Miscarriage

Miscarriages are more common than what is generally thought of. This is because it usually takes at least two to four weeks after conception for a pregnancy to be confirmed. Missing a period is almost the first sign of most pregnancies, and by that time if a miscarriage happens, it can go without being identified.

 When does a miscarriage happen?

Miscarriage is a spontaneous loss of a fetus before 20 weeks of pregnancy. From the day of conception up until 20 weeks, miscarriage can happen at any time. A recently fertilized egg before implantation or during the process of implantation can be lost too. Most of the miscarriages occur in the first trimester, that is, before 12 weeks of pregnancy.

What causes a miscarriage?

The exact cause of a miscarriage may not be known unless a previously existing physiological issue has been identified. The common cause of a miscarriage is:

Chromosomal abnormality

The complete set of genetic information present in the fertilized egg is formed as a result of the union of the mother’s and the father’s genetic materials. A normally developing embryo carries 46 chromosomes, 23 from the mother’s egg and 23 from the father’s sperm. If there happens a defect in the number of chromosomes instead of the planned 46, it becomes a chromosomal abnormality. It is the chromosomes’ ability which directs how the fertilized egg must develop further. When there is a fault in the chromosomes, it probably gets confused and results in the spontaneous termination of the pregnancy which we call as miscarriage.

It must be noted that a chromosomal abnormality is not hereditary; it has nothing to do with what has been carried in the genes. Rather, it is a random event in which either the egg or the sperm has the incorrect number of chromosomes.

Blighted ovum is a chromosomal abnormality in which the embryo implants into the uterus but fails to develop further.

Other causes of miscarriage can include:

Structural problems               

·         It may so happen that the uterus of the expectant mom isn’t structurally receptive to an embryo. A fibroid or scar in the uterus can lead to space constriction for the embryo, making it to lose its viability.

·         If the normal development of the placenta, the organ which connects the mother and the baby is affected, it can lead to depleting nourishment for the embryo, causing a miscarriage.

·         Cervical insufficiency is another structural cause for a miscarriage. In this case, the cervix (the mouth of the uterus) becomes dilated during early pregnancy causing the death of the embryo.

Infections

If the mother is infected with serious infections like sexual transmitted diseases (Ex. Syphilis) or food poisoning (Ex. Listeriosis), it can lead to miscarriages.

What are the signs of miscarriage?

If you did not know of your pregnancy in the very early stages and you had a miscarriage, you will probably not see any signs.

Signs and symptoms of miscarriage can be one or all of the following:

Vaginal bleeding or spotting: When the fertilized egg or implanted embryo disintegrates, it will pass through the vagina like menstrual blood. In most miscarriages, this happens exactly around the time of the expected period date and can be mistaken for a period. Unless a pregnancy test or ultrasound has confirmed the pregnancy prior to the vaginal bleeding, there is no way to differentiate a miscarriage bleeding and a period bleeding.

Not all vaginal bleeding, however, point to a miscarriage. It can happen in normal pregnancies as well. A mild spotting of blood in the panty liner can be due to implantation bleeding and should not be feared for a miscarriage.

Also, vaginal bleeding or spotting can also happen with cases of ectopic pregnancy, that is, the embryo gets implanted in an organ other than the uterus, mostly in the fallopian tube.

Abdominal pain or cramps: An unusual pain or cramps like sensation in the tummy can be a sign of miscarriage. Again, women who have cramps during their routine period days may not be able to distinguish if the cramps are due to period or menstruation.

Clots in vaginal bleeding: Sometimes, pregnancy tissue after a miscarriage can pass through in lumps or clots through the vagina. Normal menstrual blood usually does not contain clots. So an abnormal vaginal bleeding with clots can be a sign of miscarriage.

 Who is at an increased risk for miscarriage?

There is no certain rule that a particular trait will definitely lead to miscarriage. The following are the possible risk factors to miscarriages while it must also be noted that women who carry one or more of these may not necessarily have a miscarriage.

·         Mother’s age is 35 or above

·         Had previous repeat miscarriages

·         Health disorders such as chronic diabetes, autoimmune disorders, or thyroid disorders

·         Smoking, drinking alcohol, having drugs and high levels of caffeine during pregnancy

·         Infections

Can one conceive after a miscarriage?

Except for the fact that for expecting parents, a miscarriage can be emotionally upsetting, there is no related future impossibilities for conception. Most women can conceive and have normal pregnancies after a miscarriage. Since a miscarriage has nothing to do with what the mother did to have one, becoming pregnant subsequently is quite normal. Only in those rare cases when there is a repeat pregnancy loss for three or more number of times, there may be a concern which needs to be discussed with the doctor.