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What is miscarriage? Causes, Symptoms, Prevention and Treatment 

What is miscarriage


According to statistics, one in every five mothers has lost a child during the early stages of pregnancy, with no signs to warn them.

About 15% of pregnant women registered with the antenatal clinic do not bear children in the first trimester. 85% of spontaneous abortions happen in the first 12 weeks, and more than half of women over 45 have miscarriages. These are real data that raise the problem of early diagnosis of pregnancy and its preservation to a new level. Finding out the reasons and effective help will be able to reduce the disappointing data to a minimum.

What is a spontaneous miscarriage?

Spontaneous miscarriage is the termination of pregnancy without outside intervention for up to 12 weeks of fetal development. In some cases, pregnancy failure occurs so quickly that the woman does not know that conception has occurred.

A slight delay in a woman’s period can be attributed to stress or overwork, but it can be a completely different reason. The only thing that can indirectly hint at conception is longer periods accompanied by soreness.

Early miscarriage is a common occurrence. According to statistics, every fourth pregnancy ends in spontaneous termination. What is the reason for this condition and how to prevent the threat of miscarriage? You will find the answer in this article.

Experts note that chromosomal mutations in the fetus cause almost 60% of spontaneous abortions. If a certain abnormality appears during embryo development, the woman’s body in most cases gets rid of non-viable offspring.

Genetic defects can be inherited or develop spontaneously. It is impossible to prevent such a miscarriage, but the risk of developing mutations can be eliminated even before conception, protecting the woman from the negative effects of teratogenic factors.

Causes of miscarriage

If the pregnancy is terminated in the first trimester, there are several reasons for this. They are especially relevant for those couples who cannot conceive a child for a long time. This means it is necessary to carefully examine and identify factors that prevent normal implantation and further embryo development in the uterus.

Here are reasons that can cause miscarriage:

Genetic abnormalities in fetus.

This is the most common cause of pregnancy failure. Miscarriages can occur due to both qualitative and quantitative issues in the chromosomes. The mother’s body can usually detect potential abnormalities and will not permit the fetus to progress. Usually, rejection occurs in the third week.

Hormonal disorders in the mother’s body.

This is the second most common problem that provokes a miscarriage. Hormones are responsible not only for a successful cycle but also for the attachment of the fetus to the uterine mucosa. In case of hormonal failure, the mucous membrane is not able to provide the fetus with everything necessary, such a pregnancy also fails. Most often, termination of pregnancy occurs in the fourth week.

Rhesus conflict.

With a different Rh factor in parents, the risk of spontaneous miscarriage increases. This is true if the woman has a negative Rh and the child has inherited a positive from the father. In this case, the mother’s body can recognize the fetus as a foreign body and contribute to expulsion from the uterus. With a timely diagnosis of such a situation, it is possible to save the child through drug therapy.

Sexually transmitted diseases (STDs) and other infections. 

They also provoke an early miscarriage. The embryo is infected at an early stage, so the body unequivocally perceives it as a foreign body, and already at the fifth week of pregnancy, it stops.

Previous abortions.

This is another common reason why subsequent pregnancies may not last. Abortion is a great stress for the reproductive system. The mucous membrane of the uterus becomes thinner hence the risk of miscarriage increases.

Chronic inflammatory diseases

No less dangerous are chronic inflammatory diseases of internal organs and general infections, accompanied by the intoxication of the body. This list includes rubella, pneumonia, pyelonephritis, and viral hepatitis. Even a Banal flu or tonsillitis poses a serious threat to the fetus.

Taking certain medications.

When considering conceiving, one must be aware of the potential of certain drugs, such as antidepressants, retinoids, NSAIDs, or antifungals, to cause spontaneous abortion in early pregnancy.


Improper, unbalanced diet, excessive consumption of caffeinated drinks, and bad habits (smoking, alcohol) are risk factors that provoke an early miscarriage.

Stress and emotional overstrain

The negative impact of regular stress, psycho-emotional overstrain, deep personal experiences should also be considered. Experts recommend adjusting the lifestyle even before conception and protecting the woman as much as possible from adverse situations and strong nervous shocks.

In addition, the cause of miscarriage in early pregnancy can be chronic diseases of the female genital area, previous abortions, congenital anomalies in the development of the genital organs, obesity, and age. It is noted that after 40 years, the risk of abortion increases several times.

Symptoms of miscarriage

Symptoms of miscarriage
Symptoms of miscarriage

It is problematic to notice the manifestations of a miscarriage in the first weeks. Most women attribute this to a late period. Four weeks after, the effects of a late miscarriage become more pronounced.

This process is not fast or immediate. Before the fetus is expelled from the womb, a miscarriage progresses through three distinct stages, each accompanied by its own signs and symptoms as follows:

  1. An increase in the tone of the uterus characterizes the first stage. A woman feels heaviness in the lower abdomen and aching or painful sensations of a cramping nature. In parallel with pain in the abdomen, bloody discharge appears. Often pregnant women do not attach any importance to this and take painkillers.
  2. The second stage is accompanied by the uterine mucosa’s direct rejection of the fetus. The fetal egg begins to exfoliate, after which it turns out to be completely unrelated to the mucosa. If a woman is in the clinic at this stage, even with the onset of rejection, it is possible to stop a spontaneous miscarriage.
  3. The third stage is the process of exile, which can no longer be stopped. The female body rejects the fetus, due to which the patients feel severe spasms, and the release of the fetal egg is accompanied by heavy bleeding. In this case, consult a doctor to discover the presence of complications. Among these may be incomplete abortion or miscarriage.

If you contact the clinic on time at an early stage, then hypertonicity can be eliminated, thereby preserving the pregnancy.

The symptoms of a miscarriage do not always indicate this particular problem. An ectopic pregnancy, some cervix pathologies, and tumor diseases accompany the same sensations. Therefore, if you experience pain in the lower abdomen or bleeding, you should immediately contact the clinic.

How does a miscarriage happen?

The process of abortion develops gradually, over several hours or even days. With timely seeking medical help, a woman can still be helped. How does a miscarriage happen? In its development, spontaneous abortion goes through several stages.

  1. Risk of miscarriage: A woman develops slight bloody discharge and complaints of pulling pains in the lower back and suprapubic region. On examination, hypertonicity of the uterus is revealed. Even a slight discharge of blood is a dangerous sign that requires immediate medical attention. At this stage, it is still possible to stop spontaneous abortion.
  2. Miscarriage has begun: It is developed by similar symptoms, which gradually increase and become more pronounced. A fragmentary detachment of the fetal egg begins, and a partial opening of the cervical canal occurs. But even at this stage, a woman can still be helped under emergency hospitalization in a hospital.
  3. Miscarriage in progress: There are cramping pains in the lower abdomen, and the embryo is wholly separated from the endometrium but remains in the uterine cavity. Abundant bleeding begins, which indicates the final death of the embryo. The external and internal os of the uterus open in the lumen of the cervix or vagina, and upon examination, the elements of the fetal egg are determined.
  4. Incomplete abortion: This condition is characterized by pain in the lower abdomen and lower back and profuse bleeding. Elements of the fetal egg remain in the uterine cavity. Large blood loss is accompanied by dizziness, weakness, a drop in blood pressure, and fainting.
  5. A complete spontaneous abortion is said to happen after the complete release of all parts of the embryo. After the uterus is cleansed, it contracts, returning to its previous shape and size. All associated symptoms (pain, bleeding) disappear, and the woman does not need further therapy but remains under medical supervision.

But not always fragments of the fetal egg completely come out of the uterus. The woman will need a curettage procedure; otherwise, the embryo remains will start to putrefy in the uterus and become a source of contamination.

The spread of pathogenic microorganisms threatens with dangerous complications and severe inflammatory processes. In this case, the operation is essential for the woman’s well-being and safety.

Effects of miscarriage

A variety of difficulties can arise from a spontaneous abortion in the early stages. 

  • Injury to the endometrium during curettage of the uterus can later lead to the development of endometritis.
  • Significant blood loss during uterine bleeding often causes posthemorrhagic anemia, accompanied by constant weakness, pallor, dizziness, and decreased performance.
  • Hormonal imbalances after a spontaneous abortion can cause repeated miscarriages, which reduce the chance of carrying a normally developing pregnancy.
  • Psychological problems. A miscarriage during a long-awaited pregnancy is a strong emotional shock for a woman. Many couples go through a difficult situation that destroys hopes for the birth of an heir. At this stage, the woman and her husband need the help of a psychologist to come to terms with the loss and continue trying to find a happy, full-fledged family.

Suppose you experience a rapid increase in temperature, chills, extreme fatigue, pus from the vagina, and agony in the pelvic region after a miscarriage. In that case, you must seek medical attention right away. Similar signs indicate body infection and the development of a severe inflammatory process.

A few weeks after a complete abortion, an analysis for the level of HCH is necessary. If it does not decrease, there is a risk of developing a dangerous complication – cystic drift. Pathology is characterized by the growth of chorionic villi into fluid-filled blisters. The consequence of this condition may be infertility, intrauterine infections, or the development of malignant choriocarcinoma.

Diagnostic methods of miscarriage

Diagnostic methods of miscarriage
Diagnostic methods of miscarriage

How is threatened early pregnancy termination diagnosed? If a threat of miscarriage is suspected, the doctor conducts a gynecological examination and considers the patient’s complaints and data from laboratory and instrumental research methods.

During the survey, the obstetrician-gynecologist finds out the date of the last menstruation and draws attention to the presence and influence of adverse factors – occupational hazards, recently transferred infectious diseases, in the treatment of which certain groups of medicines were used, and other nuances. Next, the doctor assesses the woman’s general condition and the nature of the pain syndrome.

During a vaginal examination, the gynecologist finds out whether the uterus is in good shape, whether its size corresponds to the declared gestational age, and also draws attention to the condition of the cervix and the amount of vaginal discharge. In addition to routine blood and urine tests, laboratory tests are performed to determine the level of progesterone and to detect the hormone chorionic gonadotropin (hCG), the presence of which may indicate an ectopic pregnancy.

A special role in terms of diagnosis is given to ultrasound (transvaginal ultrasound). This method is the “gold standard” to determine the threat of early miscarriage. If it is impossible to conduct it, they resort to the procedure of transabdominal scanning. Using this method, it is possible to determine the cessation of the embryo’s cardiac activity or the fetal egg’s complete absence.

Therapy Methods for miscarriage

When anxiety symptoms appear, it is important not to panic. You need to contact your obstetrician-gynecologist as soon as possible for examination and treatment.

Treatment in a hospital for miscarriage

The first recommendations for a woman are the exclusion of any physical activity and adherence to bed rest. Usually a woman is placed in a hospital to maintain pregnancy. In especially severe cases, the patient is forbidden to get out of bed.

In order to maintain pregnancy, doctors prescribe to a woman drugs containing gestagens (female sex hormones) that block uterine contractions. With the threat of bleeding, tranexamic acid is used. Antispasmodics will help relieve pain – no-shpa, drotaverine, and rectal suppositories with papaverine. Additionally, the doctor may prescribe injections of vitamins and droppers for magnesia.

When a hormonal deficiency is detected, the therapy includes drugs with progesterone – Utrogestan or Duphaston. In the presence of an Rh conflict, a woman needs to take medications that eliminate the threat of rejection of the fetal egg. After the ultrasound, the doctor may recommend suturing the cervix. A similar procedure allows you to leave the fetal egg inside the female womb.

Surgery for miscarriage

Surgical intervention is resorted to at the following stages: spontaneous miscarriage in the course, incomplete abortion or massive bleeding. The purpose of such an intervention is to remove the remnants of the embryo and restore full hemostasis. The procedure is done under anesthesia using a vacuum aspirator or using mechanical curettage (scraping) of the walls of the uterus.

If the patient is admitted to the hospital with a complete abortion, they do not resort to surgical intervention, limiting themselves to monitoring the woman’s condition. In the future, in almost 85% of women who have had an early spontaneous abortion, subsequent pregnancy develops normally.

Treatment at home

If the threat of miscarriage is insignificant, a woman can stay at home, provided that all medical recommendations are carefully followed. The main ones are:

  • Exclusion of physical activity.
  • Correct daily routine.
  • Good nutrition – the basis of the diet is fresh vegetables and fruits, herbs, dairy products, and dietary meat.
  • Walks in the fresh air before going to bed.
  • A ban on taking hot baths – you should wash in the shower.

On the advice of a doctor, you can take folic acid, vitamin B6, or special vitamin complexes for pregnant women. In the treatment process, it is important to avoid negative thoughts and stressful situations. Relatives and relatives at this time should surround the pregnant woman with attention and care.

Prevention of miscarriage

Ideally, Before planning a pregnancy, you should consult a geneticist, gynecologist and endocrinologist. These specialists will help identify possible deviations and correct them, after which the pregnancy will be successful.

In order to reduce the risk of miscarriage, it is essential to practice preventive measures, particularly if conception does not happen for an extended period. Medical experts consider proper planning and preparation for pregnancy to be the principal preventive action.

It is very important at the preparation stage for the upcoming conception to exclude the influence of teratogenic factors. 

Doctors recommend:

  • Give up bad habits, taking large doses of caffeine.
  • Exclude work in hazardous industries.
  • Maintain physical activity.
  • Adjust to a healthy diet, and intake more vitamins and minerals.
  • Avoid stressful situations.
  • Treat chronic diseases in advance and eliminate foci of infection;

Additionally, you can take special vitamin complexes designed to prepare a woman’s body for conception.

Spontaneous miscarriage is not a punishment; in most cases, doctors help women who want to have a baby. The most important thing is to identify the problem in a short time and undergo full treatment by following all the doctor’s prescriptions.