Month three

Sign of mis­car­riage

Your Pregnancy - - Contents -

THE TERM USED

for a preg­nancy that’s lost spon­ta­neously in the first 20 weeks is mis­car­riage or spon­ta­neous abor­tion. Statis­tics show that one in four preg­nan­cies does end in mis­car­riage. You may be sur­prised to know that many women who think they are hav­ing a late, heavy pe­riod ac­tu­ally may be hav­ing a mis­car­riage. Be­cause preg­nancy tests can be done with ac­cu­racy and con­firmed from a very early stage, more women are aware that they are in­deed los­ing the con­cep­tus and it is not just a late pe­riod. The most com­mon warn­ing sign is vagi­nal bleed­ing, which should al­ways be checked out with your care­giver. It may be light, heavy, ir­reg­u­lar or con­stant over a few days. The sec­ond sign is pain. Pain with bleed­ing is more likely to be a sign that a mis­car­riage is oc­cur­ring. You may ex­pe­ri­ence this pain as belly cramp­ing, or pelvic cramp­ing or it may be a dull ache in your lower back. Pain may only oc­cur af­ter the ini­tial bleed­ing has started or at the same time. Blood clots and tis­sue pass­ing from the vagina to­gether with pain is also a sign. The rea­sons for a mis­car­riage oc­cur­ring is not al­ways known and the cause can­not be pin­pointed. If it oc­curs in the very early stages of preg­nancy (the first trimester) the most com­mon rea­son is a chro­mo­so­mal ab­nor­mal­ity. If there has been a hic­cup be­cause of a dam­aged or ab­nor­mal sperm or egg at the time the zy­gote was go­ing through the di­vi­sion process, the body of­ten dis­cards the “flawed” prod­ucts.

OTHER POS­SI­BLE CAUSES IN­CLUDE

Gen­i­tal or uter­ine in­fec­tions Un­usual in­fec­tions like tox­o­plas­mo­sis, lis­te­ria and syphilis Uter­ine ab­nor­mal­ity De­fi­ciency of pro­ges­terone in early preg­nancy Ma­ter­nal an­ti­bod­ies that dis­rupt the growth of the em­bryo and de­vel­op­ing

pla­centa Ma­ter­nal smok­ing Al­co­hol con­sump­tion Use of recre­ational drugs Implantation of the egg into the uter­ine lin­ing does not oc­cur prop­erly Ma­ter­nal age Ma­ter­nal trauma If you think that you are hav­ing a mis­car­riage, talk to your doc­tor im­me­di­ately. In most cases, there is noth­ing that you can do to stop it from hap­pen­ing. Ul­tra­sound scans and blood tests may be done to as­sist your doc­tor in de­ter­min­ing the next course of ac­tion. If you ex­pel all of the prod­ucts of con­cep­tion and bleed­ing and cramp­ing stops, it may be all over. If ev­ery­thing is not ex­pelled, it is nec­es­sary to un­dergo a D&C (di­lata­tion and curet­tage) pro­ce­dure. This in­volves mi­nor surgery to clear the uterus of any leftover prod­ucts that could cause pain, bloat­ing, in­fec­tion and bleed­ing. For many women los­ing a preg­nancy is dev­as­tat­ing and self-blame is com­mon. Many women ques­tion whether they played any part in caus­ing a mis­car­riage (a bumpy car trip, a Panado, a lit­tle al­co­hol, sex­ual in­ter­course, and so on) and whether there was any­thing she could have done to pre­vent it. Talk­ing about it is im­por­tant and some coun­selling may be nec­es­sary (many women hold their feel­ings in). Most peo­ple around you are sym­pa­thetic and may say some­thing like, “It was prob­a­bly for the best.” This is not what you want to hear! Some peo­ple will avoid the topic if they know that this has dev­as­tated you. You may need to take some time off work for breath­ing space and to come to terms with what hap­pened. How much time will de­pend on you, your doc­tor and your con­tract with your em­ployer. It is dif­fer­ent for every­one. While the phys­i­cal re­cov­ery is usu­ally very quick, the emo­tional re­cov­ery may take a lit­tle longer, es­pe­cially if this is not the first time you’ve mis­car­ried. When you feel emo­tion­ally ready to try again then your body will al­most cer­tainly be ready too. Phys­i­cally there is no ev­i­dence that wait­ing a long time to con­ceive again im­proves the out­come. Use com­mon sense when pre­par­ing for the next preg­nancy: Start tak­ing folic acid, stop smok­ing, en­sure a healthy diet, con­sider nu­tri­ent sup­ple­men­ta­tion, re­duce or stop al­co­hol con­sump­tion, avoid all non-es­sen­tial drugs, con­trol any med­i­cal con­di­tions (e.g. di­a­betes or hy­per­ten­sion), en­sure you are im­mune to rubella, and start a mod­er­ate ex­er­cise pro­gramme. If you have had a mis­car­riage, re­mem­ber, the statis­tics are on your side and the chances of a healthy baby next time are very high.

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