When a new baby is expected in a family, everyone will be looking forward to the birth. Suddenly you come to know that you are loosing baby and you don’t know what must have caused the problem. Sometimes we try to blame ourselves or surrounding by believing in some way they must be responsible for what has happened. This article is in the series of “Self Management of Health” to promote the self learning of our health.
A miscarriage is a term used for pregnancy that ends at a stage where the fetus is incapable of surviving on its own or if the pregnancy ends in the first 20 weeks of gestation. According to the March of Dimes, as many as 50% of all pregnancies end in miscarriage – most often before a woman misses a menstrual period or even knows she is pregnant.
Symptoms of miscarriage
- Bleeding which progresses from light to heavy
- Sever cramps
- Abdominal pain
- Back pain
If you experience the symptoms listed above, contact your obstetric health care provider right away.
What causes Miscarriage?
Most miscarriage that occur in the first trimester are caused by chromosomal abnormalities in the baby. Chromosomes are tiny structure inside the cells of the body which carry many genes. Genes determine all of a person’s physical attributes, such as sex, hair and eye colour, and blood type. Most chromosomal problems occur by chance and are not related to the mother’s or father’s health.
Factors that may lead to miscarriage:
- Exposure to environmental and workplace hazards such as high levels of radiation or toxic agents
- Hormonal problems
- Uterine abnormalities
- Incompetent cervix (the cervix begins to widen and open too early, in the middle of pregnancy, without signs of pain or labor)
- Lifestyles factors such as smoking, drinking alcohol, or using illegal drugs
- Disorders of the immune system, including lupus
- Severe kidney disease
- Congenital heart disease
- Diabetes that is not controlled
- Thyroid disease
- Certain medications such as the acne drug Accutane
- Severe malnutrition
- Old age
How is a Miscarriage diagnosed and treated?
Pelvic exam and an ultrasound test is required to confirm a miscarriage. If the miscarriage is complete and the uterus is empty, then no further treatment is usually required. Occasionally, the uterus is not completely emptied, so a dilation and curettage (D&C) procedure is performed. During this procedure, the cervix is dilated and any remaining fetal or placental tissue is gently removed from the uterus. Sometimes, certain medication can be given to cause your body to expel the contents in the uterus.
A stillbirth is a term used when a fetus dies in the uterus, most commonly after 20 weeks are completed or baby is born without any signs of life at or weighing more than 500g. In Canada, just over 4.5 in 1000 births ends in stillbirth. When a baby dies in the uterus, the mom still has to go through with the birth. The labour will usually have to be started artificially (induction). Your doctor will discuss with you and give you time to absorb what they have said before starting to induce your labour.
It’s rare that a baby dies unexpectedly during labour or birth. A problem with the placenta or umbilical cord knot, may cause baby to not have enough oxygen. Undiscovered abnormality or an infection also lead to the stillbirth.
Factors that may lead to stillbirth:
- Baby did not grow enough in the uterus.
- Genetic or physical defect in baby’s brain, heart, or other organ of the baby.
- Heavy bleeding started after 24 weeks of pregnancy. This can happen when the placenta begins to separate from the lining of the uterus. It is called a placental abruption.
- Pre-eclampsia, which can reduce blood flow to the baby via placenta. This condition is associated with placental abruption.
- An illness suffered by the mom, such as diabetes, the liver condition obstetric cholestasis, or a blood-clotting problem.
- Baby’ shoulder may get stuck as he leaves the birth canal (shoulder dystocia), severely reducing oxygen flow to the baby.
- Infections, such as listeriosis, salmonella or toxoplasmosis.
- Premature or smaller than they should be for their stage of pregnancy.
Listeria infection may be spread through different methods including direct contact with infected lesions, food-borne transmission, and passage from mother to fetus in pregnancy or to the infant during birth.
Salmonella infection may be spread through contaminated water or food.
Toxoplasmosis is an infection with a parasite. You can come into contact with the parasite through cat poo, eating raw, cured or undercooked meat, kitchen utensils used to prepared raw, cured or undercooked meat, having unpasterurised goat’s milk or cheese.
If you get toxoplasmosis during your first or second trimester, your unborn baby can develop:
- water on the brain (hydrocephalus) or brain damage
- damage to the eyes or other organs
At birth, most babies affected by toxoplasmosis have no obvious problems. But these babies then develop symptoms during the next few months or years, such as:
- eye infections
- hearing problems
- learning difficulties
Is it possible to find out what went wrong?
If doctors are not sure what caused a baby’s death it can sometimes be discovered by various investigations. These may include testing the mom’s blood, examining the placenta, or carrying out a postmortem examination (autopsy).
Topic Miscarriages Stillbirths Definition Miscarriages are end of pregnancy at a stage where the fetus is incapable of surviving independently. A stillbirth occurs when a fetus has died in the uterus. Other names Spontaneous abortion, Induced termination of pregnancy. Sudden antenatal death syndrome. Time First 20 weeks of gestation. After 20 weeks of gestation. Causes Chromosomal abnormality, Hormonal problems, Vaginal and Urinary track Infections or maternal health problems, Lifestyle, Implantation of the egg into the uterine lining does not occur properly, Maternal age and maternal trauma, Forced termination of pregnancy. Bacterial infection, Birth defects, Chromosomal aberrations, Growth retardation, Intrahepatic cholestasis of pregnancy, Maternal diabetes, High blood pressure, Maternal consumption of recreational drugs or pharmaceutical drugs, Postdate pregnancy, Placental abruptions, Physical trauma, Radiation poisoning, Rh disease, Female Genital Mutilation, Umbilical cord accidents, Malnutrition. Symptoms Mild to severe back pain, weight loss, white-pink mucus, true contractions, brown or bright red bleeding, tissue with clot like material passing from the vagina, sudden decrease in signs of pregnancy. Lack of activity of the fetus. Prevention Measures Exercise regularly, Eat healthy food, Manage stress, Keep weight within healthy limits, Take folic acid daily, Do not smoke or drink. Monitoring daily movement of the baby, Avoid drugs, Vaginal bleeding in the second half of pregnancy, Previous still births. Traits and Random Data Collections Results Women who suffered from nausea and morning sickness in the first 12 weeks of pregnancy are almost 70% less likely to miscarry. Induced abortion increases the risk of miscarriage 128% for up to 2 years. Each miscarriage raises risk of future heart attack by 40%. Recurrent miscarriage increases risk of stillbirth 1300%, preterm birth 60%, ectopic pregnancy 160%. High blood pressure and high hematocrit associated with restricted growth in the first trimester. Bacteria in the mouth is associated with preterm birth.