What Is MISCARRIAGE?

Miscarriage is the spontaneous loss of the fetus before the 20th week of pregnancy because of improper development of the fetus. Approximately 10-20% of the known pregnancies end up in a miscarriage but the actual number of miscarriages occurring is most likely higher because they occur very early in the pregnancy and are in most cases confused for a period.

Symptoms

  • Spotting or bleeding from the vagina
  • Cramping and pain in the abdomen and lower back
  • Passage of fluid or tissue from the vagina

Here it is important to mention that most women who have spotting during their first trimester have a successful pregnancy.

Causes

  • Genetic abnormalities – these are the major reason for the fetus to not develop normally. Approximately 50% miscarriages are associated with defects in the number of chromosomes. Abnormal chromosomal number can result in the following inside the womb –
    • Blighted ovum – Occurs when no embryo formation takes place.
    • Intrauterine fetal demise – Embryo formation occurs but it stops developing and dies before any symptoms of pregnancy loss can be observed.
    • Molar and partial molar pregnancies – these are caused due to abnormalities in the number of sets of chromosomes involved in the making of the embryo. In molar pregnancy, both sets of chromosomes are from the father i.e., no fetus id formed but placental growth is observed. Partial molar pregnancy occurs when the fetus has 1 set of chromosomes from the mother and 2 sets of chromosomes from the father resulting in abnormal development of the fetus and the placenta. Both the aforementioned pregnancies are unviable and are terminated inside the uterus.
  • Maternal Health Conditions – certain health problems in the mother can result in miscarriage. These are –
    • Hormonal problems
    • Uncontrolled diabetes
    • Problems in the cervix or uterus
    • Thyroid
    • Infections

The risk factors for miscarriage include –

  • Maternal age over 35 years
  • Previous history of miscarriages
  • Chronic health conditions
  • Uterine and cervical problems
  • Smoking and consumption of alcohol and drugs
  • Mother belonging to extreme weight categories – either underweight or overweight
  • Invasive prenatal testing

Can a woman get pregnant after having a miscarriage? If yes, then when?

Amongst the women who have a miscarriage, almost 90% can have subsequent normal pregnancies and deliveries. Only about 1% of the women have repeated miscarriages which is an indicator of genetic anomalies in the fetus. Medically there is no specified waiting time to plan before attempting next pregnancy but it is generally recommended to find the root cause of the miscarriage and develop strategies with the doctor to avoid the same in the future before moving on to the next pregnancy, thereby ensuring a higher success rate.

Those couples who have had a series of miscarriages are generally advised to stop trying to conceive and are recommended to undergo genetic testing to determine chromosomal aberrations in their DNA. They are also asked about the medical history of their immediate and extended family so that the inheritance pattern of the genetic anomaly can be determined and proper measures can be taken to have a successful pregnancy in the future.

Coping with miscarriage

After miscarriage, a woman’s body can recover within a few hours to a couple of days. They ovulate within two weeks after the miscarriage and their period returns within 4 to 6 weeks. Doctors advise these patients to avoid having sexual intercourse and putting external objects like tampons into the vagina for two weeks after the miscarriage.

On learning about their pregnancy, parents become attached to the idea of their child and mentally and emotionally coping for their loss is much harder than physical recovery. They undergo cycles of emotions ranging from grief to anger and guilt from not being able to protect their baby. Therefore, it is necessary for these parents to properly grieve their child and if need be, seek psychological assistance. They might never be able to forget the baby they lost, but in time they might be able to accept their loss and move on.

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