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Last Updated: Oct 23, 2019
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Bleeding In First Trimester - It Could Be A Sign Of Miscarriage!

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Dr. Nupur GuptaGynaecologist • 27 Years Exp.MICOG, MS - Obstetrics and Gynaecology, MBBS
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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 are weakness, back pain, fever, abdominal pain along with severe cramps and bleeding which starts from slow to heavy.

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 has had an earlier miscarriage 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 incomponent 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: 

  1. The doctor does a pelvic test, an ultrasound and blood tests to confirm a miscarriage.
  2. Blood tests are done to analyze the pregnancy hormone hCG. This is monitored regularly if miscarriage is suspected.
  3. Genetic tests, blood tests and medication are important in women who have a history of prior miscarriages.
  4. Pelvic ultrasound and hysterosalpingogram are tests which are done when there are repeated miscarriages.
  5. Test like hysteroscopy is also done. In this the doctor observes the inside of the uterus with a device which is thin and like a telescope. This is inserted in the vagina and cervix.
  6. 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.
  7. 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.

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