Miscarriage is the spontaneous loss of a baby before the 20th week of pregnancy. It typically happens during the first three months.
About 10-20% of known pregnancies end in miscarriage. It’s relatively common, but that doesn’t mean it’s an easy experience.
Miscarriages can be caused by a variety of medical reasons, often outside the control of a woman. Knowing the signs, causes, and risk factors will help you understand it better and get the right support and treatment.
Signs and symptoms
Signs and symptoms of miscarriage may vary for each person. There are cases that it happens so quickly and early, that the person may not even know they’re pregnant before they miscarry.
Here are the common signs and symptoms of a miscarriage:
- Bleeding that starts light and becomes heavy
- Severe abdominal cramps
- Mild to severe back pain
- Vaginal discharge that looks like tissue or white-pink mucus
- Contractions
Miscariage isn’t the only thing that can cause these symptoms. Most women who had vaginal spotting or bleeding during their first trimester had successful pregnancies. Contact your doctor right away if you’re experiencing any of these symptoms or you think you’re having a miscarriage.
Diagnosis
Your doctor may have you undergo different tests such as :
- A pelvic exam will see if the cervix has started to dilate.
- An ultrasound will see the baby’s heartbeat.
- Blood tests will determine the level of human chorionic gonadotropin (HCG), the pregnancy hormones, and will be compared to your previous results. Your doctor may also test you for anemia if you’ve experienced significant bleeding.
- Tissue tests are done to check the tissue you passed and confirm whether you had a miscarriage, or the symptoms are caused by something else.
- Chromosome tests are done if you’ve had two or more previous miscarriages. This will help determine if you or your partner’s genes are a factor.
Causes
There are things that can increase the risk for miscarriage, but most of the time it isn’t caused by something you did or didn’t do.
When a person is pregnant, their body supplies hormones and nutrients to the fetus for it to grow and develop properly. Most miscarriages within the first trimester happen because the fetus isn’t developing properly, and not due to problems inherited from parents. About half of the cases result from chromosome problems and errors as the embryo divides and grows.
Genetic or chromosome issues
Chromosomes contain genes. For a fetus to develop, one set of chromosomes should come from the mother, and another from the father.
Genetic or chromosomal issues may lead to:
- Blighted ovum: Occurs when no embryo forms.
- Intrauterine fetal demise: An embryo forms, but stops developing before symptoms of pregnancy loss occur.
- Molar pregnancy: Both sets of chromosomes come from the father, and no fetal development happens. This case is often associated with abnormal placenta growth.
- Partial molar pregnancy: Occurs when the mother’s chromosomes remain, but two sets of chromosomes also come from the father. This case is usually associated with abnormalities of the placenta and fetus.
Risk factors
In a few cases, a mother’s health condition and lifestyle might also increase the risk for miscarriage. Examples of risk factors include:
- Uncontrolled diabetes
- Untreated thyroid disease
- Infections
- Hormonal problems
- Abnormally shaped uterus
- Problems with the cervix
- Being underweight or obese
- Smoking
- Drinking alcohol
- Using illicit drugs
Age is also a factor; risk for miscarriage get higher after 35 years of age. Women who’ve had two or more consecutive miscarriages also have higher risk.
Cervical insufficiency
A miscarrige can happen when the mother has a weak cervix. This condition is called cervical insufficiency, where the cervix can’t sustain a pregnancy. This type of miscarriage commonly happens during the second trimester.
Doctors may treat an insufficient cervix with a “circling” stitch to hold the cervix closed until it’s time for delivery. This is usually done in the 12 week of pregnancy.
What does NOT cause miscarriages
Regular activities, such as the following, don’t cause a miscarriage:
- Exercise, even high-intensity activities such as jogging and cycling.
- Sexual intercourse.
- Working, unless you’re exposed to harmful chemicals or radiation.
Most medicines and minor injuries like falling don’t generally lead to a miscarriage either.
Prevention
Not all miscarriages are preventable. But there are things that can be done to help maintain a healthy pregnancy and baby:
- Get prenatal care regularly
- Stay away from preventable risk factors, such as drinking, smoking, and drug use
- Maintain a healthy weight before and during pregnancy
- Avoid infections by practicing regular hand washing and avoiding places where there is high risk for contracting infections
- Take prenatal vitamins
- Limit daily caffeine intake within 200 milligrams, or two caffeinated beverages at most
- Eat a health and well-balanced diet that includes fruits and vegetables
Types
There are different types of miscarriages, depending on the symptoms and stage of pregnancy. They are:
- Threatened miscarriage: Bleeding and abdominal cramps occur which are signs of a possible upcoming miscarriage. But the cervix hasn’t dilated, so it’s still possible for the pregnancy to continue.
- Inevitable miscarriage: Bleeding and cramping, and cervical dilation are signs that miscarriage is inevitable.
- Incomplete miscarriage: Some tissue from the baby or placental material leave your body, but some still remain in the uterus.
- Complete miscarriage: All pregnancy tissues are excreeted by the body. This type commonly happens before the 12th week of pregnancy.
- Missed miscarriage: The embryo dies or was never formed.
- Septic miscarriage: An infection occurs within the uterus.
- Recurrent miscarriage: Three or more consecutive miscarriages have happend during the first trimester.
Sources:
https://www.webmd.com/baby/guide/pregnancy-miscarriage#1
https://www.plannedparenthood.org/learn/pregnancy/miscarriage
