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How to deal with Miscarriage
after infertility treatment
Spontaneous abortion (SAB) or
miscarriage is the term used for a pregnancy that ends on it's own,
within the first 20 weeks of gestation. Often the medical name
spontaneous abortion
(SAB) gives many women a negative feeling, so throughout this
information we will refer to any type of spontaneous abortion or
pregnancy loss under 20 weeks as miscarriage. Miscarriage is the
most common type of pregnancy loss, according to the American
College of Obstetrics and Gynecology(ACOG). Studies reveal that
anywhere from 10- 25% of all clinically recognized pregnancies will
end in miscarriage. Estimations of chemical pregnancies or
unrecognized pregnancies that are lost can be as high as 50-75%, but
many of these are unknown since they often happen before a woman has
missed a period or is aware she is pregnant. Most miscarriages occur
during the first 13 weeks of pregnancy. Pregnancy can be such an
exciting time, but with the great number of recognized miscarriages
that occur, it is beneficial to be informed on miscarriage, in the
unfortunate event that you find yourself or someone you know faced
with one.
There can be many confusing terms and moments that accompany a
miscarriage. There are different types of miscarriage, different
treatments for each and different statistics for what you chances
are of having one. The following information gives a broad overview
of some of the confusing parts of miscarriage. This information is
to help equip you with knowledge so that you might not feel so alone
or lost if you face a possible miscarriage situation. As with most
complications with pregnancy, remember that the best person you can
usually talk with and ask questions of, is your health care
provider.
Why do miscarriages
occur?
The
reason for miscarriage is varied and most often, the cause can not
be identified. During the first trimester, the most common cause of
miscarriage is chromosomal abnormality-meaning that something is not
correct with the baby's chromosomes. Most chromosomal abnormalities
are the cause of a faulty egg or sperm cell or due to a problem at
the time that the zygote went through the division process. Other
causes for miscarriage include (but are not limited to):
·
Hormonal problems, infections or health problems in
the mother
·
Lifestyle (i.e. smoking, drug use, malnutrition,
excessive
caffeine and
exposure to radiation or toxic substances)
·
Implantation of the egg into the uterine lining does not occur
properly
·
Maternal Age
·
Maternal trauma
Factors that are not proven to cause miscarriage are sex, working
outside the home (unless in a harmful environment) or moderate
exercise.
What are the chances
of having a Miscarriage?
For women in childbearing years, the chances of having miscarriage
can range from 10-25%, and in most healthy women the average is
about 15-20% chance.
·
An increase in maternal age changes the chances of
miscarriage
·
Women under the age of 35 yrs old have about a 15%
chance
of miscarriage
·
Women aged 35-45 yrs old have a 20-35% chance of
miscarriage
·
Women over the age of 45yrs old can have up to a 50%
chance
of miscarriage
·
A woman who has had a previous miscarriage has a 25%
chance
of having another
(only a slightly elevated risk than for someone
who has not had a
previous miscarriage)
What are the Warning signs
of Miscarriage:
If
you experience any or all of these symptoms, it is very important to
contact your doctor or get to a medical facility as soon as
possible:
·
Mild to severe back pain (often worse than normal menstrual
cramps)
·
Weight loss
·
White-pink mucus
·
True contractions (very painful happening every 5-20
minutes)
·
Frequent bowel movements
·
Brown or bright red bleeding or spotting with or
without cramps
(20-40% of all
pregnancies can experience some bleeding in
early pregnancy,
with about 50% of those resulting in normal
pregnancies)
·
Tissue with clot like material passing from the
vagina
·
Nausea
·
Decrease in signs of pregnancy or loss of breast
tenderness
The different types of
Miscarriage:
Miscarriage is often a process and not a single event. There are
many different stages or types of miscarriage. There is also a lot
of information to learn about healthy fetal development so that you
might get a better idea of what is going on with your pregnancy.
Understanding early fetal development and first trimester
development can aide you in knowing what things your health care
provider is looking for when there is concern of a miscarriage
occurring.
Most of the time
all types of miscarriage are just called
Miscarriage,
but you may hear your health care provider refer to other terms or
names of miscarriage such as:
Threatened Miscarriage:
Some degree of early pregnancy uterine bleeding accompanied by
cramping or lower backache. The cervix remains closed. This bleeding
is often the result of implantation.
Inevitable or Incomplete Miscarriage:
Abdominal or back pain accompanied by bleeding with an open cervix.
Miscarriage is inevitable when there is a dilation or effacement of
the cervix and/or there is rupture of the membranes. Bleeding and
cramps may persist if the miscarriage is not complete.
Complete Miscarriage:
A completed miscarriage is when the embryo or
products of conception
have emptied out of the uterus. Bleeding should subside quickly, as
should any pain or cramping. A completed miscarriage can be
confirmed by an ultrasound or by having a surgical curettage
performed
Missed Miscarriage:
Women can experience a miscarriage with out knowing it. A missed
miscarriage is when embryonic death has occurred but there it not
any expulsion of the uterus. It is not known why this occurs. Signs
of this would be a loss of pregnancy symptoms and the absence of
fetal heart tones found on an ultrasound.
Recurrent Miscarriage (RM):
Defined as 3 or more consecutive first trimester miscarriages. This
can affect 1% of couples trying to conceive.
Blighted Ovum:
Also called an
anembryonic pregnancy.
A fertilized egg implants into the uterine wall, but fetal
development never begins. Often there is a gestational sac with or
without a yolk sac, but there is an absence of fetal growth.
Ectopic Pregnancy:
A fertilized egg implants itself in places other than the uterus,
most commonly the fallopian tube. Treatment is needed immediately to
stop the development of the implanted egg. If not treated rapidly,
this could end in serious maternal complications.
Molar Pregnancy:
The result of a genetic error during the fertilization process that
leads to growth of abnormal tissue within the uterus. Molar
pregnancies rarely involve a developing embryo, but often entail the
most common symptoms of pregnancy including a missed period,
positive pregnancy test and severe nausea.
Treatment of
Miscarriage:
The main goal of treatment during or after a miscarriage is to
prevent hemorrhaging and/or infection. The earlier you are in the
pregnancy, the more likely that your body will expel all the fetal
tissue by itself, and will not require further medical procedures.
If the body does not expel all the tissue, the most common procedure
performed to stop bleeding and prevent infection is a dilation and
curettage, known as a D&C. Drugs may be prescribed to help control
bleeding after the D& C is performed. Bleeding should be monitored
closely once you are at home and if you notice an increase in
bleeding or the onset of chills or fever, it is best to call your
physician immediately.
Prevention of
Miscarriage:
Since the cause for most miscarriages is due to chromosomal
abnormalities, there is not much that can be done to prevent them.
One vital step is to get as healthy as you can before conceiving to
provide a healthy atmosphere for conception to occur.
·
Exercise regularly
·
Eat healthy
·
Manage stress
·
Keep weight in healthy limits
·
Take folic acid daily
·
Do not smoke
Once you find out that you are pregnant, again the goal is to be as
healthy as possible, to provide a healthful environment for your
baby to grow in:
·
Keep your abdomen safe
·
Do not smoke or be around smoke
·
Do not drink alcohol
·
Check with your doctor before taking any
over-the-counter
medications
·
Limit or eliminate caffeine
·
Avoid environmental hazards such as radiation,
infectious
disease and x-rays
·
Avoid contact sports or activities that have risk of
injury
Emotional Treatment:
Unfortunately, miscarriage is not prejudice in whom it touches. It
can affect any couple or family. Often women are left with
unanswered questions regarding their physical recovery, their
emotional recovery and trying to conceive again. It is very
important that women try to keep the lines of communication open
with family, friends and health care providers during this time.
Some helpful websites that deal with miscarriage and pregnancy loss
include:
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