Signs of Miscarriage and Coping with it

When an embryo expells from the uterus, it results in a miscarriage causing heavy bleeding. It is a loss that is often unbearable creating severe complications for the mother during or after the pregnancy. The signs of miscarriage are though not understood but are common to occur.

What is an Early Miscarriage?

Miscarriage occurring anytime during the first 12 weeks of pregnancy is an early miscarriage, symptoms of which are often confusing for the mothers.

How common is it?

Almost 50% of women suffer from early miscarriage while some might be unaware of their pregnancy. These are very common and even turn up after a pregnancy test has shown positive.

What is a Late Miscarriage?

Anything happening between 14 and 24 weeks of pregnancy is a late miscarriage also known as second-trimester miscarriage.

How common is it?

About 1-2% happen in the second trimester when the baby is said to be in a safer zone. Britain has the third largest rate of stillbirths ranking 33 out of 35.

What is a Threatened Miscarriage?

Any bleeding other than spotting during an early pregnancy represents a Threatened Miscarriage.

Causes

  • Ectopic Pregnancy: Where the baby grows outside the uterus in one of the fallopian tubes creating risk for the mother as her fallopian tube may burst to end the pregnancy.
  • Blighted Ovum: When a fertilized egg doesn’t develop as it should due to chromosome problems
  • Illness in the mother: Major illness like German measles, infections can be dangerous in pregnancy
  • Placental problems: Lack of blood supply to the placenta can lack nourishment causing miscarriage
  • Genetic factors: Abnormal development of the baby create problems for the baby’s survival.
  • The problem in the womb: The womb may be unusual in shape preventing your baby from growing causing miscarriage.
  • Hormonal Imbalance: Regular periods due to the change in hormones is more likely to miscarry.

Signs and symptoms

  • Heavy bleeding: A light spotting to a heavy bleed is a sign of miscarriage
  • Pain in the lower abdomen: The strong period type cramping in the lower abdomen or the back is a sign.
  • Weight loss: A sudden weight loss is often a sign during pregnancy
  • White-Pink Mucus: Discharge of white-pink fluid from your vagina or discharge of tissue.
  • Loss of pregnancy symptoms: Loss of pregnancy symptoms such as breast tenderness or morning sickness

How do I know if I had a Miscarriage?

An Ultrasound is the best way to find out the miscarriage. During a routine pregnancy checkup, the doctor may find out an empty embryo sac indicating a missed or silent miscarriage.

Risks Involved

According to the American Pregnancy Association, a fit woman in the US carries the risk of miscarriage anywhere from 10-25% while when they hit the age of 35. It increases to 20-35% at the age of 45. Most miscarriages happen in the first trimester and 1-5% during the second trimester. The risk of miscarriage falls after having a normal ultrasound at 16 weeks.

Prevention

  • Do not smoke as it affects your placenta as well the baby
  • Use of drugs and alcohol increases the complications
  • Immediately report any abnormal bleeding or abdominal pain
  • Be aware of your baby’s movements
  • Talk to your doctor immediately about the risk factors of stillbirth
  • Don’t miss your antenatal appointments
  • Avoid the risk of infections like listeria (from unpasteurized cheeses) and salmonella (from raw eggs).

Complications

Despite the miscarriage being pain-free or natural, the doctor will see for future complications for months or few weeks to treat them if any. Excessive bleeding over seven days is a sign of the infection including a smelly discharge, chills, abdominal pain and fevers for which you will need antibiotics. In rare cases, you may start the abnormal growth of Choriocarcinoma (A Kind of tumor) if the placenta remains in your uterus.

About 16% of women having D&C surgery develop scarring (Asherman’s syndrome) inside the uterus/around the cervix which may need a 2nd surgery, later on, to be pregnant again.

Treatment

  • Medications: Medications such as mifepristone or misoprostol helps where you start to expel fetal tissue and placenta. These medications also cause side-effects including nausea, vomiting, cramping, bleeding and diarrhea that you might experience during the time.
  • Expectant management: Involves waiting until the pregnancy is expelled originally which can take three to four weeks before resuming to normal menstrual cycles.
  • Surgery: A minor surgery known as dilation and curettage (D&C) is another option to treat a miscarriage in which a doctor will gently scrape the fetus and placenta from your uterus resulting in the bleeding for more than a week with a slight risk of infection.

Emotions after the Miscarriage

You are likely to face many mixed emotions after miscarriage needing emotional healing. They include:

  • Anger and guilt: Blaming yourself or god for such a situation is the first emotion you carry with a feeling of hatred for the other pregnant women.
  • Shock: There may be numbness along with disbelief from the trauma of loss.
  • Depression and stress: Feeling sad all the time, crying, unable to sleep or eat, etc. are all the signs of stress from the loss.
  • Acceptance: Coping with the situation also forms a part of the loss

Getting Pregnant Again

Doctors suggest waiting for months before getting pregnant again as the uterus needs time to recover from a miscarriage. About 65% of women have a successful second pregnancy ending in a live birth, but for that, get in touch with the gynecologist to closely examine the condition. For many women, a miscarriage is an indication of future fertility after a one-time loss.

Coping up with Miscarriage

Different people handle it in their specific ways, but it is none other than a shock for the entire family. If you face trouble coping with it or if it’s causing a rift in your relationship with the partner to ask your doctor for therapies or counseling services to overcome the situation while deciding to move on. Suggested Steps include:

  • Seek counseling
  • Communicate with all and speak upfront
  • Converse with other women
  • Vent your Feelings

Facts to know

  • The physical process of miscarriage can take several days
  • A natural miscarriage involves severe cramping
  • Your fertility may return soon or might not return
  • The reasons for miscarriage are not well understood
  • You might not want the second pregnancy
  • A miscarriage may sometimes have no symptoms
  • An ectopic pregnancy is not always a medical emergency
  • Miscarriage diagnosis may take a week
  • Pregnancy bleeding is not always a miscarriage

References

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