Today we will be talking about a very serious emotionally sensitive topic of miscarriages or abortions. What causes miscarriages? What is the risk factor for the miscarriages? Can you do something about it? When can you plan your next pregnancy and a lot more?
What is a miscarriage?
Miscarriage is a spontaneous loss of pregnancy before 20 weeks, counting from the first day of last menstrual period. It is also known as spontaneous abortion.
Actually medically for us, there is no difference between the miscarriage and the abortion. It's actually very surprising that 10 to 15% of pregnancies, clinically diagnosed pregnancies may actually result in a miscarriage.
This is actually a nature's way of making sure that an abnormal baby does not take birth. Miscarriages are more common in the first trimester of pregnancy than the second trimester. And in case the miscarriages occur for more than three consecutive times, this is known as a recurrent pregnancy loss or RPL.
What causes miscarriage?
Now let's understand what causes a miscarriage. The causes of miscarriages actually vary according to the trimester.
First trimester miscarriage
In the first trimester, the most common cause of the miscarriage is a chromosomal abnormality in the fetus. This is a cause which is actually not in your hands and it just happens by chance. This could be diagnosed when the pregnancy tissue is actually sent for a genetic testing, known as karyotyping. We could also do a karyotyping of both the partners to see if there is any problem at either end.
Increasing maternal age could also be a risk factor for the miscarriages. Any chronic medical conditions like diabetes, hypertension, kidney diseases, lupus diseases, autoimmune diseases, if they are uncontrolled, also can result in increased chances of miscarriages.
Medical conditions like, uncontrolled hypo or hyperthyroidism, hypertension , diabetes mellitus, PCOD and even increased prolactin levels also increase the risk of miscarriages. Being extremely overweight or underweight also increases the risk of abortions.
Recently, we are also talking about a new immunological or an autoimmune reason of first trimester abortions. This is known as antiphospholipid syndrome or acquired thermophilia. You might find it a little technical, but in this, actually because of some antibodies, the blood tends to become a little thicker. So the tiny blood vessels which are supplying blood to the developing babies, there the blood clots and now the fetus does not get a blood supply and hence dies.
Smoking, use of recreational drugs, alcohol also increases the risk of miscarriages. Exposure to environmental workplace toxins, especially lead and mercury based chemicals also increases the risk of miscarriages.
Second trimester miscarriage
Then coming to the second trimester, infections of the genital tract or of the pelvis can cause second trimester abortions. In fact, generalized systemic infections, high grade fevers like that of malaria and typhoid, they can actually cause miscarriages at any stage of pregnancy.
There is something known as cervical incompetence. But what is cervix? Cervix is the mouth of uterus. In some people, the cervix could be weak, just like that without any reason or sometimes because of previous surgery on the cervix or maybe repeated D & Cs. Now the cervix could be weak and it is not able to hold the pregnancy. So without any pain or without any uterine contraction, cervix just dilates and the baby gets expelled.
This condition is typically diagnosed by a typical clinical symptom and of course, we can do an ultrasound to see what is the situation of the cervix and the treatment of this condition is actually putting a stitch at the mouth of uterus in the next pregnancy.
Then the abnormalities in the uterus, which could be by birth abnormalities, some kind of by birth defects in the uterus, fibroids in the uterus, some kind of growths or polyps inside the uterus also may cause a second trimester abortion.
In fact, many times, actually there is no cause of a miscarriage. In fact, many women continue to have recurrent miscarriages without any reason also. It is said that each miscarriage actually increases the risk of next miscarriage also. But at the same time, it is also said that almost 90% of women may actually have a normal pregnancy next time.
Things that May not Cause Miscarriage
Mild stress, worry or anxiety, moderate physical activity like hiking, dancing, gentle walking, gentle jogging, sex during pregnancy, lifting weights, bending over, squatting, mopping the floor, travelling.
Travelling by car, train, flight are by and large safe in pregnancy. Wearing heels, any kind of a steam or sauna, having pineapple, papaya, jackfruit, colas, they do not cause an abortion. None of our medical books or medical guidelines actually say that the cause of miscarriage could be intake of papaya.
How to Prevent Pregnancy Loss
So what can be done to prevent a miscarriage?
Never blame yourself for what happened: It is nothing which you did or nothing which you did not do which led to a miscarriage. Talk to your doctor in detail. Give a proper detailed history. Get yourself nicely investigated.
Make sure that you are not smoking, you are away from drugs, alcohol. Make sure that you maintain an optimum body weight. If possible, try and plan your pregnancy at the right age.
In case you have any chronic medical conditions, make sure they are well controlled before you are actually planning a pregnancy. Do not forget to take preconceptional folic acid which is about five milligrams per day. In case you are suffering from any genital or pelvic infections, get it treated as fast as possible.
In case of a recurrent pregnancy loss, it is important to get your uterine cavity evaluated either by a 3D scan or maybe getting a hystroscopy done. Hystroscopy is a procedure by which using an endoscope, we examine the uterine cavity internally. And next time, as soon as you miss your period, visit your doctor as soon as possible. Nowadays, we do not ask our patients to be on bed rest. We actually say that bed rest is not a good idea.
Can I get pregnant after I've had a miscarriage?
Yes, of course, in fact, 90% of the women actually will have a normal pregnancy after they've had a miscarriage. In fact, only 1% of women may actually have a recurrent pregnancy loss.
When can I try again after a miscarriage?
So, there is actually no recommended time, whenever you are feeling emotionally and mentally ready to plan for the next pregnancy, it is okay. Also when your doctor feels that you are in the right optimum health for planning a pregnancy, then that's the right time. You could actually plan the next cycle also after your previous miscarriage.
Conclusion
So, I always feel in case of an abortion, it's the nature which is actually on our side. Because the nature does not want an abnormal baby to take birth. Yes, of course, there are many other treatable reasons of abortion also.
So, please get yourself investigated and treated well. Take care of yourself. Invest your time in attaining good health before you actually plan a pregnancy. And as usual, in case today you found this information useful and relevant, please do not forget to like, and share to your loved ones.