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?
Risk factors which can lead to a Miscarriage:
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:
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.
With infertility on the rise, more and more couples are turning to IVF as a definitive solution. Though there are some inherent risks with IVF, the success rates have gone up significantly over the last couple of decades. This has made it extremely popular for a couple facing infertility. IVF is no longer just a physical issue but also a hugely emotional one.
There are various factors which determine the success rate of IVF, and a thin endometrium is one of them. This is the inner lining of the uterus which should facilitate transfer and growth of the embryo throughout the course of pregnancy.
Ideally, the endometrium should be about 7 to 8 mm thick and have a 3-layered structure on ultrasound. If it is too thin, it may not be able to support the implantation of the fertilized egg. Further, even if it supports initially, as the embryo continues to grow, it may not be able to support the weight, leading to possible miscarriages.
Causes of the thin endometrium:
While blood tests can help identify reduced estrogen levels, ultrasound can be used to measure blood flow to the uterus. The cause of thin endometrium needs to be addressed before going ahead with IVF so that the chances of success are increased.
As a society, if a couple is not able to have children, it is considered a major issue. The couple could be looked at and treated differently and so they look at various options to conceive. One of them is in-vitro fertilization or IVF, and with advances in medical technology, the success rates have risen significantly. However, there are a group of infertile couples who still do not seem to be convinced about IVF as “the” solution for infertility.
Read on to know some of the causes.
So, though IVF is helping a lot of couples, some definitely have their doubts about the process. In case you have a concern or query you can always consult an expert & get answers to your questions!
Natural therapies are a great option to support your body and prepare it for pregnancy. As with any approach trying to decrease the chance of miscarriage, these steps will help to nourish and support the body, inviting a healthy pregnancy to occur.
Preparing ahead of time for your pregnancy is also important for decreasing the chance of a miscarriage, these steps must be practiced for at least 3 months before you become pregnant again. If you are currently experiencing a miscarriage contact your doctor or midwife right away.
Prepare for conception: The first step is to prepare your body with fertility cleansing. Fertility cleansing helps you to support the liver in cleansing the body of old toxins and excess hormones while encouraging the uterus to cleanse itself of ‘old’ contents, increasing uterine circulation and tone.
Eat a nutrient dense fertility diet: The next step is to nourish and build up your body to be a healthy, baby friendly body. This can be done through eating a well balanced and nutritious diet. What you eat has a strong impact on:
Build a healthy foundation: One of the major foundational steps to increase your chance of having a healthy pregnancy is to take some basic vitamins, minerals, and EFA’s. There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation. Essential fatty acids are also extremely important for miscarriage prevention.
Endometriosis is a disease in which cells that form the lining of the uterus grow at abnormal locations. These cells grow on organs like ovaries, urinary bladder or rectum.
Symptoms that can be accompanied with this condition are as follows:
It has been observed by researchers that an estimated three to five million American women are seen to suffer from endometriosis. This disease is particularly prevalent in the age group of 30-40 years. However, it can also begin in the late teens and early twenties.
Endometriosis and Infertility
It is an established fact that about 40% of patients suffering from endometriosis will in all possibilities experience some degree of infertility. The primary cause of infertility due to endometriosis is because of blockage by scarring and adhesions in the tubes. These adhesions prevent the meeting of the egg and sperm and thus hinder the process of fertilization.
Endometriosis and miscarriage
Endometriosis can be a reason for miscarriage. In a recent study by researchers in the United Kingdom, it has been revealed that women suffering from endometriosis are at the risk of experiencing a miscarriage or an ectopic pregnancy. However, this is not supported by some other studies. Women with endometriosis can also be victims of bleeding during pregnancy, as well as preterm birth. In case you have a concern or query you can always consult an expert & get answers to your questions!
If you lose a baby before 24 weeks of pregnancy, it is called a miscarriage. If this happens in the first 3 months of pregnancy, it is known as an early miscarriage. Unfortunately, early miscarriages are common, with 10–20 in 100 (10–20%) pregnancies ending this way. Late miscarriages, after 3 months of pregnancy but before 24 weeks, are less common: 1–2 in 100 (1–2%) pregnancies end in a late miscarriage. When a miscarriage happens three or more times in a row, it is called recurrent miscarriage. Recurrent miscarriage affects 1 in 100 (1%) couples trying to have a baby.
Why does recurrent miscarriage and late miscarriage happen?
Sometimes there is a reason found for recurrent and late miscarriage. In other cases, no underlying problem can be found. Most couples are likely to have a successful pregnancy in the future, particularly if test results are normal.
There are a number of factors that may play a part in causing recurrent and late miscarriage:
Are there any other risk factors?
Being overweight increases the risk of miscarriage. Smoking and too much caffeine may also increase the risk. Excessive alcohol is known to be harmful to a developing baby and drinking five or more units a week may increase the risk of miscarriage.
The chance of a further miscarriage increases slightly with each miscarriage. Women with three miscarriages in a row have a 4 in 10 chance of having another one. This means that 6 out of 10 women (60%) in this situation will go on to have a baby next time.
Why are investigations helpful?
Finding out whether there is a cause for your recurrent miscarriage or late miscarriage is important as your doctor will be able to give you an idea about your likelihood of having a successful pregnancy. In a small number of cases there may be treatment available to help you.
What investigations might be offered?
Tests for abnormalities in the baby You should be offered tests to check for abnormalities in your baby’s chromosomes. This is not always possible but may help to determine your chance of miscarrying again. If you have had a late miscarriage you may also be offered a postmortem examination of your baby. This will not happen without your consent and you will have the opportunity to discuss this with your health team beforehand.
Tests for abnormalities in the shape of your uterus. You should be offered a pelvic ultrasound scan to check for any abnormalities in the shape of your uterus. If an abnormality is suspected, further investigations may include a hysteroscopy (a procedure to examine the uterus through a small telescope which is passed through the vagina and cervix) or a laparoscopy (a procedure in which a surgeon uses a fine telescope to look inside the abdomen and pelvis).
What are my treatment options?
Treatment for APS
If you have APS and have had recurrent miscarriage or a late miscarriage, treatment with low-dose aspirin tablets and heparin injections in pregnancy increases your chance of having a baby. Aspirin and heparin make your blood less likely to clot and are safe to take in pregnancy.
Having APS means you are at increased risk of complications during pregnancy such as pre-eclampsia, problems with your baby’s growth and premature birth. You should be carefully monitored so that you can be offered treatment for any problems that arise.
Treatment for thrombophilia
If you have an inherited tendency to blood clotting (thrombophilia) and have had a miscarriage between 12 and 24 weeks of pregnancy, you should be offered treatment with heparin. At present there is not enough evidence to say whether heparin will reduce your chance of miscarriage if you have had early miscarriages (up to 12 weeks of pregnancy). However, you may be still offered the treatment to reduce the risk of a blood clot during pregnancy.
Your doctor will discuss what would be recommended in your particular case.
Referral for genetic counselling
If either you or your partner has a chromosome abnormality, you should be offered the chance to see a specialist called a clinical geneticist. They will discuss with you what your chances are for future pregnancies and will explain what your choices are. This is known as genetic counselling.
Monitoring and treatment for a weak cervix
If you have had a miscarriage between 14 and 24 weeks and have a diagnosis of a weak cervix, you may be offered an operation to put a stitch in your cervix. This is usually done through the vagina at 13 or 14 weeks of pregnancy under a general or spinal anaesthetic. Your doctor should discuss the surgery with you.
If it is unclear whether your late miscarriage was caused by a weak cervix, you may be offered vaginal ultrasound scans during your pregnancy to measure the length of your cervix. This may give information on how likely you are to miscarry. If your cervix is shorter than it should be before 24 weeks of pregnancy, you may be offered an operation to put a stitch in your cervix.
Surgery to the uterus
If an abnormality is found in your uterus, you may be offered an operation to correct this.
Taking progesterone or human chorionic gonadotrophin hormones early in pregnancy has been tried to prevent recurrent miscarriage. More evidence is needed to show whether this works.
Treatment to prevent or change the response of the immune system (known as immunotherapy) is not recommended for women with recurrent miscarriage. It has not been proven to work, does not improve the chances of a live birth and may carry serious risks (including transfusion reaction, allergic shock and hepatitis).
What if no cause is found?
Where there does not appear to be a cause for recurrent miscarriage or late miscarriage, there is currently no evidence that heparin and aspirin treatment reduces the chance of a further miscarriage. For that reason this treatment is not recommended in these circumstances.
What does this mean for us in the future?
You and your partner should be seen together by a specialist health professional. Your doctor will talk to you both about your particular situation and your likelihood of having a further miscarriage and a successful pregnancy. If a cause has been found, possible treatment options will be offered to you to improve your chance of a successful pregnancy.
For couples where no cause for recurrent miscarriage has been found, 75 in 100 (75%) will have a successful pregnancy with this care. It is worth remembering that the majority of couples will have a successful pregnancy the next time even after three miscarriages in a row.
What happens in Miscarriage?
What causes miscarriages?
What happens after a Miscarriage?