Un­der­stand­ing mis­car­riages

The Manica Post - - Health - Dr Tendai Zuze

A MIS­CAR­RIAGE is the spon­ta­neous loss of a preg­nancy be­fore the 28th week. Up to one fifth of all preg­nan­cies end in mis­car­riage, maybe even more, but the bulk of th­ese hap­pen so early that a woman doesn’t even know she is preg­nant.

Most mis­car­riages oc­cur be­cause the foe­tus isn’t de­vel­op­ing nor­mally and in most cases no ac­tual cause can be found.

The bulk of mis­car­riages oc­cur be­fore the 12th week of preg­nancy. If you are preg­nant, you know you are hav­ing a mis­car­riage if you get;

◆ Vag­i­nal spot­ting or bleed­ing ◆ Pain or cramp­ing in your ab­domen or lower back ◆ Fluid or tis­sue pass­ing from your vagina

It is worth re­mem­ber­ing, how­ever, that most women who ex­pe­ri­ence vag­i­nal bleed­ing in the first few months go on to have suc­cess­ful preg­nan­cies.

So what causes mis­car­riages, well, the prob­lem could be with the mother, the foe­tus, or both. Most mis­car­riages oc­cur be­cause the foe­tus isn’t de­vel­op­ing nor­mally. Prob­lems with the baby’s genes or chro­mo­somes are typ­i­cally the re­sult of er­rors that oc­cur by chance as the em­bryo di­vides and grows — not prob­lems in­her­ited from the par­ents.

Ex­am­ples of ab­nor­mal­i­ties in­clude:

◆ Blighted ovum. Blighted ovum oc­curs when no em­bryo forms. ◆ In­trauter­ine foetal demise. In this sit­u­a­tion the em­bryo is present but has stopped de­vel­op­ing and died be­fore any symptoms of preg­nancy loss have oc­curred. ◆ Mo­lar preg­nancy. A mo­lar preg­nancy is a non­cancer­ous (be­nign) tu­mour that de­vel­ops in the uterus. A mo­lar preg­nancy oc­curs when there is an ex­tra set of pa­ter­nal chro­mo­somes in a fer­til­ized egg. This is a rare cause of preg­nancy loss.

In a few cases, a mother’s health con­di­tion might lead to mis­car­riage. Ex­am­ples in­clude di­a­betes, in­fec­tions, hor­monal prob­lems, thy­roid dis­ease and prob­lems with the uterus or cervix. Ex­er­cise, hav­ing sex and work­ing (pro­vided you are not ex­posed to harm­ful chem­i­cals) will not cause a mis­car­riage.

Var­i­ous fac­tors in­crease the risk of mis­car­riage, in­clud­ing: ◆ Age. Women older than age 35 have a higher risk of mis­car­riage than do younger women. Some re­search also sug­gests that women who be­come preg­nant by older men are at slightly higher risk of mis­car­riage. ◆ Pre­vi­ous mis­car­riages. Women who have had two or more con­sec­u­tive mis­car­riages are at higher risk of mis­car­riage. ◆ Chronic con­di­tions. Women who have a chronic con­di­tion, such as un­con­trolled di­a­betes, have a higher risk of mis­car­riage. ◆ Uter­ine or cer­vi­cal prob­lems. Cer­tain uter­ine ab­nor­mal­i­ties or weak cer­vi­cal tis­sues (in­com­pe­tent cervix) might in­crease the risk of mis­car­riage.

◆ Smok­ing, al­co­hol and il­licit drugs. Women who smoke dur­ing preg­nancy have a greater risk of mis­car­riage. Heavy al­co­hol use and il­licit drug use also in­crease the risk of mis­car­riage. ◆ Weight. Be­ing un­der­weight or be­ing over­weight has been linked with an in­creased risk of mis­car­riage. ◆ Invasive pre­na­tal tests. Some invasive pre­na­tal ge­netic tests, such as chori­onic vil­lus sam­pling and am­nio­cen­te­sis, carry a slight risk of mis­car­riage.

Some women who mis­carry de­velop a uter­ine in­fec­tion, also called a sep­tic mis­car­riage. Signs and symptoms of this in­fec­tion in­clude fever, chills, lower ab­dom­i­nal ten­der­ness and foul smelling vag­i­nal dis­charge. This is more com­mon after back­yard in­duced mis­car­riages.

When you are hav­ing a mis­car­riage, your doc­tor will do an exam and tests to make sure it is in­deed a mis­car­riage and in which cat­e­gory it falls. Mis­car­riages are clas­si­fied as threat­ened, in­evitable, missed, in­com­plete and com­plete de­pend­ing on whether the foe­tus is alive or not and whether the cervix is open or not.

A mis­car­riage can­not be treated as such. When it is only threat­en­ing, so called threat­ened mis­car­riage, your doc­tor will ad­vise strict bed rest. You might be asked to avoid ex­er­cise and sex as well. Although th­ese steps haven’t been proved to re­duce the risk of mis­car­riage, they might im­prove your com­fort. If you still go on to have a mis­car­riage, a pro­ce­dure known as di­lata­tion is curet­tage (D and C) is some­times done to clean the in­side of the uterus.

Phys­i­cal re­cov­ery from mis­car­riage in most cases will take only a few hours to a cou­ple of days. Ex­pect your pe­riod to re­turn within four to six weeks. You can start us­ing any type of con­tra­cep­tion im­me­di­ately after a mis­car­riage. How­ever, avoid hav­ing sex or putting any­thing in your vagina — such as a tam­pon — for two weeks after a mis­car­riage.

Of­ten, there is nothing you can do to pre­vent a mis­car­riage. Sim­ply fo­cus on tak­ing good care of your­self and your baby. Seek reg­u­lar pre­na­tal care, and avoid known risk fac­tors — such as smok­ing and drink­ing al­co­hol. If you have a chronic con­di­tion, work with your doc­tor to keep it un­der con­trol.

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