A miscarriage is also known as spontaneous abortion which is the natural termination of the fetus before the 20th week of pregnancy. The miscarriages after the 20th week are known as stillbirths. This type is the naturally occurring miscarriage and not related to the medical or surgical abortions. A miscarriage is possible with a number of causes including chromosomal abnormalities, problems with the woman’s reproductive organs and infections. A miscarriage occurs with 10 to 15% of pregnancies and 85% miscarriages develop within the 12 weeks. It is estimated that most of the fertilized eggs die spontaneously even before the woman is aware of their pregnancy. If the woman had previous miscarriages or is older than 30 years of age, the risk of another miscarriage is higher.
Causes
Most cases of miscarriages are attributed to fetus defect or a genetic condition that affects the development of the baby, although generally the cause is often not identified. Other causes of miscarriages can include severe injuries, alcohol or drug abuse, structural problems in the women’s reproductive organs, exposure to toxins, hormone abnormality, severe diabetes, obesity and disorders such as chronic kidney conditions or celiac disease. In addition, a sudden shock and minor injuries are also associated with miscarriage.
Symptoms
The initial sign of a miscarriage can include the clot-like material or vaginal bleeding but may progress to cause profuse bleeding. Low back pain or abdominal pain can also occur with cramps as the result of the uterus contracting which continues to become severe until the fetus and placenta are expelled. In the cases of no symptoms, the uterus not may enlarge. This rarely is the cause of septic abortion when the dead tissues present within the uterus become infected.
Diagnosis
The pregnant woman is examined to assess whether the cervix is opened (dilating) or thinned out (effacement), in which case, a miscarriage may occur. A vaginal or abdominal ultrasound scan can check the heart rate of the fetus and indicate if the fetus is still alive. In the case of several miscarriages, diagnostic tests such as ultrasound or hysteroscopy can assess the woman’s structural abnormalities and genetic tests for chromosomal disorders. A blood test may consist of white blood count to rule out infection, a complete blood count and blood type.
Treatment
A miscarriage is successful when the entire placenta and fetus is expelled requiring no treatment. When the fetus or placenta does not naturally leave the body after a miscarriage, a surgical removal of the fetus is required involving a process known as suction curettage or dilation and evacuation (D&E). The tissue expelled from the vagina must be examined to identify whether the placenta is normal. Certain medications are also used to induce labor and the body expelling the fetus. In the case medications are unsuccessful; the D&E may be required.