What are the signs of a miscarriage in early pregnancy. Improper development of the embryo. Medication for miscarriage

It cannot be predicted, because to some extent it is part of nature. It must be remembered that it does not have a long-term effect on the body and does not in any way affect the possibility of becoming a mother in the future.
What is a miscarriage?

A miscarriage, or premature birth, is a pregnancy that has stopped in its development. The embryo has failed to develop and the most common cause is chromosomal aberration. This type of anomaly is not hereditary and does not affect subsequent pregnancy. There is a risk of spontaneous abortion in the first trimester of pregnancy - this statistic affects 10-15% of cases, that is, it happens quite often. The risk increases with age. In some women, a spontaneous abortion occurs in the first two weeks of pregnancy, that is, before menstruation, and the woman may not even notice it. If a miscarriage occurs after 3 months, then it is called late (see p. 192).

Symptoms and signs of early pregnancy miscarriage

The first symptoms are bleeding and uterine contractions, while other pregnancy symptoms disappear, such as tight breasts and nausea. Bleeding, at first slight, subsequently becomes profuse - it lasts for several days, then quickly stops. The menstrual cycle returns to normal, and after a month, menstruation appears.

What to do if miscarriage occurs during early pregnancy?

Need a doctor anyway

If bleeding occurs, it is urgent to inform your doctor about it so that he can identify a possible cause. If the bleeding is not profuse, your doctor will order an ultrasound scan and blood tests to check for a possible ectopic pregnancy.

The aim of the study is to establish an initial diagnosis. If we are talking about miscarriage, then ultrasound shows that the embryo does not develop and it does not have cardiac activity. In some cases, it is necessary to conduct two ultrasound examinations to establish an accurate diagnosis.

Two options

Most often, if the diagnosis is established, the doctor removes the egg from the body either medically or by surgery - curettage, or curettage, under general anesthesia. Hospitalization lasts no more than one day. In some cases, the gynecologist prefers to wait until the body expels the foreign body on its own, after which it is necessary to meet with the doctor again to make sure that the egg is completely removed from the body. If the expectant mother has a negative Rh factor (see p. 72), the doctor will prescribe gamma globulin.

After an early miscarriage?

• If a future pregnancy was seen as a joy and hope for the future, then a miscarriage is perceived as a bereavement. Endless sadness becomes a response emotion. Each woman reacts differently, depending on how long she has been waiting for this child, what her personal life is, and how long it happened.
• But the psychological trauma is obvious and requires maximum sensitivity from loved ones. At the time of miscarriage, various fears may arise (the sight of blood, fear of what will happen, and the associated complications) and anxiety about the future (can I get pregnant again? Will it happen again?). The most important thing is to be honest with your doctor about your fears, and also to discuss it with your partner. Your doctor will reassure you that the miscarriage does not affect future pregnancies. This period can also be very difficult for your partner.
• After three early miscarriages, it is necessary to conduct a detailed examination to find out the cause.

Prevention of miscarriage in early pregnancy

Do not overwork

Take frequent breaks from any work. The fatigue that suddenly falls on you is associated with pregnancy. This is physiological fatigue that cannot be neglected. If the work you are doing is exhausting you, talk to your boss about changing your schedule. Rest as soon as possible while thinking of your child.

Avoid physical activity

Physical activity causes muscle contractions of the uterus, leading to a gradual detachment of the ovum, which is still weakly attached to its wall.

From this point of view, it is better not to start moving during pregnancy. Examining various options, climbing and descending stairs, carrying suitcases and settling in a new place are fraught with terrible fatigue. Wait with the move until the beginning of the 3rd month.

Also, do not plan long trips. The road is always tiring, moreover, on the road there are often no basic conditions for observing the rules of personal hygiene, and it is difficult to follow the dietary regimen for pregnant women.

You found blood on your panties

Don't panic. Blood can appear in the case of a small crack in the anus or vaginal varicose veins. To understand the reason for the appearance of blood, blot these places with a cotton swab. If traces of blood do not appear, then this means that the bleeding is uterine.

See your gynecologist immediately. He can easily establish the cause and source of bleeding (vaginal or uterine).

• Bleeding can be caused by an infection. In this case, it is necessary to undergo appropriate treatment.
• Blood may appear during the first 3 months of pregnancy on the days of your menstrual cycle on which you had your period.

You have bleeding and pain in the lower abdomen

Call your doctor immediately and go to bed. A miscarriage is possible, but there may be other reasons.

While your breasts are dense and painful to the touch, while you are tormented by toxicosis, the pregnancy continues. The doctor will prescribe you an antispasmodic agent and ask you to take a blood test for the content of chorionic hormones.
You will then be given an ultrasound scan (ultrasound).

From the end of the 3rd week, the embryo is already clearly visible. A recorded heartbeat also confirms pregnancy.

If the cervix is ​​not closed by a mucous plug, the doctor will prescribe full bed rest. If the fetus develops normally, then after taking precautions, all symptoms that worry you will disappear.
The causes of bleeding will help to establish an ultrasound scan.

Resorption of the second ovum

It happens that next to the developing fertilized egg there is another, smaller one with an embryo, the heartbeat of which is not recorded. We are talking about a twin ovum, which for unknown reasons has ceased its development and is gradually absorbed. After its disappearance, a healthy egg continues to develop normally.

Empty ("white") egg

It may happen that during an ultrasound examination, an empty fetal bladder with minor cell debris is visible on the display screen inside the uterus. In all likelihood, for some reason, the pregnancy was interrupted and the ovum degenerates.

Placenta location

If the placenta is located low enough, not far from the internal os of the uterus, then during uterine contractions, slight blood discharge from the placenta is possible. In such cases, no special measures are required. Good rest is essential.

Causes of early pregnancy miscarriage

Abnormal development of the embryo

Miscarriages are more likely to occur in the first three months of pregnancy. Most of them (70%) happen at the end of the second month. The reason may be genetic disorders in the normal development of the embryo, leading to its self-destruction. Such a miscarriage is seen as a "happy accident" - not the birth of a child with deformities.

Underdeveloped uterus

If the uterine cavity is too narrow, then the rapidly developing embryo becomes pinched. In this case, bleeding appears before the expulsion of the ovum. A similar miscarriage can occur in the first pregnancy, but it does not threaten in subsequent ones.

Hormonal Disorders

A poorly developed corpus luteum produces an insufficient amount of hormones that support pregnancy. They are not enough until the 4th month of pregnancy, that is, until the moment when the already sufficiently developed placenta takes over this function.

Infections

Toxoplasmosis can lead to miscarriage.

A miscarriage is the loss of a pregnancy within the first 22 weeks after conception.

The main symptom of a miscarriage is vaginal bleeding, which is accompanied by cramps and pain in the lower abdomen. Scanty bleeding from the vagina is quite common in the first trimester of pregnancy (first 12 weeks) and is not an unambiguous sign of miscarriage.

Various factors can provoke a miscarriage, although the exact cause cannot always be determined. Most often, pregnancy loss occurs due to circumstances beyond the woman's control. most women miscarry only once and the next pregnancy proceeds normally.

Miscarriages are far more common than many people think. The probability of this is approximately 1: 7. Very often, miscarriages occur unnoticed by a woman, when she still does not realize that she is pregnant. Three or more miscarriages in a row (the so-called habitual miscarriage) are rare, in about 1% of women.

If you know that you are pregnant and have noticed bloody vaginal discharge and abdominal pain, call an ambulance by calling your home phone 03 or mobile 911 or 112. The ambulance will take you to the gynecological department of the hospital, where doctors will conduct an examination: examination, analysis for hCG and ultrasound of the genitals.

Treatment tactics will depend on the duration of the pregnancy, the desire to keep the baby and the type of miscarriage. In the early stages of miscarriage, it is possible to maintain the pregnancy with a regimen and medication. If a miscarriage has already occurred, it will be necessary to remove the remnants of fetal tissue and placenta from the uterine cavity, which is possible with the help of medication or surgery.

Miscarriage symptoms

The most common symptom of a miscarriage is vaginal bleeding. Bloody discharge is scanty or abundant, bright red or brownish brown. Bleeding may periodically disappear and resume over several days. However, slight vaginal bleeding is quite common in the first trimester of pregnancy (first 12 weeks) and is not a clear sign of a miscarriage.

Other symptoms of miscarriage:

• cramps or pain in the lower abdomen;
• discharge of fluid from the vagina;
• discharge of fetal tissue from the vagina;
• cessation of pregnancy symptoms such as nausea, tenderness, and breast engorgement.

Most miscarriages occur in the early stages of up to 4-8 weeks, less often up to 12 weeks. At this time, a woman may not yet know about pregnancy and take the appearance of bloody discharge for the next menstruation. More often such cases end well. However, the development of severe complications, sometimes life-threatening, is possible. For example, the appearance of bloody discharge and abdominal pain against the background of a slight delay in menstruation is characteristic of an ectopic pregnancy, which can lead to the death of a woman from bleeding and shock.

Another cause of complications can be an infection of the uterus - endometritis, accompanied by high fever, prolonged discharge and abdominal pain. Another cause of complications is cystic drift - the development of atypical, tumor tissues from the remnants of the ovum. Therefore, if vaginal bleeding occurs outside of menstruation, contact your gynecologist as soon as possible.

Causes of miscarriage

It is not always possible to establish the exact cause of a miscarriage, but there are many factors that can affect the course of pregnancy. A miscarriage in the first trimester of pregnancy (from 1 to 12 weeks) usually occurs due to fetal developmental disorders, genetic defects. Early miscarriages account for approximately 75% of all cases.

Early miscarriage

Early pregnancy loss can be accidental, but there are several factors that increase the likelihood of a miscarriage. The age of the mother matters here:

• in women under 30, the risk is 10%;
• in women 35–39 years of age, the risk is 20%;
• in women over 45, the risk is more than 50%.

Other risk factors:

• smoking during pregnancy;
• drug use during pregnancy;
• drinking more than 200 mg of caffeine per day (a cup of tea contains about 75 mg of caffeine, a cup of instant coffee - about 100 mg);
• Drinking more than two units of alcohol per week: A unit of alcohol equals 250 ml of medium-strength beer, a small glass of wine, or 25 ml of spirits.

One of the immediate causes of early miscarriage may be a chromosomal abnormality. Chromosomes are densely packed DNA molecules that contain genetic information about every aspect of a baby's growth, development, and appearance, right down to eye color. Sometimes, for unknown reasons, a malfunction occurs during conception, and the embryo forms the wrong set of chromosomes. This means that the fetus will not be able to develop normally and a miscarriage occurs. It is estimated that about 60% of all miscarriages are due to chromosomal abnormalities.

Another possible cause is abnormalities in the placenta. The placenta is the tissue that connects the circulatory system of the mother and the fetus. If there is any malfunction during the formation of the placenta, this can lead to a miscarriage.

Second trimester miscarriage

The risk of miscarriage in the second trimester is increased with some chronic conditions, such as:

• diabetes mellitus (decompensated);
• extremely high blood pressure;
• lupus (a disease in which the immune system attacks healthy tissue);
• overactive thyroid gland;
• celiac disease (gluten intolerance).

The following infectious diseases also increase the risk of miscarriage:

• cytomegalovirus infection;
• toxoplasmosis;
• malaria.

The likelihood of miscarriage increases with the following medicines:

• misoprostol (taken to treat stomach ulcers)
• retinoids (analogs of vitamin A, used to treat eczema and acne);
• methotrexate (taken to treat rheumatoid arthritis);
• non-steroidal anti-inflammatory drugs (used to relieve pain and inflammation)

Before taking this medicine, make sure it is suitable for pregnant women.

Features of the structure of the uterus and tumors. Abnormal uterine structures and growths in the uterus (for example, benign growths, so-called fibroids) can also lead to miscarriage in the second trimester.

Weakness of the cervix. In some women, the muscles of the cervix are weakened. This is called ischemic-cervical insufficiency (ICI), which usually occurs as a result of trauma after surgery in the area. This can lead to premature dilatation of the cervix, causing miscarriage.

Polycystic ovary disease (PCOS). With polycystic disease, a woman's ovaries are enlarged, which can cause hormonal imbalances in the body and terminate pregnancy. Polycystic disease is considered the leading cause of infertility. Research findings also suggest that the condition increases the risk of miscarriage in women who are fertile. However, the exact relationship between them has not been established.

Misconceptions about miscarriage

If there are no other aggravating reasons, that is, the woman is healthy and the pregnancy is developing normally, the following factors do not increase the risk of miscarriage:

• the psychological state of the pregnant woman, such as stress or depression;
• shock or severe fright;
• physical activity (the level of permissible physical activity should be discussed with a doctor);
• lifting weights or straining;
• work during pregnancy;
• sex during pregnancy.

Habitual miscarriage

Many women, having experienced a miscarriage, are afraid that it will happen again. But only 1% of women face repeated miscarriages. Three or more miscarriages in a row are called recurrent miscarriages. However, this problem is treated, and most women with this diagnosis manage to become pregnant and give birth to a healthy child.

Miscarriage diagnosis

Examination for a suspected miscarriage usually includes an examination by a gynecologist, transvaginal ultrasound and hCG analysis. The examination will confirm whether there was a miscarriage, as well as whether parts of the ovum remained in the uterus (complete or incomplete miscarriage).

First of all, the doctor will conduct a gynecological examination in order to examine the vagina, cervix, identify the source of bleeding, areas of greatest pain, assess the size of the uterus.

Then, as a rule, a transvaginal ultrasound examination (ultrasound) is prescribed to accurately determine the size of the uterus, the presence of a fetus or remnants of fetal tissue in the uterus, and fetal heartbeat. To do this, a small probe is inserted into the vagina - a vaginal sensor. This procedure can be a little unpleasant, but it usually isn't painful. If you wish, you can carry out an ultrasound scan with an abdominal sensor - through the abdominal wall. Neither type of examination will harm the fetus or increase the risk of miscarriage.

In addition, a blood test is prescribed for hCG - human chorionic gonadotropin. It is a hormone produced during pregnancy. Sometimes progesterone levels are also measured. If the result is doubtful, tests can be repeated after 48 hours. In some cases, it is not possible to immediately confirm a miscarriage on the basis of an ultrasound scan and a blood test. For example, at an early stage of fetal development (less than 6 weeks). In this case, it is recommended to repeat the examination in 1-2 weeks.

Sometimes a miscarriage is diagnosed during a regular antenatal check-up. On the ultrasound, it can be seen that there is no fetal heartbeat or that the fetus is too small for a given period. This is called a frozen pregnancy.

Examination for recurrent miscarriage

3 or more miscarriages in a row are called recurrent miscarriages. In this case, additional tests and examinations are prescribed to identify the causes of miscarriage, although it is not possible to establish them in about half of women. These tests and examinations are described below.

Karyotyping is a cytogenetic study that allows you to study the structure and count the number of chromosomes. With the help of karyotyping, both partners are examined to identify chromosomal abnormalities - a possible cause of pregnancy loss.

If the analysis reveals chromosome abnormalities, you will be referred to a clinical geneticist, a specialist in genetic counseling. He will talk about the chances of a successful pregnancy in the future, as well as about existing treatments, such as in vitro fertilization (IVF).

Blood tests assigned to check the content of the following substances in it:

• luteinizing hormone - involved in the development of the egg;
• antibodies to phospholipids (APL) and lupus anticoagulant (VA) - this test is done twice, six weeks apart, before pregnancy.

Antibodies to phospholipids increase the risk of blood clots, which disrupt the blood supply to the fetus and lead to miscarriage.

Miscarriage treatment

The tactics of treatment for miscarriage depends on its type, stage and examination results.

Early miscarriages (up to 4-8, and sometimes 12 weeks) are often not diagnosed, since the woman does not know that she was pregnant, takes the bleeding for the next menstruation and does not go to the doctor. In some cases, such miscarriages end with a complete cleansing of the uterine cavity, stopping bleeding and restoring general well-being without treatment. However, there is a high probability of dangerous complications that can threaten not only health, but also the life of a woman. Therefore, with the appearance of bloody discharge from the vagina and pain in the lower abdomen against the background of a delay in menstruation, you should contact a gynecologist as soon as possible, and with an already established pregnancy, call an ambulance.

The doctor will conduct an urgent examination and, upon confirmation of the miscarriage, will prescribe treatment. Modern methods of medical and surgical treatment allow in some cases to maintain a pregnancy, and if a miscarriage has already occurred, to avoid complications and restore a woman's reproductive function.

The goal of treatment is to remove completely fetal tissue from the uterus, stop bleeding and prevent infectious complications. If the resulting bleeding indicates a threat of miscarriage (rejection of the fetus has not yet occurred), and the woman wants to preserve the pregnancy, conserving therapy is performed.

If a miscarriage is suspected, a woman is usually admitted to the hospital.

Medication for miscarriage

Drug therapy for miscarriage consists of taking medications:

• shrinking the uterus;
• increasing blood clotting;
• antibacterial and antifungal agents.

Sometimes a special treatment is prescribed to cleanse the uterine cavity from the remnants of fetal tissue. As a rule, a medicine is offered in the form of a medical suppository, which is inserted into the vagina and dissolves there, but if desired, it can be replaced with tablets.

For these purposes, the drug mifepristone is often used, and after two days - misoprostol, which begins to act after a few hours. The result of therapy will be the appearance of cramping pains in the lower abdomen and profuse bleeding from the vagina.

Get a pregnancy test three weeks after taking the medication. If the result is positive, additional tests will be required to make sure you are not having an ectopic pregnancy or a mole.

Surgery for miscarriage

If the miscarriage is accompanied by profuse bleeding, it is urgent to remove the remnants of fetal tissue from the uterus. To do this, the uterine cavity is scraped out with a special surgical instrument, and the resulting tissue is sent to the laboratory for analysis. During the operation, the cervix is ​​opened with a special dilator, if necessary, and the remaining fetal tissue is removed. The operation is performed under general anesthesia.

In some cases, instead of curettage of the uterus, vacuum aspiration is used - a more gentle removal of the contents of the uterus in the early stages of pregnancy. However, this method is not always effective.

In case of large blood loss, transfusion of donor blood components may be required. If you have Rh negative blood, you should receive an anti-D immunoglobulin shot after surgery to prevent Rh conflict in subsequent pregnancies.

Preservation of pregnancy

With the threat of miscarriage, a miscarriage that has begun, and a woman's desire to preserve the pregnancy, special therapy is prescribed:

• bed rest;
• abstinence from sex;
• drugs that reduce uterine contractility and hormonal therapy, depending on the period and condition of the woman.

After miscarriage

As a rule, this is an examination for genital infections, tests for the level of sex hormones depending on the phase of the menstrual cycle, antibodies to phospholipids (APL) and lupus anticoagulant (VA).

It is advisable to plan the next pregnancy and, with a successful attempt at conception, consult a gynecologist as early as possible in order to control the course of pregnancy from the very beginning and prevent possible problems in time.

A miscarriage can have a profound psychological impact. Many people experience a sense of bereavement. You may feel tired, have lost appetite and have little sleep, and feel guilty, shock, or anger (sometimes directed at a partner, friend, or family member who has had a successful pregnancy).

Everyone deals with grief in their own way. Communication with people helps someone, it is too difficult for others to discuss what happened. Some women accept the miscarriage after a few weeks and start planning their next pregnancy. Others, at least for some time, cannot even think about a new pregnancy.

The father of the child may also experience feelings of loss. It may be more difficult for him to express his feelings, especially if he believes that he should support the mother of the child, and not vice versa. Discuss your feelings with each other. If you or your partner can't deal with grief, find a good counselor or therapist. There are also support groups for people who have miscarried.

Abstain from sex until all symptoms have passed. Your period should resume 4-6 weeks after the miscarriage, but your cycle may not return to normal until a few months later. If you don't want to get pregnant, start using birth control right away. Plan your pregnancy in advance: consult your doctor, make sure that you are mentally and physically prepared for this. Remember that most of the time, the miscarriage happens only once, and then you can successfully carry the baby.

Prevention of miscarriage

It is not always possible to prevent miscarriage, since many of its causes do not depend on either the woman or the man. However, some tips can help reduce your chances of losing your pregnancy.

To reduce your risk of miscarriage:

• quit smoking during pregnancy;
• give up alcohol and drugs during pregnancy;
• eat healthy food, eat at least five servings of fresh vegetables and fruits a day;
• try to avoid certain infectious diseases during pregnancy, such as rubella;
• Maintain a normal weight before conception (see below).

If the body mass index exceeds 30, it means obesity. This condition increases the risk of losing a pregnancy. You can calculate your own body mass index or ask your doctor for yours.

To keep yourself and your baby safe, it is best to lose weight before pregnancy. Normal weight avoids the risks associated with obesity during pregnancy. Talk to your doctor about how you can lose weight, or find a good nutritionist.

While there is no evidence to suggest that losing weight during pregnancy will reduce the risk of miscarriage, but healthy eating and physical activity such as walking or swimming are beneficial for all pregnant women. If you have been sedentary, check with your doctor before starting regular exercise during pregnancy.

Sometimes it is possible to determine the cause of the miscarriage, and in such cases, treatment helps to preserve the pregnancy in the future. Some of the treatable causes of miscarriage are described below.

Antiphospholipid Syndrome (APS)- a disease that causes blood clots that can be treated with medication. Studies have shown that the combination of aspirin and heparin (a medicine to prevent blood clots) reduces the risk of miscarriage in women with the condition.

Isthmico-cervical insufficiency (ICI) is a weakening (failure) of the cervix. ICI is eliminated by stitching the neck with a strong thread, which prevents its premature opening. Surgery is usually performed after the first 12 weeks of pregnancy and the suture is removed at about 37 weeks. Sometimes, instead of a suture, a special device is used to fix the cervix - an obstetric pessary.

Desired pregnancy is joy, the meaning of life. But not all pregnancies end positively. In some situations, it happens that the body rejects a new life, usually this happens in the first weeks of pregnancy, that is, an interruption occurs in the early stages.

If you look at the statistics, then a miscarriage occurs in about 20% of women, some of them do not even suspect that they are pregnant. From a medical point of view, a miscarriage is a natural termination of pregnancy that occurs no later than 22 weeks.

According to the dynamics, there are early and late:

• started abortion;
• complete or incomplete;
• threatening;
• undeveloped pregnancy.

There are critical periods during pregnancy when gestation is at risk. The most vulnerable is the first trimester , because the fetus is still developing:

How interruption occurs

As mentioned above, many women do not even assume that they are pregnant, and nothing bothers them at all. Expecting the onset of menstruation, the girl simply notices that she has a delay, and after that menstruation begins, but they go more abundantly and with pain.

In some cases, a miscarriage is characterized only by pain in the lower abdomen, as well as profuse bleeding, but the woman does not consult a specialist if it ends quickly.

If, with a delay, menstruation nevertheless comes, then they pass very painfully, and one day a blood clot comes out ... In this case, we can already say for sure that there was a miscarriage. If you look at the clot, it will look like a bursting bubble. This phenomenon scares many women. After its release, you need to consult a gynecologist, because you may need cleaning. After that, it is better not to become pregnant for a while, it will also be useful to know how to survive an early miscarriage.

Sometimes a woman faces this problem several times in a row (two or more). Doctors call this recurrent miscarriage. The main reasons include the following factors:

Medical causes or health problems of a woman:

Early signs of miscarriage

There are several main points when abortion does not happen all at once. In some cases, it can be stopped. How to prevent the threat of early miscarriage will be described below.

So, the first symptoms of an interruption can be any pain that is accompanied by red or brown discharge. That is why you should not miss scheduled visits to the doctor and tests.

The main stages of miscarriage:

• The risk of spontaneous termination of pregnancy - this can happen at any time, which is why very often women have to lie in preservation. It is characterized by pain in the abdomen and back, as well as bleeding.
• The second stage is the most serious - the onset of miscarriage. At this time, the ovum exfoliates from the walls of the uterus. Doctors believe that at this stage it is possible to save the pregnancy with surgery.
• If the miscarriage is already on the move, then there is no way to save the fetus. The fertilized egg immediately dies, and the cervix is ​​open - this is called incomplete miscarriage. Cleaning is imperative.
• A spontaneous abortion is the last stage, and nothing can be done. The contraction of the uterus causes a miscarriage.

Follow-up treatment

In order to avoid any consequences, it is very important to comply with the doctor's requirements:

• carefully observe the discharge from the genital tract, in case of changes, urgently go for a consultation;
• measure body temperature: if it rises, this may mean inflammation in the body;
• wash the genitals with antiseptic solutions twice a day.

To adjust the hormonal background, a specialist can prescribe medications: COC (Lindinet, Logest). The contraceptive pill is used to prevent re-pregnancy. And also doctors can prescribe Tsifran as an anti-inflammatory agent.

Attention, only TODAY!

Approximately every fifth pregnancy ends with the onset of a spontaneous miscarriage. In most cases, miscarriages occur at a very short time, when a woman does not even know about her pregnancy. There are practically no signs of miscarriage in the early stages of pregnancy up to 2 weeks of gestation.

Symptoms of a spontaneous miscarriage after the third week of pregnancy:

1. Vaginal discharge mixed with blood

The most reliable, but at the same time, the most formidable symptom of the onset of spontaneous abortion is the appearance of uterine bleeding of any intensity - even a slight discharge of ichor. As a rule, at the beginning of a miscarriage, the blood has a brownish color, and as the bleeding intensifies, it acquires a bright scarlet color. The intensity of bleeding can also be very varied and vary from a few drops to very, very intense. Bleeding without medical intervention can continue for quite a long time. With severe blood loss, it will no longer be possible to save the child, but if the discharge is still smearing, then it is necessaryurgently seek help from a doctor.

2. Pain in the uterus and ovaries.

There is an opinion that miscarriage is always accompanied by severe pain syndrome. However, this is not always the case - in some cases, spontaneous abortion is completely painless. But more often than not, the pain appears and then disappears again. In no case do not disregard pain in the back or lower abdomen - this can signal the threat of termination of pregnancy or the beginning of a miscarriage. If pain occurs, immediately consult a doctor - only a doctor knows for sure how a miscarriage occurs and whether it is still possible to try to save your pregnancy.

3. Regular and painful tone of the uterus

Sometimes during pregnancy there is a feeling of intense tension in the lower abdomen. in the early stages it is not so noticeable, but any woman can feel it if she pays attention to this symptom. Increased tone is a contraction of the muscles of the uterus.
What are the symptoms with uterine tone?
The tone of the uterus during pregnancy is accompanied by a number of symptoms:
- Tension and heaviness in the lower abdomen;
- Pain in the lower abdomen, reminiscent of contractions;
- Pain in the pubic area and lower back;
- Firmness to the touch of the abdomen;
- Feeling as if the uterus was turning to stone;
- Shortening of the cervix - this can be seen by the doctor on examination;
- Bloody issues. In this case, you need to immediately call an ambulance and see a doctor.

Does uterine tone lead to miscarriage? Most doctors are inclined to believe not, if the tone is not regular and painful. When a tone arises, gynecologists recommend using safe antispasmodics and lying down until everything returns to normal.

Causes of spontaneous miscarriages in the first trimester (first 12 weeks).

1. Violation of hormonal levels, incl. increased content of male sex hormones in the body of a pregnant woman

If a woman who is in an early stage of pregnancy disrupts the normal hormonal background of the body, spontaneous abortion is possible. Most often, miscarriages are the result of a lack of the most important hormone in the body of a pregnant woman - progesterone. If the problem is detected early, the pregnancy can be saved in most cases. To do this, a gynecologist-endocrine specialist prescribes a course of treatment for a pregnant woman with hormonal pharmacological drugs.

Another hormonal problem is the increased content of male sex hormones in the body of a pregnant woman. These hormones significantly reduce the normal production of progesterone and estrogen, which are responsible for the normal development and course of pregnancy. The hormones produced by the adrenal cortex and the thyroid gland are also responsible for the successful course of pregnancy. Be sure to monitor the condition of these organs before pregnancy. Quite often, spontaneous miscarriage in an early period is caused by this very reason.

2. Causes of the immunological nature

Sometimes a pregnant woman has a complication such as Rh-conflict. This happens if the fetus has inherited a negative blood Rh factor from the father, and the mother has a positive Rh factor. As a result, the body of a pregnant woman perceives the embryo as something alien to it, and begins to reject them. In this case, for the prevention of spontaneous abortion, doctors also use the treatment of a pregnant woman with drugs containing the hormone progesterone, which in this case is the strongest immunomodulator.

3. The presence of genetic disorders in the embryo

According to doctors - geneticists, about 75% of all spontaneous abortions occur precisely because of the presence of various variants of a genetic disorder in the embryo. However, do not be alarmed - in most cases, these genetic defects are random. The cause of such mutations can be a variety of environmental factors - the effects of various viruses, radiation, etc. And a pregnancy terminated for this reason is a kind of "natural selection" that nature needs in order to get rid of unviable and sick offspring. Most often, it is almost impossible to avoid such miscarriages. And is it worth it? After all, if nature itself is trying to avoid the appearance of such a child, it means that he really suffers from the most serious pathologies, possibly completely incompatible with life. After all, if nature itself provokes a miscarriage, the reasons are quite serious.

The only thing that can be done in this situation is to try to avoid its occurrence long before the expected pregnancy by visiting a geneticist who will give you advice on how to do this, or at least minimize the risk. However, unfortunately, given the large number of negative effects of various factors in the modern world, the risk of developing such gene mutations always remains.

4. The presence of infectious diseases in a pregnant woman

There are a huge number of various sexually transmitted infections that provoke spontaneous abortion in the early stages: toxoplasmosis, chlamydia, trichomoniasis, syphilis, gonorrhea and others. And herpes and cytomegalovirus are responsible for 20% of all spontaneous miscarriages in early pregnancy.

A large number of different infections can often proceed without any signs of the disease at all, that is, asymptomatic. Therefore, before you decide to get pregnant, be sure to go through a complete examination of the body, incl. and for the presence of sexually transmitted infections.

Miscarriage occurs as a result of the fact that pathogenic viruses and bacteria lead to infection of the embryo and damage to the membranes. In order to avoid this, you need to undergo treatment before pregnancy. If this could not be avoided, treatment should be started as soon as possible in order to reduce the risk and the degree of negative impact on the fetus.

5. Chronic diseases of internal organs and weakened immunity

If a woman at the very beginning of pregnancy suffered an illness, which is accompanied by intoxication of the body and a significant increase in body temperature, there is a very high probability of spontaneous abortion. The most dangerous diseases are influenza, viral hepatitis and rubella.

However, even the most banal sore throat or runny nose, transferred in the first weeks of pregnancy, can provoke a miscarriage, not to mention such serious diseases as pyelonephritis, pneumonia or appendicitis. Such diseases are a very serious complication that jeopardizes the successful course of pregnancy and the birth of a healthy child.

It is very important to undergo a complete medical examination even before planning a pregnancy. This measure is necessary in order to identify all the foci of chronic inflammation in the woman's body and promptly begin treatment aimed at eliminating them. But even if it was not possible to get rid of chronic diseases before pregnancy, it is necessary to consult a doctor as soon as possible.

6. A history of abortion

Many women, for whatever reason, had abortions. Abortion is not just a surgical intervention in a woman's body, but a very serious stress for him. As a result of artificial termination of pregnancy in a woman's body, complications may arise: significant dysfunction of the adrenal cortex, ovaries and the occurrence of various inflammatory processes of the genital organs. They very often lead to disruption of the normal process of carrying subsequent pregnancies. And habitual miscarriages, and secondary infertility - all this is a consequence of induced abortion. That is why it is so important to protect yourself from unwanted pregnancies. And if, nevertheless, it was not possible to avoid an abortion, when the next pregnancy occurs, notify the gynecologist that you have previously terminated the pregnancy.

7. Taking medications and some herbs

Medicines have the ability to penetrate the placental barrier and have a negative effect on the fetus. It is especially dangerous to take medications inI trimester (first 12 weeks) of pregnancy, because it is during this period that the laying and formation of all vital organs of the fetus occurs. And if during this period drugs act on the fetus, the formation of fetal developmental defects and, as a result, premature termination of pregnancy is possible.

The most dangerous are painkillers containing codeine, some antibiotics, hormonal contraceptives, especially Postinor. If during pregnancy, while you still did not know about it, you took these medications, be sure to inform your gynecologist about this. Such pregnancies require more careful monitoring by doctors. And, if such a need arises, only a doctor should prescribe drugs in case of a threat of miscarriage.

The absolutely false belief that a woman needs to be treated with traditional medicine, that is, herbs, is very widespread. In fact, a pregnant woman should be extremely careful with the use of herbs. Many herbs have a very strong negative effect on the body of a pregnant woman and the formation of the fetus. The most dangerous in the early stages are herbs such as tansy, St. John's wort, nettle. Also, a pregnant woman should remember that such a harmless seasoning, like the usual parsley, often causes an increase in the tone of the uterus and, as a result, spontaneous abortion.

8. Stressful situations

The reasons for an early miscarriage are often commonplace. Very often, various stressful situations have an extremely negative effect on the normal course of pregnancy. Such a stressful situation can be the death of a loved one, divorce, or tensions with relatives. However, close people should remember that under the influence of certain hormones, the emotional background of a pregnant woman becomes very, very unstable. And even the most insignificant reason can become a cause for severe stress - an accidentally dropped word or a broken cup.

If, due to some life circumstances, a pregnant woman is nevertheless forced to undergo various stressful situations, she needs to tell her doctor about the current situation, who will prescribe her sedatives that have a beneficial effect on the state of the nervous system. In no case should you take any anti-anxiety medication without consulting your doctor, because many of them can cause significant harm to the fetus and provoke spontaneous abortion.

Lifting weights and other physical activity provoke spontaneous abortion only in 5% of all cases of miscarriages, but in no case can this danger be ignored. Try to give up heavy physical work during pregnancy, or at least evenly distribute the load, alternating it with rest.

And it is absolutely unacceptable to lift heavy objects. The maximum allowable weight for a pregnant woman is five kilograms. However, very often the real weight of bags with groceries is many times higher than it. And if the family already has an older child, then carrying sleds, strollers, bicycles becomes my mother's holy duty. But do not do this - it is better to ask one of your friends, neighbors or relatives. Especially if the woman already has symptoms of a miscarriage.

10. Falls and other injuries

And a pregnant woman may find herself in an extreme situation, for example, getting into a car accident or simply slipping and falling. As a rule, in such situations, the embryo rarely suffers, since it is well protected: by amniotic fluid, the walls of the fetal bladder, the mother's muscle mass and her fat layer. However, if a similar trouble happened to you, still play it safe and seek medical help.

11. Taking a hot bath

Very rarely, but the cause of a spontaneous miscarriage can still be the abuse of baths with excessively hot water by a pregnant woman and a long stay in it. No one is urging a pregnant woman to completely stop taking a bath, but you need to remember about simple precautions. In particular, the water should not be too hot, and the duration of the bath should not exceed 15 minutes. Otherwise, there is a risk of spontaneous abortion.

12. Bad habits

The course of pregnancy is very negatively affected by the presence of such bad habits as smoking or alcohol abuse in a pregnant woman. But the lack of walks in the fresh air, the daily regimen, the abuse of caffeine-containing drinks also has a very negative effect not only on the health of a pregnant woman, but also on the development of the fetus. Otherwise, spontaneous abortion is also possible.

Miscarriage can often be avoided by seeking prompt medical attention. There are several stages of spontaneous miscarriage: in the first two, pregnancy can still be saved, the rest inevitably lead to the loss of the child.

1. Threat of miscarriage

This stage is characterized by the appearance of aching pain in the lumbar region and / or lower abdomen. After this, slight bloody discharge from the genital tract may appear. If such signs appear, a woman should immediately call an ambulance or seek help from a medical institution herself. If immediate treatment is started at this stage, then in most cases the pregnancy can be saved. Some women are in this condition for almost the entire pregnancy.

2. Started abortion

This stage is characterized by the appearance of tangible pain in the sacrum and abdomen. In this case, the painful sensations are cramping in nature. Following the painful sensations, bloody discharge from the genital tract appears, which significantly increases with the movements of the woman. Soon, the woman begins to complain of a feeling of weakness and severe dizziness. However, even at this stage of spontaneous abortion, pregnancy can still be saved by seeking immediate medical attention.

Therefore, for any, even the smallest bleeding, immediate medical attention is simply necessary.Of course, in some cases, treatment is carried out at home. But most often in such situations, gynecologists prefer to place a woman for inpatient treatment in gynecological departments. A pregnant woman should never refuse the proposed hospitalization.

You should also not be afraid of hormonal treatment offered by doctors - because most often it is hormonal disruptions that threaten the normal course of pregnancy. And the hormonal background just needs to be normalized. Thus, the factor that provokes the threat of termination of pregnancy will disappear. And those hormones that doctors inject you are exactly those that the body would receive naturally in the absence of hormonal disruptions.

3. Miscarriage in progress

In the stage of spontaneous abortion on the go, a woman feels a sharp and severe pain in the lower abdomen and lower back. Painful sensations are accompanied by significant blood loss. At this stage of miscarriage, the ovum dies, and it is no longer possible to maintain the pregnancy. But sometimes the death of a miscarriage occurs several days before the start of the miscarriage. In this case, the ovum will not leave the uterus entirely, like a round grayish bubble, but in parts. This phenomenon is called incomplete miscarriage.

4. Completed abortion

After the dead ovum is completely expelled from the uterine cavity, it begins to contract, restoring its previous size. Bleeding after the expulsion of the ovum and contraction of the uterus almost completely stops. Complete miscarriage must be confirmed by ultrasound.

There is another option for a spontaneous miscarriage - frozen pregnancy or miscarriage.

With this phenomenon, the ovum dies under the influence of any reason, but its expulsion does not occur. The woman's signs of pregnancy disappear, and her overall health deteriorates significantly. During an ultrasound examination, the doctor notes the death of the fetus. In this case, the question of whether cleaning is needed after a miscarriage is not even worth it - there is no miscarriage as such. And the only way to eliminate the ovum and residues is precisely curettage of the uterine cavity.

Curettage of the uterine cavity

After a miscarriage, if it happened outside the hospital, a woman should seek medical help. Only a doctor will be able to objectively assess the condition of a woman, as well as whether it is necessary to clean the uterine cavity. Do not under any circumstances give up curettage of the uterus if your doctor insists on it. The consequences can be serious, because the complete expulsion of the fetus and membranes is extremely rare. In most cases, a woman needs surgical curettage of the uterine cavity to remove the remnants of the ovum or membranes. Otherwise, they will immediately begin to decompose, forming a wonderful breeding ground for the reproduction of pathogenic microorganisms, which will immediately lead to the development of various inflammatory processes in the female body.

The procedure for performing surgical curettage:

1. Preparation

First, the woman will be given an enema and her pubic hair removed. After that, the anesthesiologist will hold a conversation with the woman, who will find out what type of anesthesia is optimal for her.

2. Examination by a gynecologist

The gynecologist who will perform the scraping will conduct a general examination of the woman using mirrors to determine the condition of the cervix and vaginal mucosa. This will also be followed by an obstetric manual examination, the purpose of which is to determine the size of the uterus, its shape and location.

3. Anesthesia

It can be general anesthesia, in which the woman is unconscious and unaware of what is happening. This type of anesthesia is used most often - it allows you to relieve a woman of additional stress, and doctors can calmly and quickly do their job. However, in some cases, if there are contraindications, the operation is performed under local anesthesia. To do this, injections are made into the cervix with an anesthetic that blocks the nerve endings responsible for pain.

4. Operation

The woman is on the gynecological chair during the entire operation. Before starting the manipulations, the woman's genitals will be treated with iodine solution (5%). After that, the mucous membranes of the vagina and the cervix will be treated with an alcohol solution, after which the scraping itself begins directly.

With the help of vaginal mirrors, the gynecologist will expose the woman's cervix. After that, if the cervical canal is not open enough, the doctor will expand it to the required extent with the help of dilators. After that, with a special spoon-shaped curette, the doctor will remove the remnants of the ovum or membranes. After that, using a sharp curette, the doctor will scrape the uterine lining. This measure is necessary in order to exclude the development of inflammatory processes in the uterine cavity.

5. Histological examination

After the curettage of the uterine cavity is performed, the biological material will be sent to the laboratory for histological examination. Post-miscarriage histology is a must. And if this miscarriage is not the first, or there is a habitual miscarriage, then for genetic research. Such a measure will help establish what exactly caused the miscarriages.

After surgery, be sure to observe postoperative physiological rehabilitation requirements :

1. Watch out for vaginal secretions. If you have the slightest doubt, see your doctor immediately.

2. Monitor your body temperature. Its increase, as a rule, signals the onset of the inflammatory process in the body. Seek medical attention immediately at the slightest rise in body temperature.

3. Keep your genitals clean. Wash your genitals with antiseptic solutions at least twice a day. Change sanitary napkins in time to avoid the growth of pathogenic bacteria.

Do not neglect psychological rehabilitation tips after a miscarriage, they are just as important as recommendations for a woman's physical health.

1. Accept this loss and tune in to a new, positive result. The body is physically ready for a new pregnancy 1-2 months after the miscarriage. However, much longer time is needed for psychological rehabilitation. Often a woman cannot come to terms with the loss of a child for many months, especially if the pregnancy was desired and long-awaited.

2. Do not withdraw into yourself, alone experiencing pain and despair. Be sure to tell your loved ones about your feelings - husband, mother, girlfriend. If after this you do not feel better, it will be much wiser to seek help from a psychologist. Ignoring such a problem can lead to the development of prolonged chronic depression.

3. There is a specific mental disorder of women who have lost a child as a result of miscarriage. Very often they have an obsession that the miscarriage did not occur, and when cleaning the baby was also not affected. Typically, these women buy a pregnancy test from the pharmacy, which is often positive. And the test results are such because the hormonal background of the woman simply did not have time to return to its original state. But it is on the basis of the content of the hormone in the urine that the test determines the presence or absence of pregnancy.

4. No matter how hard it is to think about it immediately after a miscarriage, the best way to get rid of melancholy will be the onset of a new, successful pregnancy. However, do not forget that, in order to avoid a repetition of the tragedy, it is necessary to carefully prepare for it. A woman must undergo a full examination, be tested for all latent infections, and an ultrasound scan. And only after obtaining permission from a doctor - gynecologist, pregnancy after a miscarriage is possible.

5. Never be discouraged. Quite a little time will pass, and you will again see two such long-awaited stripes on the test. And this time you will definitely go all the way of pregnancy from the very beginning to the birth of your baby! Do not be afraid that after a miscarriage you will no longer be able to see two stripes on the test. And how to do it as quickly as possible - read the best book on how to get pregnant.

Up to 20% of women who want to become mothers face spontaneous abortion. An early miscarriage is recorded in 80% of pregnant women, and in a third of cases it occurs before 8 weeks of gestation and is caused by anembryonia. Almost every expectant mother can face the threat of miscarriage, especially in the early stages of pregnancy, that is, up to 12 weeks, but with competent and timely treatment and adherence to medical recommendations, pregnancy ends happily - with the birth of a healthy baby.

Causes of repeated miscarriages

But the most common signs are. Heavy bleeding, similar to a period of bleeding that lasts more than three days.

• Spasms or pain in the lower back or abdomen.
• The disappearance of any signs of pregnancy that you have experienced.

It has gotten better in recent years, but it can still be tricky on some days. There are many possible causes of miscarriage, the most common being an accidental genetic problem with a developing fetus that the body will reject because it will not be a viable, healthy person.

The essence of miscarriage and its classification

A miscarriage or spontaneous abortion is the termination of a pregnancy when it has occurred without medical attention or mechanical intervention. As a result of miscarriage, the fetus and membranes are expelled from the uterine cavity, which is accompanied by profuse bleeding and cramping pains in the lower abdomen.

There is nothing that can be done about this type of miscarriage, as this is nature's way of creating healthy people. Many women experience this type of miscarriage and pursue healthy, unprecedented pregnancies. Recurrent miscarriages, on the other hand, is when someone has had two, three, or more miscarriages in a row. The following are the most common causes of recurrent miscarriages and the following are the most common tests that can be performed to find out the cause of multiple miscarriages.

Common causes of recurrent miscarriage

Anatomical Causes Recurrent miscarriages that fall under this area are, unfortunately, an area where natural therapy is unlikely to be affected. If something within the body is causing the miscarriage, it is called an "anatomical cause." Examples of this are a skipped uterus, incompetent cervix, large uterine fibroids, or severe Asherman's syndrome.

Classification of miscarriages

Miscarriages, depending on the period of termination of gestation, are divided into early and late:

• early miscarriages are those that happened before the end of the first trimester, that is, before 12 weeks;
• late miscarriages - occur between 13 and 22 weeks.

Early miscarriages also include spontaneous interruption of biochemical pregnancy. About biochemical pregnancy, or rather its termination, they say when ovulation occurred, the egg was fertilized with a sperm, but for some reason it could not implant in the uterus and left it, and menstruation came on time or with a slight delay. Moreover, the only sign of such a pregnancy is a weakly positive test, since the level of hCG in urine or blood does not exceed 100 units. It is difficult to calculate the frequency of a pregnancy that has barely begun, ended immediately; according to some data, such miscarriages in very early stages are found in 65 - 70%.

What does an early miscarriage look like?

Genetic Causes Sometimes recurrent miscarriages are due to genetic defects in either the egg or the semen. Women and men over 35 are more likely to have this problem as eggs and sperm may not be as healthy as they were in younger years. Most Western doctors will say there is little you can do about it, but we disagree. While we cannot influence all genetic causes, we have observed changes in semen in our clients as well after they changed to healthier, nutritious, dense, natural lifestyles.

Depending on the clinical picture, there are several stages of miscarriage:

• threat of interruption;
• incipient miscarriage;
• spontaneous abortion in progress;
• incomplete miscarriage (at this stage, surgical intervention is required - curettage of the uterus);
• complete miscarriage.

Separately, a frozen pregnancy or a failed abortion is distinguished, when the ovum has detached from the uterine wall, but has not left the uterus.

We'll cover all of this later in this article. Bleeding Blood Blood that is too thick or tends to clot can cause miscarriages. As small blood clots begin to develop in the uterus, the placenta may be cut off; leaving the fetus deprived of the oxygen and nutrients it needs to survive. This can cause spontaneous abortion, otherwise known as miscarriage. If your pregnancy develops 24 weeks before the onset of blood clotting, stillbirth or premature birth may occur.

Causes

In the threat of miscarriage in short terms, the leading position is occupied by chromosomal abnormalities of the embryo, the frequency of which is 82 - 88%. In second place is endometritis, which results in inflammation in the uterine mucosa, which leads to the impossibility of normal implantation and further development of the embryo. Also, spontaneous abortion in a short time causes anatomical and hormonal problems, infectious and immunological factors leading to habitual miscarriage.

Without any warning signs of the body that blood clots are forming, the danger often remains invisible until it's too late. There are several tests you can do to determine if this might be a problem for you, but they should be done prior to pregnancy as part of your foresight health plan. In addition, there are natural therapies that have been shown to be helpful with this type of problem, and we will discuss both of these topics below.

High homocysteine ​​levels If you have had at least one miscarriage, or your doctor has indicated that you are at a higher risk of miscarriage than most women, you can find out what your homocysteine ​​levels are. Homocysteine ​​is a common sulfonated amino acid found in the body. While it is not harmful at normal levels, when these levels get too high, it can cause a condition called hypercoagulability. In general, your blood clots are much lighter than they need to be. Not only can this put you at a higher risk of heart attack and stroke, but it can also put your baby in danger.

Risk factors

Women with the following alarming factors are included in the high-risk group for early miscarriages:

• Age

The threat of early miscarriage increases with age. The older a woman is, the more likely she is to develop this complication of pregnancy. At the age of 20-30, the risk of abortion is in the range of 9-17%, by the age of 35 it increases to 20%, by 40 - up to 40%, and at 44 and older the risk of early miscarriage reaches 80%.

This is called an immunological disorder or an immune-system-based miscarriage. Previously, the only options available to do this were the same procedures and medications that organ transplant patients received, but thank goodness there are natural therapies that offer some of the hope in this area that has been shown to be.

Hormonal Imbalances There are many links between hormonal imbalances and recurrent miscarriages. The hormonal system is a complex orchestra of hormones that works on a very specific schedule. If one of these hormones is out of balance, it can affect the rest of the cycle, possibly affecting early pregnancy. Some of these imbalances may be as follows.

• Parity

Having 2 or more pregnancies in the past doubles the risk of miscarriage (compared to nulliparous women).

• Miscarriages in the past

The more spontaneous abortions of pregnancy were in the early stages, the higher the risk of early miscarriage of a real pregnancy.

• Smoking

If a pregnant woman smokes more than 10 cigarettes daily, she significantly increases the risk of early miscarriage.

A miscarriage can take hours, days, or even weeks. Below are examples of the types of miscarriages you may experience. A very early miscarriage, which is common - up to 50% of all miscarriages - is a pregnancy that ends shortly after implantation, sometimes only a few days later. You might not even know you were pregnant. This early loss is medically called "chemical pregnancy" and it once went unnoticed without ultrasensitive pregnancy tests on the market.

How does a miscarriage happen?

This makes it easier to get a positive result 3 or 4 days before the due date. If the home prenatal kit appeared mildly positive, it was not a false pregnancy test. This was proof that the concept took place.

• Taking NSAIDs

Taking NSAIDs (aspirin, indomethacin, nise and others) on the eve of conception suppresses the synthesis of prostaglandins, and, accordingly, disrupts implantation.

• Fever

With an increase in body temperature (37.7 degrees or more), the risk of early miscarriages increases.

• Injury to the uterus

Mechanical injury (fall, impact) or prenatal diagnostic methods (choriocentesis, amniotic fluid intake, cordocentesis) increase the risk of miscarriage to 3-5%.

Early miscarriage: symptoms

The medical term changes to Clinical Pregnancy when the baby continues to develop normally but has a miscarriage before it can be seen on an ultrasound scan. This usually occurs at about 5-6 weeks of pregnancy, or within about one week of a missed period. When your period arrives, it can be late and usually heavier than usual.

First pregnancies are most associated with childhood loss. It is often very disturbing, confusing and sad to say that the miscarriage was confirmed even at an early stage of the child's development, when the consequences of the changes in life simply drowned. For those who are particularly counting on having a baby, especially with any couples with infertility issues or for women who are recurrent intractable, this can be devastating.

• Caffeine

Excessive consumption of caffeine (strong tea, coffee) is one of the risk factors for abortion in the short term.

• Influence of teratogens

Teratogens are infectious agents, toxic substances, and some drugs that also increase the risk of early miscarriage.

• Folic acid

Its deficiency during pregnancy planning and in the first 3 months after conception leads to the formation of a pathological karyotype in the fetus and termination of pregnancy.

A missed miscarriage usually occurs early in pregnancy. You may not have any warning symptoms and find through a routine scan that your baby is not having a heart attack, the result of an unviable fetus. If there is an empty fetal sac, the egg is fertilized and attached to the wall of the uterus. Unfortunately, although it may have continued to grow for several weeks, the embryo never developed.

A threatened miscarriage can occur for several days or even weeks before you lose your baby. At this point, you may experience one of the following.

• Light bleeding.
• The pain is similar to period pain.
• Cramps The nausea and tender breasts associated with pregnancy may disappear.
• The feeling no longer "feels" the pregnancy.

About 40% of bleeding episodes occur during early pregnancy, usually within 5-7 weeks, and occur around the time your period should have been triggered.

• Hormonal disorders

Lack of hormones (estrogens and progesterone), excess of androgens, thrombophilic conditions (antiphospholipid syndrome), as a rule, are the causes of recurrent miscarriage, but also cause the threat of early interruption.

• Stress
• IVF (up to 25% of cases)
• Rhesus conflict.

Symptoms of threatened miscarriage

The threat of early miscarriage is accompanied by the following key symptoms: pain, bleeding from the genital tract against a background of delayed menstruation.

Early miscarriage: causes

Sometimes a small amount of blood is lost when the placenta matures after about 7 weeks and takes over the production of progesterone. This can be intimidating, but it's pretty common. In most cases, your pregnancy will continue as normal without harming the baby. These situations lead to miscarriage in 20% of cases.

Sometimes the diagnosis can be wrong. Sometimes, if the corpus luteum is not functioning properly and therefore does not create enough progesterone, you will be thrown out. This occurs when the cervix opens and the placenta is released from the wall of the uterus.

Pain

Pain is almost always a symptom of threatened abortion at a short time. There is a tugging sensation in the lower abdomen and / or in the lumbar region, which may become more intense. In some cases (trauma, stress), the pains begin abruptly, suddenly and quickly become cramping, accompanied by profuse bleeding, which indicates the transition of a threatening abortion to the stage of abortion in progress, when it is no longer possible to maintain a pregnancy. When conducting a vaginal examination, the cervix of the uterus of normal length is diagnosed (there is no shortening and smoothing), a closed internal pharynx. Bimanual palpation allows palpation of the uterus, the size of which corresponds to the period of delay in menstruation, but the tone of the uterus is increased. This is determined by its density and tension (normally, the pregnant uterus is soft).

Sudden absence of "morning sickness" and breast tenderness Intuitively no longer feel pregnant. Constant heavy bleeding fills more than 1 centimeter pillow in half an hour. Unusual smell from lost blood. You can see the fruit. If your miscarriage is due to an incompetent cervix, things will happen very quickly and your baby can be born alive.

• Weakness and nausea and a general feeling of badness.
• Pain is pain in a bad period or labor contractions.
• Passing pieces of the placenta that look like blood clots or liver.

When some placenta remains inside the uterus, you are likely to experience fever and chills, pain, or odor.

Allocations

Discharge when threatened is usually insignificant, serous-bloody in nature. But it is also possible that there is no bleeding at the beginning of the development of a threatening abortion. If preventive and therapeutic measures are not taken in a timely manner, then the discharge of blood becomes more intense, their color changes from dark red (incipient miscarriage) to bright scarlet (abortion in progress). The appearance of discharge during threatened miscarriage is associated with the gradual detachment of the ovum from the uterine wall, which is accompanied by damage to the blood vessels and the release of blood.

Check with your doctor as you may have an infection requiring hospital treatment. If left untreated, an incomplete miscarriage can make you very sick and may also affect future pregnancies. The main goal of treatment during and after a miscarriage is to prevent hemorrhage and infection. An unlawful miscarriage most often occurs between 6 and 12 weeks of gestation.

The earlier you are pregnant, the more likely your body is to miscarry on its own. Once the uterus is empty, the cervix closes, the pain stops, and the bleeding slows down and stops for seven days. Abortion is not all that common in companion dogs. When they do occur, abortions usually occur during the last few weeks of the bitch's pregnancy, although they can of course happen earlier. Fast bitches can actually eat any placental or fetal tissue that they expel as part of their normal hygiene activities, especially if abortion occurs early in pregnancy when these tissues are undifferentiated.

Other symptoms

Other additional signs of a threat of early miscarriage are:

Decrease in basal temperature

As a rule, doctors recommend monitoring the basal temperature after a diagnosis of a threatening early miscarriage. But in some cases (hormonal disorders, prolonged absence of pregnancy), expectant mothers even before conception have and continue to keep a chart of basal temperature. Normally, at the onset of pregnancy, the basal temperature exceeds 37 degrees and is at this level up to 12-14 weeks. An indirect sign of a threat of miscarriage is a decrease in rectal temperature to 37 and below.

Medical causes of early miscarriage

This can make early abortions extremely difficult for owners. Bitches understandably can become lethargic and depressed after aborting their puppies. It will take a lot of extra time, attention and love from their owners to get them through this traumatic experience.

Pregnancy symptoms - miscarriage - what the owner sees

The signs of a miscarriage can be difficult for even the most alert owners to detect. Usually there is nothing obvious in the house or yard to suggest that an abortion has occurred. Bitches often lick and swallow interrupted tissue from the placenta and fetus as part of their normal care, especially when an abortion occurs early in their pregnancy. A more common reproductive abnormality in domestic dogs is puppy reabsorption, where the bitch's body actually absorbs fetal and placental tissue, leaving no indication that puppies have ever been present.

Pregnancy test

Some women are so worried about their long-awaited pregnancy that they are ready to take a pregnancy test every day. In such cases, not so long ago, such a bright second strip on the test turns pale, which is associated with a drop in the level of hCG (it is on its content that the test is based). Sometimes the test can show only one strip, even in the absence of bloody discharge, which, of course, is not very good, but fixable.

HCG level

For each gestational age, there are standards for the content of hCG in the blood. A decrease in hCG levels indicates a threat of miscarriage.

Ultrasound

Far from being an indicative sign of a threat, especially at small stages of pregnancy (for example, at 5 weeks). It is impossible to speak with certainty about the threat of miscarriage if there is only an increased tone of the uterus by ultrasound. It is possible that the hypertonicity was caused by an ultrasound examination, but then the uterus relaxes again. But in the case of detection of retrochorial hematoma, which is a sign of detachment of the ovum, the diagnosis of a threat of miscarriage in a short time is quite legitimate.

Diagnostics

Diagnosis of the threat of early miscarriage is not difficult. The diagnosis is made after a thorough collection of anamnesis and complaints, general and gynecological examination. During a gynecological examination, the doctor assesses the condition of the cervix (whether / not it is shortened and flattened, the external pharynx tightness), the presence or absence of blood discharge, palpates the uterus (whether it corresponds to the gestational age, whether it contracts in response to palpation).

Also, an ultrasound scan is also performed, on which the tone of the uterus is assessed, whether there is a fetus in the uterus and whether its heartbeat is determined, whether it corresponds to the gestational age, the presence / absence of a retroplacental hematoma.

From laboratory methods are used:

• Hormonal research

Determination of the level of progesterone, hCG, 17-ketosteroid, according to the testimony of thyroid hormones.

• Colpocytological examination

The karyopycnotic index (KPI) is calculated, on the basis of which it is possible to suspect a threat in the early stages even before the appearance of the clinic (an increase in KPI is the first bell of a threatening miscarriage).

• Vaginal swabs

This item also includes a study for latent genital infections.

• Blood type and Rh factor

To exclude Rh-conflict pregnancy.

• Blood clotting

It is necessary for suspected thrombophilic conditions.

Treatment

Abroad (Europe, USA), they prefer not to treat the threat up to 12 weeks of gestation, citing the fact that up to 80% of pregnancy is terminated due to genetic and chromosomal abnormalities. In Russia, doctors insist on prescribing complex therapy for the threat of termination of pregnancy at any time. The earlier treatment is started, the higher the likelihood of maintaining the pregnancy. Treatment of a threatened miscarriage should be comprehensive and includes drug and non-drug therapy, adherence to the regimen and diet, psychotherapy, and, as a rule, is carried out in a hospital.

Basic therapy

Basic therapy means regimen and diet. Pregnant women with a threat of miscarriage are recommended to limit physical activity, up to bed rest, exclude stress and anxiety, diet, sexual rest, and proper sleep. A pregnant woman's diet should contain proteins, fats and carbohydrates in a balanced amount, and the diet should be rich in vitamins. Also shown are sessions of psychotherapy and auto-training, which will help to normalize the emotional state of a woman and calm down.

Drug treatment

Sedatives

Motherwort and valerian in tablets or tinctures / infusions are prescribed as sedatives.

Antispasmodics

Antispasmodics (no-shpa, papaverine or drotaverine) relax the uterine muscles and are prescribed for severe pain in the lower abdomen (intramuscularly). Magne-B6 tablets have proven themselves well. Magne-B6 contains magnesium (antispasmodic) and vitamin B6, which helps magnesium to penetrate into the cell, 1 tablet is prescribed 3-4 times a day. As suppositories, with the threat of interruption, suppositories with papaverine are used rectally. Papaverine is well absorbed by the intestinal mucosa, quickly relieves pain.

Hormonal drugs

Gestagens (progesterone) are recommended to be taken in case of insufficient function of the corpus luteum. Progesterone is the main hormone of pregnancy, which is responsible for its maintenance and further development. Duphaston, with the threat of miscarriage in the early stages, is prescribed in a dose of 40 mg (4 tablets) immediately and then 1 tablet every 8 hours. If the signs of threat do not stop, then the dosage is increased by 1 tablet at each next dose. Duphaston contains synthetic progesterone, and treatment is continued for up to 16 weeks (until the placenta is formed). Another progesterone-containing drug is Utrozhestan (natural progesterone). Utrozhestan, when threatened, is prescribed either internally or intravaginally. Dosage: 1 - 2 capsules twice a day. Both Utrozhestan and Duphaston are well tolerated, and drugs are withdrawn gradually.

In case of underdevelopment or malformations of the uterus, it is advisable to prescribe estrogen therapy (folliculin, microfollin) to the treatment with gestagens. Estrogens are prescribed in tablet and injectable form.

In the case of ovarian hypofunction against the background of treatment with estrogens and gestagens, choriogonin (rotnil) is prescribed intramuscularly twice a week.

In case of hyperandrogenism or immune disorders (antiphospholipid syndrome), glucocorticoids (dexamethasone, metipred) are recommended.

Hemostatics

In the event of bloody discharge with a threat of miscarriage, hemostatic drugs are prescribed. From hemostatic agents, Ditsinon, Vikasol, Ascorutin are used. Hemostatics strengthen the vascular wall, normalize microcirculation, and increase blood clotting.

Vitamins

During pregnancy, the intake of vitamins is indicated, since their lack can provoke a lag in the growth and development of the fetus or malformations. In case of a threat of early miscarriage, vitamin E (as an antioxidant), folic acid (prevention of malformations of the central nervous system), B vitamins are prescribed.

Drug-free treatment

As a non-drug treatment, physiotherapy is prescribed:

• Electroanalgesia

Has a sedative effect, reduces the severity of pain.

• Magnesium electrophoresis

Magnesium electrophoresis CMT is the introduction of magnesium preparations into the body using an electric current. Has a sedative effect, relaxes the uterine muscles.

• Electro-relaxation of the uterus

This method provides a reflex effect on the uterus, which relieves hypertonicity and relieves pain.

• Hyperbaric oxygenation

The method is based on oxygen treatment under pressure in pressure chambers. Improves microcirculation in blood vessels, has an antihypoxic and antimicrobial effect, prevents the formation of toxins.

• Acupuncture

Normalizes the tone of the uterus, stabilizes blood pressure, improves psycho-emotional state and sleep.

To quickly stop the signs of a threat of miscarriage, you must follow a number of recommendations.

What is not allowed in case of a threat:

• have sex;
• drink strong tea and coffee, sweet carbonated drinks;
• eating chocolate;
• eat foods that increase gas production: cabbage, legumes, soy (a swollen intestine presses on the uterus and increases its tone);
• eat fast food (high content of preservatives, stabilizers, salt);
• follow a diet for weight loss;
• visit baths and saunas (high temperature can provoke uterine bleeding and termination of pregnancy);
• take a hot bath, especially with bleeding;
• consume raw foods (eggs, meat, fish in the form of sushi or rolls);
• physical activity and lifting weights (more than 3 kg);
• be stressed, nervous;
• travel by any type of transport, especially air travel is prohibited;
• smoking and drinking alcohol.

What can be done in case of a threat:

• listen to pleasant, calm music;
• sleep (at least 8 hours a day) with an obligatory afternoon rest;
• walks in the park or forest (unless strict bed rest is prescribed);
• read your favorite books;
• eat fresh fruits and vegetables (with the exception of prohibited ones) as sources of vitamins;
• aromatherapy (citrus oils, mint);
• take a warm shower;
• drink compotes, juices, herbal teas (instead of the usual coffee and black tea).

Prophylaxis

Preventive measures for the threat of termination of pregnancy should begin even before its onset. But even with an already onset and desired pregnancy, you should not let things go by themselves.

The threat of early miscarriage: how to prevent:

• do not postpone registration with the antenatal clinic;
• follow all the doctor's recommendations;
• categorically give up bad habits;
• avoid stress, emotional outbursts, conflicts;
• refuse to perform heavy physical work and lifting weights (it is optimal to take a vacation during the critical period - 8 - 12 weeks);
• normalize the regime of the day and rest;
• review your diet (give up various diets, snacks on the run, fast food);
• if possible, do not travel long distances, especially those associated with a change in climate and time zone;
• avoid taking medications (antibiotics, NSAIDs and some others);
• walk more often;
• avoid injuries to the abdomen, falls.

During pregnancy planning, the following will help prevent the threat of miscarriage in the future:

• taking folic acid 3 months before conception;
• maintaining a healthy lifestyle for at least 3 months before conception;
• correction and stabilization of chronic gynecological and extragenital diseases;
• examination, and, if necessary, treatment of latent genital infections;
• scheduled vaccinations no later than 3 months before conception.

Question answer

Question:
Why can't you have sex if you are threatened with miscarriage?

During intercourse, a woman experiences an orgasm, which promotes the production of oxytocin. Oxytocin, in turn, stimulates the contractile activity of the uterus, which aggravates the detachment of the ovum from its walls and aggravates the course of this complication of pregnancy. In addition, in the presence of bloody discharge, the possibility of infection entering the uterine cavity and intrauterine infection of the embryo is not excluded, which also contributes to the termination of pregnancy.

Question:
I was discharged from the hospital with recovery after the threat miscarriage. Do I need to continue to follow the doctor's recommendations that were given in the event of a threatened termination of pregnancy?

Yes, you should definitely continue to follow all medical recommendations, as well as taking medications that were prescribed in the hospital (hormones, vitamins, antispasmodics). Even in the case of complete relief of the signs of threat, any deviation (malnutrition, daily regimen, lifting weights) can again cause signs of threatening abortion and end in termination of pregnancy.

Question:
Is it possible to use tampons in the presence of bleeding and the threat of miscarriage?

In no case. The use of tampons can provoke infection of the vagina, cervix, and after them the uterine cavity.

Question:
I have a high risk of threatened abortion, can I go to the pool?

If there are no signs of threatening abortion, and the general condition allows for an active lifestyle, then visiting the pool during pregnancy is not only not prohibited, but recommended.

Question:
I had a miscarriage. When can I plan my next pregnancy?

Any termination of pregnancy (artificial or spontaneous) involves a break (use of contraception) for at least 6 months. After this period, you can start planning your pregnancy.

Obstetrician-gynecologist Anna Sozinova

Unfortunately, no one is immune from the sad outcome of pregnancy, such as miscarriage. A miscarriage is a spontaneous termination of pregnancy, without any external factors. About 15 percent of pregnancies end in miscarriages.

Instead of sitting and jerking convulsively at every signal from the body, you need to study the enemy in the face, the reasons for its appearance, and also find out what the expectant mother can do to prevent this phenomenon.

Threatened miscarriage in early pregnancy

A miscarriage is always a spontaneous abortion, that is, the loss of a child without the influence of external factors. Most often it is characteristic of early pregnancy. This happens because the embryo, which is not yet viable, is rejected from the walls of the uterus.

Miscarriages are divided into early and late:
• early miscarriage is possible before the 12th week of pregnancy;
• late miscarriage - no later than 22 weeks.

These terms are indicated for a reason. The fact is that further fetal loss is called premature birth. Miscarriages are observed in about fifteen percent of pregnant women, but this frightening statistics applies to those women who do not change their lifestyle for the full formation and consolidation of the ovum, or those women who do not even know about their condition.

One of the types of miscarriage is the diagnosis of “threatened miscarriage”. First, you need to understand that the threat is the first signal, and you need to take action immediately. Rest is the main condition for the threat of miscarriage. After all the recommendations of the doctor, there is a high probability of the preservation and further normal development of the child.

What can cause a miscarriage?

To our deepest regret, it is not always (even after carrying out a heap of research and testing) it is possible to accurately determine the causes of a miscarriage.

As we have already noted, a miscarriage occurs in that percentage of pregnant women who for a long period were unaware of their condition and continued to lead their usual way of life, with large or even abused alcohol and other addictions.

Basically, all miscarriages are the result of the development of pathologies or from the fact that the fetus develops with abnormalities. There is a rejection from the uterine wall. Based on general data, we can generalize the causes into several groups of genetic and external factors.

The main causes of miscarriage at each stage of pregnancy differ from each other:
• in the earliest stages (up to about the sixth week of pregnancy), a miscarriage is possible due to the development of an unviable embryo with chromosomal abnormalities, or due to severe physical exertion;
• the period of the end of the first trimester (from 6 to 12 weeks) is considered the most dangerous for the threat of miscarriage, this is due to the fact that the baby's vital organs begin to form. A woman in this period is also in the risk category: various infectious diseases, uterine tone, weakening of immunity, hormonal disorders.
• The period up to 22 weeks of pregnancy includes all of the above reasons, and the fact is added that the uterus in this period is subject to a change in its size (as, in principle, the entire pregnancy) and it may turn out to be weak in order to withstand the fetus and opens ...
• A spontaneous miscarriage after 22 weeks is already considered preterm labor. It is impossible to save the life of a baby during such childbirth, since the fetus is born dead.

To avoid such dire consequences as spontaneous miscarriage, a pregnant woman should regularly undergo medical examinations and inform the doctor about the slightest suspicions. If a miscarriage is suspected, time counts down in minutes, each of which is able to save the life of your unborn child.

Symptoms of a spontaneous abortion

The symptoms and signs of a miscarriage are dire. Let's say right away that the worst thing is
this is uterine bleeding, which is life-threatening for a woman.

As with any other pathological deviation, vaginal discharge begins, but they differ in their abundance. Discharge during miscarriage is scarlet and sometimes dark purple in color. As a rule, this is the onset of bleeding and it does not stop for several days. This is followed by severe cutting pains in the lower abdomen. There will be clot impurities in these secretions. They indicate that a miscarriage has occurred.

Usually, fetal death occurs some time before the first symptoms begin. It is possible to save a pregnancy when a woman goes to the hospital on time. Indicate that you have a threat of miscarriage, there will be spotting spotting and aching lower back pain.

Symptoms are divided into several stages, for each period it has its own:
• Initial - as a rule, the fetus can be saved. Low back pain and small vaginal discharge with blood impurities.
• The second stage also has a chance to save the baby. At this stage, the woman experiences a sharp unreasonable deterioration in well-being, accompanied by stabbing pains in the abdomen. At this stage, spontaneous abortion has already begun.
• The further stage, unfortunately, already testifies to the complete death of the fetus. Bleeding begins, even loss of consciousness is possible.

If you find any signs of miscarriage, call your doctor right away and be in a state of complete rest. In this situation, you should never go to the hospital on your own. Hospitalization and medication can only be prescribed by a doctor who monitors your pregnancy.

Treatment after miscarriage

Recovery of a woman's body after a spontaneous abortion is a long and labor-intensive process, sometimes requiring the intervention of a psychotherapist.

The most important thing after a miscarriage is to stop uterine bleeding and exclude infection. It is also necessary to take tests for infection, as well as undergo a study that can identify the cause and, with further pregnancy, you will be under special care with a doctor.

After undergoing studies with a gynecologist, a visit to a therapist is mandatory. As for the restoration of the menstrual cycle, this will happen about a month after the miscarriage.