Miscarriage symptoms and signs. Treatment of threatened abortion

Pregnancy is not just an important stage in the life of every woman. This is a new step, a new test. But pregnancy does not always have a happy outcome. In some cases, a miscarriage occurs. This is the spontaneous termination of pregnancy. Most often this happens in the early stages. There are plenty of factors that provoke this phenomenon. How to recognize signs of a threatened miscarriage in the early stages?

Some statistics

Statistics show that every fifth pregnancy ends in miscarriage. Many women may not notice this. Most often this happens 7-14 days after conception. This happens for many reasons. At the same time, there are practically no signs of miscarriage at 2 weeks.

In some situations, spontaneous termination of pregnancy occurs when a woman realizes her interesting situation. To avoid a repetition of the tragedy in the future, you need to know what diseases and external factors can provoke a miscarriage, and how to avoid it.

Genetic disorders

Experts in the field of genetics believe that 75% of all miscarriages occur precisely because of genetic disorders of the fetus. Don't be afraid. In many cases, such deviations are accidental. In this case, viral diseases, negative environmental influences, radiation, etc. can lead to spontaneous termination of pregnancy. In most cases, there are no signs of miscarriage. The photo confirms that in this way nature is trying to rid humanity of non-viable or unhealthy offspring.

It is almost impossible to avoid this. The risk of developing genetic abnormalities increases every year.

Hormonal imbalances

From the moment of conception, a global restructuring begins in the female body. This also affects hormonal levels. A low progesterone level may be a sign of a threatened miscarriage in the early stages. Deficiency of this hormone can be caused by many reasons. However, if the deviation is detected in a timely manner, spontaneous termination of the current pregnancy can be prevented. For this purpose, the expectant mother is prescribed hormonal drugs.

There is another pathology that can lead to disastrous consequences. Some women experience increased levels of male hormones after conception. These substances suppress the synthesis of progesterone and estrogen. It is these hormones that support the female body and allow pregnancy to proceed without deviations.

Often, adrenal and thyroid hormones can influence the outcome. Therefore, at the planning stage it is recommended to check the condition of these organs.

Immunological problem

Probably, many have heard about such a phenomenon as Rh conflict. What does it mean? A similar phenomenon occurs in cases where a child has inherited a negative Rh factor from his father. As a result, the female body perceives the fetus as a foreign organism and begins to reject it.

In this case, abortion can be prevented if the woman is prescribed medications with progesterone in a timely manner. After all, this hormone plays the role of an immunomodulator.

Infections in women

At the moment, many diseases are known that are transmitted through sexual contact. Many of them can cause miscarriage in early pregnancy. Signs of some diseases may not appear. This is worth remembering when planning a pregnancy. Dangerous pathologies include cytomegalovirus, chlamydia, herpes, trichomoniasis, gonorrhea, syphilis, toxoplasmosis, etc.

Spontaneous abortion occurs when the embryo is infected, as well as when the membranes are damaged. To reduce the impact of diseases on a child, treatment for the identified illness should be started immediately.

Other reasons

Among other causes of miscarriage, experts identify:

• viral diseases, for example, influenza, chickenpox, rubella, sore throat, etc.;
• disruption of blood flow between the fetus and the maternal body;
• bad habits: drugs, alcohol, smoking;
• pathologies of the internal organs of the fetus;
• nervous shock, stress;
• physical activity, injuries, lifting heavy objects;
• scars on the abdominal cavity and uterus, history of abortion;
• taking medications that are contraindicated for pregnant women;
• X-ray radiation.

Premature termination of pregnancy in the second and third trimester is most often provoked by an inflammatory process in the placenta or in the uterus.

Symptoms

What are the signs of early miscarriage? For 2 weeks, a woman may not even suspect conception, and her spontaneous interruption may be mistaken for menstruation. What if the expectant mother already knows about her interesting situation? What signs of a threatened miscarriage in the early stages should she still pay attention to?

The most common symptoms include pain localized in the lower abdomen, as well as bleeding. Unpleasant sensations may be felt in the lower back. If you notice brown or red discharge, you should immediately consult a doctor. This will allow you to maintain your pregnancy. The chance is great if the discharge is scanty. If they are abundant, then the risk of spontaneous interruption increases. The main sign of a miscarriage (after it) is bloody discharge mixed with pieces of soft tissue.

Symptoms of a threat of premature termination of pregnancy include uterine tone. A few points need to be clarified here. You should start worrying only if the tone of the uterus causes discomfort and is also accompanied by pain. If such phenomena do not occur, the doctor will advise the expectant mother to avoid stress and reduce physical activity.

The signs of miscarriage are the same at any stage of pregnancy. Their difference lies only in the intensity of pain and the amount of discharge. Starting from the second trimester, damage to the amniotic fluid sac is added to the symptoms. This is accompanied by vaginal discharge with blood clots during urination. This causes severe pain in the stomach or shoulder area. This is one of the signs of internal bleeding.

Minor signs

A woman may mistake the first signs of miscarriage in the early stages for the onset of menstruation. However, it is worth considering the existence of secondary symptoms of spontaneous abortion. It is they that allow you to distinguish a miscarriage from menstruation:

• aching pain in the lower back;
• bleeding with mucus;
• sudden weight loss;
• frequent loose stools;
• vomit;
• spasm-like pain.

If these signs of miscarriage occur, you should immediately seek help from a medical facility.

How does spontaneous abortion occur?

To understand what signs of miscarriage exist, it is worth understanding the process itself. It doesn't happen overnight. This process lasts from 2 hours to several hours. There are several stages involved:

1. There are signs of a threatened miscarriage. In this case, there is a nagging pain localized in the lower abdomen. The increase in pain occurs gradually. As a result, they become paroxysmal. At this stage, bloody vaginal discharge appears. You must immediately seek help from a medical facility. Timely help can save the pregnancy, since the cervix is ​​still closed.
2. Placental abruption. As a result of this phenomenon, the embryo begins to experience oxygen starvation. At this stage, it is impossible to stop the process of spontaneous termination of the current pregnancy. The fetus dies.
3. At this stage, the placenta is completely separated. The dead embryo still remains in the uterine cavity. It is from this moment that the separation of the fetus begins.
4. The final stage. The dead fetus leaves the uterine cavity along with the afterbirth.

After a miscarriage, the doctor should carefully examine the woman. If necessary, cleaning is carried out to remove any remaining soft tissue.

Dangerous periods of pregnancy

Knowing the first signs of miscarriage in the early stages of pregnancy, you can avoid many problems. However, you can protect yourself by contacting specialists at the planning stage.

Most often, miscarriages occur 2-3 weeks after conception. The woman may not even know about pregnancy. Therefore, such miscarriages are often mistaken for menstruation, since the symptoms are similar: pain in the very lower abdomen or lower back, discharge with blood.

Miscarriages occur most rarely at later stages - up to 20 weeks. How this happens is described above. Spontaneous termination of pregnancy after the 20th week is called stillbirth.

Frozen pregnancy

In medicine, there is the concept of “frozen pregnancy”. It is also called a missed miscarriage. What it is? At a fairly long period (up to 28 weeks), the cessation of fetal development and then its death are observed. This condition can be determined by the following symptoms:

• general weakness;
• decrease in basal temperature;
• no toxicosis.

Types of miscarriages

Spontaneous abortions can be divided into several main types. Each of them is characterized by certain signs of miscarriage. Let's look at them in more detail:

• Incomplete miscarriage. This condition is characterized by pain in the lumbar region and lower abdomen. This causes the cervix to dilate. As a result, the integrity of the fetal membrane is compromised. At this stage, the bleeding and pain do not stop.
• Full. The embryo or fetus completely leaves the uterine cavity after death. At the same time, bleeding stops and other signs of early miscarriage disappear.
• Failed. The dead embryo or fetus remains in the uterine cavity. A doctor can detect a frozen pregnancy during an examination of the patient by listening to the heartbeat. An ultrasound is performed for diagnosis. With this pathology, all signs of pregnancy disappear.
• Repeated. Often, such a miscarriage occurs in those women who have had more than three spontaneous abortions in the early stages.
• Anembryony. With this pathology, fertilization of the egg occurs, but the fetus is not formed. A woman may not have her period. In this case, all signs of pregnancy are noted.
• Choriadenoma. This pathology is a genetic error that occurs during fertilization. In this case, abnormal tissue grows in the uterine cavity instead of the fetus. A woman with this condition may show signs of pregnancy.

It is worth noting that all of the listed deviations from the norm end in termination of pregnancy or mechanical cleaning of the uterine cavity.

Diagnostics

Unfortunately, it is not always possible to diagnose a miscarriage based on symptoms alone. Therefore, women are recommended to undergo a thorough examination and all necessary tests at the stage of pregnancy planning. If conception occurs suddenly, a doctor can determine the threat. For this:

• The condition of the uterus is determined: whether the organ is in good shape or not.
• The consistency of the gestational age and the size of the organ is checked.
• The cervix is ​​checked: is it closed or not.
• Particular attention is paid to vaginal discharge.

At later stages, a transvaginal ultrasound is performed to identify the threat of miscarriage. This is the most reliable diagnostic method. During the procedure, the internal structure of the organ and the length of the neck are determined.

If bleeding and other signs of miscarriage appear, the woman may be transferred to a day hospital to monitor her condition. If nothing threatens the child, then she can be discharged home.

Consequences

We looked at the signs of miscarriage in early pregnancy. But within the framework of this topic, it is worth mentioning the consequences of this phenomenon. After a miscarriage, the doctor may give two days for the remaining soft tissue to come out of the uterine cavity on its own. At the same time, a woman should monitor what kind of discharge she has. If the residue does not come out, then mechanical cleaning is prescribed. To do this, scraping is performed. After the procedure, a long period of recovery of the body is required.

The first menstruation after spontaneous abortion may be accompanied by prolonged bleeding. This may be due to the remains of amniotic membranes in the uterine cavity. To diagnose this, an ultrasound is prescribed. If such shells are detected, repeated cleaning is carried out. If the ultrasound shows that the uterine cavity is clean, the doctor prescribes medications to stop the bleeding and speed up the process of contraction of the organ.

An inflammatory process may begin. An increase in temperature may indicate this. If symptoms of inflammation occur, you should consult a doctor immediately.

If there are no complications, then the body recovers after a spontaneous abortion in 30-60 days. However, we should not forget about psychological trauma. Therefore, experts recommend contacting a psychologist if depression occurs. Experts explain to women how to cope with trauma and how not to dwell on the problem. The most important thing is not to experience the loss alone. As practice shows, the best remedy in psychological therapy is a new pregnancy. However, before conceiving, it is worth preparing your body and eliminating the cause of the miscarriage.

Is it possible to prevent

As mentioned earlier, spontaneous termination of an ongoing pregnancy can be prevented if you promptly seek help at the first sign of a threat. If symptoms of pathology are detected, the doctor prescribes bed rest. In some cases, a woman is not even allowed to stand up. If there is a threat of miscarriage, all physical activity is reduced to a minimum.

Do not forget that the condition of the fetus is negatively affected by any excitement, as well as negative thoughts. Therefore, a pregnant woman needs to avoid stress. To calm the nervous system, the doctor may prescribe an infusion of motherwort or valerian.

In some cases, a specialist may prescribe drug therapy to block uterine contractions. In some cases, this helps avoid premature termination of pregnancy. If necessary, the specialist performs a repeat ultrasound. If insufficiency is diagnosed, in the hospital sutures are placed on the uterus, allowing the fertilized egg to be preserved inside the organ. The operation is performed under anesthesia. In this case, relaxing drugs are injected into the uterus.

Determining the cause

Identifying the cause of spontaneous abortion will help avoid a recurrence of the situation in the future. Therefore, a woman should undergo a series of examinations and a course of appropriate therapy. To determine the cause, your doctor may prescribe:

• Consultation with geneticists. In this case, tests are carried out to determine the chromosome and gene set of not only the mother, but also the father.
• Consultation with an immunologist. A specialist may prescribe tests to identify autoimmune diseases that can lead to miscarriage.
• Consultation with an endocrinologist. A specialist will help identify problems with the thyroid gland.
• Gynecological examination. It may be associated with defects in the structure of the uterus that do not allow bearing a child.

Prevention

It is not so easy to determine early miscarriage by signs. Therefore, experts recommend adhering to certain rules of prevention to maintain pregnancy:

• A woman’s complete renunciation of bad habits. This applies to alcohol abuse, drug abuse, and smoking.
• Moderate physical activity.
• Maintaining an exceptionally correct lifestyle.

If signs of pregnancy are detected, a woman should:

Finally

The first signs of a miscarriage do not always make it possible to timely determine the presence of a threat. Many women can lose a child, already knowing about its existence. However, a miscarriage should not be a reason to give up your desire to have a child. Statistics show that the chances of a normal subsequent pregnancy are 80%.

However, with subsequent miscarriages, this figure decreases significantly. Therefore, when planning a pregnancy, it is worth taking all the necessary tests and determining the cause of spontaneous abortions. If this is a disease, then it is treated. It is worth planning a pregnancy after a miscarriage and mechanical cleaning of the uterus after 2 months.

You still easily fit into skinny jeans, you haven’t yet encountered morning sickness, age spots, stretch marks on your stomach. But you already have a test with two red stripes - the main proof that you belong to the happy class of pregnant women.

Your treasure is still very tiny. Only the most sensitive equipment can detect his presence in your womb. But this doesn’t stop you from coming up with a name for him, talking to him and stopping at stores with baby clothes to look for something for an unborn but already existing baby. But this joyful prospect, this rosy illusion can be interrupted overnight by a terrible and inexorable word.

According to statistics, 15-20% of all pregnancies end in miscarriages. In most cases, this happens when the woman does not yet realize that she is pregnant. But sometimes this also happens to those who have already become attached to their belly and love him. How to console a woman in this case? Only with the next pregnancy. But those who have had such a misfortune in their lives, and those who have not yet experienced the bitterness of loss, should undergo a short educational program on issues related to miscarriage. The most important thing is to know what factors can cause miscarriage and what can be done to prevent miscarriage.

The small embryo develops in the uterus, embedded in its mucous membrane, for nine months. If for some reason it is expelled from the uterus before 22 weeks of pregnancy, then they speak of spontaneous abortion. Or, as it is more commonly called, a miscarriage.

Miscarriage can be early - up to 12 weeks, and late - from 12 to 22. Expulsion of the fetus from the uterus at 23 to 37 weeks is considered premature birth. From 37 to 42 weeks - urgent birth, that is, normal. But if childbirth occurs after 42 weeks, then it is called late and in this case they say that the woman is “post-term.”

There is also its own, so to speak, classification of newborns. If childbirth occurs before 22 weeks, doctors talk about the expulsion of the fetus from the uterus. But a fetus born between 22 and 37 weeks is already considered a premature newborn. At the same time, it must weigh at least 500 grams and have a height of at least 25 cm. In recent years, doctors have finally come to a consensus that the sixth month, or rather 22-27 weeks, should be considered the border between miscarriage and premature birth pregnancy. As experience shows, starting from the twenty-eighth week of pregnancy, the newborn has a chance to survive. Along with miscarriage (spontaneous abortion), which occurs without outside intervention, there is also a so-called artificial abortion (from the Latin abortus artificialis\ in which the pregnancy is deliberately terminated by prescribing medications or minor surgical intervention. Approximately 10% of pregnancies end in miscarriage. The first symptoms of a miscarriage are cramping pain in the lower abdomen and bleeding. When examining the blood released during a miscarriage, in more than 50% of cases the fetus could not be detected at all, or it had pathologies. Thus, a spontaneous miscarriage is a natural termination of pregnancy, which is regulated by the body itself. women.

Symptoms:
Cramping pain in the lower abdomen.

Bleeding in the first 22-27 weeks of pregnancy.

Rules and exceptions

Typically, a baby born before six months is not viable. Only in one case out of a hundred do doctors manage to save the life of this tiny creature. As an example, we can recall one five-month-old Danish girl who was born with the weight of a chicken - 675 grams! There was practically no chance of saving her; such babies are not able to “mature” in an ordinary incubator. But the doctors put the baby in... a font with a nutrient solution, creating for her some semblance of a mother’s womb. And the girl survived! Seven-month-old babies survive quite easily, naturally, with proper care and under medical supervision. But eight-month-old newborns have a paradoxical situation! - there is practically no chance of survival...

Why do spontaneous abortions occur? What prevents the fetus from developing normally inside the uterus? What forces expel him from his mother’s womb prematurely?

Miscarriage - SYMPTOMS

If you notice the first signs of impending trouble in time, you can usually save the pregnancy. Symptoms may vary, but any kind of bleeding should be considered a dangerous signal.

Pain in the lower abdomen or lower back, especially cramping pain, spotting, bleeding - if any of these symptoms appear, immediately consult a doctor, call an ambulance. In such situations, every minute counts. Bleeding with pieces of tissue indicates that a miscarriage has already occurred.

Although bleeding is not always a threat. A miscarriage begins with bleeding, progressing from light to heavy, as well as possible cramping. Sometimes it is very small, no more than a drop. Sometimes the blood is bright red, sometimes dark brown. The bleeding may be very light but may continue for several weeks.

A woman may feel abdominal cramps or other unpleasant sensations similar to those that occur during menstruation. Some women experience pain, but not all. Then all this may stop completely, and then resume again. If treatment is started immediately, in some cases the embryo can be saved and the pregnancy can be brought to its logical end - childbirth.

Or it may be that once a woman becomes pregnant, she feels quite normal for several weeks or months. And suddenly, suddenly, she starts having contractions and bleeding.

If among the discharge she finds something similar to particles of an embryo, then a miscarriage has occurred and the pregnancy has ended. Usually the fetus dies a few days or weeks before nature removes it from the womb. Therefore, parts of it are small and may not be noticed among the blood discharge. Actually, a miscarriage resembles an inflated gray-white balloon.

This is the case if the placenta is not ruptured. Or you may see pearly white particles in blood clots. Then you need to see a doctor as soon as possible.

We will talk about early miscarriages that occur before 12 weeks, since the vast majority of them happen during this period. So, the most common causes of miscarriages in early pregnancy:

1. Genetic disorders in the fetus
   According to statistics, about 73% of miscarriages occur for this reason. As a rule, these genetic defects are not hereditary in nature, but are the result of single mutations that occurred in the germ cells of the parents under the influence of harmful environmental factors (radiation, occupational hazards, viruses, etc.). Termination of pregnancy for this reason is a kind of natural selection - getting rid of weak, non-viable offspring. It is almost impossible to prevent such a miscarriage; you can only reduce the risk of genetic abnormalities even before conception, protecting yourself as much as possible from the effects of mutagenic factors. But in modern ecology, the likelihood of mutations still remains, therefore miscarriages that occur for this reason can be considered a blessing, because they save a woman from many problems and troubles in the future.


2. Hormonal disorders
   When the balance of hormones in a woman’s body is disturbed, early pregnancy termination often occurs. Most often this happens due to a lack of the main pregnancy hormone - progesterone. If this problem is detected early, pregnancy can be saved with the help of progesterone medications. Excess male sex hormones can also cause early miscarriage - they suppress the production of estrogen and progesterone. Often, androgens are the cause of repeated (habitual) miscarriages. Hormones of the adrenal glands and thyroid glands also influence the formation and development of pregnancy. Therefore, dysfunction of these glands can also cause miscarriage.


3. Immunological causes
   As a rule, this happens with Rhesus conflict. The embryo inherits the Rh-positive father, while the mother's Rh-negative body rejects the embryo's tissues that are foreign to it. To prevent miscarriage during an immune conflict, progesterone preparations are used, which in this case have an immunomodulatory effect.
4. Sexually transmitted infections: trichomoniasis, toxoplasmosis, syphilis, chlamydia, as well as herpetic and cytomegalovirus infections often cause miscarriage.
   Pathogenic bacteria and viruses cause infection of the fetus, damage to the membranes, resulting in miscarriage. To prevent this from happening, it is advisable to treat infections before pregnancy.


5. General infectious diseases and inflammatory diseases of internal organs.
   All diseases accompanied by intoxication and an increase in body temperature above 38 o C can lead to miscarriage. Rubella, viral hepatitis, and influenza are at the top of this list. Even a banal sore throat can become fatal at 4-10 weeks of pregnancy. And pneumonia, pyelonephritis, appendicitis are a serious risk for the fetus. That is why, when planning a pregnancy, it is worth undergoing a full medical examination, identifying and treating all foci of chronic infection.


6. History of abortion
   Abortion is not just a medical manipulation: it is a huge stress for the female body, which can cause dysfunction of the ovaries and adrenal glands; promoting the development of inflammatory processes in the genital organs. This can cause infertility and recurrent miscarriages in the future.


7. Medicines and herbs
   In the first trimester of pregnancy, it is advisable to avoid taking medications altogether. Many of them can cause abortion or cause developmental defects in the fetus. So, for example, narcotic analgesics or hormonal contraceptives often cause abortion. You also need to be careful with medicinal herbs: parsley, nettle, cornflower, St. John's wort, tansy are contraindicated for early pregnant women.


8. Stress
   Severe fear or unexpected grief, resentment or prolonged mental stress are dangerous for the little creature in your womb. If, by the will of fate, you are forced to be under the influence of stress, discuss with your doctor the possibility of taking sedatives, at least valerian.


9. Unhealthy Lifestyle
   Taking alcohol, drugs, smoking, regularly drinking coffee, unhealthy and poor nutrition - all these are allies of miscarriage. It is better to adjust your lifestyle before conception.


10. Falls, heavy lifting, sexual intercourse
    All this, although rare, can become a trigger for termination of pregnancy, so take care of yourself, and therefore your baby!

Many are convinced that spontaneous abortion occurs due to a fall, bruise or some other physical shock. Any woman who has had a miscarriage can remember that not long before she either fell or lifted something heavy.

And I am sure that I lost my unborn child precisely because of this. But the reason is not this, but in the disorders of the pregnancy itself.

Approximately half of spontaneous abortions occur due to abnormal genetic development of the fetus, which can be hereditary or accidental. The woman’s body itself destroys the defective and non-viable fetus. But you shouldn't be afraid of it.

If one embryo has a defect, it does not mean that all the others will be the same.

The other half of spontaneous abortions are caused by various known and unknown factors, such as various types of acute infectious diseases suffered in the first trimester of pregnancy, poor environment or difficult working conditions, excessive psychological or physical stress, abnormal development of the uterus, radiation, alcohol, drugs and some types of medications.

Among infectious diseases, the leading role is played by influenza, which is the most common disease.

A miscarriage can occur due to a sore throat, pneumonia, pyelonephritis, appendicitis and other acute inflammatory processes in various systems and organs. One of the reasons why spontaneous abortion can occur is very poor nutrition (malnutrition and hunger), as well as elevated blood sugar levels.

Common causes include previous induced termination of pregnancy.

An induced abortion during the first pregnancy is especially unfavorable. Women are often prescribed progesterone, since many pregnancy terminations occur due to a lack of this particular hormone in the mother's body.

It must be said that, regardless of the reason for which a miscarriage occurs, doctors have identified a depressing pattern: with each spontaneous termination of pregnancy, the danger that the same thing will happen again during the next pregnancy increases.

There is a diagnosis: habitual miscarriage, which means that the woman had not one miscarriage, but several. This diagnosis is usually made if a woman has had three spontaneous abortions in a row without a normal pregnancy. But in no case should we forget that after a miscarriage you can give birth to an absolutely healthy child.

It should be remembered: despite the fact that each miscarriage reduces the chance of a subsequent successful pregnancy outcome, a woman can still give birth to a full-fledged healthy child.

In this article:

Pregnancy is a wonderful period in a woman’s life. But it is not always destined to end with the birth of a child. Sometimes the body itself decides to expel the emerging life from the female womb. In most cases, miscarriage occurs at the very beginning of pregnancy - in the first trimester. But why and how does a miscarriage happen? There are many reasons - from bad habits of the mother to chromosomal pathologies in the fetus.

According to statistics, every fifth pregnancy ends in spontaneous abortion. To avoid this, a woman should know the symptoms and signs of miscarriage, as well as what to do if she finds herself in a similar situation.

How does pathology develop?

How does a miscarriage occur is a question that worries every woman who is faced with the threat of miscarriage. The body rejects the fetus as a result of the influence of negative factors. It is excreted from the uterus either completely, which is typical in the first weeks of pregnancy, or partially. Often, women completely overlooked the symptoms of miscarriage, not noticing their condition.

Depending on the cause, for example, the presence of an acute infectious-inflammatory process in the body (flu, rubella, etc.), the immune system begins to show aggression towards the developing pregnancy, which can result in a miscarriage. The formation of a connection between the mother and the unborn child is disrupted, it ceases to function, and the fetus is deprived of support and nutrition.

As a result, the fertilized egg is rejected from the lining of the uterus and comes out of it along with bleeding. Depending on the mechanism of development of a miscarriage, experts determine its causes.

Types of miscarriages

Let's look at the main ones:

• Incomplete miscarriage , also called inevitable. In this case, the woman notes pain in the sacrum and lower abdomen, which is accompanied by bleeding and dilation of the cervix. If we are talking about an inevitable miscarriage, then in this case the membranes have ruptured. For an incomplete miscarriage, the symptoms of pain and bleeding are constant.
• Complete miscarriage means that the fertilized egg or fetus is completely expelled from the uterine cavity. In such a situation, bleeding may stop on its own, like other symptoms.
• Failed miscarriage . The embryo or fetus dies, but remains in the uterine cavity. Usually this condition is called frozen pregnancy, and it is discovered accidentally during a routine ultrasound examination or examination by a gynecologist.
• Anembryony . Despite the fusion of the sex cells of a man and a woman, the fetus does not begin its development in the uterus. In this condition, signs of pregnancy may be observed and even the gestational sac and corpus luteum can be diagnosed using ultrasound, but the child is absent from it; curettage is necessary, as after a miscarriage.
• Repeated miscarriage is diagnosed in a woman if she has had at least three spontaneous abortions one after another. This disorder occurs rarely, in no more than 1% of families. Usually it is included in the group of consequences after a miscarriage.
• Chorioadenoma . This disorder is also preceded by fertilization, but during it a breakdown of chromosomal information occurs, and instead of an embryo, tissues develop in the uterus, which grow and increase in volume over time. The pathology may end spontaneously as a miscarriage, or it may require cleaning of the uterine cavity.

Causes

About 20% of pregnancies end in miscarriage. Most often, this happens at a time when the woman herself does not yet know about her situation. But this can also happen to those who were planning a pregnancy and managed to rejoice at its onset. Why is this happening?

The reasons for miscarriage in early pregnancy (mainly before the 12th week, since the first trimester is the decisive point in this matter) will be as follows:

• Chromosomal problems in the fetus . Experts believe that in approximately 73% of cases, pregnancy is terminated solely due to genetic disorders. At the same time, chromosomal mutations are not always inherited at the genetic level; their occurrence can be influenced by negative environmental factors, for example, radiation, viruses and much more. It is believed that in this case the pregnancy is terminated according to the type of natural selection, that is, initially such an embryo is not viable. Therefore, we are talking about a condition such as micro-miscarriage, which occurs much earlier than at 12 weeks of pregnancy. Many women do not even know that they were pregnant, perceiving unexpectedly heavy periods as a menstrual disorder.
• Hormonal disorders . Fluctuations in hormonal levels in the early stages of pregnancy often lead to its termination. Usually the culprit is progesterone, a hormone aimed at supporting pregnancy. If the problem is detected in time, the fetus can be saved. Spontaneous abortion can also be provoked by an excess of male hormones - androgens, which inhibit the synthesis of progesterone and estrogen. This usually leads to multiple, repeating miscarriages.
• Immunological problems . Most often they occur in the blood of the mother and fetus. In this case, the child inherits the father’s Rh factor with a “+” sign, while the mother’s Rh factor is “-”. The woman’s immune system perceives the Rh-positive embryo as foreign bodies, beginning an active fight against them.
• Infections . The causative agents of cytomegalovirus, herpes, chlamydia and other pathogenic bacteria and viruses infect the membranes and the fetus itself in the uterine cavity, causing miscarriage. To avoid this, you need to prepare for pregnancy and promptly treat any infectious and inflammatory processes in the body. Common infectious diseases are also fraught with a threat to the development of the fetus, these include influenza, rubella, etc. All these diseases occur with intoxication damage to the woman’s body and a strong increase in body temperature, which can cause spontaneous abortion.
• Past abortions . This is not just a medical procedure aimed at removing the fetus and membranes from the uterus. This is also a serious stress for a woman’s body, which can lead to complications. For example, dysfunctional ovarian dysfunction, changes in adrenal function, inflammatory phenomena in the reproductive system. In the future, all this leads to infertility and problems with carrying subsequent pregnancies.
• Taking medications and medicinal plants . Almost all pills and other medications are dangerous in the first trimester, as the fetus is actively developing. Most drugs provoke malformations of the fetus or disrupt the formation of the placenta, all of which can lead to spontaneous abortion. Tablets that can cause miscarriage, for example, at 12 weeks - hormonal drugs, narcotic analgesics, etc. Not only medicine can cause a miscarriage, but also some medicinal herbs that are quite harmless at first glance - mint, parsley, nettle, tansy and much more.
• Stress . Any mental shock is dangerous for pregnancy. If you cannot avoid stress, it is important to seek help from a specialist to prevent the possibility of miscarriage.
• Bad habits . Alcohol abuse, smoking, and drug addiction can cause early pregnancy termination. If a woman wants to give birth to a healthy and strong child, she must give up bad habits at the stage of planning conception and ask her partner about it.
• Excessive exercise . Violent sexual intercourse, falling, lifting heavy objects sometimes become a trigger for miscarriage. Pregnancy is a time when you need to take the utmost care of your own health.

Symptoms

What symptoms occur during a miscarriage? The first sign is abdominal pain, which is soon followed by spotting. Painful sensations are not always localized in the lower abdomen; many women note that it radiates most intensely to the sacral area.

Discharge from the genital tract can be different, varying in color and intensity. But their detection, in any case, requires consultation with a doctor. Light spotting may indicate a threat of miscarriage and the possibility of saving the pregnancy. Profuse uterine bleeding, especially with tissue particles and clots, speaks for itself - the fetus has died, and cleaning is needed after a miscarriage.

These signs are typical for any stage of pregnancy, so it doesn’t matter at what week they appeared. It is more important to know what symptoms are characteristic of the loss of a child, and what measures need to be taken in this situation.

There are 4 stages of miscarriage, let's look at them briefly:

1. Threatened miscarriage . A woman complains of pain in the lower back and lower abdomen. There may be slight bleeding from the vagina. In this case, the pregnancy can still be saved.
2. Incipient miscarriage . The pain increases and becomes like contractions. The discharge intensifies. Weakness and dizziness appear. The chances of saving the fetus are minimal.
3. Miscarriage in progress . The pain intensifies and the bleeding is significant. Fetal death at this stage is obvious. The fetus may leave the uterus completely with bloody discharge, or it may require cleaning after a miscarriage.
4. Completed miscarriage . The fetus and its membranes are expelled, and the uterus contracts after a miscarriage. The bleeding stops. It is necessary to perform an ultrasound to determine the condition of the uterus and the presence of remnants of the fertilized egg.

When does a miscarriage occur?

Typically, pregnancy is terminated in the first trimester due to the fact that the fetus is not viable. More often this happens during the expected onset of menstruation, and then the woman may not even know that she was pregnant. If this happens later, the fertilized egg rarely comes out completely; vacuum cleaning of the uterus is necessary after a miscarriage.

It is much less common for a pregnancy to be terminated in the second trimester. This condition is called late miscarriage.

Diagnostics

Diagnosing a miscarriage is not difficult for a specialist. The doctor examines the patient on a gynecological chair, determining whether the size of the uterus corresponds to the duration of pregnancy, the presence of tone, the condition of the cervix and the nature of the discharge. For a final assessment of the woman’s condition, an ultrasound is prescribed. With its help, the specialist sees the localization of the fertilized egg, the presence of detachment or its complete absence.

Based on the diagnostic examination, subsequent treatment tactics are decided. If the pregnancy can be saved, the woman is sent to the hospital. If we are talking about fetal death, the patient needs cleaning after a miscarriage and treatment.

Is it possible to independently determine that there was a miscarriage?

Determine for yourself that a miscarriage is occurring , it is difficult if the pregnancy is short and the woman did not know anything about it; it’s another matter if spontaneous abortion occurred later, for example, at 12 weeks. In this case, the woman simply cannot miss the symptoms associated with the death and expulsion of the fetus. This situation requires mandatory consultation with a doctor, as cleaning will be required after a miscarriage.

Therapy

Therapeutic measures depend entirely on the results of ultrasound and the clinical manifestations of the pathology. When a miscarriage threatens and has begun, the woman is prescribed treatment aimed at maintaining the pregnancy.

If the fertilized egg detaches and bleeding begins, then the pregnancy has already been terminated, and cleaning or curettage is necessary after a miscarriage.

For a miscarriage at a later stage, for example, at 28 weeks, means are needed to contract the uterus and artificially induce contractions (Oxytocin). After expulsion of the fetus, so that the uterus contracts better and bleeding decreases, an ice pack is placed on the woman’s stomach.

Treatment after a miscarriage does not end there. A woman must undergo an examination to determine the cause of spontaneous abortion: pelvic ultrasound, diagnosis of infections, hormones, cytogenetic examination of the ovum, etc. For up to 6 months, the woman is prescribed oral contraceptives to restore the reproductive system and prevent unwanted pregnancy, since sex soon after a miscarriage may lead to a repeat situation. The body needs to be given time to get stronger.

Complications after miscarriage

Complications after a miscarriage are often associated with the fact that the situation may recur. Therefore, it is important to undergo rehabilitation and find out why the failure occurred and when you can get pregnant again.

If treatment after a miscarriage is ineffective, a woman may experience the following complications:

• development of inflammation in the organs of the reproductive system with subsequent chronicization of the process into endometritis, salpingo-oophoritis, adhesions, etc.;
• hormonal disorders;
• problems with conception and secondary infertility.

In addition, frequent consequences after a miscarriage - extreme stress, depression, psychological experiences of a failed mother.

Prevention

It is impossible to prevent a miscarriage at 12 or any other week of pregnancy due to genetic factors - you cannot influence genetics. But every woman who wants to have children can adjust her lifestyle and take care of her health.

So, how to minimize the likelihood of miscarriage and complications after it:

• plan your pregnancy in advance, while adjusting your diet, giving up bad habits, undergoing examinations and treatment;
• after the onset of pregnancy, direct all efforts to preserve it, for example, timely diagnosis if there is a threat of miscarriage;
• avoid stress, physical and psycho-emotional fatigue, visit the gynecologist on time.

Since complications after a miscarriage can be serious, it is recommended to plan a new pregnancy six months after the miscarriage. At this time, doctors advise using hormonal contraceptives, which allow the body to recover faster.

According to statistics, sex after a miscarriage already on the twelfth day of the cycle can lead to a new pregnancy. Some women take advantage of this, wanting to quickly forget a failed pregnancy. Thus, they expose themselves to a new blow, because the weakened body can again reject the fetus. There is no need to rush, only time and effort will help set up the reproductive system to expect a child.

Useful video about early miscarriage

Miscarriage, also known as spontaneous abortion, occurs when the pregnancy does not develop until the 20th week. Miscarriages are quite common, occurring in approximately 25% of pregnancies. To determine whether you've had a miscarriage, you should evaluate risk factors and look for symptoms such as heavy vaginal bleeding and pain. Sometimes it can be difficult to determine whether there has been a miscarriage, as some symptoms can also occur during a healthy pregnancy, so if you have the slightest suspicion, you should consult a doctor. Always contact your doctor if you think you are having a miscarriage.

Steps

Part 1

Causes and symptoms of miscarriages

Why do miscarriages happen? Miscarriages often occur in the early stages of pregnancy. Chromosomal abnormalities are considered the most common cause of miscarriages, and in such cases, a woman cannot do anything to prevent the situation. The risk of miscarriage decreases after the thirteenth week of pregnancy. By this time, usually all pregnancies with chromosomal pathologies are terminated. The risk of miscarriage is higher in the following cases:

• Age. The risk of miscarriage in women aged 35-45 years is about 20-30%, and in women over 45 the risk of miscarriage increases to 50%.
• Severe chronic illnesses, such as diabetes and lupus, increase the risk of miscarriage.
• Uterine pathologies, including scarring, increase the risk of miscarriage.
• Smoking, drug use and alcohol use can also lead to miscarriage.
• Women who are overweight or underweight are more likely to have miscarriages.
• Women who have already had a miscarriage are at higher risk of having another miscarriage.

1. Check for vaginal bleeding. Heavy vaginal bleeding is the most common sign of miscarriage. They are often accompanied by severe pain, similar to that experienced during menstruation. The blood from such bleeding is usually brown or bright red.

   Pay attention to vaginal discharge. Symptoms of a miscarriage may include pink-white vaginal discharge that may contain tissue particles. If your discharge looks like particles of tissue, this could be a symptom of a miscarriage. In this case, you are advised to consult a doctor as soon as possible.

   Pay attention to the pain. Any pregnancy can be accompanied by various pains. During a miscarriage, as a rule, pain occurs in the lower back; it can vary in intensity, from mild to very strong. If you have lower back pain, see your doctor as soon as possible.

   Pay attention to pregnancy symptoms. Pregnancy is often accompanied by many symptoms, all of which are associated with hormonal changes in the body. If your pregnancy symptoms have improved, it may be a sign that you are having a miscarriage and that your hormone levels are returning to normal "pre-pregnancy" levels.

   • If you have had a miscarriage, you will probably notice that you are no longer nauseous in the morning, your limbs are not swollen, and your breasts are less painful. With a normal pregnancy, all of these symptoms disappear after the 13th week, which reduces the risk of miscarriage.
   • Symptoms and their severity may vary between pregnancies. If you notice any sudden change in your condition, consult your doctor.

2. See your doctor to confirm or deny that you have had a miscarriage. Contact your doctor, gynecologist, or emergency room to confirm or deny that you have had a miscarriage. Even if you experience all of the above symptoms, there is a chance that the fetus survived - it all depends on the type of miscarriage.

   • Depending on how far along you are in your pregnancy, your doctor may need to do a blood test, a pelvic exam, or an ultrasound, all of which can help determine the viability of the fetus.
   • If you are bleeding heavily early in your pregnancy, your doctor may ask you not to come to your appointment unless you want to.

Part 2

Treatment for miscarriage

1. Different types of miscarriage. Miscarriage occurs differently for different women. In some cases, tissue leaves the body very quickly, in other cases the process takes a long time and is accompanied by various difficulties. There are several types of miscarriages:

   Tell your doctor if the bleeding stops on its own. If you've had heavy bleeding that gradually goes away on its own, and you're early in your pregnancy, then you probably don't need to go to the hospital. Many women prefer not to go to the hospital or clinic again, but to relax at home. Usually there is nothing wrong with this if the bleeding has stopped in 10-14 days.

   Contact your doctor if the bleeding does not stop. If you are experiencing heavy bleeding or other symptoms of a miscarriage and you are not sure whether the miscarriage is complete or incomplete, your doctor may recommend the following:

   Monitor your symptoms. If bleeding continues longer than your doctor says, you need to seek help. If you experience any other symptoms, such as chills or fever, call your doctor or go to the hospital as soon as possible.

2. Seek psychological help. Miscarriage early in pregnancy can be emotionally traumatic. It is important to accept the loss and seek psychological help if necessary. Ask your doctor to recommend a specialist to help you cope with grief.

   • There is no specific time frame for when you will feel better – this varies from woman to woman. Give yourself time to mourn the loss and grieve.
   • When you are ready for another pregnancy, be sure to talk to your doctor and make an appointment with a doctor who specializes in high-risk pregnancies. This is usually necessary for women who have had two or more miscarriages.

It cannot be predicted because to some extent it is part of nature. It must be remembered that it does not have a long-term effect on the body and does not in any way affect the possibility of becoming a mother in the future.
What is a miscarriage?

A miscarriage, or premature birth, is a pregnancy that has stopped developing. The embryo failed to develop and the cause is most often a chromosomal aberration. This type of anomaly is not hereditary and does not affect subsequent pregnancies. There is a risk of spontaneous abortion in the first trimester of pregnancy - this statistic affects 10-15% of cases, that is, it happens quite often. The risk increases with age. In some women, spontaneous abortion occurs in the first two weeks of pregnancy, that is, before menstruation, and the woman may not even notice it. If a miscarriage occurs after 3 months, it is called late (see p. 192).

Symptoms and signs of miscarriage in early pregnancy

The first symptoms are bleeding and uterine contractions, while other pregnancy symptoms disappear, such as tight breasts and nausea. Bleeding, initially small, subsequently becomes profuse - it lasts several days, then quickly stops. The menstrual cycle returns to normal, and a month later your period appears.

What to do if a miscarriage occurs in early pregnancy?

In any case, you need a doctor

If bleeding occurs, you should immediately inform your doctor so that he can identify a possible cause. If the bleeding is not heavy, your doctor will order an ultrasound and blood tests to check for a possible ectopic pregnancy.

The purpose of the study is to establish an initial diagnosis. If we are talking about a miscarriage, then an ultrasound shows that the embryo is not developing and has no cardiac activity. In some cases, two ultrasound examinations are necessary to establish an accurate diagnosis.

Two options

Most often, if the diagnosis is established, the doctor removes the egg from the body either with medication or by surgery - curettage, or curettage, under general anesthesia. Hospitalization lasts no more than one day. In some cases, the gynecologist prefers to wait until the body expels the foreign body on its own, after which it is necessary to meet with the doctor again to make sure that the egg is completely eliminated from the body. If the expectant mother has a negative Rh factor (see P. 72), the doctor will prescribe gamma globulin.

After a miscarriage in early pregnancy?

• If a future pregnancy was seen as joy and hope for the future, then a miscarriage is perceived as a bereavement. The response emotion is endless sadness. Each woman reacts differently, depending on how long she has been waiting for this child, what her personal life is like, and on how long it all happened.
• But the psychological trauma is obvious and requires maximum sensitivity from loved ones. At the moment of a miscarriage, various fears may arise (the sight of blood, fear of what will happen and the complications associated with this) and worries about the future (will I be able to get pregnant again? Will this happen again?). The most important thing is to be honest about your fears with your doctor, and also discuss it with your partner. Your doctor will reassure you that a miscarriage will not affect future pregnancies. This period can also be very difficult for your partner.
• After three early miscarriages, it is necessary to conduct a detailed examination to determine the cause.

Measures to prevent miscarriage in early pregnancy

Don't overwork yourself

Take frequent breaks from any work. Fatigue that suddenly hits you is associated with pregnancy. This is physiological fatigue that cannot be neglected. If the work you do is stressing you out, talk to your boss about changing your schedule. Rest as soon as possible, thinking about your child.

Avoid physical activity

Physical activity causes muscle contractions of the uterus, leading to the gradual detachment of the fertilized egg, which is still weakly attached to its wall.

From this point of view, it is better not to start moving during pregnancy. Inspecting various options, going up and down stairs, carrying suitcases and settling into a new place is associated with terrible fatigue. Wait to move until the beginning of the 3rd month.

Don't plan long trips either. The road is always tiring, and on the road there are often no basic conditions for observing the rules of personal hygiene, and it is difficult to follow the diet prescribed for pregnant women.

You found blood on your panties

Don't panic. Blood may appear in the case of a small crack in the anus or vaginal varicose veins. To understand the cause of the blood, blot these areas with a cotton swab. If traces of blood do not appear, this means that the bleeding is uterine.

Contact your gynecologist immediately. He can easily determine the cause and source of bleeding (vaginal or uterine).

• Bleeding may be caused by infection. In this case, it is necessary to undergo appropriate treatment.
• Blood may appear during the first 3 months of pregnancy on the days of the menstrual cycle on which you had your period.

You are bleeding and have pain in your lower abdomen

Call a doctor immediately and go to bed. A miscarriage is possible, but there may be other reasons.

While your breasts are dense and painful to the touch, while you are tormented by toxicosis, pregnancy continues. The doctor will prescribe you an antispasmodic drug and ask you to take a blood test to measure human chorionic hormones.
You will then have an ultrasound examination (ultrasound).

From the end of the 3rd week, the embryo is already clearly visible. A registered heartbeat also confirms pregnancy.

If the cervix is ​​not closed by the mucus plug, the doctor will prescribe complete bed rest. If the fetus is developing normally, then after taking precautions, all the symptoms that worry you will disappear.
An ultrasound will help determine the cause of bleeding.

Resorption of the second ovum

It happens that next to the developing fertilized egg there is another, smaller one with an embryo whose heartbeat is not recorded. We are talking about a twin fertilized egg, which for unknown reasons has stopped developing and is gradually being absorbed. After its disappearance, a healthy egg continues to develop normally.

Empty ("white") egg

It may happen that during an ultrasound examination, an empty amniotic sac with minor cell remains will be visible on the display screen inside the uterus. In all likelihood, for some reason the pregnancy was interrupted and the fertilized egg is degenerating.

Location of the placenta

If the placenta is located low enough, not far from the internal os of the uterus, then during uterine contractions slight bleeding from the placenta is possible. In such cases, no special measures need to be taken. A good rest is necessary.

Causes of miscarriage in early pregnancy

Abnormal embryo development

Miscarriages most often occur in the first three months of pregnancy. Most of them (70%) occur at the end of the second month. The cause may be genetic disturbances in the normal development of the embryo, leading to its self-destruction. Such a miscarriage is considered a “lucky accident” - not the birth of a child with deformities.

Underdeveloped uterus

If the uterine cavity is too narrow, then the rapidly developing embryo becomes trapped. In this case, bleeding appears before the expulsion of the fertilized egg. Such a miscarriage can occur in the first pregnancy, but does not threaten subsequent ones.

Hormonal disorders

A poorly developed corpus luteum produces insufficient amounts of hormones that support pregnancy. They are not enough until the 4th month of pregnancy, that is, until the moment when the already sufficiently developed placenta takes over this function.

Infections

Toxoplasmosis can lead to miscarriage.