Miscarriage Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Miscarriage is the death of the fetus in the womb before the age of 20 weeks of pregnancy. This is a problem in pregnancy which is often a scourge for women who are pregnant.
Many studies show that 8-20 percent of women who find out they are pregnant miscarry before 20 weeks of gestation. And 80 percent of miscarriages occur in the first 12 weeks of pregnancy.
However, the exact number of miscarriages cannot be predicted precisely because many women experience them before knowing that they are pregnant. Therefore, it is very important to know the symptoms of miscarriage.
Symptoms
A common symptom of miscarriage is the appearance of blood streaks from the vagina. The discharge that comes out varies, ranging from brown mucus, light blood spots, to quite a lot of bleeding.
This condition can come and go and last for several days. However, keep in mind that light bleeding is quite common in the first 12 weeks of pregnancy.
Other symptoms of miscarriage can include:
- Abdominal cramps and pain in the lower abdomen
- discharge from the vagina
- Discharge of tissue from the vagina
- No longer experiencing pregnancy symptoms, such as nausea
In the medical world, doctors use the following terms to describe the types of miscarriage:
Threatened miscarriage
This is a condition in which a pregnant woman experiences vaginal bleeding but does not show any other symptoms of miscarriage. The cervix is still closed and the size of the uterus is appropriate for gestational age. If the gestational age is quite a week, the fetal heart rate can be detected.
In many women who experience this type of miscarriage, the blood will gradually stop coming out. Pregnancy can also be continued until the time of delivery. However, bleeding can occur more intensely and trigger a miscarriage.
Inevitable miscarriage
This is an unavoidable miscarriage because the cervix is already open, the bleeding is profuse, and the patient also experiences stomach cramps.
Incomplete miscarriage Incomplete
miscarriage means that the patient has removed fetal tissue from the uterus, but there is still tissue left in the uterus. Usually, what decays is the fetus. While the remaining part in the uterus is part of the placenta. The cervix remains open and there is considerable bleeding.
Complete miscarriage
If all of the pregnancy tissue such as the fetus and placenta has been shed, this is what is known as a complete miscarriage. This miscarriage is common in pregnancies under 12 weeks of age.
After a miscarriage, the patient will still have bleeding and stomach cramps, but these two things will get better on their own. At the time of the ultrasound examination, it will be seen that the cervix has closed again and no gestational sac is visible.
Reason
There are many things that can cause a miscarriage, but the exact cause is unknown. Most cases of miscarriage are not caused by the normal activities of the mother.
Experts estimate that 70 percent of miscarriage cases are caused by chromosomal abnormalities in the fetus. This abnormality can result in the fetus not being able to develop as it should. If a miscarriage occurs in the second trimester (between the 14th and 26th week), it is usually caused by an illness or health condition of the mother.
In addition to fetal chromosomal abnormalities, miscarriages can occur due to the following factors:
- Mother’s age over 35 years
- Chronic (long-term) disease, such as diabetes or thyroid disease
- Maternal health problems, such as abnormal uterine structure
- Certain infectious diseases, such as malaria and toxoplasmosis
- Response of the mother’s immune system
- Consumption of drugs that have bad side effects on the fetus, such as retinoids and non-steroidal anti-inflammatory drugs
- Smoking, drinking, and abusing drugs
- Excessive consumption of caffeine
- Overweight or underweight
- Have had more than three miscarriages
- Ectopic pregnancy (pregnancy outside the womb) can also trigger a miscarriage. This type of pregnancy has a risk of rupture and cause internal bleeding. Symptoms of an ectopic pregnancy include missing periods, severe abdominal pain that doesn’t go away, bleeding or spotting from the vagina, shoulder pain, dizziness, and dizziness.
Diagnosis
Initially, the doctor will collect information about the symptoms that occur and perform a physical examination. A physical examination is carried out to ensure that a miscarriage has occurred, and to check whether there is still pregnancy tissue in the uterus or not.
Generally, the first physical examination performed is an ultrasound (USG). The goal is to check the development of the fetus including its heartbeat.
In most cases of miscarriage, the ultrasound that is performed is a transvaginal ultrasound, that is, by inserting a scan tool into the vagina. The patient will feel uncomfortable during the examination.
Sometimes, a miscarriage cannot be diagnosed quickly using an ultrasound or blood test. This is because the fetal heart rate is not clearly visible in early pregnancy (less than six weeks). If this happens, the patient will be advised to check his condition again within one to two weeks.
If the patient has had three miscarriages or even more, ongoing examinations must be carried out to find out other medical factors that might be the cause.
Examinations that will be carried out include:
- Gene examination to see if there are abnormalities in the patient’s or partner’s chromosomes.
- Transvaginal ultrasound examination performed at 10-12 weeks of gestation. This is done to see the structure of the patient’s uterus and cervix.
- Blood test. The patient’s blood sample will be checked for levels of antiphospholipid antibodies (aPL) and lupus anticoagulant. An examination should be carried out at least twice with a six-week interval when the patient is not pregnant. aPL antibodies are known to increase the chance of blood clots and change the way the placenta attaches.
Treatment
Unfortunately, there is no medical method that can stop the process of miscarriage. Once the process begins, there are several options available depending on the stage of the miscarriage process, the patient’s condition, and other factors.
These options are:
Observation
Treatment for women who experience a miscarriage at less than 12 weeks of gestation, have normal blood pressure and show no signs of infection generally do not require treatment or curettage.
Over time, all the tissue will come out naturally from the uterus. This process can take around 3-4 weeks. When the process is complete, the doctor will do an ultrasound to make sure the uterus is clean.
1. Drugs
In some cases, drugs can be given to stimulate the uterus to expel the remaining pregnancy tissue. These drugs can be given in the form of tablets or drugs that are inserted into the vagina. Generally, the drug will be effective within 24 hours.
2. Operation
The operating method in question is the curettage procedure. This method is done by dilating the cervix and using a tool to remove the remaining tissue from inside the uterus. The curettage procedure needs to be carried out as soon as possible in patients who experience severe bleeding or have symptoms of infection. The risk of this procedure is that cervical tissue and uterine lining can be injured.
3. Post-Miscarriage Conditions
Miscarriage is an experience that can be physically and emotionally draining for a person. Women who have just had a miscarriage generally feel guilty, shocked, and angry. In this period, the support of partners and surroundings is needed.
After the condition has recovered and you have experienced one menstrual cycle, you are usually allowed to get pregnant again. However, make sure you are ready both physically and emotionally.
Prevention
Can miscarriage be prevented? Unfortunately, the majority of miscarriages cannot be prevented. If a miscarriage has been experienced three or more times, the doctor will give medicines to maintain the condition of the pregnancy.
However, there are several steps that pregnant women can take to reduce the risk of miscarriage, including:
- Avoid smoking and consuming alcoholic beverages.
- Avoid drug abuse.
- Follow a healthy diet.