Spontaneous miscarriage: what is it and why does it happen?

• How often does it occur?
• Causes of miscarriage
• Symptoms
• Stages
• Possible complications
• How to diagnose
• How to treat
• Recovery after treatment
• Prevention

An unexpected termination of pregnancy in the first trimester, accompanied by pain and bleeding, is called spontaneous abortion, or miscarriage. This dangerous condition not only stops the development of the embryo, but also threatens the life of the woman. The consequences of a miscarriage damage the reproductive organs and reduce the chances of becoming pregnant in the future.

What are the signs of a miscarriage?

To understand what's going on, you need to understand what spontaneous miscarriage looks like. The most common symptom is excessive bloody discharge with clots. Sometimes they can be weak at first, and then quite large. You should monitor your condition and if even slight bleeding begins, you should immediately consult a doctor.

Sometimes a miscarriage can start suddenly. But it happens that before this there may be slight nagging pain in the lower abdomen, lower back, and brown spotting.

Women may not immediately realize that they are having a miscarriage. Especially if the delay is only a few days, and the test was not done, then you might think that your period just started.

But usually, a woman who already knows about her pregnancy remembers how a spontaneous miscarriage occurs forever. In most cases, this is heavy bleeding with blood clots, mucus and severe abdominal pain. If measures are not taken immediately, chills, fever, and the skin may become pale. The patient may even lose consciousness. If a woman does not immediately see a doctor or call an ambulance, she may even die from blood loss, since sometimes such bleeding can be incredibly serious.

Spontaneous miscarriage may also have symptoms such as nausea, vomiting, frequent urination, dizziness, weakness,

What can cause early miscarriage?

Why does it happen that a miscarriage occurs? Many reasons can be given here, but in each specific case, research is carried out, the patient undergoes tests.

The causes of spontaneous abortion may be as follows in the first trimester:

• Increased contractile activity of the uterus, which literally “pushes out” the embryo.
• Genetic abnormalities in the fetus. Sometimes this happens once in one woman, as a result of genetic “breakdowns”. And it happens that it’s all about the genes of the future father and mother, and therefore it is necessary to look for problems together with a geneticist.
• Lack of the hormone progesterone. This is the so-called “pregnancy hormone”. If it is not enough, then it is prescribed additionally.
• Immunological disorders that prevent the embryo from developing normally.
• Intoxication.
• In the second trimester, the reasons for miscarriage may be slightly different:
• Uterine fibroids.
• Adhesive processes in the pelvic organs.
• Polyps in the uterus that prevent the embryo from developing normally.
• Endometriosis, which causes connective tissue to grow outside the uterus.
• Pathology of the cervix, namely an open cervix, which does not allow you to carry a child to term and give birth to it on time.
• Infections that can cross the placenta and cause fetal death.
• Some chronic diseases of the mother.

But besides this, there may be many other specific reasons that are individual for each woman. For example, hard physical work, work in hazardous enterprises, severe stress and anxiety can also cause spontaneous abortion. Many women are at risk of spontaneous miscarriage, but not everyone can have an abortion. Much depends on the state of health, immunity, even emotional state.

How to prevent the threat of miscarriage

• Plan your pregnancy in advance by conducting a comprehensive examination to prepare the woman’s body for conception. If any diseases are present, it is necessary to treat and eliminate their possible impact on the course of pregnancy;
• protect your health from possible stress and anxiety, do not overwork, get enough sleep and relax;
• eat well, consuming sufficient amounts of vitamins, micro- and macroelements necessary for normal intrauterine development of the fetus and maintaining the health of the female body;
• Do not lift anything heavy under any circumstances;
• choose comfortable shoes without high heels (minimizing the possibility of an accidental fall and the appearance of thrombophlebitis);
• taking into account the recommendation of a specialist, constantly perform special physical exercises for pregnant women, which will later help during childbirth.

To maintain a normal pregnancy, vitamins should not be taken synthetic, but should be taken from foods rich in them, with a living molecular structure. Fresh natural fruits and vegetables, juices from them, rich in fiber, calcium, B vitamins and vitamin C are especially important for the overall strengthening of a woman’s immune system.

Despite the fairly common threat of miscarriage, today there are many options for help for a woman who wants to carry and give birth to a healthy baby. The main thing is to constantly undergo consultation, take tests in a timely manner, and follow all the recommendations of the gynecologist.

Obstetrician-gynecologist, services, prices, registration

What types of miscarriage can there be?

There are several types of spontaneous abortions:

• Early (up to 12 weeks)
• Late (13-22 weeks).

You can also distinguish some other types:

• Threatening miscarriage. It manifests itself as slight abdominal pain, spotting, and the muscles of the uterus are quite active. But at the same time the cervix is ​​closed.
• Incipient miscarriage. There is a detachment of the ovum, bloody discharge. The cervix is ​​closed, but the internal os is open.
• Abortion is on the move. The fertilized egg leaves the uterus and is located in the cervical canal. Severe pain and bleeding begin.
• Incomplete abortion. Part of the egg may come out of the uterus, and part may still be in it. In this case, there is severe bleeding, abdominal pain, and shock may develop.
• Complete abortion. With it, the fertilized egg is completely released from the uterus. This is a “mini birth”, with some bleeding and abdominal pain.
• Failed abortion. With it, the fertilized egg remains in the uterus. In this case, the fetus is already dead. Such an egg can remain inside a woman for some time, her condition worsens, and signs of pregnancy disappear.

Also, such miscarriages can be divided into several more types:

• Interrupted biochemical pregnancy. It happens within 1-3 weeks. But a woman usually perceives it as the beginning of her period.
• Spontaneous miscarriage (before 22 weeks).
• Premature birth (after 22 weeks).

Diagnosis of miscarriage

To accurately understand that a spontaneous abortion has occurred, it is necessary to correctly diagnose it. To do this you should:

• Analyze the patient's complaints. Usually this is bleeding, pain and cramps in the abdomen, poor general health, pale skin, increased body temperature.
• Conduct a gynecological examination. The uterus is palpated, the cervix and external os are examined.
• Colpocytological examination is carried out.
• They take tests for certain hormones.
• An ultrasound of the pelvic organs is performed.

If such miscarriages occur frequently, then it is necessary to find out the reason. To do this, they conduct various studies, consultations with geneticists, endocrinologists and other specialists.

How to carry out treatment?

How to treat a spontaneous miscarriage depends on the type of miscarriage. If it is threatening and has begun, then the following must be taken:

• The woman must be in hospital.
• A diet that contains all the necessary minerals and trace elements.
• The patient must remain in bed.
• Sedative medications and drugs that relax the muscles of the uterus should be prescribed.
• If abortion is “in progress,” then all measures must be taken to stop the bleeding.
• If the abortion is complete and incomplete, then everything “unnecessary” that is in the uterus should be removed. For this purpose, curettage can be used.
• If there is a failed abortion, then sometimes they use expectant tactics, when they wait for everything to “come out of the uterus on its own.” And sometimes they do curettage.
• Also, sometimes during a frozen pregnancy, expectant management can be used, especially for nulliparous women. Then after about 4-6 weeks a spontaneous miscarriage may occur. Sometimes drug treatment is used, in which special pills are used to help complete the pregnancy. And sometimes they do surgical curettage.

In any case, abortion should not be left to chance; you must consult a doctor who will choose a treatment tactic.

Another pregnancy after a miscarriage

If spontaneous abortion occurs in the case of the first pregnancy, doctors usually do not prescribe any specialized examinations. Efforts for another pregnancy can begin at the next ovulation, 2-6 weeks after the miscarriage.

If during a miscarriage it becomes necessary to curettage the uterus, the doctor will tell you when it will be possible to return to trying to conceive a child and to sexual relations in general. The chances of a healthy pregnancy after one miscarriage are estimated at 80-87%, and a second at 72-82%.

What consequences?

Typically, spontaneous miscarriage in early pregnancy carries certain risks. The consequences of spontaneous miscarriage can be different:

• Heavy bleeding, pain.
• Infertility.
• But the most difficult and life-threatening miscarriages are those that a woman causes herself, at home. If they are not treated and the consequences are not eliminated, they can result in the woman’s death.

Usually, if the patient was provided with high-quality medical care, there are practically no complications. After about 10 days, the bleeding stops, and after 4 weeks the woman begins her normal menstruation.

Miscarriage - risk factors during pregnancy

Prognosis factors associated with the course of pregnancy that have a significant impact on the risk of miscarriage:

• Location of the gestational follicle
  . Follicles located above the internal ostium are more prone to miscarriage than those located below. The location of the gestational follicle can be assessed using ultrasound;
• Fetal heart function
  . Decreased fetal heart function – bradycardia – is an unfavorable prognostic symptom;
• Bleeding
  . An unfavorable prognosis factor is bleeding lasting 4 days or more;
• Human chorionic gonadotropin (beta-hCG) level.
  Lack of growth or a decrease in the level of this hormone is an unfavorable prognosis factor, indicating the presence of a dead fetus. Under normal conditions, the concentration of human chorionic gonadotropin increases every 48 hours by approximately 66%. This hormone is produced by the embryo, and its greatest secretion occurs in the 10th week of pregnancy. Slower growth indicates fetal abnormalities.

Is there any prevention?

Pregnancy after a spontaneous miscarriage can occur and be quite successful. But first the cause of the abortion must be established. If these are genetic problems, endocrine pathologies, problems with the blood or the uterus, then it is necessary to undergo special treatment. But there are general recommendations that will help reduce the risk of miscarriages:

• After termination of pregnancy, a woman needs to rest well, gain strength, take a course of vitamins, possibly oral contraceptives, prescribed by the doctor. It is best to plan your next pregnancy after about 6 months.
• You should lead a healthy lifestyle.
• Do not smoke or drink alcohol.
• Exercise regularly.
• Take vitamins and balanced meals.
• Visit your gynecologist regularly.
• Have fewer stressful situations, give up heavy physical activity.
• Reduce work with harmful substances and poisons to a minimum.
• Normalize weight if it is too small or, on the contrary, too large.
• Consultations with a psychologist and psychotherapist are possible.

Spontaneous abortion is an unpleasant phenomenon that can happen to every woman. But it is necessary to carry out treatment correctly and consult a doctor on time. In addition, preventive measures should be taken.

Previous abortions

Getting and maintaining a pregnancy is often complicated by a previous abortion. Even the safest option, termination of pregnancy with the help of special medications, greatly affects the hormonal balance. Among the delayed consequences of these drugs is disruption of the ovaries and adrenal glands, which are responsible for the hormones on which the onset of the next pregnancy depends.

Vacuum cleaning or surgery often injures the walls of the uterus. Injuries lead to inflammation, scar formation, and neoplasms, which increase the risk of miscarriage and reduce the possibility of conception.

What can be done in this case? If a woman has had an artificial termination of pregnancy, then before conception it is advisable to examine the uterus and evaluate its condition.