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

Most of us are affected by diseases, which spread through physical contact, but most of us do not consider it important to get them checked, due to which they turn into major ailments. Sexually transmitted diseases (stds) are infections, which are transmitted through any kind of sexual contact. The organism that causes the disease is transmitted from one person to the other during sex intercourse. Sometimes stds can be asymptomatic (no symptoms or signs)

Here are some stds that you should be informed about:

1. Gonorrhoea: genital infection caused by bacteria is called gonorrhoea, its symptoms include 

 Bloody vaginal discharge
 Painful urination
 Heavy period bleeding
 Anal itching

2. Chlamydia: bacterial infection in the genital tract is called chlamydia. Chlamydia is usually difficult to diagnose, its symptoms include

 Pain during urination
 Pain in lower abdomen
 Vaginal discharge
 Painful intercourse
 Bleeding between menstrual cycles

3. Syphilis: the bacterium treponema pallidum causes syphilis, its symptoms include

 Rashes
 Sores in the mouth, anus or vagina
 In later stages, it causes nerve and organ damage

4. Genital herpes: the herpes simplex virus (hsv) causes herpes. Signs and symptoms include-

 Small red bumps or ulcers in the anal, genital and other areas
 Itching or pain around the genital area, thighs and buttocks

5. Human papillomavirus (hpv) and genital warts: genital warts are caused by hpv. It infects the genital tract. Hpv has been linked to cervical cancer, its symptoms include

 Small swellings in the genital area
 Itching
 Bleeding during sex

6. Chancroid: chancroid is a bacterial infection. The bacterium haemophilus ducreyi causes chancroid, its symptoms include

 Development of red bumps on the skin folds covering the genitals
 Pain during urination
 Burning sensation during bowel movement

7. Ectoparasitic infections: ectoparasitic infections are caused by small parasitic bugs like mites or lice. The parasites usually affect the hair or skin. Scabies and crabs are common parasites that cause such infections. They both cause intense itching and visible rashes.

8. Human immunodeficiency virus (hiv) and acquired immunodeficiency syndrome (aids): the virus that causes aids is called hiv. It can spread through blood, vaginal fluids, semen and breast milk. Unprotected sex or sharing needles with an infected person is how the disease spreads. It includes symptoms, such as

 Slight fever
 Fatigue
 Muscle aches
 Weight loss.

Most Common STDs in Women

There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

Genital herpes is a sexually transmitted disease. One out of every six people in the United States suffers from this disease. It is more common than you think. Like any other STD, it is extremely important to take proper protection (use a condom) while engaging in sexual activities.

Genital Herpes is caused by the herpes simplex virus (HSV). There are two types of herpes simplex virus.

HSV-1 is most commonly associated with blisters and ulcers around the mouth known as cold sores.
HSV-2 is associated with blistering lesions in genital areas that are exposed during sexual contact.
However, both types of herpes simplex virus can infect the mouth or the genital areas, meaning that genital contact with a cold sore on the mouth can lead to genital herpes. Likewise, kissing someone with a cold sore can spread the herpes simplex virus infection.

After the initial outbreak of herpes, the virus travels through the nerves and resides in nerve tissue within the body.

Most people with genital herpes don t know they have it. That s because in most people it produces either no symptoms or very mild ones.

Symptoms of Genital Herpes:

The area around your genitalia becomes red and cracked without any pain or itching.
Itching around your anal region
Blisters around your genitalia can cause immense pains when they break open.
Pain in the open sores while urination.
Headaches and backaches.
Flu and swollen lymph nodes are very common.
Fatigue is also felt if you suffer from genital herpes.
Symptoms like these can be mistaken for other infections such as vaginal yeast infections, bacterial infections and bladder infections. So, if you are suffering from such symptoms it is advisable to go in for a health check up followed by a physical exam and a blood test to confirm whether you have genital herpes or not.

How can it get spread?

You can only get Genital Herpes from vaginal intercourse and not anal or oral intercourse. The fluid present in the sore of a genital herpes patient has infected fluid. If the fluid comes in contact with their partner s sexual organs while having intercourse they can be easily infected.

Can Symptoms Be Treated?

There is no cure for genital herpes. But the symptoms can be lessened and prevented with treatment. Treatment can also reduce the risk of infecting others.

Your healthcare provider may prescribe antiviral medications to help prevent or reduce the pain and discomfort from an outbreak of symptoms. Medication taken on a daily basis to suppress the virus can reduce the number of outbreaks and reduce the risk of infecting others

How to Avoid Getting Genital Herpes:

Try to have sex with people who have been tested negative for herpes or any other STDs.
Use a latex condom while having sex. It prevents any sort of liquid to pass inside your partner s genitalia.

Genital Herpes - A Sexually Transmitted Disease!

Miscarriage is a spontaneous abortion that occurs around the first to second trimester of pregnancy; wherein the foetus is automatically expelled from the uterus due to its inability to survive because of environmental influences or chromosomal abnormalities.

Unless the miscarriage occurs due to a severe health issue, the fertility of the woman may not necessarily be compromised. Studies show that one miscarriage doesn t predict the possibility of a future one. Once the bleeding and pain subside, it is the emotional trauma that must be addressed to begin with which poses a greater threat than the physical one.

The fertility of the woman remains unaltered and the body can be ready after the menstrual cycle returns to normal. However, it still requires some time for the woman to be physically and emotionally prepared to go through another pregnancy. The medical history and reasons behind miscarriage must be evaluated before the couple decides to try again.

Complications after miscarriage only occur if the woman is above 35 years of age or has a rather unhealthy lifestyle. The concept of fertility varies from person to person and it isn t possible to pass a common judgement about fertility in this scenario.

The gynaecologist mostly suggests couple therapy after the trauma of the miscarriage. The psychological loss is given more importance before considering another attempt by most doctors. The fertility loss only occurs with age and unhealthy lifestyle and it is widely accepted and proven that a miscarriage has little or nothing to do with it.

Ways to Increase Fertility

If a couple is certain they are ready to conceive again, there are a few things a woman can do to help her chances of becoming pregnant-

The first thing to do is to stop any unhealthy habits. These include smoking, drug use, or alcohol abuse. It s reported that high consumption levels of caffeine are detrimental to conception so that should also be limited.
Eliminating stress can also help. Eliminating stress is one of the most important factors in having a successful pregnancy. So, it makes sense that getting over-stressed can reduce fertility levels.
Eat healthy. If depression was experienced due to the miscarriage, it s possible that the woman s diet has not been the healthiest. It s common for women who have experienced a miscarriage to have a loss of appetite and not eat enough or to eat out of sorrow, eating too much. More attention should be paid to the diet and more healthy foods added to meals.
Talk to a Doctor

If a couple is having issues with fertility after early miscarriage, they should talk to a doctor. There are many options available. More than likely, the first thing the doctor will do is to test fertility levels of both the man and the woman. If you don't want to visit a doctor for this, there is a new at-home kit available called Fertell. This test, retailing for approximately $100, measures fertility levels for both a man and a woman.

If it is found that there is a loss of fertility after early miscarriage, fertility drugs or therapies may be prescribed for a period of time.

The doctor may report that there are no issues with fertility. At this point, it would be a good idea to use an ovulation predictor in order to time effective intercourse. This isn't the most romantic idea, but it may well be one of the most logical ways for a couple to conceive.

Bottom Line

Fertility is not normally decreased after miscarriage. A woman's fertility levels return to normal as soon as her menstrual cycle returns. Fertility may be decreased due to emotional issues as a result of the miscarriage. However, if a couple is ready, both physically and emotionally, there should be no physiological hindrances to conception.

The decision to try again is not an easy one. However, fertility won't typically be an issue.

Pregnancy - Understanding Fertility After Early Miscarriage!

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

Don't wait any longer, manage your Robotic Gynecologist online with a Lybrate doctor today

Consult for Robotic Gynecologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES