One of the most common pregnancy related issues is the miscarriage. This is a loss of baby in the first twenty weeks of pregnancy. There are some studies in which are said that about 15 – 20% of pregnancies end in miscarriage [1]. Miscarriage is also known as spontaneous abortion. It is defined as a spontaneous loss of a pregnancy in the first twenty weeks. This is the most common type of pregnancy loss. It is estimated that more than 80% of women miscarriages happen in the first trimester [2] so this is a reason why many women decide to wait before they tell to their relatives and friends about the good news until they pass the 13th week. When the miscarriage has started, there is no way to stop it. This is a reason why you should visit your doctor and to get treatments to prevent hemorrhaging and infections.
Miscarriage Symptoms and Causes
Symptoms: The spotting in the early pregnancy is very common but this symptom should never be considered as normal and you should always talk with your doctor. The presence of spotting does not always indicate a miscarriage but it is a sign that something abnormal may be going on in the pregnancy. There are some women who do not experience any symptoms of miscarriage at all. Here are the possible signs of miscarriage:
- Bleeding
- Passing tissue or clot – like material
- White – pink mucus
- Loss of pregnancy symptoms, such as nausea or vomiting
- Pain in your back or abdomen
- Mild to severe cramps
Causes: There are many women who blame themselves or their behavior if they have a miscarriage but it is important not to blame yourself because there is nothing you can do to prevent it. Miscarriage is not caused by a small daily cup of coffee, sex or moderate exercise. The genetic abnormality in the embryo is the most common cause for miscarriage. There are many issues that could lead to miscarriage, such as
- High fever: It is not important how healthy you are normally, if you develop a high fever during the early pregnancy, then you can experience a miscarriage. The fever which is considered as high is over 102 degrees. It is known fact that a high core body temperature is the most damaging to the embryo before six weeks. [3]
- Chronic illness: It is known fact that chronic illnesses such as liver disease, kidney disease, heart disease, lupus and autoimmune disorders are causing as many as 6% of the recurrent miscarriages. If you suffer from some chronic illness, then you should find an obstetrician experienced in caring for women who have this condition.
- Uterine problems: When you have uterine fibroids inside the uterus, then they can interfere with the implantation or blood supply to the fetus [4]. There are some women who are born with a septum which is an uncommon uterine defect that is linked to miscarriage. Other women develop bands of scar tissue in the uterus from surgery or second – term abortions which can keep an egg from implanting properly or may hamper blood flow to the placenta. Your doctor can determine the uterine defects through specialized X – rays and most of them can be treated.
- Hormone imbalance: There are about 15% of all miscarriages which are attributed to the unbalanced hormones, such as insufficient progesterone levels which can prevent the fertilized egg from implanting in the uterus. [5]
- Chromosomal problems: In the fertilization process, the eggs and sperm each bring 23 chromosomes together to create 23 perfectly matches pairs of chromosomes. It is a complex process and if there is minor glitch, this can result in a genetic abnormality which can prevent the embryo from growing. There are many doctors who are blaming the genetics for the most miscarriages. As we are getting older, these glitches are having more chances to happen. [6]
Miscarriage Risk factors
Risk factors: Here are some factors which can result in miscarriage:
- Infections such as Lyme disease or Fifth disease
- Advanced maternal age (over 35)
- Certain medication
- Maternal trauma, such as car accident [7]
- Listeria which is a bacteria that can be present in raw eggs, undercooked meats and unpasteurized dairy products
- Excess drinking [8]
- Smoking [9]
- Drug use
References:
[1] Tommy’s: Together, for every baby. Miscarriage statistics. Retrieved from www.tommys.org/our-organisation/charity-research/pregnancy-statistics/miscarriage
[2] The American College of Obstetricians and Gynecologists. Early Pregnancy Loss. Retrieved from www.acog.org/Clinical-Guidance-and-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Early-Pregnancy-Loss?
[3] Sass L, Urhoj SK, Kjærgaard J, et al. Fever in pregnancy and the risk of congenital malformations: a cohort study. BMC Pregnancy and Childbirth. 2017;17:413.
[4] Hartmann KE, Velez Edwards DR, Savitz DA, et al. Prospective cohort study of uterine fibroids and miscarriage risk. American Journal of Epidemiology. 2017;186(10):1140-8.
[5] Jukic AMZ, Weinberg CR, Wilcox AJ, Baird DD. Effects of early pregnancy loss on hormone levels in the subsequent menstrual cycle. Gynecological Endocrinology. 2010;26(12):897–901.
[6] de Marqui ABT. Chromosomal abnormalities in recurrent miscarriages by conventional karyotyping analysis. Revista Brasileira de Saúde Materno Infantil. 2018;18(2).
[7] Qu F, Wu Y, Zhu YH, et al. The association between psychological stress and miscarriage: A systematic review and meta-analysis. Scientific Reports. 2017;7:1731.
[8] Avalos LA, Roberts S, Kaskutas LA, et al. Volume and type of alcohol during early pregnancy and the risk of miscarriage. Substance Use & Misuse. 2014;49(11):1437–45.
[9] Knopik VS. Maternal smoking during pregnancy and child outcomes: Real or spurious effect? Developmental Neuropsychology. 2009;34(1):1–36.
