any abnormalities of the uterus (womb) or cervix (weakness of the neck of the womb)
- Having certain medical conditions (systemic lupus erythematosus)
- Having diabetes mellitus that is not well controlled
- Having particular infections such as German measles (rubella)
Factor V Leiden: This blood-clotting genetic mutation has been found in studies to result in a lower live birth rate.
Even after three miscarriages in a row, more than 7 women out of every 10 will not have a miscarriage the next time around.
How is a miscarriage usually treated?
Once a pregnancy has ended, there is nothing that can be done to prevent miscarriage from occurring.
- Natural: Many women prefer to wait for the miscarriage to occur naturally. An incomplete miscarriage should happen within a week. A missed miscarriage may take longer to begin naturally (three to four weeks).
- Medication: Women may prefer to take medication to ensure the miscarriage happens sooner rather than later. An incomplete miscarriage will usually be passed within six to eight hours of taking the medication. A missed miscarriage can happen quickly or may not happen for a few weeks. There are side effects that can occur with the medication, such as nausea and vomiting, chills, fever and diarrhea. These effects usually only last for a few hours but can be distressing.
- Surgery: In rare cases, women need surgery to remove the pregnancy tissue (called a dilation and curettage or D&C). This may happen in the case of a missed miscarriage if there is severe bleeding and pain or if patient preference is to avoid medication and they don’t wish to wait for a miscarriage to begin naturally. A surgery called D&C happens under general anesthesia and the surgery happens through the vagina. Like all surgical procedures, there are some risks involved such as infection, heavy bleeding (retained pregnancy tissue), damage to the cervix and risks associated with anesthesia.
Patients may also be advised to take
- Tylenol (acetaminophen) for cramps
- Water for hydration
- A balanced diet that is high in iron and vitamin C. Patients may be low in iron because of blood loss. Foods rich in iron include red meat, shellfish, eggs, beans and leafy green vegetables. Foods high in vitamin C include citrus fruits, tomatoes and broccoli. Doctors may also prescribe iron pills or a multivitamin.
- Counseling in some cases
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