A miscarriage, or spontaneous abortion, is a pregnancy loss that occurs prior to 20 weeks gestation. Most miscarriages occur in the first 12 weeks of pregnancy (first trimester). A miscarriage is a naturally occurring and involuntary event in which the fetus and placenta are separated from the uterine wall.
Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage. Chemical pregnancies may account for 50-75% of all miscarriages. This occurs when a pregnancy is lost shortly after implantation, resulting in bleeding that occurs around the time of her expected period.
Miscarriages, or spontaneous abortions, occur in a continuum of 4 stages: threatened, inevitable, incomplete, and complete abortion. A threatened abortion refers to vaginal bleeding during the first 20 weeks of pregnancy that may indicate that a miscarriage could occur, although
no dilation of the cervix is present; this happens in about 20% to 30% of pregnancies, although only 50% of threatened abortions actually lead to miscarriage. An inevitable abortion has bleeding with dilation of the cervix and is more likely to lead to miscarriage than a threatened abortion. An incomplete abortion involves bleeding, cervical dilation, cramping, and passage of some of the contents of the uterus: only tissue may be passed, while the fetus or placenta remains in the uterus. An incomplete abortion is not to be confused with a missed abortion that occurs when the fetus has died but remains in the uterus, a specific condition that may lead to elective abortion. A complete abortion occurs when all the contents of the uterus are expelled through the vagina. All the symptoms of earlier stages of spontaneous abortion are typically present, but the miscarriage is complete and the uterus is empty.
no dilation of the cervix is present; this happens in about 20% to 30% of pregnancies, although only 50% of threatened abortions actually lead to miscarriage. An inevitable abortion has bleeding with dilation of the cervix and is more likely to lead to miscarriage than a threatened abortion. An incomplete abortion involves bleeding, cervical dilation, cramping, and passage of some of the contents of the uterus: only tissue may be passed, while the fetus or placenta remains in the uterus. An incomplete abortion is not to be confused with a missed abortion that occurs when the fetus has died but remains in the uterus, a specific condition that may lead to elective abortion. A complete abortion occurs when all the contents of the uterus are expelled through the vagina. All the symptoms of earlier stages of spontaneous abortion are typically present, but the miscarriage is complete and the uterus is empty.
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Causes of miscarriage
The reason for miscarriage is varied, and most often the cause cannot 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 damaged egg or sperm cell, or are due to a problem at the time that the zygote went through the division process.
Other causes for miscarriage
Ø Hormonal problems
Ø Infections or maternal health problems
Ø Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
Ø Implantation of the egg into the uterine lining does not occur properly
Ø Maternal age
Ø Maternal trauma,
Ø Malnutrition
Ø history of uterine tumors
Ø fibroids, uterine defects
Ø Cervical incompetence
Ø uncontrolled thyroid disease or other hormonal imbalances
Ø kidney disease, active infection
Ø chronic disease (e.g., diabetes, polycystic ovary syndrome, lupus erythematosus, hypertension, and antiphospholipid syndrome)
Ø maternal-fetal Rh incompatibility may also increase the risk of miscarriage.
Factors that are not proven to cause miscarriage are sex, working outside the home (unless in a harmful environment) or moderate exercise.
The chances of having a Miscarriage
For women in their childbearing years, the chances of having a miscarriage can range from 10-25%, and in most healthy women the average is about a 15-20% chance.
An increase in maternal age affects the chances of miscarriage
Women under the age of 35 yrs old have about a 15% chance of miscarriage
Women who are 35-45 yrs old have a 20-35% chance of miscarriage
Women over the age of 45 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)
The Warning signs of Miscarriage
If you experience any or all of these symptoms, it is important to contact your health care provider or a medical facility to evaluate if you could be having a miscarriage:
Ø Mild to severe back pain (often worse than normal menstrual cramps)
Ø Weight loss
Ø White-pink mucus
Ø True contractions (very painful happening every 5-20 minutes)
Ø Brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)
Ø Tissue with clot like material passing from the vagina
Ø Sudden decrease in signs of pregnancy
Types of Miscarriage
Most of the time all types of miscarriages 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 (D&C) performed.
Missed Miscarriage: Women can experience a miscarriage without knowing it. A missed miscarriage is when embryonic death has occurred but there is not any expulsion of the embryo. 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 for miscarriage
With an uncomplicated, complete abortion, in which all fetal tissue is passed out of the uterus, no unusual surgical or medical treatment is required. Follow-up care is necessary to check for infection or excessive blood loss.
A threatened abortion is a watch and wait situation, and no medical therapy is given other than bed rest, an increase in fluid consumption, and possibly progesterone supplements, although there is no evidence that hormone therapy is useful.
An incomplete, inevitable, or missed abortion, in which some of the products of conception remain in the uterus, may require removal of uterine contents by D&C (dilation and curettage or suction curettage). If this is not done, the tissue remaining inside the uterus can cause an infection or delayed bleeding. The D&C may be done under general anesthesia at the outpatient department of a hospital or clinic. A medical alternative to surgical intervention is administration of misoprostol, a drug that induces complete abortion with few complications in most women (87% to 96.3%).
If bleeding continues after D&C, due either to perforation of the uterus or blood vessels, electrocauterization of the bleeding site may be done using laparoscopy or laparotomy to access the uterine cavity.
Rh-negative women are given Rho(D) immune globulin to prevent antibody development and future Rh complications. Psychological treatment such as counseling or psychotherapy may be indicated for help in coping with the loss of the pregnancy. Some women may also benefit from attending support groups with other women who have experienced a miscarriage.
Prevention of Miscarriage:
Since the cause of 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 within healthy limits , Take folic acid daily , Do not smoke
The pregnant woman's diet chart should be on the following lines:
Breakfast: Fresh fruits and a glass of milk mixed with a teaspoonful of honey.
Lunch: Steamed vegetables, boiled rice or whole wheat chappatis and soup or buttermilk.
Mid afternoon: A glass of fruit juice or a whole fruit.
Dinner: Cooked diet similar to the afternoon meal may be taken till the seventh month. After that, fruits, nuts, germinated seeds and sprouts, milk, buttermilk and soups must form her diet because they reduce the workload on the digestive system and thus help avoid indigestion, constipation and related disorders.
Indian gooseberry, known as amla in the vernacular, is considered useful in preventing abortion. A teaspoonful fresh amla juice and honey mixed together should be taken every morning during the period of pregnancy. It will also prevent infections and help in the absorption of iron. A brew made from safflower foliage is also said to prevent abortion.
Complications
Complications may include infection, severe bleeding, or complications from a D&C and/or blood transfusion. The timeliness of the D&C is critical in preventing morbidity and mortality. Anemia may occur due to severe blood loss or hemorrhage. Disseminated intravascular coagulation (DIC) is a serious coagulation disorder that can develop with prolonged heavy bleeding. Shock may also accompany DIC. Women who have had a D&C are at risk for developing adhesions in the uterine cavity (Asherman syndrome), which can interfere with future fertility. Psychological depression may slow overall physical recovery.
HOMEOPATHY FOR HABITUAL ABORTION
A complete history is important to prescribe a remedy for habitual abortion. Previous pregnancy and family history of the patient should be taken in detail. Cause of abortion and emotional constitution of the patient determines the homeopathic remedy for the complaint. Homeopathic remedy should be taken under a qualified homeopath. Homeopathic remedy prevents the recurrence of miscarriage. I am going to give you some important homeopathic medicines and its symptoms related to abortion. As I always tell you, a homeopath treats man in disease and he or she designs the medicine which suits for the patient.
Caulophyllum
For women who have a tendency to suffer from miscarriages. There is a weakening of the uterine tissues. For habitual miscarriage or women under constant threat of recurring miscarriages, all kinds of bleeding from the uterus, and heaviness in the abdominal area when pregnant. Physical symptoms evident during the condition include the presence of severe uterine spasms passing all over the body, the development of an excruciating pain that seems to radiate in all directions within the body. Trembling physical weakness in the body. Symptoms also include profuse to thin and extremely acrid vaginal discharge from time to time. The menstrual cycle of the woman may often come early, and is always heavy or prolonged in duration. Symptoms include extreme physical exhaustion, and sudden appetite loss, the weak memory, and tendency to suffer from insomnia and other sleep disorders.
Sabina
This is a remedy useful to prevent impending abortion occurring about the third month, ushered in by the appearance of blood, which is oftentimes the first symptom; then follow pain in the small of the back, going around and through the pubes ; there are forcing and dragging pains from the sacrum to the pubes. The flow is bright red and clotted. It is useful for metritis accompanied by flooding from miscarriage. Cinamomum. Useful for abortion from a strain or misstep with profuse haemorrhage and slight pain. Arnica. Threatened miscarriage from traumatism.
Viburnum opulus.
Threatening miscarriage when the pains come from the back around to the lower part of the abdomen and go into the thighs. It will often stop these spasmodic pains. It is a remedy to be used in frequent and early miscarriages. Sepia is one of our most important remedies as a preventive of miscarriage. It is indicated by nervous irritability, laxness of tissues and a sense of weight in the anus. Belladonna. Threatened miscarriage with profuse hot haemorrhage, backache, headache and the peculiar uterine tenesmus of the remedy and violent aching of the body. The least jar is painful.
Cimicifuga
For the threat of a miscarriage during the third month of pregnancy. Extreme and cramping pains that seem to fill the abdomen across from side to side, and tend to radiate left to right, or down to the thighs. Accompanied by nausea, and spells of fainting or dizziness and backache. Can be doubled up with the extreme painful sensations passing over the body. Symptoms include the ovarian neuralgia. The woman may often cry out from the pain. psychological symptoms include feelings of insanity due to the extreme pain. Psychological symptoms also include the presence of a deep and persistent depression along with a feeling of constant dread about her surroundings and life in general. Menstrual issues tend to be very dark, often clotted, offensive smelling. The menstrual cycle is irregular and the painful sensations often increase with the flow of blood from the uterus.
Sabina
Has a special action on the uterus; also upon serous and fibrous membranes; hence its use in gout. Pain From sacrum to the pubis. hemorrhages, where blood is fluid and clots together. Tendency to miscarriage, especially at third month. Violent pulsations; wants windows open. Better in cool fresh air. Worse from least motion, heat, warm air.
Secale
For the constant threat of a miscarriage during the third month of a pregnancy. Extremely heavy flows of a black, and offensive smelling, watery looking or oozing blood during the menstrual period. Extremely cold and almost blue skin, often with cramping in the fingers. Physical feebleness and exhaustion. Pain forces the woman to bear or bend down; these forceful sensations are present at all times of the day and night.
Sepia
For tendency to get miscarriages during the fifth to the seventh month of a term of pregnancy. Persistent morning sickness every day. Sensation of a ball like structure within the uterus. The painful sensations may make women feel like they need to bear or bend down with the pain. The woman may also suffer from a prolapsed uterus, and can often be affected by fibroids in the uterine tissues. The woman also finds any motions performed by the developing fetus to be intolerable and extremely uncomfortable. Yellow colored discharges. There are also extreme and severe itching sensations in the vulva which can trigger the miscarriage. Chills running down the body; physical exhaustion at most times of the day and night. Worsein the mornings and in the evenings; dampness aggravates. Very weary, and worn out from fatigue. Depression, and indifference to most things, aversion to sexual intercourse. The woman in addition desires to be left alone at most times.
Platina, phosphorus, pulsatilla, natrum mur, lycopodium, calcarea carb, silicea, baryta carb, ignatia, sulphur..Etc can also be prescribed constitutionally.
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