What is an early miscarriage called? Miscarriage in early pregnancy, symptoms, causes, treatment

A miscarriage is considered to be an abortion before 22 weeks or with a fetal weight of less than 500 g, regardless of the presence or absence of signs of fetal life.

How does a miscarriage happen?

A miscarriage is the premature exit of the fetus from the mother's body. There are two options for the course of this process, which directly depend on the timing of pregnancy.

The first option is a miscarriage by the type of rejection. This type of miscarriage occurs in the first trimester of pregnancy as a result of the immune conflict between the mother and the fetus. As a result, there is a violation of the functions of the future placenta and the production of antibodies to the cells of a "foreign" organism. In this case, the chorion is destroyed, and the fetal egg is expelled from the uterine cavity. The process is accompanied by bleeding of varying degrees - more often it is heavy bleeding.

The second variant of miscarriage occurs according to the type of childbirth, and is observed in the second and third trimesters of pregnancy. The main role in this variant is played by a change in the tone of the uterus - a significant increase in the tone of the uterine muscles or insufficiency of the closing apparatus of the uterus. In this case, there are contractions, the opening of the cervix and the birth of the fetus.

How to understand that a miscarriage has occurred?

With miscarriages in the first trimester, there are pulling pains in the lower abdomen, smearing red-brown compartments appear, bleeding may occur, and sometimes the urge to urinate and defecate. In this case, the fetus completely or partially leaves the uterine cavity with blood clots.

At a later date, a miscarriage proceeds according to the type of premature birth with contractions and cramping pain, the release of amniotic fluid and the fetus with its membranes, in whole or in part.

What to do if a miscarriage occurs?

If you notice the appearance of bloody compartments in the early stages of pregnancy, consult a doctor immediately, as there is a chance to save the pregnancy before heavy bleeding occurs. With heavy bleeding, hospitalization is necessary, since large blood loss, blood poisoning and death for a woman are possible. Preservation of pregnancy in such cases, as a rule, fails.

If a late miscarriage occurs, a visit to the doctor or hospitalization is also necessary, since the fetal membranes may remain in the uterine cavity, the infection of which is a threat to the life and health of the mother.

What to do if a miscarriage occurs at home?

In case of any miscarriage or suspicion of it, call a doctor or an ambulance immediately! Try to clearly and distinctly tell the dispatcher your address, the symptoms that bother you and the timing of pregnancy.

You should also know what a woman needs to do before help arrives if a miscarriage occurs:

1. Lie on the bed with a rolled-up blanket or pillow under your buttocks to help reduce bleeding.
2. Cold (ice pack, if there is none - any frozen foods wrapped in a towel, a heating pad with as cold water as possible) on the lower abdomen.
3. Remember your blood type and Rh factor (blood transfusion may be needed). It is better to write this information down and put a note next to it.
4. Do not throw away diapers, towels and blood-soaked materials - the doctor needs them to assess blood loss.
5. Monitor your general condition - measure blood pressure and pulse before the doctor arrives.
6. If possible, prepare a set of instruments for gynecological examination and curettage.

What happens after a miscarriage?

After a spontaneous miscarriage occurs, the membranes of the fetus, blood clots, and remnants of amniotic fluid remain in the birth canal, which become infected and decompose. The complete exit of all membranes is extremely rare, which requires diagnostic curettage of the remnants of the uterine cavity and suturing of ruptures, if any.

Spontaneous miscarriages are a signal of the need for examination to prevent future abortions. It is necessary to find out the cause of the miscarriage and eliminate it. In the early stages of pregnancy, miscarriages rarely threaten a woman's reproductive health and more often prevent the birth of a child with chromosomal developmental anomalies, often incompatible with life.

It's good when the pregnancy is desired. However, two clear stripes on the test do not at all guarantee that the baby will be all right until birth. Sometimes the female body, for some reason, independently gets rid of the fetus some time after its appearance. We are talking about miscarriage in early pregnancy. Why is this happening and is there a way to prevent trouble?

Let's turn to impartial statistics: a quarter of all early-term pregnancies are doomed to spontaneous termination. In order to be able to influence the course of events, it is important to know the causes of a miscarriage and its signs.

How does an early miscarriage occur?

Unfortunately, in the presence of serious prerequisites for spontaneous abortion at an early stage, it is almost impossible to reverse the pathological process. The fetus at this time is so small that the woman does not even understand what is happening to her. At first glance, it looks like the resumption of the menstrual cycle after a long delay (1 - 2 weeks). Menstruation, more abundant than usual, is accompanied by pulling pain in the lower abdomen. In addition, not all women go to the hospital after the incident. Only a few get to see a doctor - mostly those who are frightened by the appearance of a blood clot that has come out, resembling a torn bladder. Ideally, all women need a medical examination - if there really was a miscarriage, then additional cleaning may be necessary after it.

When a woman is aware of her "interesting" situation, it is much easier for her to predict the onset of a spontaneous miscarriage at an early date. First of all, you should carefully monitor the sensations in the lower abdomen and back. Painful dull and pulling spasms, smearing discharge with bloody or tissue lumps signal danger. If you seek medical help immediately, there is a chance to keep the pregnancy.

An early miscarriage is said to be when the pregnancy ends spontaneously before the 12th week of the fetus's existence. A late miscarriage occurs for up to 22 weeks, and subject to the timely and coordinated actions of doctors, a premature baby has every chance of surviving.

Early miscarriage: prejudice

There are many myths in society about the causes of spontaneous abortion. How to avoid an early miscarriage, you will be told on any women's forum, but not all advice can be trusted. It is reliably known that before the 12th week of pregnancy, the following factors do not pose a threat to the intrauterine development of the fetus:

• air travel by plane;
• minor blunt trauma in the abdomen;
• moderate exercise;
• a single case of spontaneous abortion up to 12 weeks in history;
• active sex life;
• stress.

The real causes of miscarriage in the early stages

Doctors cite many socio-biological and medical factors as the reasons for spontaneous abortion. It is often very difficult to determine what exactly caused the misfortune: sometimes a miscarriage is based on one factor, and sometimes a whole complex. A certain percentage of women are familiar with this pathology firsthand: the unfortunate survived several miscarriages in a row. In medical circles, this phenomenon was designated as habitual miscarriage. We list the most serious and common factors that cause the threat of miscarriage in the early stages:

• most often, the body itself gets rid of non-viable offspring if the appearance and development of the fetus is associated with a certain anomaly or genetic pathology. This may be a hereditary “breakdown” at the gene level or a spontaneous mutation caused by radiation, a dangerous virus, or a difficult environmental situation. Medicine, alas, cannot change or prevent this process. That is why thorough preparation for the upcoming pregnancy is impossible without the advice of future parents from a geneticist;
• a significant danger to the normal development of pregnancy is a violation of the immune and hormonal systems. A woman needs to pass the necessary check at the stage of planning a child, then doctors will be able to eliminate all the "pitfalls" in advance. Quite often, progesterone deficiency, an excess of androgens, pathologies in the activity of the thyroid gland and adrenal glands become an obstacle to fulfilling the dream of motherhood;
• Another urgent problem for the successful development of the fetus in the womb of a woman is the Rhesus conflict. The mother's body reacts to the fetus as a foreign object and gets rid of it, since the Rh factor of its blood is with the “-” sign, and it was taken from the father with the “+” sign. If concerns about this are real, the situation is corrected with the help of immunomodulatory therapy even at the stage of pregnancy planning;

• The undoubted enemy of a healthy pregnancy is infection (regardless of origin). In particular, these are all diseases that are transmitted “through the bed”: herpes, cytomegalovirus, toxoplasmosis, syphilis, chlamydia, trichomoniasis, etc. Pathogens, affecting the fetal membranes, infect the fetus, which leads to miscarriage at an early stage of pregnancy;
• a disappointing ending of early pregnancy awaits a woman with chronic inflammatory and infectious diseases of internal organs. The most insidious of them: viral hepatitis, rubella, pneumonia, influenza, severe tonsillitis;
• it is extremely difficult for the female body to cope with pregnancy because of the stress caused by abortion. Artificial termination of pregnancies in the past threatens with secondary infertility and habitual miscarriage in the future. A woman must certainly inform the doctor about such facts of her biography during pregnancy planning;

• one should not ignore such individual characteristics of the female body, such as, for example, congenital anomalies of development and oncological diseases of the internal genital organs, ICI. These and other pathologies exclude pregnancy as such.

The first symptoms of a miscarriage in the early stages

The nature of the development of a miscarriage excludes simultaneity - spontaneous abortion can be divided into several stages. So, let's find out how to determine an early miscarriage.

The first "bells" are painful sensations covering the back in the lumbar region and lower abdomen. Often at the same time, brownish or reddish clots stand out from the genital tract. Blood during an early miscarriage is a very dangerous sign that indicates that tissue detachment has begun. Even a few drops of blood on underwear are a serious reason for immediate medical attention. Reliable prevention of spontaneous abortion is a regular visit to the antenatal clinic for a routine examination and delivery of all necessary tests. Only in this way will the expectant mother be sure that everything is in order with her baby.

What does an early miscarriage look like: the main stages

The first stage of the pathology, the signs of which we learned above, is very common in expectant mothers. To save the baby, expectant mothers are forced to lie on the conservation of almost the entire prenatal contractions. The initial stage of the pathology is marked by hypertonicity of the uterus, bleeding and discomfort, reminiscent of contractions.

The second stage of violation leads to more serious consequences. At this moment, all the signs already indicate a full-fledged miscarriage at an early stage: a fragmentary detachment of the fetal egg from the inner wall of the uterus begins. However, at this time, the trouble can still be prevented, doctors say. This is possible thanks to the immediate and coordinated intervention of professionals, provided that the pregnant woman got to the hospital in a timely manner.

The next stage of spontaneous abortion at an early stage is a miscarriage on the go. Now there is nothing to help the fetus. The pregnant woman is suddenly seized by sharp spasms, bleeding begins almost immediately - the most convincing sign of an early miscarriage. This indicates the final death of the fetal egg, which comes out in whole or in part (incomplete miscarriage). In the photo, a fetal egg with an early miscarriage:

Pathology ends with a complete spontaneous abortion. After an early miscarriage, the uterus contracts and quickly returns to "pre-pregnant" size. A complication in this case is an incomplete abortion or missed pregnancy (diagnosed on ultrasound), when there is a high risk of pus formation or the onset of sepsis.

How to recognize a miscarriage early

At first glance, it is quite simple to determine a miscarriage, so some women believe that if they feel well after the incident, they can neglect a visit to the hospital. However, this is a dangerous delusion: all signs of spontaneous abortion at an early stage are also characteristic of other, more serious diseases, which, without proper diagnosis, can be mistaken for a miscarriage:

• ectopic pregnancy;
• malignant formation in the cervical region;
• bloodless torsion of an ovarian cyst;
• cervical injury.

These conditions can be excluded only within the walls of a medical institution.

What to do with an early miscarriage

Unfortunately, doctors are not able to radically change the course of events at the very beginning of pregnancy - you cannot go against nature.

It is common practice to prescribe Tranexam to stop bleeding. If a woman has had several failed pregnancies in the past, Utrozhestan will be prescribed. When, thanks to the efforts of doctors, the pregnancy can be brought to the second trimester, with a threatened miscarriage, it is worth applying stitches or a pessary if there is a short cervix with isthmic-cervical insufficiency. In principle, this is where the methods of dealing with pathology end.

Now we list what will not help in the process of developing a miscarriage:

• bed rest - a conscious decrease in the mother's motor activity cannot stop a miscarriage if there are real prerequisites for its accomplishment;
• taking drugs: No-shpa, Papaverine, Magne B6, Analgin.

A few weeks after a complete miscarriage, a woman needs to see a doctor and donate blood to analyze the level of hCG. If all indicators are normal, there is nothing to worry about. However, if the level of the hormone has not decreased at all, or has decreased, but has not dropped to the required minimum, there is a possibility of a mole. This is a dangerous complication that requires immediate medical attention.

An abortion in progress can be completed in several ways. If, during the examination, blood is still excreted from the vagina, and the fetal egg or embryo is still in the uterus, the doctor may determine the following tactics of action:

• expectant approach lasting up to 7 days (perhaps the body will reject the unnecessary without outside interference);
• a drug approach (a woman is prescribed Misoprostol, under the influence of which the uterine muscles are strongly compressed and bring the remnants of the fetal egg out);
• surgical cleaning (if vaginal bleeding becomes massive).

How to prevent early miscarriage

To exclude all possible factors that provoke an early miscarriage, you need to acquire offspring under the professional guidance of a doctor. To do this, a woman undergoes a full examination not during pregnancy, but even at the stage of planning a child. This is the only way to make sure that there are no various “breakdowns” at the cellular level and internal pathologies. Moreover, future parents are reviewing and adjusting their usual lifestyle in accordance with the upcoming changes: at this stage, it is important to put an end to addictions, adjust the daily routine and diet.

Early miscarriage: how to understand where to go next

After such a crushing failure, the woman is recommended to undergo a rehabilitation course of treatment. If the cause of the incident could not be established earlier, doctors will conduct the necessary diagnostics to determine it now. This is important, otherwise a woman runs the risk of facing the same problem the next time she prepares for motherhood.

The ultrasound procedure is a mandatory step after an early miscarriage. If there are fragments of an egg or embryo in the uterus, a woman will need a cleaning to avoid the development of inflammation or infection. After all the necessary procedures, the doctor will prescribe the patient a course of antibiotic therapy, which will exclude various infectious diseases, as well as a course of hormones that will put the woman's endocrine system in order.

Among other things, a failed mother is in dire need of professional psychological support. The loss of a baby, even if it is so tiny, leaves an indelible imprint in the mind of a woman. It is important to experience this moment with the support of a psychologist or relatives.

It is wrong to fence oneself off from the outside world and remain alone with one's misfortune, so negative emotions will simply “eat up” all hope for the best. Psychologists recommend that women who have experienced a miscarriage not be ashamed of their feelings and not hold back aggression and tears - the sooner you can get rid of them, the faster the recovery will come. And in no case should you be afraid of the future: modern medicine and competent doctors will do everything possible so that a new pregnancy ends with the triumphant cry of a long-awaited baby!

The loss of a child causes a deep shock in parents. And seldom is grief lessened by the fact that the baby was still tiny and was in the womb. Almost always, a woman and a man go through this period very hard, but it is worth continuing to live on for the sake of their future children, who will definitely appear.

For many women, the information we have prepared below can bring up unpleasant memories and a bitter aftertaste. However, there are those who would be comfortable knowing more about their loss.

What is a miscarriage? At what time does it take place?

This term is widely used to explain early pregnancy loss, which could be normal or ectopic. According to general estimates, approximately 20-25% of all pregnancies end in miscarriage, which often occurs so early that the woman is not even aware of this event. In this publication, we use this word, although from a medical point of view, this event is called spontaneous abortion.

Brief dictionary - what are miscarriages

Induced abortion is a planned voluntary termination of pregnancy. Sometimes it becomes a necessity due to certain diseases of the mother or fetus.

Spontaneous abortion (miscarriage) - when the uterus pushes the fetus and membranes up to 28 weeks of pregnancy (sometimes up to 20 or up to 24 weeks - depending on the opinion of experts). In common parlance, a pregnancy is terminated before the fetus can survive outside the mother's womb. Almost 75% of miscarriages occur early - before 12 weeks of pregnancy.

Incomplete abortion - some tissue in this case is not expelled, but remains in the uterus. Curettage will be required to remove the remaining tissue from the uterine cavity.

Complete abortion - observed more often in the later stages (from 12 to 28 weeks), both the fetus and all amniotic membranes are expelled. In this case, the woman does not need cleaning (scraping).

Habitual miscarriage - when a woman loses a child as a result of spontaneous abortion more than 2 times in a row.

Many women are diagnosed with a "threatened miscarriage", but in most cases such a pregnancy can be saved if you go to the hospital in time.

Scraping (cleansing) is done under general anesthesia, local anesthesia or sedation. The method is selected by the doctor depending on the situation.

How does a miscarriage happen? Symptoms

When a miscarriage threatens a pregnancy, little depends on the woman herself, her family, and even medical workers. This is no less a terrible time, full of uncertainty and anxiety.

The pregnant woman is sent for an ultrasound, where the specialist will determine the opening. It is unfortunate, but if the heart does not beat and the cervix is ​​open, then the miscarriage has either already occurred, or will inevitably happen in the near future.

A miscarriage may be followed by its threat, but sometimes it can occur without any precursors (it does not matter, the precursors did not appear in or).

The very first signs of interruption:

• Uterine bleeding, which may increase.
• Painful contractions in the lower abdomen, similar to menstrual pain.

If a complete spontaneous abortion occurs, then bleeding and pain stop. If incomplete, symptoms will be present until the complete cleaning of the uterine cavity.

Why is the pregnancy terminated?

There are many possible causes, such as infections, hormonal imbalances, implantation problems, or problems with the placenta. More often than not, something went wrong immediately or shortly after conception and the fetus does not develop properly.

For most women, it is impossible to determine why a miscarriage occurred. Even after extensive testing.

Here are some of the most common reasons:

Abdominal surgery.

A history of abdominal surgery (for example, a woman previously had an operation to remove an ovarian cyst) quite often leads to habitual or solitary miscarriages

Empty fertilized egg

Sometimes the egg is fertilized but does not continue to divide. The pregnancy test and hCG analysis will be positive, the fetal sac is formed, but the baby itself is not. In this case, an interruption occurs from 7 to 12 weeks.

Any severe or poorly controlled chronic disease

Diseases such as hypothyroidism and diabetes, if left unchecked, can cause miscarriage, although rarely.

Isthmic-cervical insufficiency.

Insufficiency of the cervix, when it is unable to hold the contents of the uterus and dilates painlessly too early, usually after 14 weeks. According to the Congress of Obstetricians and Gynecologists of Russia: “If cervical insufficiency was detected at a period of 12 to 26 weeks, surgical correction was performed according to the McDonald method. Women were also examined for the presence of urogenital infections and their hormonal levels were studied. After the operation, tocolytic , hormonal and antibacterial therapy, rectal suppositories with interferon and sanitation of the lower genital tract were performed with an aqueous solution of povidone-iodine.Thus, timely diagnosis and such treatment in 95% of cases made it possible to obtain viable newborns, and in 79% of cases made it possible to prolong the pregnancy to full term ."

Chromosomal defects or abnormalities.

Most chromosomal abnormalities or defects occur by chance, and in most cases their causes are unknown.

direct injury.

A strong direct blow to the lower abdomen can damage the uterus and placenta.

immunological problems.

Sometimes (for example, with a Rh conflict), the mother's immune system begins to reject the fetus, defining it as an aggressor for the woman's body.

Infections or viruses

For example, listeriosis or toxoplasmosis is very dangerous for the fetus.

Anomalies in the shape of the uterus

Excessive abuse of bad habits.

If the expectant mother smokes, consumes large doses of alcohol or drugs every day, then the likelihood of losing a child increases.

How to avoid losing a child?

The success of this event depends on the stage at which the interruption process is currently located. If a woman has a threat of miscarriage with aching pain in the lower abdomen and small spotting, then a medical institution can carry out preservation treatment and the child's life will be saved.

If blood clots appear, the bleeding intensifies and the pulling pains do not stop, then in this case everything can end well, you just need to seek help from the hospital in time.

But when parts of the fetal egg are already visible in the discharge, then nothing can be done.

A lot of research has been done and so far they have not found a way that would 100% guarantee protection against miscarriage. Why? The reason is that in most cases, a pregnant woman loses a fetus that is not viable. It has been established that bed rest, the absence of heavy physical exertion or malnutrition do not affect abortion in any way.

The materials of the Congress of Obstetricians and Gynecologists of Russia indicate:

In patients with alloimmune disorders, the therapy of choice is a combination of active and passive immunization in the first trimester of pregnancy. In autoimmune pathology (APS), the most effective is the appointment of antithrombotic therapy in a continuous mode up to 16 weeks of pregnancy.

Life after a miscarriage

Period.

The next period will begin approximately 30-45 days after the interruption.

Depending on the duration of the pregnancy loss, the uterus may remain enlarged for 1-2 months.

Allocations

Normally, discharge lasts no more than 2 weeks. At the same time, their number must necessarily decrease, there should be no pain and an unpleasant odor. Most often, with a complete miscarriage without cleaning, only a brown "daub" remains after 1-2 days.

Normally, there should be no pain. Maximum - mild pulling pains, which are associated with the restoration of the uterus to its previous size. In other cases, pain indicates the remnants of the membranes, endometrium in the uterus, or infection, inflammation, chronic disease. Be sure to consult your doctor if the pain is severe or does not go away for a long time.

HCG test

A blood test for hCG will show a high amount for 2-3 weeks, but the level will gradually fall.

After a late miscarriage, a woman may begin to produce milk. Breast milk usually does not appear if the pregnancy lasted less than 14 weeks. Lactation can be suppressed with drugs, avoid breast stimulation at first and wear a special bra at all times.

Planning for the next pregnancy

In most cases, the likelihood of another pregnancy after termination is not complicated by anything. But it is very important to try together with the doctor to determine the cause that led to the miscarriage in order to protect yourself in the future.

When to get pregnant? Not earlier than six months after the loss of the child.

A miscarriage is the loss of a pregnancy within the first 22 weeks after conception.

The main symptom of a miscarriage is vaginal bleeding, which is accompanied by cramps and pain in the lower abdomen. Scanty spotting from the vagina is quite common in the first trimester of pregnancy (first 12 weeks) and is not an unambiguous sign of a miscarriage.

Miscarriage can be triggered by various factors, although the exact cause is not always possible to determine. Most often, pregnancy loss occurs due to circumstances beyond the control of the woman. Most women have only one miscarriage and the next pregnancy proceeds normally.

Miscarriages happen much more often than many people think. The probability of this is approximately 1:7. Very often, miscarriages occur unnoticed by a woman, when she does not yet realize that she is pregnant. Three or more miscarriages in a row (called habitual miscarriage) are rare, occurring in about 1% of women.

If you know you are pregnant and notice vaginal bleeding and abdominal pain, call an ambulance by calling your home number 03 or mobile 911 or 112. An ambulance will take you to the gynecological department of the hospital, where doctors will perform an examination: examination, analysis for hCG and ultrasound of the genital organs.

Treatment tactics will depend on the duration of pregnancy, the desire to keep the child and the type of miscarriage. In the early stages of a miscarriage, it is possible to maintain a pregnancy with the help of a regimen and medical support. If a miscarriage has already occurred, it will be necessary to remove the remnants of the tissues of the fetus and placenta from the uterine cavity, which is possible with the help of medications or surgery.

Miscarriage symptoms

The most common symptom of a miscarriage is vaginal bleeding. Bloody discharge is scanty or abundant bright red or brown-brown. Bleeding can periodically pass and resume within a few days. However, light vaginal bleeding is quite common in the first trimester of pregnancy (first 12 weeks) and is not a clear sign of a miscarriage.

Other symptoms of a miscarriage:

• cramps or pain in the lower abdomen;
• discharge of fluid from the vagina;
• isolation of fetal tissue from the vagina;
• cessation of pregnancy symptoms such as nausea, soreness, and breast engorgement.

Most miscarriages occur in the early stages up to 4-8 weeks, less often - up to 12 weeks. At this time, a woman may not yet know about pregnancy and take the appearance of spotting for the next menstruation. Most of these cases end happily. However, it is possible to develop severe complications, sometimes life-threatening. For example, the appearance of spotting and abdominal pain against the background of a slight delay in menstruation is typical for ectopic pregnancy, which can lead to the death of a woman from bleeding and shock.

Another cause of complications can be an infection of the uterus - endometritis, accompanied by high fever, prolonged discharge and abdominal pain. Another cause of complications is cystic drift - the development of atypical, tumor tissues from the remains of the fetal egg. Therefore, if vaginal bleeding occurs outside of menstruation, contact a gynecologist as soon as possible, who If there is a delay in menstruation, or you already know that you are pregnant, call an ambulance by calling 03 - from a landline phone, 112 or 911 - from a mobile phone.

Causes of miscarriage

It is not always possible to determine the exact cause of a miscarriage, but there are many factors that can affect the course of pregnancy. A miscarriage in the first trimester of pregnancy (from 1 to 12 weeks) usually occurs due to fetal developmental disorders, genetic defects. Early miscarriages account for approximately 75% of all cases.

Early miscarriage

Early pregnancy loss can be accidental, but there are several factors that increase the chance of a miscarriage. The age of the mother matters here:

• in women under 30, the risk is 10%;
• in women 35-39 years old, the risk is 20%;
• in women over 45, the risk is over 50%.

Other risk factors:

• smoking during pregnancy;
• drug use during pregnancy;
• consuming more than 200 mg of caffeine per day (a cup of tea contains about 75 mg of caffeine, a cup of instant coffee contains about 100 mg);
• drinking more than two units of alcohol per week: a unit of alcohol equals 250 ml of medium strength beer, a small glass of wine or 25 ml of spirits.

One of the immediate causes of early miscarriage may be a chromosomal abnormality. Chromosomes are densely packed DNA molecules that contain genetic information about all aspects of the growth, development and appearance of an unborn child, down to its eye color. Sometimes, for unknown reasons, a failure occurs during conception, and the embryo has an incorrect set of chromosomes. This means that the fetus will not be able to develop normally, and a miscarriage occurs. According to some estimates, about 60% of all miscarriages occur due to chromosomal abnormalities.

Another possible cause is the pathology of the placenta. The placenta is the tissue that connects the circulatory system of the mother and fetus. If any failure occurs during the formation of the placenta, this can lead to a miscarriage.

Miscarriage in the second trimester

The risk of miscarriage in the second trimester is increased with certain chronic diseases, such as:

• diabetes mellitus (decompensated);
• extremely high blood pressure;
• lupus (a disease in which the immune system attacks healthy tissue);
• hyperactivity of the thyroid gland;
• celiac disease (gluten intolerance).

The following infectious diseases also increase the risk of miscarriage:

• cytomegalovirus infection;
• toxoplasmosis;
• malaria.

The chance of miscarriage is increased by taking the following medicines:

• misoprostol (taken to treat stomach ulcers)
• retinoids (analogues of vitamin A, used to treat eczema and acne);
• methotrexate (taken to treat rheumatoid arthritis);
• non-steroidal anti-inflammatory drugs (used to relieve pain and inflammation).

Before taking the medicine, make sure that it is suitable for pregnant women.

Features of the structure of the uterus and tumors. Incorrect structure of the uterus and neoplasms in the uterus (for example, benign neoplasms, the so-called fibroids) can also lead to miscarriage in the second trimester.

Weakness of the cervix. In some women, the muscles of the cervix are weakened. This is called isthmic-cervical insufficiency (ICI), which usually occurs as a result of trauma after surgery in this area. This can cause the cervix to dilate prematurely, causing a miscarriage.

Polycystic ovaries (PCOS). With PCOS, a woman's ovaries are enlarged, which can cause a hormonal imbalance in the body and an abortion. Polycystic is considered the main cause of infertility. Research also suggests that the condition increases the risk of miscarriage in fertile women. However, the exact relationship between them has not been established.

Misconceptions about miscarriage

If there are no other aggravating causes, that is, the woman is healthy and the pregnancy develops normally, the following factors do not increase the risk of miscarriage:

• the psychological state of the pregnant woman, such as stress or depression;
• shock or severe fright;
• physical activity (the level of permissible physical activity should be discussed with the doctor);
• lifting weights or straining;
• work during pregnancy;
• sex during pregnancy.

habitual miscarriage

Many women, having experienced a miscarriage, are afraid that it will happen again. But only 1% of women experience repeated miscarriages. Three or more miscarriages in a row are called recurrent miscarriages. However, this problem is treated, and most women with this diagnosis manage to become pregnant and give birth to a healthy child.

Diagnosis of a miscarriage

Evaluation for suspected miscarriage usually includes a gynecological examination, transvaginal ultrasound, and an hCG test. The examination will confirm whether there was a miscarriage, and also whether parts of the fetal egg remained in the uterus (complete or incomplete miscarriage).

First of all, the doctor will conduct a gynecological examination to examine the vagina, cervix, identify the source of bleeding, areas of greatest pain, and assess the size of the uterus.

Then, as a rule, a transvaginal ultrasound (ultrasound) is prescribed to accurately determine the size of the uterus, the presence of a fetus or remnants of fetal tissues in the uterus, and the fetal heartbeat. To do this, a small probe is inserted into the vagina - a vaginal probe. This procedure can be a little uncomfortable, but usually does not cause pain. If desired, an ultrasound can be performed with an abdominal sensor - through the wall of the abdomen. Neither type of examination will harm the fetus or increase the risk of miscarriage.

In addition, a blood test for hCG, human chorionic gonadotropin, is prescribed. It is a hormone produced during pregnancy. Sometimes progesterone levels are also measured. If the result is doubtful, the tests can be repeated after 48 hours. In some cases, it is impossible to immediately confirm a miscarriage based on ultrasound and blood tests. For example, at an early stage of fetal development (less than 6 weeks). In this case, it is recommended to repeat the examination after 1-2 weeks.

Sometimes a miscarriage is diagnosed during regular antenatal care checkups. An ultrasound may show that there is no fetal heartbeat or that the fetus is too small for the given term. This is called a missed pregnancy.

Examination for recurrent miscarriage

3 or more miscarriages in a row are called recurrent miscarriage. In this case, additional tests and examinations are prescribed to identify the causes of miscarriage, although in about half of the women it is not possible to establish them. These tests and examinations are described below.

Karyotyping- This is a cytogenetic study that allows you to study the structure and count the number of chromosomes. With the help of karyotyping, both partners are examined to identify chromosomal abnormalities - a possible cause of pregnancy loss.

If the analysis reveals chromosomal abnormalities, you will be referred to a clinical geneticist, a specialist who provides genetic counseling. He will talk about the chances of a successful pregnancy in the future, as well as available treatments, such as in vitro fertilization (IVF).

Blood tests are appointed to check the content of the following substances in it:

• luteinizing hormone - involved in the development of the egg;
• antibodies to phospholipids (APL) and lupus anticoagulant (LA) - this test is performed twice with an interval of six weeks, before pregnancy.

Antibodies to phospholipids increase the risk of blood clots, which disrupt the blood supply to the fetus and lead to miscarriage.

miscarriage treatment

The tactics of treatment for miscarriage depends on its type, stage and results of the examination.

Miscarriages in the early stages (up to 4-8, and sometimes 12 weeks) often go undiagnosed, because the woman does not know that she was pregnant, takes the bleeding for the next menstruation and does not go to the doctor. In some cases, such miscarriages end with a complete cleansing of the uterine cavity, stopping bleeding and restoring general well-being without treatment. However, there is a high probability of dangerous complications that can threaten not only the health, but also the life of a woman. Therefore, with the appearance of bloody discharge from the vagina and pain in the lower abdomen against the background of a delay in menstruation, you should contact a gynecologist as soon as possible, and with an already established pregnancy, call an ambulance.

The doctor will conduct an urgent examination and, if a miscarriage is confirmed, prescribe treatment. Modern methods of medical and surgical treatment make it possible in some cases to maintain a pregnancy, and if a miscarriage has already occurred, to avoid complications and restore the reproductive function of a woman.

The goal of treatment is to completely remove fetal tissue from the uterus, stop bleeding and prevent infectious complications. If the bleeding that occurs indicates a threat of miscarriage (fetal rejection has not yet occurred), and the woman wants to keep the pregnancy, preservation therapy is carried out.

If a miscarriage is suspected, a woman is usually hospitalized.

Medical treatment for miscarriage

Drug therapy for miscarriage consists of taking medications:

• reducing the uterus;
• increasing blood clotting;
• antibacterial and antifungal agents.

Sometimes a special treatment is prescribed to cleanse the uterine cavity from the remnants of fetal tissues. As a rule, medicine is offered in the form of a medical candle, which is inserted into the vagina and dissolves there, but if desired, it can be replaced with tablets.

For these purposes, the drug mifepristone is more often used, and after two days - misoprostol, which begins to act after a few hours. The result of therapy will be the appearance of cramping pains in the lower abdomen and profuse bleeding from the vagina.

Take a pregnancy test three weeks after taking the medicine. If the result is positive, further tests will be needed to make sure you don't have an ectopic pregnancy or a mole.

Surgery for a miscarriage

If a miscarriage is accompanied by heavy bleeding, it is urgent to remove the remnants of fetal tissue from the uterus. To do this, the uterine cavity is scraped out with a special surgical instrument, and the resulting tissues are sent to the laboratory for analysis. During the operation, the cervix is ​​opened with a special dilator, if necessary, and the remaining tissue of the fetus is removed. The operation is performed under anesthesia.

In some cases, instead of scraping the uterus, vacuum aspiration is used - a more gentle removal of the contents of the uterus in early pregnancy. However, this method is not always effective.

With a large blood loss, transfusion of donor blood components may be required. If you are Rh negative, you should be given an anti-D immune globulin after surgery to prevent Rh conflict in future pregnancies.

Preservation of pregnancy

With the threat of a miscarriage, a miscarriage that has begun and the desire of a woman to maintain a pregnancy, special therapy is prescribed:

• bed rest;
• abstaining from sex;
• drugs that reduce uterine contractility and hormone therapy, depending on the period and condition of the woman.

After a miscarriage

As a rule, these are examinations for sexual infections, tests for the level of sex hormones depending on the phase of the menstrual cycle, antibodies to phospholipids (APL) and lupus anticoagulant (LA).

It is advisable to plan the next pregnancy and, with a successful attempt at conception, contact a gynecologist as early as possible in order to control the course of pregnancy from the very beginning and prevent possible problems in time.

A miscarriage can have a strong psychological impact. Many experience a sense of bereavement. You may feel tired, lose your appetite, and sleep little, as well as guilt, shock, or anger (sometimes directed at your partner, friends, or family who have had a successful pregnancy).

Everyone deals with grief in their own way. Communication with people helps someone, it is too difficult for others to discuss what happened. Some women come to terms with a miscarriage after a few weeks and start planning their next pregnancy. Others, at least for some time, cannot even think about a new pregnancy.

The father of the child may also experience a sense of loss. It may be more difficult for him to express his feelings, especially if he believes that he should support the mother of the child, and not vice versa. Discuss your feelings with each other. If you or your partner cannot cope with grief, find a good psychologist or psychotherapist. There are also support groups for people who have experienced a miscarriage.

Refrain from sex until all symptoms are gone. Menstruation should resume 4-6 weeks after the miscarriage, but the cycle may not return to normal until a few months later. If you don't want to get pregnant, start using birth control right away. Plan your pregnancy in advance: consult your doctor, make sure you are mentally and physically ready for this. Remember that most often a miscarriage occurs only once, and then you can successfully bear a child.

Prevention of miscarriage

It is not always possible to prevent a miscarriage, since many of its causes do not depend on either the woman or the man. However, some tips will help reduce the likelihood of pregnancy loss.

To reduce the risk of miscarriage:

• stop smoking during pregnancy;
• give up alcohol and drugs during pregnancy;
• eat healthy, eat at least five servings of fresh vegetables and fruits a day;
• try to avoid certain infectious diseases during pregnancy, such as rubella;
• maintain normal weight before conception (see below).

If the body mass index exceeds 30, they are said to be obese. This disease increases the risk of pregnancy loss. You can calculate your body mass index yourself or get yours from your doctor.

To protect yourself and your baby, it is better to get rid of excess weight before pregnancy. Normal weight avoids the risks associated with obesity during pregnancy. Talk to your doctor about how you can lose weight or find a good nutritionist.

While there is no evidence that losing weight during pregnancy will reduce the risk of miscarriage, a healthy diet and physical activity, such as walking or swimming, are beneficial for all pregnant women. If you have led a sedentary lifestyle, check with your doctor before starting regular exercise during pregnancy.

Sometimes it is possible to determine the cause of the miscarriage, and in such cases, treatment helps to keep the pregnancy in the future. Below are some of the causes of miscarriage that can be treated.

Antiphospholipid Syndrome (APS)- a disease that causes the formation of blood clots, amenable to drug treatment. Studies have shown that the combination of aspirin and heparin (drugs to prevent blood clots) reduces the risk of miscarriage in women with this condition.

Isthmic-cervical insufficiency (ICI)- this is a weakening (failure) of the cervix. ICI is eliminated by stitching the neck with a strong thread that prevents its premature opening. Usually, surgery is performed after the first 12 weeks of pregnancy, and the suture is removed around the 37th week. Sometimes, instead of a suture, a special device is used to fix the neck - an obstetric pessary.

The most serious and dangerous symptom of the possibility of a miscarriage is uterine bleeding, even the smallest. Most often, spontaneous abortion begins with weak blood discharge, which intensifies. It may also be accompanied by cramps in the lower abdomen. The color of the discharge can vary from scarlet to brown. Allocations can be very weak, but do not stop for several days.

Pain may or may not accompany a miscarriage. Often symptoms appear, disappear for a while, then return again. A woman should use this period of time to go to a gynecologist's consultation. Often an immediate visit to the doctor saves the life of the unborn child.
A woman's condition can worsen very sharply, without any warning signs. In the event that pieces of tissue are present in the discharge, this usually means that a miscarriage has occurred.

Most often, the fetus died long before it began to be excreted from the body. Therefore, often the withdrawal occurs not entirely, but in parts. If the dead fetus is excreted in its entirety, then it looks like a grayish round bubble. Sometimes white particles are observed among the spotting. Bleeding may be observed for several more days, and pain may still be present.

In the case when the uterus has cleared completely and independently after the termination of pregnancy, the woman does not need treatment. But if fragments of the placenta or fetus remain in the uterus, they should certainly be removed.
The next menstruation, as a rule, begins a month and a half after the miscarriage.

Terms of miscarriage

A miscarriage is a spontaneous termination of pregnancy when the embryo is rejected by the mother's body before the term of twenty-two weeks.

Miscarriages are early - if they occur in the first 12 weeks of pregnancy. If the interruption occurred from 12 to 22 weeks, then it is called a late miscarriage.

In the case when spontaneous interruption occurred from 23 to 37 weeks of pregnancy, doctors will call it premature birth. Well, if the fetus is rejected from 37 to 42 weeks, this is called urgent delivery. In fact, this is already a normal situation in which an absolutely viable baby is usually born. In the same case, when a woman gives birth after forty-two weeks of pregnancy, childbirth is considered late, which is not very good both for the condition of the baby and for the course of childbirth.

In the case when the baby is born before 22 weeks, from a medical point of view, this is a fetus. But if the birth occurred from 22 to 37 weeks - this is already a premature newborn. Such a baby weighs about half a kilogram, and a sprout is a little more than twenty-five centimeters.

It's amazing that now doctors have learned to nurse babies born even with a weight of six hundred and seventy-five grams! Such cases are extremely rare, but the technology and possibilities of medicine are constantly evolving. Now it is practically not a problem to raise a baby born at seven months. Although such a crumb will cause quite a lot of trouble, especially in the first months of life.

Types of miscarriages

(the world's first operation of an unborn child, in which the child survived. The kid grabbed the surgeon's finger)))

Doctors distinguish between several types of miscarriages or their stages:

Inevitable or incomplete - this is pain in the lumbar region or lower abdomen, combined with the expansion of the lumen of the cervix or uterine hemorrhages. It is called inevitable when there is an increase in the lumen of the cervix, and also when the fetal membrane bursts. With an incomplete miscarriage, pain and discharge do not stop.

Complete miscarriage - spontaneous abortion when the embryo or fetus has completely left the uterus. With such a course of the hemorrhage process, they stop, as well as all unpleasant sensations.

Failed - the fetus or embryo dies, however, remains in the uterus. A similar condition is detected at a gynecologist's consultation when listening to the heartbeat.

Repeated - if a woman has at least three miscarriages in a row in the early stages. Such a violation accompanies approximately one percent of families.

Anembryony - fertilization occurs with a similar course, but the fetus is not formed. The egg attaches to the wall of the uterus, possibly even developing a gestational sac with a yolk sac. However, there is no fetus in the uterus. Although symptoms of pregnancy may be present.

chorionadenoma - with such a violation, fertilization occurs with a violation of genetic information, as a result of which, instead of an embryo, a simple piece of tissue is formed, which gradually increases in size. All these painful conditions end in spontaneous abortion or abortion for medical reasons.

Causes of miscarriage

According to statistics, 15-20% of all pregnancies end in miscarriages. In most cases, this happens when a woman does not yet realize that she is pregnant. But sometimes it happens to those who have already become attached to their belly-maker and fell in love with him. How to console a woman in this case? Only next pregnancy. But those who have had such a misfortune in their lives, and those who have not yet known the bitterness of loss, should go through a small 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 conversation will focus on early miscarriages that occur for up to 12 weeks, because the vast majority of them happen during this period. So, the most common causes of miscarriages in early pregnancy:

• 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, by protecting yourself from the effects of mutagenic factors as much as possible. But with modern ecology, the probability of mutations still remains, because miscarriages that occur for this reason can be considered a boon, because they save a woman from many problems and troubles in the future.
• Hormonal disorders
  When the balance of hormones in a woman's body is disturbed, early pregnancy termination often occurs. Most often this happens when there is a lack of the main hormone of pregnancy - progesterone. With the timely detection of this problem, pregnancy can be saved with the help of progesterone preparations. An excess of male sex hormones can also cause an early miscarriage - they suppress the production of estrogen and progesterone. Androgens are often the cause of recurrent (habitual) miscarriages. The adrenal and thyroid hormones also influence the formation and development of pregnancy. Therefore, dysfunction of these glands can also cause miscarriage.
• Immunological causes
  As a rule, this happens with an Rhesus conflict. The embryo inherits the Rh-positive father, while the mother's Rh-negative body rejects embryonic tissues that are foreign to it. To prevent miscarriage during immune conflict, progesterone preparations are used, which in this case have an immunomodulatory effect.

  Sexually transmitted infections: trichomoniasis, toxoplasmosis, syphilis, chlamydia, as well as herpetic and cytomegalovirus infection often cause miscarriage. Pathogenic bacteria and viruses cause infection of the fetus, damage to the membranes, resulting in a miscarriage. To prevent this from happening, it is advisable to treat infections before pregnancy. General infectious diseases and inflammatory diseases of the internal organs. All diseases accompanied by intoxication and an increase in body temperature above 38 ° C can lead to miscarriage. The leaders in this list are rubella, viral hepatitis, influenza. Even a banal sore throat can become fatal at 4-10 weeks of pregnancy. And pneumonia, pyelonephritis, appendicitis are a serious risk to the fetus. That is why, when planning a pregnancy, it is worth undergoing a complete medical examination, identifying and treating all foci of chronic infection.

• History of abortion
  Abortion is not just a medical manipulation: it is a huge stress for the female body that can cause dysfunction of the ovaries and adrenal glands; contributing to the development of inflammatory processes in the genital organs. This can cause infertility and habitual miscarriages in the future.
• 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 the formation of developmental defects in the fetus. So, for example, narcotic analgesics or hormonal contraceptives often become the culprits of abortion. You also need to be careful with medicinal herbs: parsley, nettle, cornflower, St. John's wort, tansy - are contraindicated in early pregnancy.
• stress
  Strong fright or unexpected grief, resentment or prolonged mental overstrain are dangerous for a small creature in your womb. If you, by the will of fate, are forced to be under the influence of stress, discuss with your doctor the possibility of taking sedatives, at least the same valerian.
• Unhealthy Lifestyle
  Alcohol, drugs, smoking, regular coffee consumption, improper and incomplete nutrition are all allies of a miscarriage. It is better to correct your lifestyle even before conception.
• Falls, heavy lifting, sexual intercourse
  All this, although rare, can become a trigger for abortion, so take care of yourself, and therefore your baby!

Risk of miscarriage

If during pregnancy a woman feels heaviness in the lower abdomen, pain in this area or cramps, and if spotting bleeding is observed, this may indicate a threatened miscarriage.
In the event that a woman does not go to the doctor and leaves the situation to chance, spontaneous abortion may occur. Often, with a timely visit to the doctor, a miscarriage can be prevented. But the woman will be under the close supervision of the attending physicians until the birth itself. If the threat was observed in the first weeks or months of pregnancy, this may indicate an abnormal development of the embryo. Therefore, an ultrasound examination is prescribed, which not only allows you to assess the condition of the fetus, but also detect uterine hypertonicity or problems with the cervix. In addition, a blood test for hormone levels and a special urine test are prescribed.

Often, the doctor considers it necessary to check the function of the thyroid gland. For this, a special blood test is also prescribed. It is important to check whether an infection, such as cytomegalovirus, toxoplasmosis, or herpes, is the cause of the pregnancy disorder. In order to get a complete picture of the state of the body, there are two more tests: for antibodies to chorionic gonadotropin, as well as for lupus anticoagulant.

Upon receipt of the results of examinations, the doctor prescribes treatment. In the presence of blood secretions, a woman is placed in a hospital, but if her condition does not cause concern, the drug is taken at home.

After a miscarriage

To quickly conceive a new baby after a miscarriage is a natural desire of parents. Although, after the experience, many are afraid that they will fail again. This is a completely normal reaction of the human psyche to a stressful situation. But couples who have experienced a miscarriage should be guided primarily by the advice of a doctor. And they generally boil down to the following:

1. It is advisable to take a break for six months before the next conception. According to doctors, if you become pregnant immediately after a spontaneous abortion, the risk of such an outcome increases by one and a half times.
2. During this "technical" break, you need to carefully select contraceptives. Only a knowledgeable doctor can help with this.
3. Measures to prevent new failures must be discussed with the treating doctor.

Today there are medical institutions specializing specifically in human reproduction. The specialists of these clinics can develop an individual plan of action that will ensure a successful pregnancy in the future. Do not neglect the help of doctors. It is imperative to investigate and find the cause of the interruption. Since these causes can lead to serious illnesses in the future, as well as jeopardize the well-being of subsequent pregnancies.

When prescribing any medications, it is important to check with the doctor how they can affect the functioning of the reproductive system and whether it is possible to become pregnant while taking these drugs, and how long after the end of treatment, conception is allowed.