By Dr. Junamoni Borgohain, Gynaecology
Miscarriage is the early loss of foetus within 20 weeks of pregnancy. It is also known as ‘spontaneous abortion’. According to research, about 20-30% of the pregnancies end in miscarriage. Out of the total number of miscarriages 80% of them end within 12 weeks of pregnancy. Miscarriages are a process and not a condition.
Types of Miscarriages and their Symptoms-
- Threatened Miscarriage – This causes excessive bleeding accompanied by cramps and pain in the lower back. The cervix will however remain closed.
- Inevitable or Incomplete Miscarriage – This causes bleeding along with an open cervix. When there is dilation and effacement or thinning of the cervix, miscarriage is inevitable. There can be constant bleeding and cramps till the miscarriage completes.
- Complete Miscarriage – Complete miscarriage is when the embryo has emptied from the uterus. The pain and bleeding should stop once the foetus has vacated automatically. This can be confirmed through ultrasound or surgical curettage.
- Missed Miscarriage – Missed miscarriage happens when there is no sign of the death of the embryo and there is no expulsion of the embryo. It can be detected from the absence of heartbeat of the embryo found in ultrasound.
- Recurrent Miscarriage – It happens when there are two or three miscarriages within 20 weeks. It affects about 1% of the pregnancies.
- Increase of maternal age i.e., women above 35 years.
- Excess or insufficient chromosome received by foetus can cause miscarriage.
- Placenta is the organ which links mother and the baby for blood supply. Problem in the development of placenta can cause miscarriages.
- Excessive smoking and drinking during pregnancy.
- Obese women have higher risks of miscarriage.
- Long term health conditions like high blood sugar liver disease can also cause miscarriage.
- Infections like rubella, HIV, malaria.
- Weakened cervix, which is the result of previous injury or surgery, can also result in miscarriage.
What are the signs of miscarriage?
- Bleeding or spotting can be one of the signs of miscarriage. Though it should be kept in mind that 1 of 4 pregnant women suffers from spotting or bleeding, they don’t usually end in miscarriage.
- Lower backache starts right after bleeding, which can be persistent or you could have cramps which may be mild or sharp and can feel like more of pelvic pressure.
- Most miscarriages are detected through ultrasound when the doctor finds that there is no heartbeat of the foetus or when the uterus is not growing.
What are the treatments after miscarriage?
- Medicines – The doctor may prescribe for miscarriage that can help in speeding up the process of passing the embryo. It can take a day or two to two weeks or longer depending on the type of miscarriage. However, medicines are not prescribed if:
- There is heavy bleeding. Medicines are not favourable for pregnancies above nine weeks.
- The tissue does not pass out the doctor has to opt for surgery.
- Surgery – Dilatation and curettage (D&C) is a simple operation which is done under general anaesthesia. There is no cutting involved as it happens through the vagina. The process needs only five to ten minutes, but the patient has to stay in the hospital for about 3-4 hours. This process is opted when -
- There is heavy bleeding or excessive pain.
- The patient suffers from missed miscarriage.
What can you do to prevent miscarriage?
- You should add exercise to your daily routine. Moderate dose of exercise is good during pregnancy. However ensure you don’t stretch yourself too much which might put pressure on the placenta and the foetus.
- You should have a well-balanced diet. Studies have shown that a diet loaded with fruits and veggies help in avoiding miscarriage.
- Limit the consumption of caffeine during pregnancy.
- Avoid smoking, alcohol and drugs to prevent you from miscarriage.
- Avoid stress and anxiety. Studies have shown that being happy and relaxed can reduced the risk of miscarriage by up to 60%.