Miscarriage A pregnancy loss that occurs before 20 weeks of gestation, that is, long before the fetus can survive outside the uterus. About 10 - 15% of all pregnancies end in her loss, and 40% of miscarriages go unnoticed for a woman, because she does not even suspect that she was pregnant.

Causes of miscarriages

The causes of miscarriages are not well understood, but most abortions occur when the pregnancy does not develop normally. There is usually nothing a woman or her doctor can do to prevent this condition.

Most miscarriages occur in the first trimester of pregnancy () and are worn. In many cases, the cause remains unknown.

However, a number of factors can contribute to a miscarriage in the first trimester of pregnancy:

1. Chromosomal abnormalities in the fetus - More than 50% of early miscarriages are caused by chromosomal problems in the fetus. Chromosomes are thread-like tiny structures in every cell of the body that contain our genes. Each person has 23 chromosome pairs, consisting of an equal number of maternal and paternal chromosomes.

Most chromosomal abnormalities result from damage to an egg or sperm cell that contains an extra chromosome, or, conversely, that does not have enough chromosomes. As a result, the embryo receives the wrong number of chromosomes, and this usually leads to a miscarriage. The presence of chromosomal abnormalities is more likely in too mature parents, thus the risk of miscarriage increases with age.

2. Empty gestational sac or molar pregnancy - a condition in which there is no embryo in the fetal egg. This happens either when the embryo does not form at all, or when its development stops at a very early stage. Often an empty fetal egg is a consequence of chromosomal abnormalities.

Early in pregnancy, a woman may notice that her pregnancy symptoms have disappeared and she may experience vaginal bleeding (most often dark brown). On ultrasound, the doctor sees an empty amniotic sac. Ultimately, such a pregnancy ends in a miscarriage, but sometimes this can drag on for several weeks.

3. Mother's health status Hormonal problems, infectious diseases, diabetes, thyroid disease, and other autoimmune diseases can increase the risk of early miscarriage. Treating these conditions before (and even during) pregnancy can sometimes help prevent miscarriage.

4. Mother's lifestyle Women who abuse alcohol or use drugs are at increased risk for miscarriage. A recent study found that women who consume more than 200 milligrams of caffeine per day (about 350 grams of coffee) are twice as likely to have miscarriages as women who do not consume caffeine. Therefore, women who are already pregnant or just trying to get pregnant should not consume more than 200 mg of caffeine per day.

Late miscarriages or miscarriages of the second trimester - spontaneous termination of pregnancy for a period of 13 to 19 weeks of pregnancy - occur less frequently, in about 1 - 5% of cases.

Late pregnancy losses are most often caused by problems with the uterus or a weakened cervix (cervical insufficiency) that begins to dilate prematurely. Late miscarriages can also be caused by chromosomal abnormalities, infections, and maternal health conditions.

Miscarriage symptoms

Vaginal spotting or bleeding, sometimes accompanied by lower abdominal cramps (as with menstruation) or more severe abdominal pain, may be a sign that a woman may have miscarriage.

However, many pregnant women have spotting in the early stages, but with a timely visit to the doctor, miscarriage can be avoided. A woman should immediately contact her doctor if she notices any bleeding (even light spotting) during pregnancy. Her primary care physician will perform an internal exam to assess the condition of her cervix (for signs of a miscarriage), order an ultrasound and blood tests.

miscarriage treatment

Most women who have had an early miscarriage do not need treatment. As a rule, the uterus clears itself, and the woman notices this as a very heavy period.

However, if the doctor sees on an ultrasound that there is tissue left in the uterus, or if the woman is bleeding heavily, she may recommend treatment to clear the uterine cavity. This can be done through a surgical procedure called curettage (uterine cleansing) in which the cervix is ​​dilated and tissue is removed from the uterus using a vacuum extractor or a surgical instrument called a curette.

In some cases, a doctor may offer a woman the option of using misoprostol to expel any remaining tissue from the uterus. Recent studies show that misoprostol is effective in 84% of cases. This drug, along with Mifepristone, is also used for medical abortion in the early stages (up to 7 weeks) of pregnancy.

Examinations after a miscarriage

As a rule, if miscarriage occurred for the first time and in the first trimester of pregnancy, the woman does not conduct any additional studies and tests. The reasons for these early losses are often unknown, so doctors chalk it up to chromosomal abnormalities.

If a woman has a miscarriage in the second trimester, or has had two or more miscarriages (called a habitual miscarriage) in the first trimester of pregnancy, a gynecologist will usually recommend a series of tests to determine the cause.

Analyzes to determine the cause of habitual miscarriage are as follows:

• A blood test for chromosomal abnormalities, which is taken from both parents (called a karyotype) and for some hormonal and immune system problems, disorders in the mother's body;
• Analysis for chromosomal abnormalities of tissues resulting from a miscarriage (if tissues are available);
• ultrasound of the uterus;
• Hysterosalpingography (x-ray of the uterus);
• Hysteroscopy (examination of the uterine cavity using a special device (hysteroscope), which is inserted through the cervix into the uterus);
• Biopsy of the endometrium (pinching off a small piece of the endometrium (the lining of the uterus).

Recovery of a woman after a miscarriage

In order to recover physically after a miscarriage, a woman needs from a week to a month (or more), depending on how long she was pregnant. So, for example, some pregnancy hormones remain in the blood of a woman after a miscarriage for another 1-2 months. The menstrual cycle in most women resumes 4 to 6 weeks after the miscarriage.

But emotional recovery can take much longer! A woman (and a failed father) can experience many emotions, including shock, sadness, guilt, depression, and anger. Both partners will handle grief in different ways, thereby creating tension between them at a time when they need each other the most. Therefore, parents who have suffered a pregnancy loss need to rally, and together it will be easier for them to survive the tragedy.

Pregnancy after a miscarriage

A woman should not try to get pregnant again until she is physically and emotionally ready for it. In addition, before getting pregnant again, one should try to find out the cause of the miscarriage.

Medically, a woman can become pregnant again after she has had one normal menstrual cycle if she is not treated for the cause of her last miscarriage.

However, in order for a woman to be mentally prepared to become pregnant again after a miscarriage, much more time must pass, preferably at least two to three months.

Miscarriage, spontaneous abortion - spontaneous pathological termination of pregnancy. Spontaneous abortion ends in 15-20% of clinically established cases of pregnancy. These numbers are a low estimate, as many miscarriages occur in the early stages, before the woman realizes she is pregnant, with clinical signs of miscarriage being mistaken for heavy or delayed periods.

The threat of miscarriage is a pathology and in some cases is subject to inpatient treatment. Different from a medical abortion performed on purpose.

Gynecologists in Nizhny Novgorod are ready to help you.

Types of miscarriages

The 2009 WHO Glossary of Terms for Assisted Reproductive Technologies distinguishes between the following types of miscarriages (spontaneous abortions):

Biochemical pregnancy (preclinical spontaneous abortion) - a pregnancy that has not reached the clinical stage and is determined only by the results of the analysis of chorionic gonadotropin in blood serum or urine;

Spontaneous abortion (miscarriage) is a spontaneous termination of a clinical pregnancy that occurred before 20 completed weeks of gestational age, that is, within 18 weeks after fertilization. With an unknown gestational age, spontaneous abortion is considered the loss of an embryo or fetus weighing up to 400 g.

A live or stillbirth birth that occurs between the 22nd and 37th completed weeks of gestational age is classified as a preterm birth.

Classification of miscarriages

The clinical picture of threatened abortion describes any bleeding during pregnancy before fetal viability, which has yet to be assessed further. On examination, it may be found that the fetus remains viable and the pregnancy continues without further problems.

Alternatively, the following terms are used to describe that the pregnancy is no longer ongoing:

• An empty sac is a condition where the gestational sac develops normally while the embryonic part is either missing or stops growing very early. Another name is an empty fetal egg.
• Inevitable abortion describes a condition in which the cervix is ​​already dilated and open, but the fetus has not yet been expelled. Typically, this condition will progress to a complete abortion.
• Complete abortion - exclusion of all products of conception. Products of conception may include the trophoblast, villi, chorion, yolk, embryo, and, in late pregnancy, the fetus, umbilical cord, placenta, amniotic fluid, and amniotic membrane.
• An incomplete abortion occurs when tissue is shed, but some parts of the fetus or embryo remain in utero.
• Frozen (non-developing) pregnancy - the death of the fetus or embryo and the absence of a miscarriage. Another name is a delayed or missed miscarriage.

The following two terms describe further complications or consequences of a miscarriage:

• A septic abortion occurs when tissue from a missed or incomplete abortion becomes infected. Infection of the uterus carries the risk of spreading the infection (sepsis) and is a serious threat to a woman's life.
• Recurrent miscarriage or recurrent miscarriage (medical term for habitual abortion) is the occurrence of three consecutive miscarriages. If the proportion of pregnancies ending in one miscarriage is 15%, and assuming that miscarriages are independent events, then the probability of two consecutive miscarriages is 2.25%, and the probability of three consecutive miscarriages is 0.34%. The occurrence of intermittent pregnancy loss is 1%. The vast majority of women (85%) who had two miscarriages had a normal birth thereafter.

The physical symptoms of a threatened pregnancy vary depending on the duration of the pregnancy:

• For up to six weeks, only small blood clots may be present, accompanied by moderate cramps and occasional pain.
• For a period of 6 to 13 weeks, many clots up to 5 cm in size, parts of the fetus, may appear. This process can take several hours or, periodically paused and resumed, last several days. Symptoms vary widely and may include vomiting and diarrhea, possibly due to physical discomfort.
• Starting at 13 weeks, the fetus can easily leave the uterus, but the placenta is more likely to remain completely or partially in the uterus, leading to an incomplete abortion. Physical symptoms: Bleeding, cramps, and pain that may resemble early miscarriage, but are sometimes more severe and similar to those of childbirth.

Signs and symptoms

The most common symptom of a miscarriage is bleeding (threatening miscarriage). Half of the women who seek medical attention for bleeding during pregnancy will have a miscarriage. The remaining symptoms are not statistically associated with miscarriage.

A miscarriage can be detected during an ultrasound scan or through a series of human chorionic gonadotropin (hCG) levels. There are medical options for terminating a pregnancy with a documented non-viable fetus that has not been expelled naturally.

Psychological symptoms

Despite the fact that physically a woman recovers quickly after a miscarriage, psychological rehabilitation can take a long time. Much depends on the individual: for some, a few months is enough to move on, while for others it may take more than a year. A survey (GHQ-12 General Health Questionnaire), which interviewed women with an abortion, showed that half (55%) of them experienced a significant psychological disorder immediately after the termination of pregnancy, 25% within 3- x months; 18% - 6 months, and 11% during the year after the miscarriage.

The feeling of loss, lack of understanding from others is of great importance. People who have not experienced a miscarriage find it difficult to empathize with those who have. Pregnancy and miscarriage are often not mentioned in communication because the topic is too painful. This can make a woman feel more isolated from everyone. The interaction of pregnant women with newborn babies is painful for parents who have experienced a miscarriage. Sometimes this makes it difficult to communicate with friends, acquaintances and family.

Causes of miscarriages

A miscarriage can occur for a variety of reasons, not all of which can be identified. Some causes are genetic, uterine or hormonal disorders, genital tract infection, and tissue rupture.

First trimester

Most clinical miscarriages (two-thirds or three-quarters in different studies) occur during the first trimester. Chromosomal abnormalities occur in more than half of the embryos after a miscarriage in the first 13 weeks. Pregnancy with genetic problems with a probability of 95% ends in a miscarriage. Most chromosomal problems happen by accident, have nothing to do with the parents, and are unlikely to recur. Chromosomal problems related to the genes of the parents, however, are possible. In the case of repeated miscarriages, there is a possibility of genetic disorders in one of the parents of the child. Also, this reason should be considered if the parents have children or close relatives with disabilities or defects. Genetic problems are more likely to occur with older parents.

Another cause of early miscarriage can be progesterone deficiency. For women with low progesterone levels in the second half of their menstrual cycle (luteal phase), progesterone support during the first trimester may be recommended. However, no study has shown that first trimester drug progesterone supplementation reduces the risk of miscarriage (when the mother may have already lost the baby). Even the link between luteal phase problems and miscarriage is in question.

Second trimester

Up to 15% of pregnancy losses in the second trimester may be due to a uterine defect, a growth in the uterine cavity (fibroids), or problems with the cervix. These conditions can also contribute to preterm labor.

One study found that 19% of pregnancy losses in the second trimester were due to problems with the umbilical cord. Problems with the placenta can account for a significant number of late term miscarriages.

General Risk Factors

• The age of the pregnant woman.
• Multiple pregnancy.
• Diabetes mellitus in the stage of decompensation (uncontrolled). Because diabetes can develop during pregnancy (gestational diabetes), an important part of prenatal care is monitoring for signs of the disease.
• Polycystic ovary syndrome. Two studies showed that metformin treatment significantly reduced the miscarriage rate in women with polycystic ovary syndrome. However, a 2006 review of metformin treatment during pregnancy did not find sufficient evidence of safety.
• High blood pressure (preeclampsia).
• Severe hypothyroidism. The presence of antithyroid autoantibodies is associated with an increased risk of miscarriage.
• Some infectious diseases: measles, rubella, chlamydia, etc.
• Smoking. An increased risk of miscarriage is also associated with a father who smokes. One study noted a 4% increased risk for husbands who smoked less than 20 cigarettes a day and 81% for husbands who smoked more than 20 cigarettes a day.
• Drug addiction.
• Physical injury, exposure to environmental toxins.
• Use of the IUD at the time of conception.
• The antidepressants paroxetine and venlafaxine can lead to spontaneous abortion.

Suspected Risk Factors

Several factors have been associated with a higher rate of miscarriages, but it remains to be seen if these are the causes of miscarriages.

Some research suggests that autoimmune diseases are a possible cause of recurrent or late miscarriage. Such diseases occur when the immune system acts "against the host organism". Thus, it destroys the growing fetus or interferes with the normal progression of the pregnancy. Further research has also shown that autoimmune diseases can cause genetic disorders in embryos that. in turn, can lead to miscarriage.

morning sickness

Nausea and vomiting during pregnancy are associated with a reduced risk of miscarriage.

Exercises

One of the risk factors is exercise. The study found that most types of exercise (with the exception of swimming) are associated with an increased risk of miscarriage before 18 weeks. High-impact exercises are especially associated with an increased risk of miscarriage. No relationship has been found between exercise and miscarriage after 18 weeks of gestation.

Diagnosis of a miscarriage

A miscarriage can be detected using special ultrasound equipment. When looking for microscopic pathological symptoms of a miscarriage, you should look at the picture. The microscopic ones include villi, trophoblast, parts of the fetus. You can also perform genetic tests to look for abnormal chromosomes. The role in morphological research is to identify and study morphological changes in the material obtained during spontaneous abortions.

Actions in the event of a threatened miscarriage

Blood loss during early pregnancy is the most common symptom. In case of blood loss, pain and both, a transvaginal ultrasound is performed. If the viability of intrauterine pregnancy is not established by ultrasound, then certain serial tests must be performed to rule out an ectopic pregnancy, which is life-threatening.

No treatment is necessary to diagnose a complete abortion. In the event of an incomplete abortion, an empty pouch, or a miscarriage, there are three treatment options:

If left untreated (watchful waiting), things will happen naturally within two to six weeks. This way avoids the side effects caused by drugs and surgeries.

Medical treatment usually consists of the use of misoprostol and helps to complete the miscarriage.

Surgical treatment (most often vacuum aspiration) is the fastest way to complete a miscarriage. It also reduces the duration and severity of bleeding, and helps to avoid the physical pain associated with a miscarriage. In the case of recurrent miscarriage, vacuum aspiration is also the most convenient way to obtain tissue samples for karyotype analysis. However, this operation also has a high risk of complications, including the risk of damage to the cervix and the uterus itself, uterine perforation, scarring, and a potential intrauterine lining. This is an important factor for those women who would like to have children in the future, maintain their fertility and reduce the likelihood of future obstetric complications.

There is currently no way to prevent miscarriage. However, experts believe that identifying the causes of a miscarriage can help prevent it from recurring in future pregnancies.

Epidemiology of miscarriages

Determining the prevalence of miscarriage is difficult. Many miscarriages occur early in pregnancy, before the woman knows she is pregnant. Prospective studies using very early pregnancy tests have shown that 26% of miscarriages occur within six weeks of a woman's last menstrual period. However, there are other sources that say otherwise:

University of Ottawa: "The spontaneous abortion rate is 50% of all pregnancies due to the fact that many terminate pregnancies spontaneously and without clinical intervention.

The NIH reports: "Up to half of all fertilized eggs die before the woman knows she is pregnant. Among those women who know they are pregnant, miscarriage is about 15-20%. Clinical miscarriages occur in 8% of pregnancies.

The risk of miscarriage drops sharply after 10 weeks from a woman's last menstrual period.

The prevalence of miscarriage increases significantly with the age of the parents. Pregnancy at 25 has a 60% lower risk of miscarriage than pregnancy at 40.

It's good when the pregnancy is desired. However, two clear stripes on the test do not at all guarantee that the baby will be all right until birth. Sometimes the female body, for some reason, independently gets rid of the fetus some time after its appearance. We are talking about miscarriage in early pregnancy. Why is this happening and is there a way to prevent trouble?

Let's turn to impartial statistics: a quarter of all early-term pregnancies are doomed to spontaneous termination. In order to be able to influence the course of events, it is important to know the causes of a miscarriage and its signs.

How does an early miscarriage occur?

Unfortunately, in the presence of serious prerequisites for spontaneous abortion at an early stage, it is almost impossible to reverse the pathological process. The fetus at this time is so small that the woman does not even understand what is happening to her. At first glance, it looks like the resumption of the menstrual cycle after a long delay (1 - 2 weeks). Menstruation, more abundant than usual, is accompanied by pulling pain in the lower abdomen. In addition, not all women go to the hospital after the incident. Only a few get to see a doctor - mostly those who are frightened by the appearance of a blood clot that has come out, resembling a torn bladder. Ideally, all women need a medical examination - if there really was a miscarriage, then additional cleaning may be necessary after it.

When a woman is aware of her "interesting" situation, it is much easier for her to predict the onset of a spontaneous miscarriage at an early date. First of all, you should carefully monitor the sensations in the lower abdomen and back. Painful dull and pulling spasms, smearing discharge with bloody or tissue lumps signal danger. If you seek medical help immediately, there is a chance to keep the pregnancy.

An early miscarriage is said to be when the pregnancy ends spontaneously before the 12th week of the fetus's existence. A late miscarriage occurs for up to 22 weeks, and subject to the timely and coordinated actions of doctors, a premature baby has every chance of surviving.

Early miscarriage: prejudice

There are many myths in society about the causes of spontaneous abortion. How to avoid an early miscarriage, you will be told on any women's forum, but not all advice can be trusted. It is reliably known that before the 12th week of pregnancy, the following factors do not pose a threat to the intrauterine development of the fetus:

• air travel by plane;
• minor blunt trauma in the abdomen;
• moderate exercise;
• a single case of spontaneous abortion up to 12 weeks in history;
• active sex life;
• stress.

The real causes of miscarriage in the early stages

Doctors cite many socio-biological and medical factors as the reasons for spontaneous abortion. It is often very difficult to determine what exactly caused the misfortune: sometimes a miscarriage is based on one factor, and sometimes a whole complex. A certain percentage of women are familiar with this pathology firsthand: the unfortunate survived several miscarriages in a row. In medical circles, this phenomenon was designated as habitual miscarriage. We list the most serious and common factors that cause the threat of miscarriage in the early stages:

• most often, the body itself gets rid of non-viable offspring if the appearance and development of the fetus is associated with a certain anomaly or genetic pathology. This may be a hereditary “breakdown” at the gene level or a spontaneous mutation caused by radiation, a dangerous virus, or a difficult environmental situation. Medicine, alas, cannot change or prevent this process. That is why thorough preparation for the upcoming pregnancy is impossible without the advice of future parents from a geneticist;
• a significant danger to the normal development of pregnancy is a violation of the immune and hormonal systems. A woman needs to pass the necessary check at the stage of planning a child, then doctors will be able to eliminate all the "pitfalls" in advance. Quite often, progesterone deficiency, an excess of androgens, pathologies in the activity of the thyroid gland and adrenal glands become an obstacle to fulfilling the dream of motherhood;
• Another urgent problem for the successful development of the fetus in the womb of a woman is the Rhesus conflict. The mother's body reacts to the fetus as a foreign object and gets rid of it, since the Rh factor of its blood is with the “-” sign, and it was taken from the father with the “+” sign. If concerns about this are real, the situation is corrected with the help of immunomodulatory therapy even at the stage of pregnancy planning;

• The undoubted enemy of a healthy pregnancy is infection (regardless of origin). In particular, these are all diseases that are transmitted “through the bed”: herpes, cytomegalovirus, toxoplasmosis, syphilis, chlamydia, trichomoniasis, etc. Pathogens, affecting the fetal membranes, infect the fetus, which leads to miscarriage at an early stage of pregnancy;
• a disappointing ending of early pregnancy awaits a woman with chronic inflammatory and infectious diseases of internal organs. The most insidious of them: viral hepatitis, rubella, pneumonia, influenza, severe tonsillitis;
• it is extremely difficult for the female body to cope with pregnancy because of the stress caused by abortion. Artificial termination of pregnancies in the past threatens with secondary infertility and habitual miscarriage in the future. A woman must certainly inform the doctor about such facts of her biography during pregnancy planning;

• one should not ignore such individual characteristics of the female body, such as, for example, congenital anomalies of development and oncological diseases of the internal genital organs, ICI. These and other pathologies exclude pregnancy as such.

The first symptoms of a miscarriage in the early stages

The nature of the development of a miscarriage excludes simultaneity - spontaneous abortion can be divided into several stages. So, let's find out how to determine an early miscarriage.

The first "bells" are painful sensations covering the back in the lumbar region and lower abdomen. Often at the same time, brownish or reddish clots stand out from the genital tract. Blood during an early miscarriage is a very dangerous sign that indicates that tissue detachment has begun. Even a few drops of blood on underwear are a serious reason for immediate medical attention. Reliable prevention of spontaneous abortion is a regular visit to the antenatal clinic for a routine examination and delivery of all necessary tests. Only in this way will the expectant mother be sure that everything is in order with her baby.

What does an early miscarriage look like: the main stages

The first stage of the pathology, the signs of which we learned above, is very common in expectant mothers. To save the baby, expectant mothers are forced to lie on the conservation of almost the entire prenatal contractions. The initial stage of the pathology is marked by hypertonicity of the uterus, bleeding and discomfort, reminiscent of contractions.

The second stage of violation leads to more serious consequences. At this moment, all the signs already indicate a full-fledged miscarriage at an early stage: a fragmentary detachment of the fetal egg from the inner wall of the uterus begins. However, at this time, the trouble can still be prevented, doctors say. This is possible thanks to the immediate and coordinated intervention of professionals, provided that the pregnant woman got to the hospital in a timely manner.

The next stage of spontaneous abortion at an early stage is a miscarriage on the go. Now there is nothing to help the fetus. The pregnant woman is suddenly seized by sharp spasms, bleeding begins almost immediately - the most convincing sign of an early miscarriage. This indicates the final death of the fetal egg, which comes out in whole or in part (incomplete miscarriage). In the photo, a fetal egg with an early miscarriage:

Pathology ends with a complete spontaneous abortion. After an early miscarriage, the uterus contracts and quickly returns to "pre-pregnant" size. A complication in this case is an incomplete abortion or missed pregnancy (diagnosed on ultrasound), when there is a high risk of pus formation or the onset of sepsis.

How to recognize a miscarriage early

At first glance, it is quite simple to determine a miscarriage, so some women believe that if they feel well after the incident, they can neglect a visit to the hospital. However, this is a dangerous delusion: all signs of spontaneous abortion at an early stage are also characteristic of other, more serious diseases that, without proper diagnosis, can be mistaken for a miscarriage:

• ectopic pregnancy;
• malignant formation in the cervical region;
• bloodless torsion of an ovarian cyst;
• cervical injury.

These conditions can be excluded only within the walls of a medical institution.

What to do with an early miscarriage

Unfortunately, doctors are not able to radically change the course of events at the very beginning of pregnancy - you cannot go against nature.

It is common practice to prescribe Tranexam to stop bleeding. If a woman has had several failed pregnancies in the past, Utrozhestan will be prescribed. When, thanks to the efforts of doctors, the pregnancy can be brought to the second trimester, with a threatened miscarriage, it is worth applying stitches or a pessary if there is a short cervix with isthmic-cervical insufficiency. In principle, this is where the methods of dealing with pathology end.

Now we list what will not help in the process of developing a miscarriage:

• bed rest - a conscious decrease in the mother's motor activity cannot stop a miscarriage if there are real prerequisites for its accomplishment;
• taking drugs: No-shpa, Papaverine, Magne B6, Analgin.

A few weeks after a complete miscarriage, a woman needs to see a doctor and donate blood to analyze the level of hCG. If all indicators are normal, there is nothing to worry about. However, if the level of the hormone has not decreased at all, or has decreased, but has not dropped to the required minimum, there is a possibility of a mole. This is a dangerous complication that requires immediate medical attention.

An abortion in progress can be completed in several ways. If, during the examination, blood is still excreted from the vagina, and the fetal egg or embryo is still in the uterus, the doctor may determine the following tactics of action:

• expectant approach lasting up to 7 days (perhaps the body will reject the unnecessary without outside interference);
• a drug approach (a woman is prescribed Misoprostol, under the influence of which the uterine muscles are strongly compressed and bring the remnants of the fetal egg out);
• surgical cleaning (if vaginal bleeding becomes massive).

How to prevent early miscarriage

To exclude all possible factors that provoke an early miscarriage, you need to acquire offspring under the professional guidance of a doctor. To do this, a woman undergoes a full examination not during pregnancy, but even at the stage of planning a child. This is the only way to make sure that there are no various “breakdowns” at the cellular level and internal pathologies. Moreover, future parents are reviewing and adjusting their usual lifestyle in accordance with the upcoming changes: at this stage, it is important to put an end to addictions, adjust the daily routine and diet.

Early miscarriage: how to understand where to go next

After such a crushing failure, the woman is recommended to undergo a rehabilitation course of treatment. If the cause of the incident could not be established earlier, doctors will conduct the necessary diagnostics to determine it now. This is important, otherwise a woman runs the risk of facing the same problem the next time she prepares for motherhood.

The ultrasound procedure is a mandatory step after an early miscarriage. If there are fragments of an egg or embryo in the uterus, a woman will need a cleaning to avoid the development of inflammation or infection. After all the necessary procedures, the doctor will prescribe the patient a course of antibiotic therapy, which will exclude various infectious diseases, as well as a course of hormones that will put the woman's endocrine system in order.

Among other things, a failed mother is in dire need of professional psychological support. The loss of a baby, even if it is so tiny, leaves an indelible imprint in the mind of a woman. It is important to experience this moment with the support of a psychologist or relatives.

It is wrong to fence oneself off from the outside world and remain alone with one's misfortune, so negative emotions will simply “eat up” all hope for the best. Psychologists recommend that women who have experienced a miscarriage not be ashamed of their feelings and not hold back aggression and tears - the sooner you can get rid of them, the faster the recovery will come. And in no case should you be afraid of the future: modern medicine and competent doctors will do everything possible so that a new pregnancy ends with the triumphant cry of a long-awaited baby!

The threat of early miscarriage: causes, timing, symptoms, how to keep the pregnancy

THREATS OF MISSION AT EARLY TERMS

Spontaneous rejection of the fetus during pregnancy called a miscarriage. According to statistics, in recent decades, the number spontaneous miscarriages women increased to 16% of all planned pregnancies . This material details the causes of spontaneous abortion, describes the signs of a threatened miscarriage, how a miscarriage occurs and looks like, as well as the timing of early and late rejection of the fetal egg.

What signs of a threatened miscarriage should I pay attention to first of all during pregnancy?

If a woman is regularly disturbed by weak pulling pain in the lower abdomen and periodically appear smearing highlights of red with an admixture, you should immediately go for an examination to a gynecologist, since such symptoms can be harbingers of the onset of fetal rejection . The sooner the threat of spontaneous miscarriage is identified and treatment is started, the more the probability of preserving the fetus and carrying the child safely until the end of the gestation period.

Severe bleeding and the like contractions constant pain in the lower abdomen in early pregnancy are symptoms of the rejection of the fetus in the uterus (photo). In this case, prevent risk of spontaneous miscarriage does not seem possible. It is extremely important to call an ambulance as soon as possible in order to promptly stop bleeding and replenish .

WHAT A MISSION LOOKS LIKE

In case of spontaneous miscarriage at 5-7 weeks of pregnancy , a fetal egg will come out of the uterus with grayish red streaks the size of a quail egg (see photo below). What does a miscarriage look like at 8- 12 weeks pregnant - if the fetal egg comes out completely with all the shells, then it will be the size of a chicken egg, elongated, possibly flesh-colored with veins. On the later pregnancy miscarriage, as a rule, comes out with shell fragments.

CAUSES OF EARLY MISSION

- hormonal disorders. If a during pregnancy in the female body there is an imbalance hormonal background , then it might happen early fetal rejection . Typically, the cause of a miscarriage is lack of the hormone progesterone in the body of a pregnant woman . If this problem can be detected in time, then the threat of miscarriage can be prevented by treatment with special preparations with progesterone.
Violation thyroid function and adrenal glands can cause early fetal rejection. If the content of male hormones in a woman's body is too high, then they suppress the release of estrogens and the same progesterone. Androgens often cause 2 miscarriages in a row or more (recurring).

- genetic abnormalities in the developing fetus. Reduce the risk of miscarriage in this case, it is extremely difficult, since the mechanism of natural selection is turned on and the woman's body gets rid of the embryo with abnormal deviations in genetic development.

-pathologies of internal organs, infectious diseases.
Often viral hepatitis , rubella and flu are a threat of early miscarriage, especially with a weakened immunity of a pregnant woman . If an infectious disease causes a woman's temperature to rise to 38 C and above, as well as severe intoxication, that is chance of fetal rejection . Before pregnancy planning it is necessary to eliminate all foci of the spread of infection in the body ( pyelonephritis , pneumonia, etc.).

- some medicinal herbs and medicines.
Medicines should be used with extreme caution during pregnancy and only with the permission of your doctor! Some drugs can cause fetal defects and induce a miscarriage. At an early stage - in the 1st trimester of pregnancy, it is advisable not to use any medications and folk remedies at all. For example, hormonal drugs and analgesics can cause a threatened miscarriage in early pregnancy. Even such common greens in folk methods of treatment as parsley, tansy, St. John's wort are not recommended for use. in the first trimester of pregnancy , especially - at 4-7 weeks .

- Rhesus conflict in a pregnant woman.
Immunological disorders during gestation can provoke early spontaneous miscarriage . If a woman has an Rh-negative blood factor, and the embryo has inherited an Rh-positive factor from her father, then the female body can identify the fetus as a foreign body and begin to reject it. If reveal Rhesus conflict up to a possible threat of miscarriage , then you can prescribe immunomodulatory therapy using drugs with progesterone.

- stressful situations, emotional instability, severe fear.
Frequent mental stress, unexpected fear, severe grief can cause spontaneous miscarriage (see photo). If you are often stressed or depressed, talk to your doctor about the use of sedatives such as valerian.

- lifting and carrying heavy objects, severe falls with bruises can cause spontaneous abortion. Try to take care of your safety, as you are responsible not only for your health during pregnancy . The threat of early miscarriage is especially high if you neglect your own safety.

- and another common reason in recent decades, capable of causing miscarriage both early and late pregnancy Unhealthy Lifestyle. If a pregnant woman eats food that is harmful to her body and fetus, drinks a lot of coffee, drinks alcohol and smokes, then the chance cause spontaneous miscarriage increases significantly.

HOW DOES A MISSION HAPPEN. SYMPTOMS OF SPONTANEOUS TERMINATION OF PREGNANCY

Miscarriage in early pregnancy - symptoms

Miscarriages that occur in the first 12 weeks of pregnancy , are called early, and in the period from 12 to 23 weeks of gestation - late miscarriages.

How does an early miscarriage happen?

- How does a complete miscarriage happen?
During spontaneous interruption, the fetus completely leaves the womb, while pain disappears and bleeding stops.

How does an incomplete (inevitable) miscarriage happen?
The fetal membrane bursts and an increase in the lumen appears in the cervix . Uterine hemorrhages begin lower abdominal pain and in the lumbar region.

- How does a recurrent miscarriage occur?
Occurs rarely. Spontaneous interruption occurs 3 or more times.

- How does a miscarriage happen?
Often found during a visit to the gynecologist. When listening to the fetal heartbeat, there is no heart rhythm. The fetus dies, but does not come out with secretions but remains in the uterus

INDIRECT SIGNS OF MISSION IN EARLY PREGNANCY:

If a woman does not know she is pregnant , red highlights can take for normal menstruation.
How to distinguish between menstrual flow from bleeding during an early miscarriage, if there are no obvious signs of spontaneous interruption?

There are indirect signs of a miscarriage:

- frequent urges of nausea;

Cramps and pulling pains in the lower abdomen;

Noticeable weight loss;

Possible mucus discharge ;

Problems with the digestive system;

Aching pain in the lumbar region.

SIGNS OF THREATS OF MISSION IN LATE PREGNANCY:

- chronically feeling unwell and nausea;

Severe pain in the lower abdomen;

Red and brown discharge ;

Frequent urge to urinate;

Dizziness;

If there is sudden heavy discharge in late pregnancy, the fetus can no longer be saved.

EARLY AND LATE MISSION

Miscarriage 4 to 6 weeks

According to statistics, miscarriage at such an early stage in most cases occurs due to malformations and genetic abnormalities. Often the cause of these pathologies is the use of potent drugs by a woman on the eve of conception.

Miscarriage 6 to 13 weeks

The reasons

- Chronic ill health and a weak immune system body of a pregnant woman. A weakened female body is simply not able to withstand the load during the period of bearing a child.

Another common cause of miscarriage during this period of pregnancy is inflammatory processes, provoked by gynecological diseases, curettage after an abortion, flu, tonsillitis.

- the fetal body is rejected by the female body due to the fact that it was not properly fixed in the womb. It can happen due to endocrine disorders .

- Rhesus conflict provokes the production of antibodies that attack the fetus and causes a threat of miscarriage in the early stages;

- hormonal imbalance in the body of a pregnant woman, it can cause an increased tone of the uterus, which leads to a miscarriage (photo), if the balance of hormones is not corrected in the early stages of pregnancy;

During this period of pregnancy, the anatomical features of the structure of the uterus (bend, other defects) do not allow the fetus to develop normally further and spontaneous miscarriage may occur.

Miscarriage 13 to 22 weeks

The causes of miscarriage in late pregnancy can be immune disorders, anatomical pathologies, endocrine diseases, and infections.

Also, the common causes of late miscarriages include isthmic-cervical insufficiency - a weak cervix opens, as it cannot hold the fetus.

Miscarriage after 22 weeks of pregnancy

The most common cause of miscarriage at this late date is severe damage to the reproductive organs (from bumps, falls). Also spontaneous abortion at a later date, it can cause a woman to perform heavy physical work.

LATE SPONTANEOUS MISSION

According to statistics, the risk of spontaneous termination of pregnancy in the later stages is significantly reduced if the fetus had the opportunity to successfully develop during the first 13 weeks of pregnancy. . Moreover, if the interruption occurs after 22 weeks of bearing a child, then in medical practice this is already considered a premature birth and there are many means for gynecologists in the arsenal of nursing a premature baby.

As a rule, disturbances in the development of the fetus are not the cause of late miscarriage. Causes of late miscarriage include:

- severe stress experienced by a pregnant woman;

Premature exfoliation of the placenta;

Inflammation of the walls of the uterus or placenta ;

Operations on the uterus or vessels can also provoke a miscarriage at a later date.

HOW TO RESTORE HEALTH AFTER A MISSION

Cleaning after a miscarriage and further treatment

In the event that the life and health of a woman after a miscarriage is not in danger, the attending physician suggests allowing the remnants of fetal tissues to come out with secretions on their own within a few days. If the remnants of the fetal membranes and the fetal egg have not come out completely, then a cleaning of the uterus after a miscarriage is prescribed. Cleaning is performed by scraping the uterine cavity (vacuum removal of residues or removal by curettage). Further treatment and the restoration of reproductive functions in a woman after a miscarriage takes place in several directions: the complete elimination of inflammatory processes in the body and detection of latent infections, periodic examination changes in basal temperature and planned ultrasound of the intrauterine cavity, the imposition of a circular suture on a weak cervix (if necessary: ​​if a woman has already had 2 miscarriages in a row, then a possible reason is weak cervix ), restoring the hormonal background in the body.

Period after miscarriage

Any deviations that occur during the menstrual cycle after a miscarriage should be a reason to seek advice from a gynecologist.

Often after interruption, monthly discharge resume a few weeks later or other pathological conditions are observed menstrual irregularities in a woman - for example, bleeding does not end.
It is possible that in the womb, even after cleaning, there are still particles of the fetal shell. In this case, it is necessary to do an ultrasound scan and, if necessary, repeat scraping. If everything is in order, the doctor prescribes hemostatic drugs that help the uterus contract more actively and recover after scraping.

Pregnancy after a miscarriage

After a miscarriage, you must definitely undergo the necessary examinations and pass the necessary tests. It is important to accurately identify the cause of spontaneous abortion and completely eliminate it.

You can not rush into a new pregnancy after an early or late miscarriage. A woman must restore the emotional and physical balance in the body. It is advisable to plan a new pregnancy after a miscarriage not earlier than 1 year later. Theoretically, you can get pregnant 2 months after a spontaneous abortion, but each subsequent miscarriage reduces the chances of a woman

How does a miscarriage occur, in what weeks does it become possible and why? These are important questions that worry the heads of expectant mothers. After all, they can perceive any slight tingling in the abdomen or vaginal discharge as symptoms of a miscarriage in the early stages. Let's figure it out.

The most worrying time, according to doctors, is the first trimester. Immediately after conception and up to 12 weeks. During this period of time, the laying and formation of all organs and systems takes place, while the embryo itself is very susceptible to any negative influences and changes. So, spontaneous miscarriage can occur due to taking Nurofen, a non-steroidal anti-inflammatory drug that doctors so often prescribe to relieve pain and fever. That is why it is so important to know right away that pregnancy has occurred, and not to take medicinal, and even folk, drugs for treatment at your own discretion. And during the consultation, it is imperative for the doctor to say that you are “in a position”, so that he takes this into account when prescribing treatment. Many medications are toxic to the fetus, their use can lead to the formation of numerous malformations in it.

And yet, at what time can a miscarriage occur most often? Some doctors refer to weeks 4, 8, 12 as when a new menstrual cycle was supposed to begin. But scientists deny this. They say that the most dangerous are 6-8 and 10-12 weeks. Moreover, in the first case, most often the embryo dies first, that is, the pregnancy becomes frozen, and then, after a while, a miscarriage begins. But in the second case, at the end of the first trimester, the expulsion of the ovum occurs more often.

How a miscarriage occurs in the early stages depends largely on the week in which everything happens. For example, abortions often occur literally in the second week of delayed menstruation, when many women are not at all aware of their situation. Toxicosis may not yet begin. Well, the delay ... It happens to everyone. There may be uterine spasms, bleeding. In general, almost everything is like with normal menstruation. Doctors even say that such unidentified miscarriages happen at least once in a lifetime for all women. And the reasons why a miscarriage occurs in these cases is almost always - random deviations in the chromosome set in the unborn child.

But the longer the period, the harder the miscarriage proceeds. The woman already knows about her position, and can adequately respond to pathological symptoms. As we wrote above, up to 10 weeks, miscarriages often occur with an embryo that has already stopped developing. That is, the pregnancy first “freezes”, and then, after a few days, the uterus gets rid of the “contents”. A woman learns a miscarriage, what it is from her own experience. If doctors diagnose a missed pregnancy in a woman, they are often immediately sent for a “cleansing”. It is possible to diagnose a frozen pregnancy only by passing an ultrasound examination.

At 10 weeks and later, pregnancy in many cases is terminated very quickly. The fertilized egg flakes off and leaves the uterus.

What to do if there was a miscarriage at an early stage of pregnancy, and at the same time you know for sure that you were pregnant? For example, if there was a positive pregnancy test, or you took a blood test for hCG. First of all, you need to do an ultrasound. If you have stopped bleeding, nothing hurts, and according to the ultrasound everything is normal, there is nothing left of the fetal egg in the uterus, you do not need to do curettage of the uterus. Moreover, if the miscarriage was for the first time, even additional examinations are not required. The exception is the desire to have a baby soon and the failure to undergo a standard examination when planning a pregnancy earlier (before a miscarriage).