All About Miscarriage: Signs, Causes, Diagnosis and Treatment

“Miscarriage” whenever you get to hear the word it brings countless thoughts, opinion and emotions all at a time, but it is not very often when you talk about it openly. Basically, there is a certain stigma attached to the word miscarriage, as if the couples who went through the experience are responsible for it.

Mark Zuckerberg, the biggest and most celebrated tech billionaire of the millennium, came in open and shared his personal experience of going through three miscarriages with his Wife Priscilla Chan: “We’ve been trying to have a child for a couple of years and have had three miscarriages along the way…….. Most people don’t discuss miscarriages because you worry your problems will distance you or reflect upon you — as if you’re defective or did something to cause this. So you struggle on your own.” His words summarize it pretty well.

Its very important to understand we can remove this stigma only when we start talking about it, being open and honest. as Mark rightly pointed out: “discussing these issues doesn’t distance us; it brings us together……It creates understanding and tolerance, and it gives us hope.When we started talking to our friends, we realized how frequently this happened –that many people we knew had similar issues and that nearly all had healthy children after all.”

Hence, we decided to talk about it and hear it from you too.

Studies have shown that 75 percent of the miscarriages occur during the 1st trimester of a woman’s pregnancy. It is as such understandable then why every mom-to-be should be well informed about this.  In this article, we would like to provide our readers with as much information as possible.

What is a miscarriage?

Let us start by answering this simple question.

Miscarriage means the loss of the fetus before it has the ability to survive outside the womb which is before the 20th week of pregnancy in the US and in the 23rd week in the UK. The medical term for miscarriage is ‘spontaneous abortion’.

What are the signs of a miscarriage?

The major sign of miscarriage is vaginal bleeding and period-like cramps. Other symptoms may include tissue discharge, fluid discharge from the vagina or feeling light-headed. If you have any of these symptoms, seek out your doctor immediately.

It is possible that the symptoms may subside by themselves and the pregnancy will continue. This is called a threatened miscarriage. There is some evidence to show that a threatened miscarriage can be treated or stopped by administering Progesterone. It is worth a try to ask your doctor about it. Though unfortunately if a miscarriage is underway, it will usually take its course.

In the case of any kind of vaginal bleeding during early pregnancy, call your doctor or the nearest EPU ( Early Pregnancy Unit).  Some miscarriages might go unnoticed and may only be discovered.

What are the Causes of miscarriage?

There may be a number of factors which affect pregnancy and contribute to miscarriage.Sometimes the chromosomes do not line up properly making it hard for the fetus to develop in its natural way eventually resulting in miscarriage. Alcohol intake heavily during pregnancy, smoking or high caffeine intake is injurious to the fetus as the harmful chemicals are carried to the fetus through the placenta thereby increasing the risk of a miscarriage. Obesity is also a factor leading to miscarriage.Sometimes abnormalities in the womb structure or a weakened cervix leads to the expulsion of the fetus from the womb before it has become viable ie. capable of surviving outside the mother’s body.Underlying health conditions like diabetes, lupus, high blood pressure proves harmful for the ongoing pregnancy. It is also to be noted that certain medicines like anti-depressants too may cause harm to the fetus and so it is recommended that expecting mothers consult their doctor before continuing any of the medicines from before their pregnancy. For more details, consult our article what causes and doesn’t cause miscarriage

What is Ectropic Pregnancy?

About 1% of the miscarriages are due to Ectropic pregnancies. Ectopic pregnancies are those in which the fertilized egg settles down and grows outside the inner uterine lining. There is internal bleeding and so the chances of losing the baby are high. Signs that one is going through an Ectropic pregnancy are severe abdominal pains, dizziness, light-headedness and shoulder-tip pain.

What is the diagnosis for miscarriages ?

To diagnose a miscarriage one of the three methods are generally used-

• Ultrasound scans- In trans-vaginal ultrasound, a small probe is placed into the woman’s vagina to check for the heartbeat of the fetus the absence of which confirms a miscarriage.
• Blood tests- The blood tests are important to determine levels of  beta-human chorionic gonadotropin (hCG) and progesterone both of which are associated with a healthy pregnancy.
• Pelvic exams- they help in determining if the cervix has opened up or thinned out.

What is the treatment after a miscarriage?

In most cases, the miscarriage takes a natural turn and nothing further needs to be done. In this case, the bleeding stops after a week or at most 10 days and you can easily rest at home with the prescribed painkillers and the good old hot-water bottles to stave off the pain. You may be asked by the doctor to take a pregnancy test again to confirm that the pregnancy is terminated. The most important thing is to have someone to take care of you both physically and mentally.

Depending on the stage of the pregnancy the doctor may set up appointments to check up on you. If the bleeding does not subside after two weeks or so, it is likely that some of the pregnancy tissues are left in your uterus.If such is the case it is called an incomplete miscarriage and the doctors may suggest the following treatments-

• Expectant management- the bleeding is left as it is and the body is given a chance to heal on it’s own.
• Medical management- The doctor will prescribe certain medicines for the completion of the miscarriage. The doctor may prescribe pills to be swallowed or a pressary to be inserted into the vagina. There might be heavy bleeding after taking the medicines and the bleeding might take longer to subside.
• Surgical management- The doctor will perform a minor surgery to complete the miscarriage.This is called SMM by the docs.  The surgery takes a few minutes and you are likely to recover quickly.  The bleeding stops soon after the surgery which means that there would be less visits required to the hospital.

Most doctors prescribe SMM only when there are chances of infection or there is heavy bleeding. Most doctors discuss the options and leave it up to the women to decide their course of action. Most women choose to let nature take its course.

Psychology Soothing: Miscarriage does not only take a physical toll o the mother but a mental toll as well. Sometimes it may propel the mother towards depression. We would request the mothers not to push away the family members and their spouses, rather draw on their strength and care. They can take up the process of self-soothing by trying to absolve the issue themselves or consulting the psychologist. The main thing is to understand that it was nobody’s fault and it couldn’t have been prevented. The mother should seek to heal herself mentally.

Once again, going by the words of Zuckerberg: “It’s a lonely experience.” But, this is not the end of the life, think,hope and look forward to a brighter future. The good news is: “isolated miscarriage does not lower the rate of successful pregnancy in the future, and even those with recurrent miscarriages are most likely going to have healthy children.”-  CNN Opinion

Cheer Up you beautiful couples!