How to understand that a miscarriage is early. What rules need to be followed so that there is no miscarriage? Early miscarriage treatment

The spontaneous loss of an embryo or fetus during the first 24 weeks of pregnancy is called miscarriage (spontaneous abortion). Miscarriages occur most often due to abnormalities in the development of the fetus, which significantly reduce the chances of its survival in the future. Spontaneous abortion is a common process, and in 30% of women it usually occurs before they even realize that they are pregnant. How do you know if a miscarriage has occurred? How should one react in such a case?

How do you know if a miscarriage has occurred?

If you have any worrisome symptoms or feel unwell, see your doctor as soon as possible. Every effort must be made to save the child, because he can help find out the cause of spontaneous abortion and make it clear what anomaly is present in the fetus. Also, look out for the following signs of a miscarriage:

The main signs of a miscarriage

vaginal bleeding. Most often, miscarriages begin with. It may be weak, but heavy bleeding occurs more often. But at the same time, vaginal bleeding does not necessarily indicate a loss of pregnancy. On average, 1 in 4 women experience spotting in the first trimester of pregnancy, and not all of them experience spontaneous abortion.

Spasmodic pain. After vaginal bleeding, abdominal pain may occur. Most often, it is pulling, of varying intensity, and is felt in the pelvic region or in the lower back. In some cases, the pain may be constant cramping and accompanied by bleeding. If these two symptoms are present, there is a high chance that a miscarriage has actually occurred.

What to do if a miscarriage occurs?

In the event of a miscarriage, there will be bleeding for some time along with spasms. During this time, you can use sanitary pads, but not a tampon. Don't worry if bleeding or spasms get worse; this usually happens when the body is trying to expel the products of conception, i.e. fetal tissue and placenta. These products of conception may also include blood clots or have a grayish appearance. You can take an over-the-counter pain reliever such as acetaminophen to relieve pain.

Could it be something else?

Sometimes pain and bleeding are signs of a molar pregnancy. Whatever the cause, it is important to seek medical attention.

How can you be sure it's really a miscarriage?

A miscarriage can also be discovered by a consulting physician during a routine prenatal visit. Suspicion may arise if the size of the uterus is small or if the fetal heart is not audible after the middle of the first trimester. Sometimes vaginal bleeding or abdominal pain occurs several weeks after the fetus stops developing - this is called a missed pregnancy or delayed miscarriage.

A miscarriage is confirmed by an ultrasound or blood test. If your doctor suspects that a miscarriage may have occurred, he will refer you for these tests.

What should I do if I think I'm losing a child?

If unusual symptoms occur, such as vaginal bleeding or abdominal cramps, it is important to seek immediate medical attention. It will determine if the bleeding is from the uterus or cervix. In addition, they are tested in the blood serum to determine whether the amount of the hormone is increasing or decreasing. Tests are repeated two to three days later to compare hCG levels.

Ultrasound can rule out another cause of vaginal bleeding and spasm—an ectopic (ectopic) pregnancy. If, despite the absence of visible problems, bleeding continues, a second ultrasound is performed after 7 weeks.

After seven weeks of pregnancy, the chances of a normal pregnancy increase if an embryo with a normal heart rhythm is found on ultrasound. Although the chances of miscarriage are reduced, you may need further testing if bleeding continues. If the new ultrasound shows an embryo of normal size, but there is no heartbeat, then the baby did not survive.

On the other hand, if the size of the fetus and the amniotic sac are small according to the ultrasound results and the heart rhythm is not heard, you may have miscalculated the timing of pregnancy, and the fetus is simply not as old as you thought. In any case, to get a definitive diagnosis, the doctor may order repeat blood tests and an ultrasound in the next couple of weeks.

Bed rest: if there is a threat of termination of pregnancy, consulting specialists recommend bed rest. While there is no evidence to support this theory, bed rest is believed to reduce the chance of miscarriage. For this purpose and for constant monitoring, a woman may also be asked to lie down for preservation in a maternity hospital or pathology department. In addition, the doctor may suggest abstaining from sexual activity if bleeding or cramps are observed. There is usually no relationship between intercourse and miscarriage, but it's best to be careful.

Women who are Rh negative need an injection of anti-Rh immunoglobulin in case of bleeding that lasts for 2-3 days. The fact is that if a positive Rh factor was transmitted from the father to the unborn child, then the mother's immune cells can attack his red cells, which is called Rh sensitization. In addition to the threat of late miscarriage and stillbirth at a later date, this also creates the risk of developing serious pathologies in the child after childbirth. Immunoglobulin is not needed if the child's father is also Rh negative. Also, there is usually no risk and no need for an injection if this is the first pregnancy (the blood has not yet mixed before birth and the corresponding antibodies have not yet developed in the mother). Although, for example, the American College of Obstetricians and Gynecologists recommends that all Rh-negative mothers, regardless of the blood type of the fetus, receive anti-Rh immunoglobulin at about 28 weeks of gestation and again shortly after delivery.

What happens after a miscarriage?

After a miscarriage, slight cramps are felt in the abdomen, similar to those observed during menstruation (menstruation). Usually these sensations persist for a day or two and are followed by light bleeding for a week. Spasms are observed even after the release of the products of conception. To control bleeding and pain, use sanitary pads along with an over-the-counter oral pain reliever such as ibuprofen or acetaminophen. Avoid using tampons, swimming, vaginal treatments, sex, and douching during this time.

You need to see a doctor immediately or go to the emergency room if you have any signs of infection (such as fever, pain, and foul-smelling vaginal discharge), abdominal pain, or excessive bleeding (using one or more pads per hour) . With heavy bleeding, there is a chance of fainting, dizziness and weakness, so seek help as soon as possible.

What about future pregnancy?

Miscarriages are quite common. One spontaneous loss of a fetus does not mean that something is wrong with you or your partner, but worrying about future pregnancies is understandable.

When should you try to conceive again?

After a miscarriage, it usually takes 4-6 weeks for the body to normalize. It doesn't matter if everything went naturally or the tissues were helped out with drugs, you need to wait before planning a child again.

Recover emotionally from loss

Women usually take longer to emotionally recover from a miscarriage, even if they are ready to physically have a baby.

Everyone has a different way of recovering from a loss. Discuss your feelings with your partner and decide if you want to wait or try again. During this period, you can also seek help from a support group.

In addition, contact a consulting doctor, who can then recommend a psychologist for you.

If you must explain the termination to your other children, first think about how to talk about the incident yourself, and then explain it to them.

Tests that a doctor can prescribe after a miscarriage

Depending on what the doctor thinks is appropriate, he may order a blood test and genetic tests after two or three

Pregnancy is one of the most beautiful periods in the life of every woman. Future mothers are especially beautiful, and their eyes radiate so much happiness and warmth that one could warm the whole world. Unfortunately, not every pregnancy proceeds normally and ends with the birth of a healthy baby. Sometimes it happens that the pregnancy is unexpectedly terminated, and the dreams of a failed mother are not destined to come true. Why it happens? Let's try to understand in more detail.

What is a miscarriage and what types does it occur?

In order to understand how a miscarriage occurs, you must first know what it is.

4. The cause of recurring miscarriages can also be the so-called polycystic ovary syndrome. One recent British study showed that 44 to 56% of patients who had multiple miscarriages in a row had polycystic ovary syndrome, characterized by irregular or no menstrual cycles. Most often, this syndrome is observed in overweight women.

5. Rhesus incompatibility (hemolytic disease), which occurs when the mother has a positive Rh factor, and the father is negative.

6. Disorders of the immune system are the cause of 5-10% of miscarriages. This is due to the fact that the immune system of a pregnant woman, programmed to fight bacteria and viruses, fails and attacks healthy body cells. One of the most well-known disorders of the immune system is antiphospholipid antibody syndrome. It appears when the body mistakenly believes that phospholipids are foreign elements. As a result, antibodies are produced that cause blood clots in the placental vessels, interrupting the flow of oxygen and nutrients from the mother to the fetus.

7. Other reasons: features of the anatomical structure of the uterus, viral and bacterial infections, anti-drug and anti-stress medications, exposure to harmful substances.

What symptoms indicate a miscarriage?

Every woman worries about how a miscarriage occurs. Symptoms that indicate an impending or ongoing miscarriage are of great importance for timely medical intervention and the prevention of spontaneous abortion. The most common symptoms include the following:

Sudden weight loss;

The disappearance of such signs of pregnancy as nausea, swelling of the breasts, drowsiness;

False contractions, called Braxton-Hicks contractions;

Real contractions (painful, with a frequency of 5-10 minutes);

The appearance of blood spots;

Light, painless bleeding (although this is not always a symptom of a miscarriage);

Severe bleeding with or without clots, accompanied by cramps and severe pain in the abdomen or lower back;

Vaginal discharge that is not accompanied by pain or bleeding.

A molar pregnancy, a damaged egg, or an ectopic pregnancy will eventually lead to a miscarriage. The symptoms are similar, except that in the case of a molar pregnancy, the size of the uterus may be larger than usual, and the level of hCG (pregnancy hormone) is increased.

Signs and features of a miscarriage in the early stages

In the first weeks of pregnancy, only after learning about their interesting situation, women become very sensitive, and it is not surprising that they are visited by a variety of thoughts related to their well-being and the health of their future babies. The slightest changes occurring in the body make them worry. They see everything as signs of an early miscarriage. Therefore, it is very important to have information. How to understand that a miscarriage has occurred? Does it really make sense and reason to worry? Are these feelings justified? How does a spontaneous miscarriage happen? It is impossible to answer these questions unambiguously. Each case, like each organism, is absolutely individual, and they should be considered separately.

It is almost impossible to identify the causes of most miscarriages in the early stages (more than 60%). It is assumed that these are genetic causes. When an embryo is formed, half of its genes are taken from the sperm, the other half from the egg. Sometimes, without any apparent motive, something goes wrong and the pregnancy is terminated. A miscarriage can occur two to three weeks after the death of the fetus. Obstetricians-gynecologists call the following main causes of miscarriage at the initial stage of pregnancy:

The embryo does not implant in the uterus as it should;

Hormonal problems;

Chromosomal abnormalities;

Diseases of the uterus or cervix;

Various intrauterine infections;

Viral infections, such as the flu;

Strong blows to the stomach of a pregnant woman;

Multiple pregnancy;

Miscarriages that have taken place in the past.

Signs of an early miscarriage:

Strong convulsions.

Bleeding.

Blood clots.

At what stage of pregnancy can a miscarriage occur?

Most often, a miscarriage occurs at the earliest possible time (2-3 weeks). In most cases, a woman does not even suspect that something similar has happened to her. Early spontaneous miscarriages are often confused with normal menstruation. This is due to the fact that the main manifestations of a miscarriage at the beginning of pregnancy are identical to normal menstruation: vaginal bleeding and pain in the lower abdomen. This is the answer to the question of how a miscarriage occurs.

Less common are miscarriages in later pregnancy (before the 20th week). Spontaneous abortion that occurs after the 20th week is called stillbirth.

How does a miscarriage happen?

Due to lack of awareness, many women sometimes do not even suspect that something terrible has happened to them - the loss of a child. They have no idea how quickly a miscarriage occurs and what follows after that. In order to be fully equipped, you need to remember the following:

1. Spontaneous abortion, fetal death and rejection by the body usually do not occur at one moment, but last for several hours or even days. The process proceeds in several stages: the threat of miscarriage, imminent (started) miscarriage, incomplete abortion and, finally, complete abortion.

2. The threat of miscarriage is characterized by the onset of placental abruption and the appearance of the first signs of miscarriage (pain in the lower abdomen and slight bloody discharge from the vagina). At this stage, the uterus is closed, and the pregnancy can still be saved.

3. An imminent (beginning) abortion is characterized by placental abruption and, accordingly, further fetal death. An imminent abortion cannot be stopped.

4. With an incomplete abortion, the placenta exfoliates, the fetus dies, and the process of its rejection by the body begins.

5. During a complete abortion, the fetus and place are eliminated from the uterus, as well as from the female genital tract.

Is it possible to independently determine that a miscarriage has taken place?

Becoming registered with a antenatal clinic, women and even their husbands often ask doctors how to find out that a miscarriage has occurred. Unfortunately, it is almost impossible to determine this on your own. If there is a suspicion that a miscarriage has occurred, you should immediately consult a doctor or call an ambulance. Only after a medical examination of a woman can one say with complete certainty whether a miscarriage has occurred or not. In order to determine this, the doctor will refer the patient to an ultrasound.

In addition, an analysis that will determine the level of hCG in the blood can tell about a miscarriage that has occurred. HCG is a hormone produced by the body exclusively during pregnancy. It can be detected in the blood one week after ovulation, when a fertilized egg is implanted in the uterus. In the first three weeks of pregnancy, the hCG level should double every 2-3 days. When this level remains unchanged, a spontaneous miscarriage may have occurred.

Doctors also resort to measuring the heart rate (HR) of the fetus. To do this, they use a special device that allows them to listen to the heart rhythms of the fetus in the mother's abdomen from 7-12 weeks of pregnancy. If the heartbeat of the fetus is heard, then there can be no talk of a miscarriage. Remember that if you do a regular pregnancy test, it can show its presence even after interruption. Therefore, you should not waste precious time and wonder how to determine that a miscarriage has occurred. At the slightest sign, go straight to your gynecologist.

How can you induce a miscarriage?

Not every pregnant woman is delighted with the fact that she will soon become a mother. Each has its own reasons. Some pregnant women seek medical help and terminate the pregnancy in the hospital, while others prefer to go on their own and learn all the possible ways to have a miscarriage on their own. Since ancient times, various herbs have been used for this, such as tansy. It was boiled and taken orally, which almost 100% guaranteed rejection of the fetus.

There are many such cases when women, in order to get rid of an unwanted child, took and continue to take hot baths to this day. Some try to bring the body to exhaustion with heavy physical exertion. Young girls even manage to drink milk to which iodine is added. More "advanced" young ladies do not risk experiencing folk methods. They prefer more modern means, such as hormonal pills.

Only a few think about the consequences of such methods and experiments. As a result, rash actions can lead to very disastrous results. Any attempt to have a miscarriage at home threatens the health and even the life of a pregnant woman. Not a single folk remedy that can provoke an abortion guarantees that bleeding will not begin and any infection will not be introduced.

The safest way to get rid of an unwanted pregnancy on your own is the so-called medical abortion. A prerequisite is the minimum time from conception (up to two weeks from the delay in menstruation). In this case, most likely, the miscarriage will occur quickly and painlessly, and the uterus will be completely cleaned. In addition, complications are practically excluded. However, it should be noted that drugs that are used for medical abortion are not sold in pharmacies. Only doctors who have a special license are entitled to prescribe such drugs to their patients. In addition, the cost of such drugs is quite high and not every girl can afford it.

Instead of thinking about how to have a miscarriage and get rid of the fetus, maybe you should imagine what the future baby will look like and how much joy and happiness it will bring to the house? The decision is up to each parent. Responsibility for all actions lies entirely on their shoulders.

What to do after a miscarriage occurs?

What happens after a miscarriage is familiar to many. Some women who have had an abortion do well. However, others (in 4-10% of cases) show a number of complications. A period of treatment and rehabilitation follows, which lasts up to several weeks. In the first week after a spontaneous miscarriage, a woman may experience abdominal pain. In addition, bleeding may occur. In the first two weeks after an abortion, you must refrain from sex. Seek medical attention immediately if symptoms such as:

heavy bleeding;

Severe pain in the lower abdomen;

High fever and convulsions;

Cardiopalmus;

Nausea and vomiting.

Immediately after a spontaneous miscarriage, it is necessary to identify the reason why this happened. To date, there are a huge number of specialized medical centers, turning to which a woman will receive qualified recommendations on what needs to be done.

Experts recommend planning the next pregnancy only two months after the miscarriage. In order not to become pregnant before this time, it is necessary to use reliable contraceptives. According to statistics, if a woman becomes pregnant immediately after a miscarriage, the likelihood of a recurrence of the situation increases several times. However, if pregnancy does occur, you should not panic. Under the close and constant supervision of doctors, the outcome can be positive.

Is it possible to protect yourself from spontaneous miscarriage?

In order to minimize the risk of spontaneous miscarriage, it is recommended:

A woman who has just learned about her interesting position needs to:

1. Do not postpone for later, but go to the doctor as soon as possible, get tested and register for pregnancy.
2. Give up all bad habits (smoking, alcohol and drugs) and reduce the amount of coffee and strong tea consumed.
3. Reduce physical activity and avoid sports that can lead to injury.

A miscarriage (spontaneous abortion) is a spontaneous termination of pregnancy before 22 weeks of gestation. Accordingly, they are divided into early and late. According to the dynamics of what is happening, they distinguish:

• Threatened abortion
• Started abortion
• Complete (or incomplete) abortion

The division into these types is very conditional, they can flow into each other. For example, a threatened abortion turns into a complete one, and a missed pregnancy still ends with the release of a fetal egg.

How often is a pregnancy terminated?

It is believed that at least 20% of all conceptions end in spontaneous abortion. It is possible that this figure is underestimated. Indeed, many women are not even aware of an interrupted pregnancy when it occurs at week 4, taking it for a late period. The percentage of such events increases with the age of the woman.

Some statistics:

• 80% of all sudden abortions are losses in the 1st trimester
• 90% of losses in the first trimester and about 30% in the second are due to random chromosomal abnormalities that most likely will not happen again
• more than half of all women with a threatened miscarriage successfully carry a pregnancy up to 40 weeks
• at age 40, a woman has a 50% risk of miscarriage.

Possible causes of abortion

Unfortunately, it is not always possible to establish the exact cause of such an event. Most of the worries of parents planning a new pregnancy after a failure are associated with this.

Developmental Disorders of the Embryo

Almost 90% of pregnancies terminated before 8 weeks were associated with a mutation. Chromosomal anomalies are, as it were, “screened out” by nature in order to prevent the birth of unviable children. Therefore, abroad at such an early date they do not even try to treat a threatening abortion.

Immune failures

The phrase "antiphospholipid syndrome" in recent years inspires fear in all women who have ever lost their pregnancy. It is this diagnosis that they try in vain to find with spontaneous abortion up to 12 weeks, passing unnecessary tests.

APS is a syndrome in which the body produces antibodies to its own proteins. As a result, thrombosis, thromboembolism occur in the absence of visible causes of miscarriage in the early stages of 10 weeks. In addition, there is an increased risk of fetal growth retardation and severe preeclampsia. True APS requires treatment throughout all subsequent pregnancies.

To diagnose the syndrome, in addition to the detection of antiphospholipid antibodies, certain symptoms are needed (unexplained miscarriage, thrombosis). Therefore, it makes no sense to be tested for APS during the first pregnancy or after a single loss of it in the early stages.

Uterine anomalies

Congenital defects of the genital organs, for example, an incomplete uterine septum, increase the risk of spontaneous abortion by almost 2 times. Surprisingly, more severe disorders (bicornuate and bicervical uterus) are less likely to result in miscarriage.

Cervical (isthmic-cervical) insufficiency

In the second trimester, the role of cervical insufficiency increases in the structure of spontaneous miscarriages. In this case, the cervix softens and shortens prematurely, which leads to the outflow of amniotic fluid and the onset of labor. The cause of this condition may be trauma during gynecological manipulations, anatomical features, frequent induced abortions. Most often, this process occurs asymptomatically, only occasionally discharge or pain may appear. Therefore, absolutely all women in the period of 19-21 weeks need to undergo cervicometry - measuring the length of the neck using an intravaginal ultrasound sensor.

Hormonal causes

There is some evidence that it may be low. Luteal phase deficiency is a manifestation of progesterone deficiency. In reality, this condition is less common than the diagnosis sounds. Sometimes NLF is combined with changes in the ovaries, pituitary gland and other endocrine organs. Very often, low progesterone is successfully combined with a normal pregnancy.

infections

High temperature and severe intoxication of the mother's body can stimulate uterine contractions and cause abortion. Therefore, any infection is potentially dangerous. However, some diseases especially often threaten miscarriage. These are rubella, toxoplasmosis, listeriosis, brucellosis (see). Other infections are not associated with an increase in abortion rates. It is important to note that in the case of repeated abortions, the role of infection is sharply reduced.

Systemic diseases of the mother

There are diseases that not only complicate the course of pregnancy, but can increase the frequency of spontaneous abortions. These include:

• (with poor glucose control)
• Blood clotting disorder
• Autoimmune diseases

Poisoning and injury

A clear link between toxic substances and abortion has not been established. It is believed that working with organic solvents and narcotic gases can provoke an abortion. Smoking, large doses of alcohol and drugs have the same effect.

Abdominal injury accidents and ovarian and intestinal surgeries can be dangerous during pregnancy. But the embryo in the uterus has good protection, so most of these interventions end well.

Myths about the causes of early pregnancy loss

Before 13 weeks, abortion is almost never associated with the following factors:

• Airplane flight
• Mild blunt abdominal trauma
• Sports activities (adequate)
• One previous miscarriage before 12 weeks
• sexual activity
• Stress

• In case of infection of the genital tract (if the bleeding is prolonged, for example), the doctor prescribes antibiotics. It makes no sense to take them only for preventive purposes during self-abortion. If its completion was stimulated by misoprostol, then the fever on the first day will be due to the drug, not infection, so do not worry. During surgery, a single prophylactic antibiotic is usually prescribed.
• If pregnancy loss was accompanied by significant bleeding, then iron supplements may be required to treat anemia.
• Under certain circumstances, the gynecologist may recommend taking contraceptives. But with uncomplicated spontaneous abortion at different times, you can start planning a pregnancy as soon as the psychological mood appears.
• With habitual miscarriage (3 or more spontaneous abortions in a row), it is necessary to undergo additional procedures and pass tests.

Examination for habitual miscarriage

If spontaneous abortion is repeated 2 or more times (and by some standards - 3), then this condition is called habitual miscarriage. It requires careful examination and clarification of the reasons. An approximate plan for examining and solving the problem:

Survey	Treatment when a problem is identified
Analysis of environmental, social conditions and habits	Exclusion of bad habits, normalization of body weight, housing and psychological conditions
Karyotyping of abortus and parents (determination of the chromosome set)	In case of chromosomal breakdowns, a thorough genetic examination of the embryo in subsequent pregnancies is necessary.
Ultrasound of the pelvic organs,	Removal of fibroids, polyps, uterine septum and other anatomical defects
Tests for APS	With a confirmed syndrome in the next pregnancy, taking low molecular weight heparin and aspirin to thin the blood
Thrombophilia tests (only if the woman and her immediate family had a history of thrombosis)	Appropriate treatment
Checking the functioning of the thyroid gland (the level of TSH and other hormones)	Treatment (often with L-thyroxine)
Test for hyperprolactinemia (high)	Treatment with dopamine agonists
Determination of glycated hemoglobin (in diabetes mellitus)	Treatment with insulin
Tests for STIs (CMV, herpes, chlamydia, gardnerellosis, etc.), as well as toxoplasmosis.	If necessary, eliminate the infection

Prevention of pregnancy loss

The main task for all women planning to become mothers is to approach their new status wisely. It is important to take only the necessary drugs (folic acid, iron), get rid of bad habits and stress. For repeat abortions, additional testing and treatment may also reduce the risk of failure. But most importantly, you need to understand that most women with pregnancy losses in the past managed to become pregnant, endure and give birth to healthy children.

FAQ

Two years ago there was a fading of pregnancy for a period of 7 weeks. Now I am pregnant again, the period is 5 weeks, the doctor prescribed Utrozhestan in candles. Is there any evidence for this? Will the drug harm the child?

A frozen pregnancy alone is not an indication for the appointment of Utrozhestan. Perhaps there are other reasons for taking it that you did not specify. In such a situation, Utrozhestan does not pose a danger to the child.

The gestation period is 16 weeks. Starting from the 14th week, heavy bleeding continues. According to ultrasound, the fetus is alive, there is a large hematoma. It worries that the level of hemoglobin is rapidly falling, doctors are setting up an interruption. Is there a chance to keep the pregnancy with heavy bleeding?

Could a cold at 7 weeks cause a miscarriage?

Theoretically, high temperatures can promote abortion. But in such a short period of time, spontaneous genetic damage is most likely.

How long after an unsuccessful pregnancy (ended at 6 weeks) can you plan a new one?

If there are no complications, you can start planning immediately. But it is better to wait 1-2 menstrual cycles for psychological preparation and folic acid intake.

What are the symptoms at 2 weeks with a miscarriage?

If we consider the obstetric method for determining the gestational age by the last menstruation, then at 2 weeks there has not even been a conception. If we mean the age of the embryo, then it corresponds to a period of 4 weeks. Such an interrupted pregnancy is called biochemical, since nothing can be seen on ultrasound yet. Therefore, the symptom will be bleeding, coinciding in time with menstruation or with a delay of several days.

You still easily fit into tight jeans, have not yet encountered morning sickness, age spots, stretch marks on your stomach. But you already have a test with two red stripes - the main proof of your belonging to the happy class of pregnant women.

Your treasure is still quite tiny. Only the most sensitive equipment can detect its presence in your womb. But this does not prevent you from coming up with a name for him, talking to him and stopping at stores with children's clothes to look after something for an unborn, but already existing baby. But this joyful prospect, this rosy illusion can be interrupted overnight by a terrible and inexorable word Miscarriage.

According to statistics, 15-20% of all pregnancies end in miscarriages.

In most cases, this happens when a woman does not yet realize that she is pregnant. But sometimes it happens to those who have already become attached to their belly-maker and fell in love with him. How to console a woman in this case? Only next pregnancy. But those who have had such a misfortune in their lives, and those who have not yet known the bitterness of loss, should go through a small educational program on issues related to miscarriage. The most important thing is to know what factors can cause miscarriage, and what can be done to prevent miscarriage.

The conversation will focus on early miscarriages that occur for up to 12 weeks, because the vast majority of them happen during this period.

The most common causes of miscarriages in early pregnancy

1. Genetic disorders in the fetus
   According to statistics, about 73% of miscarriages occur for this reason. As a rule, these genetic defects are not hereditary in nature, but are the result of single mutations that occurred in the germ cells of the parents under the influence of harmful environmental factors (radiation, occupational hazards, viruses, etc.). Termination of pregnancy for this reason is a kind of natural selection - getting rid of weak, non-viable offspring. It is almost impossible to prevent such a miscarriage, you can only reduce the risk of genetic abnormalities even before conception, by protecting yourself from the effects of mutagenic factors as much as possible. But with modern ecology, the probability of mutations still remains, because miscarriages that occur for this reason can be considered a boon, because they save a woman from many problems and troubles in the future.


2. Hormonal disorders
   When the balance of hormones in a woman's body is disturbed, early pregnancy termination often occurs. Most often this happens with a lack of the main hormone of pregnancy - progesterone. With the timely detection of this problem, pregnancy can be saved with the help of progesterone preparations. An excess of male sex hormones can also cause an early miscarriage - they suppress the production of estrogen and progesterone. Androgens are often the cause of recurrent (habitual) miscarriages. The adrenal and thyroid hormones also influence the formation and development of pregnancy. Therefore, dysfunction of these glands can also cause miscarriage.


3. Immunological causes
   As a rule, this happens with a Rh-conflict. The embryo inherits the Rh-positive father, while the mother's Rh-negative body rejects embryonic tissues that are foreign to it. To prevent miscarriage in case of immune conflict, progesterone preparations are used, which in this case have an immunomodulatory effect.
4. Sexually transmitted infections: trichomoniasis, toxoplasmosis, syphilis, chlamydia, as well as herpetic and cytomegalovirus infection often cause miscarriage.
   Pathogenic bacteria and viruses cause infection of the fetus, damage to the membranes, resulting in a miscarriage. To prevent this from happening, it is advisable to treat infections before pregnancy.


5. Common infectious diseases and inflammatory diseases of the internal organs.
   All diseases accompanied by intoxication and an increase in body temperature above 38 ° C can lead to miscarriage. Rubella , viral hepatitis , flu are in the lead in this list . Even a banal sore throat can become fatal at 4-10 weeks of pregnancy. And pneumonia, pyelonephritis, appendicitis are a serious risk to the fetus. That is why, when planning a pregnancy, it is worth undergoing a complete medical examination, identifying and treating all foci of chronic infection.


6. History of abortion
   Abortion is not just a medical manipulation: it is a huge stress for the female body that can cause dysfunction of the ovaries, adrenal glands; contributing to the development of inflammatory processes in the genital organs. This can cause infertility and habitual miscarriages in the future.


7. Medicines and herbs
   In the first trimester of pregnancy, it is advisable to avoid taking medications altogether. Many of them can cause abortion or cause the formation of developmental defects in the fetus. So, for example, narcotic analgesics or hormonal contraceptives often become the culprits of abortion. You also need to be careful with medicinal herbs: parsley, nettle, cornflower, St. John's wort, tansy - are contraindicated in early pregnancy.


8. stress
   Strong fright or unexpected grief, resentment or prolonged mental overstrain are dangerous for a small creature in your womb. If you, by the will of fate, are forced to be under the influence of stress, discuss with your doctor the possibility of taking sedatives, at least the same valerian.


9. Unhealthy Lifestyle
   Alcohol, drugs, smoking, regular coffee consumption, improper and malnutrition - all of these are allies of a miscarriage. It is better to correct your lifestyle even before conception.


10. Falls, heavy lifting, sexual intercourse
    All this, although rare, can become a trigger for abortion, so take care of yourself, and therefore your baby!

Pregnancy is a period of joyful expectation, which, unfortunately, is often interrupted by such a terrible phenomenon as a miscarriage. According to statistics, approximately 1/5 of all pregnancies end in miscarriage. Although we note that most of them happen at a very early date, that is, at a time when many still do not even know about their pregnancy.

Note! If a miscarriage occurs before two weeks, then no symptoms of this are often observed.

But sometimes a tragedy happens to those who have already managed to sincerely love the baby, and the only ray of light for them is the realization that they can soon try to get pregnant again. But in order for a miscarriage to never happen again, you need to know about the main factors that provoke it. So, today we will talk about an early miscarriage (no later than the 12th week).

It is worth noting that in the later stages this happens extremely rarely.

The most common symptoms are aching pain in the lower abdomen and bleeding (of any intensity). Pain (it has a wave-like character) is sometimes transmitted to the lower back. Allocations may also indicate a threat of miscarriage, and if they are brown or red, then you should definitely go to the hospital.

Note! With severe bleeding, the chances of saving a child are much less than with a small one. But if the discharge contains pieces of flesh, then the miscarriage has already happened.

Less commonly, the symptom is uterine tone, accompanied by pain and discomfort. And if the tone is not accompanied by anything, then in such cases, doctors advise reducing the number of stressful situations and reducing physical activity. Sometimes, even if all the above signs are present, pregnancy proceeds normally, but, of course, only under medical supervision.

If at least one of the symptoms has been noticed, then you should immediately go to the hospital.

Main reasons

1. Genetic abnormalities are the cause of miscarriage in ¾ of cases. But there is no need to panic, because these violations are usually random and occur due to radiation, various kinds of viral infections, and so on. Such miscarriages can be considered one of the forms of natural selection, when nature gets rid of sick or non-viable offspring.
   
2. Hormonal imbalances can also trigger an interruption. Often this leads to a deficiency of progesterone, although with timely diagnosis and treatment, the child can be saved (a course of hormonal drugs is prescribed). Another violation is an increased concentration of the male hormone that prevents the production of estrogen and progesterone.
3. Sometimes a Rh conflict occurs, that is, when the mother and the fetus have different Rh factors. As a result, the mother's body sees something foreign in the embryo and, therefore, rejects it.
   
   
4. Infectious diseases that are sexually transmitted also cause abortion. These include chlamydia, gonorrhea, syphilis, etc. In addition, there is also cytomegalovirus with herpes, which provoke miscarriage in about 1/5 of cases. It must be remembered that most infections occur without any symptoms, so it is recommended to do tests for STIs before conception and, if necessary, undergo treatment, otherwise the pathogenic virus will infect the fetus and provoke a miscarriage.
   
5. previous abortions. If a woman has already had an abortion, this can lead to miscarriage or, in the worst case, infertility.
   
6. Wrong way of life. Even at the planning stage, you should give up bad habits.
7. At an early stage, taking any medications is undesirable, otherwise defects in the development of the embryo may occur.
   
8. Severe stress, tension, grief - all this can have a negative impact on the development of a new life. In such cases, it is permissible to use some sedative drugs, but only as directed by a doctor.
   
9. Rarely, too frequent hot baths lead to spontaneous miscarriages. Of course, no one forbids pregnant women to swim, but one should not forget about safety. So, too high water temperature is not allowed, and the duration of the procedure should not exceed 15 minutes.
10. Excessive exercise or accidental falls can lead to a miscarriage, but only if one of the above reasons is present.

Note! Usually the fetus dies before its excretion begins.

Classification of miscarriages

Note! The most effective way to diagnose a miscarriage is an ultrasound scan performed by an experienced doctor.

If the embryo has come out completely (in this case, it looks like a rounded gray bubble), and the uterus has cleared itself of fetal fragments on its own, then the woman does not need further therapy. Usually, the clearing lasts for 2-3 weeks after the miscarriage and is manifested in bloody discharge (sometimes with white particles). But if the fetus came out in parts or a frozen pregnancy happened and it continues to be in the uterus, then a gynecological cleaning of the uterine cavity will be required (the procedure is also called curettage or curettage).

Note! Many consider brushing to be an over-precaution. If a miscarriage occurs at home, then after the rejection of the embryo, women often do not resort to medical care, believing that they no longer need it. But in reality this is not so.

Not in all cases, the fetus is completely out of the body. If not cleaned, the residues will begin to decompose, which will lead to the spread of pathogenic microorganisms and, as a result, inflammation. Therefore, if the termination of pregnancy occurred outside the hospital, you should immediately consult a doctor, because only a qualified specialist will be able to assess the condition of the body and determine whether cleaning is required. And if the doctor strongly recommends curettage, then you can’t refuse the operation! Otherwise, the consequences will be the most deplorable.

How is cleaning done? Under normal conditions, this should be done two to three days before the onset of menstruation (so the uterus will recover faster), although after a miscarriage this, of course, is not always possible. Cleaning is carried out on a gynecological chair. First, an injection is made of a drug that puts the woman to sleep, then a special dilator is inserted into the vagina, which allows you to visually observe the cervix. Next, a probe is inserted into the uterus to perform hysteroscopy - examination of the uterine cavity using a portable video camera. Such an examination allows for maximum safety of the operation, since the surgeon can see how the cleaning is carried out.

For the scraping itself, a curette is used - a surgical instrument resembling a spoon. The doctor carefully scrapes off the surface layer of the walls of the uterus, and the extracted material is subsequently used in a histological examination. Roughly speaking, the operation lasts about half an hour.

Curettage, like any other surgical operation, can lead to complications. The most common uterine bleeding occurs in women with hemophilia. Oxytocin injections are given to prevent bleeding. If the discharge is too strong, the woman must immediately inform the attending physician.

Another possible consequence is the accumulation of blood clots in the uterine cavity (hematometra), which can cause inflammation. This is a consequence of cervical spasms at the end of the procedure. To prevent hematomas, before starting the operation, you need to take antispasmodics (for example, no-shpu), which help the uterus relax.

Finally, after cleaning, the uterine mucosa may become inflamed, and therefore, at the end of the procedure, antibiotics are prescribed. It is extremely important that all doctor's recommendations are followed. The main symptoms of inflammation are abdominal pain and high fever.

Note! As you can see, it is very important to know about the possible consequences of curettage and warn the doctor in time if weakness, abdominal pain, fever, etc. appear.

Serious problems are rare. Complications can be if a miscarriage is provoked by folk / medicines or, for example, if after that particles of the embryo remain in the uterine cavity (although the latter usually happens at a later date). And to prevent this, after a miscarriage, an ultrasound should be performed.

In addition, you need to go to the hospital even when the next menstruation goes “wrong” (too heavy discharge, pain).

What conclusions can be drawn? Curettage after a miscarriage is not always required (an exception is a frozen pregnancy, in which it is mandatory), but in any case, you need to undergo an appropriate examination.

	Research
In time of miscarriage (if detected missed pregnancy)	1) Ultrasound of the small pelvis with a transvaginal sensor (for congenital anomalies of the genital organs, myomatous nodes). 2) During curettage during missed pregnancy and incomplete miscarriage, histological analysis of the contents of the uterine cavity. 3) Cytogenetic analysis of the fetus for genetic abnormalities.
After a miscarriage /ZB/ (immediately)	1) Testing for latent infections (TORCH-complex), namely sowing on ureaplasma, mycoplasma; antibodies to chlamydia, herpes virus, human papillomavirus, cytomegalovirus. 2) Genetic research For woman: --- Karyotype study and determination of the frequency of spontaneous chromosomal aberrations (and many other studies) For a man: ---Study of the karyotype and determination of the frequency of spontaneous chromosomal aberrations ---Investigation of microdeletions of the AZF locus in the Y chromosome ---Study of the most common mutations in the cystic fibrosis gene (and many other studies) 3) Spermogram
After a miscarriage /ZB/ (in 1-3 months)	1) Testing for latent infections (TORCH-complex), namely sowing on ureaplasma, mycoplasma; antibodies to chlamydia, herpes virus, human papillomavirus, cytomegalovirus 2) A smear from the vagina for gonococcus and flora (purity of the vagina). Bacterial culture for group B streptococci 3) Determination of hormone levels /etradiol, progesterone, FSH, LH, 17-OP, testosterone, dehydroepiandrosterone (DHEA), 17-ketosteroids, prolactin, thyroid hormones/ - at the beginning of the cycle 5-6 days - in the middle of the cycle - at the end of the cycle 21-25 days You can find out more about when to donate which hormones HERE 4) Tests for the diagnosis of antiphospholipid syndrome (APS) ---Venous blood test for lupus anticoagulant (LA) --- Blood test for antiphospholipid antibodies 5) Determination of the titer of autoantibodies to cardiolipin, DNA, thyroid gland, nerve growth factor 6) Immunogram 7) Coagulogram and hemostasiogram (blood clotting control) 8) Typing for class 2 tissue compatibility antigens (HLA) for both spouses 9) Determination of the level of blood homocysteine ​​(indicates an increase in the frequency of genetic failures)
Front planned pregnancy (prevention repeated miscarriages and ST)	1) Careful sanitation infections; translation of chronic infections in the remission phase. 2) Exclusion of male sperm /fractionation of sperm into X and Y fractions, followed by insemination with X fraction, which excludes the birth of a boy/, if miscarriage (MC) is associated with fetal pathology linked to X chromosome /boys in the family in such a situation either die in utero or are born sick/. 3) Progesterone with it insufficient content in the blood plasma. 4) Rh0-(aHTH-D)-Ig (anti-rhesus immunoglobulin) immediately after curettage or miscarriage if the woman's blood is Rh-negative. 5) Drugs that reduce blood hypercoagulability. Treatment antiphospholipid syndrome. 6) Treatment of isthmic- cervical insufficiency by suturing the cervix with a circular suture for a period of 14-18 weeks. Treatment of anomalies and myomas with surgery way.