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The miscarriage: what is it? Causes, Symptoms and Treatment

A miscarriage (termed spontaneous abortion for doctors) is the natural interruption of pregnancy before 20 weeks of pregnancy. It occurs in 15 to 20% of pregnant women. Most miscarriages occur very early in pregnancy, sometimes even before a woman knows she is pregnant.

In most cases, it is impossible to prevent a miscarriage.

Causes of miscarriage

There are many causes of miscarriage that are not always identifiable. The most common are:

  • Genetic abnormalities . The development of the embryo or fetus is not normally done because of genetic problems. This is the most common cause of miscarriage during the first trimester.
  • Women’s health problems . Certain health conditions of the woman may lead to miscarriage, for example, uncontrolled diabetes, thyroid gland disease, infection (eg rubella or influenza), hormonal problems or uterine abnormalities or cervix.

Can everyday activities cause miscarriage?

Contrary to popular belief, daily activities do NOT cause miscarriage. Pregnant, you can totally:

  • To exercise.
  • Lifting weights or forcing.
  • Have sex.
  • Work (unless exposed to dangerous chemicals)

Complications related to miscarriage

Rarely, some women who have a miscarriage can develop a uterine infection called septic miscarriage. This is due to the fact that there are cell residues inside the uterus and this can become infected. The symptoms are:

  • The fever .
  • Chills.
  • Diffuse body pain.
  • Nauseating vaginal discharge.

Psychological aspects

Many women experience depression after a miscarriage. This condition can partly be explained by hormonal changes caused by miscarriage, which is very similar to baby blues or postpartum depression.

Miscarriage can also lead to stress, worry, disappointment, or questioning related to motherhood. Do not hesitate to use psychological help to comfort you. The vast majority of women who have a miscarriage eventually have healthy babies. One in two women miscarries in her life and that does not stop her from becoming a mother most of the time.

Symptoms of miscarriage

Bleeding, pain … all symptoms:

  • Of light or heavy vaginal bleeding , irregular or constant. A doctor should be consulted in case of bleeding, especially if they are accompanied by pain.
  • Pain in the lower back or abdomen.
  • Abdominal cramps.
  • Tissues or clots of blood expelled through the vagina.

Who has the highest risk of miscarriage?

  • Women over 35 years old . Women 35 years of age have a 20% risk of miscarriage. At age 40, this risk increases to 40% and at age 45, it is 80%. The age of the father could also play a role (the risks of miscarriage would be higher for women whose partner is over 40).
  • Women who had 2 miscarriages or more . After a miscarriage, the risk of making a second one is the same as during the first pregnancy.
  • Women with  chronic diseases  ( diabetes , thyroid gland disease,  lupus ,  celiac disease ).
  • Women who have abnormalities of the cervix or uterus ( uterine fibroids , polyps, polycystic ovary syndrome).
  • Women with an infection (flu, rubella)
  • Women who smoke (relative risk multiplied by 3).
  • On the other hand, the fact of having an abortion , of having taken a contraceptive contraception, of having several children does not play on the risk of miscarriage.

Risk factors for miscarriage

Coffee and pregnancy: risk of miscarriage?

According to Health Canada, pregnant and breastfeeding women should not consume more than 300 mg of caffeine per day (just over two cups of coffee, or approximately 235 ml). Two epidemiological studies have highlighted the increased risks of miscarriage and the birth of a baby with a low birth weight  in pregnant women who consume more than 3 cups of coffee a day. On the other hand, other data indicate that, despite what was believed at one time, coffee consumption is not associated with the risk of fetal death or congenital malformation.

  • Smoking increases the risk considerably,
  • Alcohol or drugs during pregnancy. (Remember that one must drink zero alcohol during pregnancy).
  • Regular exposure to certain chemicals.
  • Taking medication during pregnancy, such as ibuprofen, naproxen, and other nonsteroidal anti-inflammatory drugs.

See the news on Passeportsanté.net: Anti-inflammatory drugs are linked to miscarriages

  • Caffeine consumption in high doses, more than 3 cups a day.
  • Some prenatal tests such as amniocentesis or chorionic villus sampling. (see box)
  • Consumption of raw (unpasteurized) milk potentially leading to contamination by Samonella , Listeriaor E. coli bacteria .
  • Fever.
  • The rubella virus and other untreated maternal infections (toxoplasmosis, cytomegalovirus, influenza).

Prenatal tests and risks of miscarriage

The amniocentesis is the technique most common prenatal diagnosis. It makes it possible to determine with certainty whether the fetus has trisomy. This test can be performed when 14 weeks of pregnancy have been completed. For amniocentesis, amniotic fluid is collected from the pregnant woman’s uterus using a thin needle inserted into her abdomen. This test involves a risk of fetal loss of about 1 in 200 or 0.5% . That’s why doctors offer this test especially to women 35 years and older or women who are at high risk following a blood test.

The removal (or biopsy) of chorionic villi (PVC) involves the removal of placenta fragments called chorionic villi. The sample is taken through the abdominal wall or vaginally between 11 and 13 weeks of pregnancy. The technique makes it possible to determine if the fetus carries a chromosomal anomaly, for example trisomy. The biopsy of the chorionic villi has a risk of miscarriage of 0.5 to 1% .

Is it possible to prevent a miscarriage?

In most cases, it is not possible to prevent a miscarriage, since it is often related to abnormalities of the embryo. However, a woman can reduce certain risks by adopting good habits for her health and that of her unborn child.

  • Vaccinate against rubella if you have not had it.
  • Regularly screen for toxoplasmosis (if you are not immune) to be treated quickly when needed.
  • Vaccinate against the flu before the beginning of your pregnancy.
  • Adopt healthy eating habits.
  • Exercise regularly.
  • Ban completely the alcohol consumption
  • Do not smoke any cigarettes.
  • Make regular visits to a health professional to monitor the pregnancy.
  • If you suffer from a chronic illness, consult your doctor so that your treatments ensure optimum health for you and your fetus.

If you have had several consecutive miscarriages, it may be advisable to make a detailed assessment of your health or that of your spouse, in order to identify possible causes.

Medical treatment of miscarriage

When a woman has a miscarriage early in pregnancy, no treatment is necessary. The uterus usually clears the residual tissue by itself after 1 or 2 weeks (sometimes up to 4 weeks).

In some cases, a drug (misoprostol) can be administered (orally or placed in the vagina) to stimulate the uterus and facilitate tissue evacuation (usually within a few days).

When bleeding is heavy, the pain is severe, or the tissues are not naturally drained, it may be necessary to curettage to remove any tissue remaining in the uterus. The gynecologic surgeon dilates the cervix and the remains of tissue are gently removed by suction or by gentle scraping.

When a miscarriage occurs after the first trimester (13 weeks of pregnancy and over), the gynecologist may decide to cause the work to facilitate the passage of the fetus. These second-trimester interventions usually require a hospital stay.

Following a miscarriage, it is best to wait for a normal menstrual cycle before trying to conceive a new baby.

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