Miscarriage is termed as the loss of the fetus in or before 20th week of pregnancy. Medically, miscarriage is known as spontaneous abortion, though the word spontaneous is more of a keyword as it is not an abortion.

Symptoms of Miscarriage 
Miscarriage happens due to weakness, back pain, fever, abdominal pain along with severe cramps and bleeding, which starts from slow to heavy.

Cause of Miscarriage 
Common cause of miscarriage is when the fetus is known to have fatal genetic problems and these are not related with the mother. The other causes are infection, medical problems like thyroid and diabetes, immune system rejection, hormonal imbalance, abnormalities of the uterus, and physical problems of the mother. If a woman is over 35 years of age, has thyroid and diabetes and had an miscarriage earlier then that woman is at a high risk of getting a miscarriage.

Sometimes a miscarriage might take place due to the cervical insufficiency. This is due to the weak cervix, also known as the incompetent cervix, which is unable to hold the pregnancy. A miscarriage in this condition usually occurs in the second trimester. Though there are a very few symptoms in this, but there might be a feeling of sudden pressure that the water is going to break and tissues from the placenta and fetus are released without any pain. This can however, be treated by a stitch in the cervix at 12 weeks. This stitch helps to hold the cervix until the full term is completed. If it is first pregnancy and cervical insufficiency is diagnosed, then also a stitch can be applied, thus resulting in full term and avoiding miscarriage.

Diagnosis of Miscarriage: 
-   The doctor does a pelvic test, an ultrasound and blood tests to confirm a miscarriage
-   Blood tests are done to analyze the pregnancy hormone hCG. This is monitored regularly if miscarriage is suspected
-   Genetic tests, blood tests and medication are important in women who have a history of prior miscarriages
-   Pelvic ultrasound and hysterosalpingography are tests, which are done when there are repeated miscarriages
-   Test like hysteroscopy is also done. In this the doctor observes the inside of the uterus with a device, which is thin telescope like device. This is inserted in the vagina and cervix.
-   If the cervix is dilated, then the woman might be diagnosed with an incompetent cervix and this can be corrected by cerclage, a procedure done to close the cervix.
-   If the blood type of the pregnant woman is Rh negative, she is prescribed a blood product called Rh immune globulin (Rhogam). This prevents from forming, antibodies which could turn to be harmful for the baby.

Bleeding in Early Pregnancy: Diagnosing Miscarriage

Once you have got the happy news of a little one coming soon in your life, you should start taking some special care so that you can enjoy the journey of pregnancy and get a healthy baby.
 These are some pointers you have to follow during pregnancy:
Maintain good hygiene during pregnancy.Take bath regularly. Warm shower or sponge bath is considered better than tub bath.
Brush your teeth regularly and have a regular dental check up. Caries tooth can be extracted after 12 weeks of pregnancy.
Avoid wearing tight clothes and shoes with high heels. Wear loose and light clothes.
Take lots of fluid, fresh fruits & vegetables.
Take a diet which is light, nutritious, easily digestible & rich in protein, less fat, minerals and vitamins.
Stop smoking and drinking alcohol. It can cause miscarriage, defect in the development and growth of the baby.
Avoid jerky travelling, especially in 1st 12 wks and last 6wks of pregnancy. Prolonged sitting in a car or plane should be avoided. Air travel is not advisable to women who have high blood pressure, less hemoglobin (anemia) and low lying placenta.
Avoid taking any unprescribed drugs, exposure to X-Ray & chemicals especially in the 1st 12 weeks of pregnancy.
Take adequate rest in the lateral position and relax 1-2 hrs in the afternoon & 8 hrs at night.
Start taking folic acid at least 3 months before planning pregnancy & continue it till the 1st 12 weeks of pregnancy.
Start taking iron & calcium after 12 wks of pregnancy and continue it throughout pregnancy and 6 months post delivery.
Exercise regularly during pregnancy. Walking is the best exercise, but long periods of walking should be avoided. Also avoid heavy weight lifting and prolonged standing. Diving, water sking, gymnastic, netball, hockey, horse riding, cycling, rock-climbing, & scuba diving exercises should be avoided during pregnancy.
If you have any of these symptoms - vaginal bleeding, persistent abdominal pain, persistent vomiting, watery discharge from vagina, less or no fetal movement, severe headache, swelling on hands, face & feet, fever, dizziness, blurring of vision, double vision, spots before eyes, painful urination and diarrhea, immediately consult your gynecologist.

Do's and Don'ts in Pregnancy

12 Changes in your body you can expect during the second trimester of pregnancy

The second trimester (starting from the 4th and lasting through the 6th month) of pregnancy is considered to be the easiest for a woman. During the second trimester of pregnancy, you can expect several changes in your body and baby. Here are the changes to expect:

Increased energy: Many women find that they have more energy during the second trimester, after the fatigue of the first trimester.
Quickening: Around the middle of the second trimester, you may feel your baby moving for the first time. These movements, called quickening, are often described as fluttering sensations.
Growing belly: As your baby grows, your uterus will expand and your belly will start to become more noticeable.
Changing breasts: Your breasts will continue to grow and may become more sensitive. You may also start to produce colostrum, a pre-milk substance that will nourish your baby in the first few days after birth.
Changing skin: As your skin stretches to accommodate your growing belly, you may develop stretch marks. You may also experience changes in skin pigmentation, such as darkening of the areolas or the appearance of a line down the center of your abdomen.
Increased risk of miscarriage: While the risk of miscarriage decreases significantly after the first trimester, it is still possible during the second trimester. Most miscarriages occur during the first 12 weeks of pregnancy.
Backaches: The additional weight that you gain during these past few months begins to bear down on your back, making it achy and tired. For relief from pressure, there are certain things that you can do such as using a chair that offers strong support to your back; sleeping on the side with a pillow placed in between your legs, and wearing shoes that come with solid arch support. 
Bleeding gums: Hormonal changes occurring during this period bring about a greater flow of blood to the gums, making them extremely sensitive and prone to bleeding. The gums don t remain tender for long and return to their normal form after delivery. But during these three months, make sure to use toothbrushes with softer bristles and be gentle when flossing.
Congestion and bleeding of the nose: In addition to making your gums tenderer, hormonal changes also bring about the swelling of mucous membranes that line your nose. These changes can lead you to have a stuffy nose as well as may even cause your nose to bleed very easily. To clear any nasal congestion that may occur during this period, you should use natural methods or saline drops obtained from a chemist. 
Hair growth: Pregnancy also sees your hair growing rapidly due to the action of the hormones on the hair follicles. Additionally, you also experience hair growth in places where hair is sparse. To remove unwanted hair, you should stick to tweezing or shaving, waxing and the use of depilatories aren t recommended by medical experts as they aren t considered safe for the baby.
White vaginal discharge: White vaginal discharge during this time is very common. The discharge ensures that harmful yeast or bacteria don t breed in your private areas. But if the discharge takes on a foul smell and a green or yellow color, you should immediately consult a gynaecologist as you may be down with a vaginal infection.
Leg cramps: A very common occurrence during the second trimester, leg cramps usually last through the last leg of pregnancy, which is the third trimester as well. The reasons behind their occurrence may be hormonal, weight-related, or deficiency of magnesium and calcium.
It's important to remember that every pregnancy is different, and you may experience different changes or none of these changes at all. It's always a good idea to discuss any concerns you have with your healthcare provider.

'Consult'.

12 Changes You Can Expect During the 2nd Trimester of Pregnancy

When you are pregnant, your body is at a very delicate stage as you are carrying another individual inside you. While you are pregnant, there are many restrictions and regulations you must follow to ensure the birth of a healthy child. Bad habits such as smoking and consuming alcohol are strictly prohibited. It is also advised that you should not be in any kind of stress.

When it comes to travelling, it depends on the stage of your pregnancy. You should consult your doctor before travelling and know well about the restrictions that would be imposed, even if you are allowed to travel. The ideal time for you to travel during pregnancy is after the second trimester, when you will be less fatigued.

Here are some tips you should follow if you choose to travel when you are pregnant.
Travelling by car, train
1. You should always put your seatbelt on while travelling in a car when you are pregnant. Wear both the lap belt and the shoulder belt to keep yourself and your baby inside, safe and static.
2. The airbags should always be turned on for safety purpose.
3. Buses are narrow and should be avoided when you are pregnant. If you are availing a bus, avoid getting up when the bus is moving. In case you have to move, take the support of the railings.
4. When you are travelling by train, always hold on to the railings and seats while moving about in motion.
5. Avoid long hour journeys in cars or trains. The maximum travel duration should be not more than six hours, when you are carrying a child.
6. Make it a point to halt at points to take a walk. This would enhance your blood circulation.

Travelling by air, sea
1. This mode of travel is safer than any other travel modes for pregnant women.
2. Pregnant women can fly until eight months or nine months, after consulting a doctor.
3. Moving about in an airplane, which is flying is a bad idea for pregnant women and should be avoided.
4. Always choose an aisle seat while travelling by air. It will make moving convenient in case you need to visit the restroom.
5. Choose to travel on trustworthy, major airlines with a pressurized cabin and avoid small airplanes or private jets. Do not travel above a height of 7000 ft.
6. Travelling by sea should be strictly avoided as it causes motion sickness and pregnant women might have nausea.

Travel for pregnant women is restricted in many ways, and all the instructions should be followed.

Is It Safe for Me to Travel During Pregnancy?

Do you know that the future health of your baby is decided  before you even conceive? Your preconception health is very important. Planning a baby is a demanding task, but if you plan it well you will have a healthier and easier pregnancy. 

These are a few tips which can do wonders

1. Relaxation at Work and Household Backup - Plan out your work schedule. You might need to change your work hours or may be change the job profile. You will also need someone to help you out with the household chores around this time.

2. Finances - Get your finances settled and insurance plan changed accordingly.

3. Lifestyle Modification - Eat healthy. Stop the intake of alcohol and stop smoking. Set aside a time for regular exercise if possible. Try to lose that extra flab and stay very active.

4. Reduce Stress - Create a support system for yourself. Engage in activities that uplift your mood.

5. Take Folic Acid -Take 400 mcg of folic acid tablet daily. It helps prevent birth defects of brain and spine in the baby.

6. Avoid Exposure to - Harmful chemicals, metals and toxic substances at workplace and home. Protect yourself from infections. Stay away from cats.

7. Up-to-Date Vaccination - Make sure your vaccination is complete. Vaccination against rubella and flu are very important. It is also important to maintain a gap of at least one month between your rubella shot and pregnancy planning.

8. Optimize your Medical Condition - If you have Hypertension, Diabetes, Asthma, Epilepsy or any other medical condition you must take complete advice from the physician. Blood pressure and sugar levels have to be under full control. The type and dose of the drug may need modifications.

9. Check Family History - Ask your parents, grandparents, brothers, sisters, aunts and cousins about any health problems in the family like genetic problems, mental retardation or malformations in babies. This can help your Gynaecologist to determine which problems to look for and how to prevent it. 

10. Visit your Doctor - Carry a record of your medical conditions, family history and a checklist of your queries. Get tested for Li Blood Group, Thalassemia, HIV, Thyroid Levels, and Blood Sugars.



Why Your Baby's Health is Decided Much Before You Even Conceive

Reasons for spotting during pregnancy and what you can do about it

Seeing spots of blood during pregnancy is usually a cause for concern. However, it is not uncommon. The light bleeding, which is known as spotting may occur for a number of reasons.

Bleeding during the first trimester

Spotting is most likely to happen during early pregnancy and the reasons could be many, such as:

- implantation bleeding occurs during the first month of pregnancy when the fertilised egg gets attached to the wall of the uterus.

- cervical polyps ( a tumour that form on the surface of the cervix) or yeast infection may also cause episodes of spotting.

- miscarriage may be another possible reason for spotting

- ectopic pregnancy is another cause. It is the condition in which the embryo plants itself in either of the fallopian tubes instead of the uterus.

- molar pregnancy is a rare condition associated with spotting during pregnancy. When this is the case, instead of your baby, an abnormal tissue grows inside the uterus. Sometimes it can be cancerous too.

Bleeding during the second or third trimesters

Spotting may also occur during late pregnancy and the possible reasons are listed below.

- problems related to placenta like placenta previa placental abruption can also result in spotting. These are serious conditions when the placenta either covers the cervix or it gets detached from the uterine wall respectively.

- uterine rupture is the rare and unfortunate event when a scar from a previous surgery (like the removal of fibroid or previous caesarean scar bursts open and the baby slips into the pregnant woman's abdomen.

- premature labour occurs when your body is too eager to deliver the baby, usually one month before the due date of delivery.

- vasa Previa is another rare condition when a baby who is still developing has his blood vessels entangled in the umbilical cord or placenta-crossing the cervix. It is extremely dangerous because the blood vessels may burst open thus causing the baby to bleed and lose oxygen.

Here's what you can do about spotting

It is strongly recommended that you should immediately see your doctor as soon as you detect any spotting during your pregnancy. Only a well-qualified medical expert can suggest the appropriate steps to be taken, depending on your individual reasons and symptoms related to spotting.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 6 Changes You Can Expect During the 2nd Trimester of Pregnancy

Reasons for Spotting During Pregnancy

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