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Miscarriage: What Is it and Can it be prevented?

Updated: Nov 22, 2021

Going through a miscarriage is a very draining experience, and the mere thought of miscarriage frightens a lot of women. Yet, miscarriages are much more common than the majority of people realise. It is estimated that around 20% of pregnancies will end in a miscarriage. In addition, many miscarriages happen even before the woman knows that she is pregnant. Can miscarriages be prevented and what are the signs and causes for a loss of pregnancy?

Signs of miscarriage

A miscarriage is said to have taken place if a pregnancy is lost during the first 20 weeks of pregnancy. Most miscarriages take place within the first 12 weeks of pregnancy or a trimester. A vaginal bleeding along with cramping and a lower abdomen pain are among the main signs of a miscarriage. However, it is worth noting that a vaginal bleeding during the first 3 months of pregnancy is relatively common and is not always a symptom of a miscarriage. It could be due to the implantation process and further tests will confirm if the pregnancy is viable. It is vital that if you experience any bleeding, you should seek the assistance of a healthcare professional.

Types of miscarriage

There are various types of miscarriage-complete, incomplete, threatened, inevitable, missed and recurrent. This table summarises the types of miscarriage.

Causes of miscarriage There could be numerous medical reasons for a miscarriage to happen and most of them are not within the woman’s control. Fetus development depends on chromosomes which are strings of DNA that contain numerous genes which in turn determine the baby’s development. Abnormal chromosome development such as having too many or not enough chromosomes in the fetus is thought to cause most miscarriages, and this does not indicate the abnormality in either parent. The miscarriage in these cases is thought of as a body’s or “nature’s” way of ending an abnormal pregnancy. In addition, there are other causes of early miscarriage:

  1. Infections during pregnancy

  2. Cervix problems

  3. Abnormally shaped uterus 

  4. Blood clotting disorders

  5. Autoimmune disorders

  6. Hormonal issues such as low progesterone production by the mother

  7. Inadequate embryo implantation into the uterine wall

Miscarriages are not caused by minor accidents, exercise, falls or sexual intercourse. Later miscarriages tend to occur due to placental issues, infections, uterine ruptures or congenital birth defects. Reducing the Risk of Miscarriage Unfortunately most miscarriages cannot be prevented; however, not being overweight prior and during pregnancy, leading  a healthy lifestyle, eating a healthy diet and taking folic acid supplements will help to reduce the risk of a miscarriage. A future mother is also recommended to avoid drinking alcohol, smoking and using drugs prior to conception and during pregnancy. Treatment  If you have the symptoms of a miscarriage, you must seek medical help immediately. An ultrasound is usually performed to confirm the miscarriage. If a miscarriage is confirmed, then options for its management will be explained to you by healthcare professionals to make an informed decision.  If miscarriage has happened and there is no pregnancy tissue left in the uterus, you do not require any treatment. However, if there is still some pregnancy tissue in your uterus, there are three other treatment options:

  1. Expectant management that involves waiting for the remaining pregnancy tissue to leave the body naturally. It can take up to a few weeks.

  2. Medical management that involves taking certain medications that will push out the remaining pregnancy tissue from the uterus. You can be admitted to the hospital for 24 hours for the procedure to be completed or you might go home after medication has been administered and miscarry at the comfort of your home.

  3. Surgical management that involves surgical removal of any remaining pregnancy tissue from the uterus. It is quick and does not require hospital admission. 

Recurrent miscarriage In most cases a miscarriage is a one-off event and most of women go on to have successful pregnancies and healthy babies in the future. However, 1 in 100 women is affected by a recurrent miscarriage, which is a miscarriage that has happened 3 times in a  row.  It is advised for a woman and her partner to undergo a complex evaluation  to identify possible reasons for recurrent miscarriage. Tests will be carried out with regards to autoimmune factors, genes, blood groups and other related factors. After miscarriage After a first miscarriage a majority of women will go on to have healthy pregnancies. However, many women choose to wait before trying to conceive again following a miscarriage. That is mostly because a miscarriage is emotionally and physically draining and can create an array of emotions such as sadness, loss, guilt and anger. Many hospitals offer counselling services to address these feelings and other issues after a miscarriage. It is advisable to wait around two to three months before trying to conceive again as it gives enough time for the uterine lining to restore to its normal state; however, if conception has occured earlier, there is no any increased risk of miscarriage than previously. Every couple should decide for themselves when they are emotionally ready for a new conception.

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