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Overview

Miscarriage - Symptom, Treatment And Causes

What happens in Miscarriage?

A Miscarriage usually occurs when the fetus dies before the 20th week of pregnancy. In medical terminology, a Miscarriage is also called a spontaneous abortion. Miscarriages are very common, according to a study, approximately 50% pregnant women can experience a miscarriage. Signs of a Miscarriage include severe back pain, weakness, fever, abdominal pain, acute cramps and mild to heavy bleeding. It is important to consult your obstetrician if you experience such symptoms.

What causes miscarriages?

  • Dangerous genetic problems which the unborn baby can develop.
  • Infection
  • Medical conditions existing in the mother like thyroid diseases and diabetes.
  • Hormonal problems
  • A very weak immune system.
  • Physical problems experienced by the mother.
  • Abnormalities or problems in the uterus

Risk factors which can lead to a Miscarriage:

  • If a woman’s age is over 35.
  • If a woman has medical conditions such as thyroid problems or diabetes.
  • If she has had three or more Miscarriages in the past.
  • A woman can also experience a Miscarriage is she has a weak cervix. This is also known as incompetent cervix, in such cases the woman’s cervix cannot hold a pregnancy. A Miscarriage caused due to cervix insufficiency occurs during the second trimester.

    Symptoms of a Miscarriage caused by cervical insufficiency:

    • A sudden pressure in her uterus.
    • A woman’s “water” can break all of a sudden.
    • Tissue from the placenta and fetus gets expelled from the vagina without any pain.

    What happens after a Miscarriage?

    The health care provider or an obstetrician will perform some blood work, ultrasound test and a pelvic exam to confirm if there has been a Miscarriage. Sometimes, during a Miscarriage the uterus usually gets empty and no treatment is required. But in case the uterus isn’t empty a procedure called dilation and curettage (D & C) procedure is carried out. In this surgery the cervix is dilated at first and then the remaining placental or fetal tissue is removed from the uterus. Most of the times, certain medications are prescribed so that your body can expel the remaining tissues out of your uterus. This is an ideal option for some women who want to avoid a surgery and have a stable condition during the Miscarriage.

    Medications, genetic tests and blood tests are mandatory for women who have had more than three miscarriages in a row so that the doctor can diagnose the root of the problem and avoid further Miscarriages in future.

    Treatable by medical professional Require medical diagnosis Lab test always required Short-term: resolves within days to weeks
    Symptoms
    Fluid, blood or tissue passing from the vagina Pain in the belly or lower back

    Popular Health Tips

    Bleeding In Early Pregnancy - Can It Be A Miscarriage?

    MS - Obstetrics & Gynaecology, Fellowship in Fetal Medicine
    Gynaecologist, Amritsar
    Bleeding In Early Pregnancy - Can It Be A Miscarriage?

    Numerous ladies encounter some bleeding in early pregnancy. Around one in four perceived pregnancies end in an unnatural miscarriage. Most are brought about by irregularities in the genes. Continuously tell your specialist in case you have vaginal bleeding when you are pregnant. Bleeding with pain can likewise be an indication of an ectopic pregnancy. However, it is to be taken seriously and needs dire therapeutic care. Losing a pregnancy can be hard for both the partners. In any case, most couples that encounter this will go ahead to have an effective pregnancy next time. Here are a few reasons why bleeding takes place in early pregnancy:

    1. Numerous women may have a small amount of bleeding during their missed period. Sometimes, this may also be called an implantation bleed. It happens when the prepared egg inserts itself in the mass of your womb (uterus). In such cases, it is considered harmless.
    2. The most widely recognised reason for bleeding is an early premature delivery. Miscarriage is the loss of a pregnancy at any time until the twenty- fourth week. A miscarriage after this time is known as a stillbirth.
    3. A less normal reason for bleeding during pregnancy is an ectopic pregnancy. This is a pregnancy that happens outside the womb. It happens in about one in every hundred pregnancies.
    4. Smoking increases your chances of bleeding and miscarriage.
    5. Drinking a lot of liquor can also cause the same. Drinking four units of liquor a week (one unit is a large portion of a half quart) can increase the risk of a miscarriage to four times.
    6. Using recreational medications can lead to bleeding.
    7. Have had fertility issues in the past or having taken a long time to conceive may also create such a condition.
    8. Having any complications with womb (uterus) can cause bleeding.
    9. Have certain medical conditions (for instance, systemic lupus erythematosus, antiphospholipid disorder) may also cause the same.
    10. Have diabetes that is not controllable can lead to bleeding at this time.
    11. Have specific infections like listeria and German measles (rubella) may cause bleeding during pregnancy.

    You need to report any bleeding in pregnancy to your specialist. It is essential to get the right conclusion, as unsuccessful labour is not by any means the only aim of vaginal bleeding. In case that you are bleeding intensely or have serious stomach pain when you are pregnant, call an ambulance immediately.

    Women with bleeding in early pregnancy need to see an obstetrician. It is important to have an ultrasound check. This is normally done by inserting a little probe inside the vagina. This helps figure out if the bleeding is happening due to:

    1. A possible miscarriage
    2. A premature delivery (no pulse is seen).
    3. Some other reason for bleeding, (for example, an ectopic pregnancy)
    4. In case that it is unclear from your ultrasound check whether the pregnancy is sound or not, then you might need to go for a repeat scan in two weeks.
    1 person found this helpful

    How To Know If You Are At Risk Of Having A Miscarriage?

    DGO, MBBS
    Gynaecologist, Chandigarh
    How To Know If You Are At Risk Of Having A Miscarriage?

    Do you know about the various signs and symptoms that indicate a miscarriage? Miscarriage refers to pregnancy, which ends on its own, within 20 weeks of gestation. Miscarriage is a matter of great loss and grief for pregnant women. It accounts for being the most common form of pregnancy loss. According to studies, almost 10% to 25% of pregnancies result in a miscarriage. Chemical pregnancies are likely to be responsible for almost 50% to 70% of miscarriages.

    Causes of miscarriage

    1. The causes of miscarriage vary from one woman to another and in many cases the exact cause is not identified.
    2. During the first trimester of pregnancy, chromosomal abnormality is the most common cause of miscarriage. It signifies some problem with your baby’s chromosomes. Most cases of chromosomal abnormalities occur because of damaged eggs and sperm cells.
    3. A certain problem which appears after the zygote goes through divisional procedures may also be responsible for a miscarriage.

    Other causes for miscarriage include the following:

    1. Hormonal imbalance, maternal health complications, and infections
    2. Several habits such as smoking, malnutrition, excessive caffeine consumption, drug abuse, and exposure to toxic substances
    3. Maternal age
    4. Maternal trauma
    5. When implantation of the egg in the uterine lining occurs improperly

    Warning signs of miscarriage
    There are several warning signs of miscarriage. The most important of them are as follows:

    1. Back pain, which can vary from being mild to fatal. This pain can be even worse than menstrual cramps.
    2. Loss of weight
    3. Discharge of mucus that is whitish pink in color
    4. True contractions are likely, in which pain occurs after every 5 to 20 minutes.
    5. Bright red or brown bleeding with or without the presence of cramps may indicate a miscarriage.
    6. Passage of tissue with a cloth material from your vagina.
    7. Sudden reduction in the signs and symptoms of pregnancy

    Chances of miscarriage
    There are certain factors, which indicate whether you are likely to have a miscarriage. They are as follows:

    1. Increase in your maternal age increases the chances of a miscarriage.
    2. Women who are in between the age of 35 to 45 are at a higher chance of miscarriages than women who are relatively young. In women above the age of 45, the chances of miscarriage are maximized.
    3. A woman having a miscarriage in the past has more chances of having another miscarriage.

    In case you experience some or any one of these symptoms, it is important for you to seek professional health care as you need to evaluate whether you are having a miscarriage or not.

    In case you have a concern or query you can always consult an expert & get answers to your questions!

    4557 people found this helpful

    Recurrent Pregnancy Loss - Things You Should Avoid!

    MBBS, DNB(ob/gy)
    Gynaecologist, Delhi
    Recurrent Pregnancy Loss - Things You Should Avoid!

    Recurrent pregnancy loss is termed as the occurrence of three or more miscarriages. Recently, the American Society for Reproductive Medicine has altered the definition and limited the number of miscarriages to two. A pregnancy loss can only be termed so if the pregnancy is clinically recognized and is ends involuntarily before 20 weeks. The pregnancy loss must be identified by a registered doctor to term it as pregnancy loss.

    What are the major causes of Recurrent Pregnancy Loss?
    There could be a lot of reasons behind recurrent pregnancy loss. Most of the pregnancy failure happens from reasons such as abnormalities of the genes, chromosomes and other random events. It is estimated that close to 15 percent of the pregnancies end up in miscarriages. While 30-60 percent of the pregnancies expire within the first 12 weeks, fifty percent of the women are believed to be not aware of the pregnancy in the first place. The risk of miscarriage, however, is less than 50 percent.

    An advanced maternity age is another crucial factor towards recurrent 2pregnancy loss. The risk of miscarriage dramatically increases among these women owing to their poor quality of egg, abnormalities in the chromosome etc. At a time, it has been observed that either the father or the mother might have irregularities in the gene leading to early miscarriage.

    An abnormality in the uterus might also be a reason for a miscarriage. Poor blood supply and inflammation of the uterus are two of the topmost reason for miscarriages among many women. While some women born with a defective uterus, some develop uterus anomalies due to lifestyle and unhealthy life practices.

    Last but not the least, a woman’s immune system might also play a pivotal role towards a miscarriage. Certain hormonal irregularities, diabetes and thyroid diseases might lead to a miscarriage. Then there are the environmental factors such as stress, occupational factors, lifestyle practices etc that contributes towards a miscarriage.

    What are the tests conducted?
    To evaluate the exact reason for repeated miscarriages, a doctor performs a detailed physical and surgical examination. Some other areas where a doctor sneaks into include family history, genetic history etc. A karyotype test might also be prescribed in case a doctor feels the need of doing so. The uterus cavity and the uterus are closely monitored to understand any potential lack in the anatomy. This is followed by a list of imaging tests that a doctor might prescribe. These include MRI, X-ray, hysteroscopy etc.

    What are the treatment options?
    The treatment options are decided based on the finding of the tests. Sometimes plain medicines along with antibiotics can cure the condition, while sometimes surgery might be required to fix any potential threat within the uterus. In any case, the probability of future pregnancy after treatment goes as high as 77 percent.

    In case you have a concern or query you can always consult an expert & get answers to your questions!

    3690 people found this helpful

    7 Most Common Causes Of Miscarriage

    Urologist
    Urologist, Gurgaon
    7 Most Common Causes Of Miscarriage

    What is Miscarriage?

    Miscarriage is defined as the spontaneous loss of the foetus before it is able to survive on its own outside the womb. Miscarriage usually occurs within the first trimester of the pregnancy. It is a very common complication in early pregnancies.

    Miscarriage can be a common complication, but it can have devastating effects on the minds of the parents.

    Signs and Symptoms of Miscarriage:

    The most common visible signs are slight to heavy bleeding from the vagina. But the other common symptoms are:

    1. Dizziness, light-headedness

    2. Discharge from the vagina

    3. Tissue discharge from the vagina

    4. Cramping and pain in the abdomen

    It is advised to go visit your doctor if you experience any of the above signs and symptoms.

    What causes a miscarriage?

    1. Chromosomal Abnormalities: A lot of miscarriages are caused due to mismatched chromosomes. Some women who have experienced miscarriage over two times may learn through tests that there are chromosomal abnormalities that may not affect them but prevent them from getting pregnant.

    2. Abnormalities in the Uterus: Sometimes, the uterus may be too hostile to house a foetus. It can be a genetic disorder or a non-genetic disorder like fibroids or cysts that can lead to a spontaneous abortion.

    3. Hormones: Low levels of progesterone in the body can lead to problems with implantation of the foetus.

    4. Obesity: Studies have shown that every 1 in 4 women who are obese before the conception lose the foetus to spontaneous abortion.

    5. Drugs and Toxins: Consuming alcohol or smoking during the pregnancy is seen to increase the risk of miscarriages manifold. Also, women who are exposed to toxins present in plastic such as Bisphenol A are seen to undergo miscarriage more often than women who are not exposed to such toxic substances. Coffee can be consumed in moderate levels during pregnancy.

    6. Infections: Infections including Mycoplasma can infect the uterine lining and unknowingly cause complications such as miscarriage. Women who have undergone multiple gynaecologic procedures are seen to be at increased risks.

    7. Diabetes: When the diabetes becomes uncontrolled, it can increase the risks of miscarriage. If you wish to discuss about any specific problem, you can ask a free question.

    3031 people found this helpful

    Recurrent Miscarriage - How You Can Deal With It?

    M.Sc, MD, MBBS
    IVF Specialist, Delhi
    Recurrent Miscarriage - How You Can Deal With It?

    It is no hidden fact that miscarriages hurt you deeply. The trauma that comes with it is unbearable, but you will have to get through it. Don’t blame yourself for the situation, you may not know it but miscarriages are quite common. Doctors have said that one out of four pregnancies ends up in a miscarriage. If you have experienced more than two consecutive miscarriages then you are suffering from a recurrent miscarriage. If you are going through recurrent miscarriages then there are some medical conditions to blame.

    Is miscarriage the end?
    A recurrent miscarriage may sometimes complicate things a little, but don’t think that it is the end. As the medical research has progressed, there are several ways for you to get pregnant or have a child. There is in vitro fertilization or IVF which is one of the best ways to cope with a miscarriage. Even if you are having some problem with your fallopian tube IVF can solve your problems and fertilization will be done in the lab and the embryo will be implanted.

    How to cope with the emotional stress?
    Miscarriages are hard in itself, and you need to deal with the post-miscarriage situation with the utmost maturity to keep your psychological and physical state under complete care. Emotionally good health will go a long way and let you think clearly about your options. If the stress and sadness of the miscarriage have brought you down, then seek the counseling of psychiatrist. Don’t feel ashamed to share your feeling and never suppress them. Talk about them and if needed join a support group that will help you to get through the tough situation.

    Remember one thing that if you are emotionally aggrieved and suppress your feelings then that will take a toll on your relationship with your partner. With IVF becoming so developed, there is no need to lament about miscarriage.

    How can I improve my fertility?
    You may be suffering from recurrent miscarriages, but you should not lose your hope. Keep on trying and you may succeed. You never know. Visit the specialists and let them know your medical history. With special care, IVF can solve all your problems.

    But only IVF would never work. Opt for a healthy lifestyle by doing exercises, eating healthy foods, quit smoking, and reduce your alcohol and caffeine intake. You should take a multivitamin rich in folic acid every day. You should also restrict your exposure to environmental chemicals and toxins. It is advisable that you leave behind any kind of heavy lifting, strenuous physical exercises, and any dangerous contact sports. Try not to take stress by taking up yoga or tai chi. And most importantly, try to maintain a healthy sexual relationship with your partner and contact your doctor to know when can you get pregnant again. If you wish to discuss about any specific problem, you can consult an IVF Specialist.

    3396 people found this helpful

    Popular Questions & Answers

    I have gone through a miscarriage. My USG report shows" Gravid uterus. Irregular marginated mild elongated intra-uterine gestational sac is seen, containing an embryo of approx. 6 weeks 6 days. No cardiac activity is seen. Cervix is normal. CRL-8.6 mm 6 weeks 6 days LMP date- 2.2.18 GA by LMP 12 weeks 0 days" I want to know about it. What is the explanation behind my miscarriage?

    MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
    Gynaecologist, Mumbai
    Those getting only one majority of the times it is nature who does not allow pregnancy of abnormal sperm or ovum to grow. Those who get 2 or more detailed reports are required to find cause.
    1 person found this helpful

    Hi doctor, I had 2 miscarriage due to tubal pregnancy and my right tube has been removed at 1st miscarriage and 2nd miscarriage is done through mtx shot. After that I gone for diagnostic lap to check my uterus and left tube. Everything is normal and TTC for 5 months now but no positive result. Kindly suggest I am very much depressed.

    MBBS, DNB - Obstetrics and Gynecology, MNAMS - General Surgery
    Gynaecologist, Delhi
    Stress is an important factor that contributes towards failure of conception. Visit your nearest gynecologist and get follicular monitoring done to know which month you have good chances of conception.
    2 people found this helpful

    I had a miscarried 6 months before. Took torchnil treatment for 3 months and took 6 months gap. I was only igg positive with very low titres. I conceived again and again had a miscarriage. Is torch responsible for recurrent miscarriage and do I need to start torchnil the very first day I miss my menses the next time or can I wait for few days to confirm my pregnancy.

    MS - Obstetrics and Gynaecology
    Gynaecologist, Delhi
    IgG +ve denotes past infection .and is not the cause of miscarriage, you need to consult a doctor in person and get investigated so that cause of recurrent abortions can be known and treated.
    1 person found this helpful

    Table of Content

    What happens in Miscarriage?

    What causes miscarriages?

    What happens after a Miscarriage?

    Play video
    Medical Or Surgical Abortion
    I am Dr Ruby Sehra, consultant Sri Balaji Action Medical Hospital and Director of Progeny IVF Centre at Punjabi Bagh, New Delhi.

    Today we have just going to talk about 10 things which you should keep in your mind before undergoing any medical abortion. As everybody knows that tablets for medical abortion are available on the chemist counter, but they are really been misused, a chemist is not doctors and your pregnancy is a human pregnancy respect it and carefully abort it, under the supervision of a doctor. I would like to mention that there are certain things which you should always keep in your mind before undergoing a medical abortion, number one that never takes the tablets on your own, always consult your gynaecologist or doctor. Secondly, try it to recollect, when did you have your normal periods, when was a normal flow of the period. Sometimes the flow is scanty next two periods and you start counting and you have scanty periods, the pregnancy started when you had normal periods. That means you had last month scanty periods but normal periods but 2 months back, so the pregnancy will not be of the 4 weeks it will be 8 weeks. So, bigger pregnancies cannot be dealt with a tablet. So make sure that you remember correctly when you had normal periods. Thirdly, never hide from the doctor that you ever had pills in between suppose you had scanty pills or the pregnancy test was positive, you took the pills but you never abort it. So this should be also told to the doctor that you had the pills but you never aborted, you tried to hide it is going to create complications. Then you should never hide from your doctor that you have undergone any surgery you had any complications during pregnancy or during medical termination of pregnancy like you had severe bleeding, you had a perforation of the uterus or there was some problem during getting an abortion done. This has an impact on your abortion during this time if it was perforated the uterus is weak this time again the complication can arise, so the doctor will choose whether you have to undergo a medical abortion or you have to go a surgical abortion. So never hide that you had this complication during your delivery, during any surgery, or during last medical termination of pregnancy. As I told you, you should always consult your gynaecologist before you undergo any medical abortion so that she can properly guide you that how the tablets are to be taken and what should be timing and how many tablets are to be taken. In market only one kit is available you just you don't know what time to take whether its just food related or not and you just take the tablets and you never take antibiotics after that and you just keep on bleeding-bleeding-bleeding and once after 2 months you realise that next period has also not gone now you will go to the hospital or a doctor but then you already landed up in complication. So, always consult before taking tablets on your own consult your doctor or qualified a gynaecologist. Then seven-point is that if the doctor has prescribed you medicine you please take it as prescribed further the doctor and do not try to take haphazardly because food and other things have an impact on the medical termination of pregnancy. Remember it is a painful procedure, it should never be taken when you are alone at home you need somebodies help, if you have pain you should have somebody else also who can help you out to take to the doctor. Secondly, then once you have taken your tablet and you are completely awarded or not that has to ascertain with the help of a fresh ultrasound, that means after abortion you must get an ultrasound done, after a week or 5 days because so as to rule out that there are no retained products of conception and you don't require any further treatment. That means if she doesn't get it then if the product keeps lying you will keep bleeding, you will have septicemia and it is going to be a big problem for you. Then never hesitate the last but not the least never hesitate to get a DNC done, that is a cleaning of the uterus, if the products are remaining inside the uterus it needs to be cleaned otherwise you will not have normal periods, it will cause septicemia and it will further the periods will be regulated.

    If you have any further queries about this problem or any other gynaecological problems or IVF related problem you can consult doctor Ruby Sehra.
    Play video
    Recurrent Miscarriages or Abortions
    Good afternoon, I am Dr. Puneet Kocchar. I am a consultant gynecologist and a fertility specialist at Elixir Fertility Center, New Delhi. Today I will be talking about Recurrent miscarriages and abortions.

    A positive pregnancy test is a very exciting news not only for the couple but for the entire family. However, sometimes there is a miscarriage and the chances of miscarriage in the normal pregnancy are about 10-15%. If you have had only one miscarriage, then the chances that you will carry on till term without requiring any medical extensive treatment in your next pregnancy are nearly 80% or more. For women who have had only one miscarriage, we will not recommend going for extensive testing or treatment.

    What is recurrent abortion or recurrent miscarriage?

    If a lady has had 3 or more repeated abortion, it is called recurrent abortions. Even these days we start doing test and treatment if a lady has had 2 abortions and we do not wait for third one to occur.

    So, why does an abortion occur?

    In simple terms, either it is a fetus, that is, an embryo is not normal or the womb which is going to carry the pregnancy has some problems in it. What happens to a fetus if you are carrying a genetically abnormal baby, that can lead to miscarriage. It is nature's way to take care of the pregnancy and not letting the abnormal baby come into life. So, we do tests called genetic tests to check the chromosomic make up of a baby. They can be done on the products of conception. We also recommend that we have complete parental care, that is the blood test of both mom and dad to check the both of the chromosomal content.

    Sometimes, in2-5%of the cases, there is balanced chromosomal translocation. Now this translocation will not cause any problem to the person who is guiding translocation. But when you produce an egg or the sperm, the embryo can be abnormal and this will lead to a miscarriage.

    What happens to a person carrying a translocation?

    If you are carrying a translocation which is leading to repeated miscarriages, it is better to plan IVF cycle along with PGD or PGS rather than normal conception.

    IVF is where we create an embryo using the eggs from the lady and sperm from the husband. When the embryo is ready, we take a small biopsy and we subject it to test and a complete chromosomal analysis. And once the results are back, the normal embryo is transferred back into the lady's womb resulting in healthy pregnancy. This is one factor that we just addressed.

    The second factor that we talked about is abnormalities in the womb. Now, simple test to analyze hormonal balance from the blood taken from the lady will tell us about thyroid status, diabetes, abnormal prolactin. These are all hormones which if are elevated or below the range can lead to abortions. THis can all be treated by giving oral tablets. So, these are important to be tested for any women having recurrent abortions.

    Then we look into other factors such as autoimmune problems which are very common, occurring in about 20% of the patients. During pregnancy, we advise you to take low dose aspirin tablets and low molecular weight hampering injections for the entire duration of pregnancy. And this results in more than 60% successful pregnancies.
    Another important factor that leads to abortion, which is Thrombophilias. THese are inherited problem which increases the tendency of blood to clot. Since the blood flow to the uterus is not occurring properly, you might again need blood gain agents such as aspirin.
    Some of the other common factors are an anatomical factor. So, if the uterus or a womb is carrying a fibroid can also lead to abortions. Now, these can be easily diagnosed by doing an ultrasound either 2-dimensional or 3- dimensional. If such a problem is present, we can treat it by doing a hysteroscopic procedure.
    Another important factor that leads to Abortion, especially in our part of the country, that is North India, is Tuberculosis. This is one of the commonest cause of miscarriages especially in our part of the country. It can be tested by doing Biopsy. Take a small amount of tissue from the uterus and check whether the lady is carrying Tuberculosis or not. It can be treated by giving oral medication of tuberculosis that has to be taken for the period of 6-9 months.
    Another common cause is the imbalance of Th1 or Th2 cytokines. These are the cytokines present in the uterus which may not let the embryo or the pregnancy to grow. And if these are found to be positive, we recommend Immunomodulation.
    So, these are the various causes due to which a lady can have an abortion. An important thing here is do not loose hope and do not give up treatment. If you have had 2-3 abortions, you need to get complete panel of tests done and with the help of a treatment, you have 60% of the chance to deliver a baby normally.

    If you wish to consult me, please contact me through Lybrate or you can visit my clinic directly.

    Thank you.



    Play video
    Early Pregnancy Loss
    Miscarriage: Causes and Treatment for Early Pregnancy Loss

    Hello friends, I'm Dr. Mukti Sethi. I'm a Consultant Gyenic specializing in life expectancy and infertility. I've done my graduation from GSV Medical COllege Kanpur, and my post graduation from Aligarh Muslim University. Today, on this session I'm going to talk on the subject which is a great cause of stress and anxiety among patients who are expecting pregnancy or area pregnant, that is early pregnancy loss. So early pregnancy loss, what exactly do we mean by early pregnancy loss. Early pregnancy loss is a loss of pregnancy during the first thirteen weeks of pregnancy, that is, the first trimester of pregnancy. It is commonly mentioned as miscarriage or spontaneous abortion.

    So how many pregnancies lands into a pregnancy loss or what is the incidence of pregnancy loss? Around one in every five pregnancy, which is, unfortunately, a very high incidence rate, lands in a non-developmental form or loss of a pregnancy or a miscarriage. So what are the causes of this pregnancy loss? The most common cause, around 60% of the pregnancy loss, is due to are due to random chromosomal defects are seen during the process of fertilization. What is the process of fertilization? Fertilization is when the female's ova or egg combines with the sperm to form a fetus or a zygote. During the process, the mismatch of the chromosomes results in an abnormal chromosomal formula of the fetus. So these pregnancies won't be able to grow further and nature has its own process to curtail these pregnancies or abnormal pregnancies from growing. So these pregnancies are going to land in an abortion or miscarriage or missed abortion or blighted abortion that we generally see. So a big number, that is 60% is because of these chromosomal defects which we do not have any control over.

    So coming over other causes, it might be a defect in the reproductive system of the female like a defect in uterus, fibroid or septa. Then coming over to infections, yes there are a set of infections that can be a cause of these pregnancy losses or abortion, like torch infections or tuberculosis. Then coming onto the hormonal causes, we have seen so many patients coming who have a thyroid problem or are diabetic. Again coming onto patients who are suffering from PCOD. So they have high chances of having an abnormal pregnancy or unhealthy pregnancy which might result in abortion. Then there are certain medical conditions or toxins, environmental conditions which might land a patient into a pregnancy loss. Now, what can an individual or a girl who is planning to get pregnant do to reduce the risk of having an abortion? First of all, you need to maintain a healthy lifestyle and then prelating, that is before getting pregnant always see a gynecologist or a consultant. There is a set of investigations that you people should go through- your blood group, your CBC, your diabolic sugars. You should go through these tests before planning a pregnancy. Next is a healthy lifestyle, certain vitamins like folic acid are extremely important. Taking them for 3-4 months before getting pregnant might reduce the risk of getting abnormal pregnancies like deformities seen in the fetus is considerably reduced. Then yes, coming over to the lifestyle that we see today, females planning to get pregnant should stop smoking, alcohol intake should be reduced or stopped if possible.

    Then there are some general questions patients do ask me that should we stop coffee. Yes, you can take coffee but try to restrict it to two cups a day. Then any food or anything which can cause abortion is more of a myth. Generally, all foods like vegetables, fruits which god has created for us is quite healthy and generally do not result in any injury to the fetus. But still certain foods like Chinese or Ajinomoto, we do ask the patient to reduce the intake for the first trimester of pregnancy. Then there can be certain girls or females that are working in an environment which can be hazardous for the growing fetus like many of our staff that are woking with X-rays or chemical setups or factories which are there, also around fumes. So you need to be a little cautious about the environment where you are working so that there is no harm in the early fetus. So yes you can take certain steps to have a healthy pregnancy.

    Now how can your doctor or your gynecologist help to reduce the risks? Very thorough check up with the doctor so that she would be able to diagnose any hormonal problems or any defects in the uterus, something which she can do about and that way she will surely be able to help you out. But again coming back to the point, the majority of pregnancy loss is due to chromosomal abnormality during the process of fertilization which are not in control of the doctor or the patient. So you need to be somewhat relaxed, nature has its way , and if there is something or some abnormality in the foetus then nature will not allow it to grow. But yes there are other causes in which you can or your doctor can help you out so that you have a healthy pregnancy. Now, how to know that you might be heading towards a pregnancy loss or towards an abortion. The main symptoms that the patient will complain about are spotting or bleeding or cramps. Patients come to us with a history of missing periods and there is an episode of bleeding. Now here I would like to say that all patients who have bleeding during the first trimester of pregnancy are not going to land in an abortion. But yes you need to be extra cautious, you need to see your doctor, your doctor would like to help with certain hormones or support with the hormones or pregnancy with the vitamins which might avert the abortion.

    So the first symptom is pain and bleeding. Now all patients of bleeding will not land in an abortion but yes when you are having it you need to undergo certain investigations so that there is a diagnosis to know the problem. So how would your doctor diagnose that yes it is a case of abortion or missed abortion or a blighted one? A physical examination by the doctor, the general upper vaginal examination will guide the doctor towards the cause of bleeding. Doctor will ask or recommend a certain set of investigations like ultrasound and even beta HCG that is a blood test which will help to diagnose, and sometimes you know these tests need to be repeated, and at that moment of time patients tend to get very anxious that why the doctor is not able to answer my questions that it is a healthy pregnancy or not. Because sometimes the pregnancy needs to be of a certain duration to assess that yes it is going at par or not. So we have to repeat the investigations like ultrasound needs to be done after an interval of a week or ten days to see the difference in growth, has the baby grown in ten days or not, or to say with confidence that it is a growing pregnancy. Once the diagnosis of missed abortion or abortion has been made, now what is the treatment or what would be the next step. Sometimes a patient comes to us that it is a very early pregnancy, very small sac or she is bleeding, having a heavy flow like a periods flow. Then we would just ask the patient to wait and watch. Let her clear off with the periods and sometimes the pregnancy will be washed on its own and doctor would decide not to interfere with the natural process, and at times it is sufficient. But yes if the sac is a little larger in size or the bleeding is not that much in flow, or period is not there, the doctor might give some medicines to you so that there is proper flow and pregnancy is washed off.

    But there might be certain cases which would require intervention by the doctor that is a surgical procedure or such an evaluation or dilation and then by the patient to remove whatever products of conception still remain. Even after medicines, sometimes you know all the products of conception won't be washed out then after a period of two weeks the doctor might advise you to go for another ultrasound to confirm that everything is clear and if still there are some fragments then surgical procedure might be advised to you. Generally, the next question is will it in any way harm the next pregnancy. No, it is not like that. Generally, these are safe procedures and very necessary at that period, therefore, you people are advised about it and they are not related to any long term consequences. So here we have discussed the treatment of early pregnancy loss. Generally, these people do quite well, have good chances of having a healthy pregnancy the next time they become pregnant. So my advice to you all doesn't get anxious, look for support from your doctor, from your family, with your partner. Decide well in advance before your next pregnancy.

    If any of you need to consult me about this you are most welcome. You can get in touch with me through Lybrate.com or if you want to see me in your clinic I'm available at Indirapuram at Ghaziabad NCR. You can fix an appointment and see me personally and I hope this talk was useful for you.
    Play video
    Common Miscarriage Causes
    Hello I am Dr. Mohan Raut, a practicing gynecologist from last 27 years and partner of ICPRM, India's first immunotherapy Center for treatment of patients with repeated miscarriages, IVA failure, rod implantation failure.

    Today I am going to discuss about various causes that lead to repeated miscarriages.

    Miscarriage is a traumatic experience for a woman and when it happens repeatedly it can be devastating. The problem of repeated miscarriage is huge because it affects almost 1% of couples. So at any given moment the number of patients suffering from this problem is really high. There are five common causes of this problem, those are;

    Genetic factor- In this case, there are chromosomal or genetic abnormalities in the pregnancy and because of which the fetus can't grow, leading to miscarriage.
    Structural problems- Structural problem in uterus or the womb. Here there can be double uterus. There can be a curtain or septum within the uterus which leads to compromise in the space allowing pregnancy not to grow leading to miscarriage.
    Endocrine group- The problem arises in conditions such as diabetes, mellitus, thyroid ( hypothyroidism or hyperthyroidism), a condition called as PCOD or polycystic ovarian disease. These can lead to repeated miscarriages
    Infection- Certain viral infections and infections like toxoplasma can infect the pregnancy leading to miscarriage.
    Autoimmune factor or autoimmune disorders- This includes formation of antibodies against mother's own group and conditions like anti-thyroid antibodies, or antibodies against for a phospholipid part of the mother's body. The conditions known as collagen disorders are responsible for this and lead to repeated miscarriages.
    Now when all these factors are tested, it has been found that almost 50% of couples with repeated miscarriages show that all these tests are normal. Then what is the cause in these couples? And in these couples the cause is found to be called as alloimmune factor or there is immunological rejection of pregnancy by the mother.

    Now what is this alloimmune problem and how pregnancy is nature's miracle? I will discuss these in my next video.

    For more information you can contact me on www.lybrate.com. Thank you.

    Play video
    Immunotherapy (Lymphocyte Immunization Therapy - LIT)
    Treatment for Repeated Miscarriages and IVF Failure

    Hello, I am Dr. Mohan Raut, practicing Gynecologist for last 20 years and partner of CPRM, India's first Immuno therapy center for treatment of patients with repeated miscarriages and IVF failure or implantation failure. Today I'm gonna discuss a unique treatment called Immuno therapy, that is, Lymphocyte Immunization Therapy which is a form of active immune therapy for patients who have repeated miscarriages or repeated IVF failure.

    LIT or Lymphocyte Immunization Therapy uses the patient's husband's white cells called lymphocytes for the treatment. In this, once the LI immune factor is confirmed, we separate certain type of white blood cells called lymphocytes from husband's blood and they are injected into the wife by sub-cutaneous intravenous route. Once this injection is given then the couple is asked to wait for a period of four weeks and after that, they should make active attempts at pregnancy and over the next one year, she should conceive. This is a very safe procedure as it has no long term side effects and it is quite effective.

    We have been doing this treatment for more than 20 years and it has helped more than 500 couples whom we have given this treatment. Apart from LIT, there are other forms of therapy which can be given and these are the use of intravenous immunoglobulins, use of Intra liquids, use of medicines like steroids and certain injections like low molecular weight restaurant. So, with this therapy, it has been possible to overcome the problem of repeated miscarriages especially when all other factors are normal because the reason is LI immune problem.

    For more information, you can contact me on www.lybrate.com. Thank you.
    Having issues? Consult a doctor for medical advice