Miscarriage is something most women worry about during pregnancy. The risk is usually high during the first three months which reduces drastically after 20 weeks. Usually, one in five pregnancies ends in miscarriage.
In many cases, women may not have even known they were pregnant, instead, the miscarriage may be mistaken for a period. A chemical pregnancy is when an early miscarriage occurs shortly after implantation. There are chances that a late or heavy period could have been a chemical pregnancy. If your period has occurred around 2 weeks late, one cannot confirm if it was a miscarriage or not. It can only be confirmed by checking the pregnancy hormone hCG (human chorionic gonadotropin) in the blood. Chances of early pregnancy loss increase as women get older.
If there is severe pain and you experience dizziness or fainting along with abnormal bleeding, then there is a chance of ectopic pregnancy and you will need to seek medical help immediately as it is risky.
Signs of miscarriage:
- Spotting or Bleeding in the form of small lumps of blood (not necessary that a light spotting or bleeding may be a miscarriage)
- Cramping or back pain.
- The sudden disappearance of morning sickness.
- If you have had a miscarriage before 8 weeks it may seem like a period but if it is later there will be large blood clots or tissues.
Cause of miscarriage in the first trimester
- The most common cause is chromosomal abnormality due to which the fetus may not have developed properly.
- Placental issue where the placenta may not have developed properly.
- Another cause can be deficiency of the pregnancy hormone progesterone.
Cause for miscarriage in the second trimester includes:
- placental abruption, placental previa
- smoking or using alcohol and drugs
- Immune system problems(APS)
- any form of trauma
In the third trimester loss of pregnancy is not considered as miscarriage but a stillbirth.
Early pregnancy loss can be diagnosed by taking an ultrasound of the uterus or checking the level of hCG (human chorionic gonadotropin) in the blood which is the pregnancy hormone.
When do you need to contact a doctor?
You have to contact the doctor if there are blood clots or tissue along with uterine contractions. If the doctor confirms that a miscarriage has occurred, they may ask for an ultrasound scan to ensure all the tissue has gone or not. It may take two weeks for the tissue to go completely and the doctor may also prescribe medicines to increase the uterine contraction to completely clear the tissue from the uterus.
If after miscarriage the pregnancy tissue still continues to remain in the uterus or does not get cleared the treatment required is Surgical management of miscarriage (SMM) by gentle suction. General anesthesia is provided for this procedure. The surgery is done via the vagina.
Avoid the use of tampons and sex for some time to prevent infection. You may need to take a pregnancy test after two weeks to ensure if the hormone levels are back to normal. You will need to contact the doctor if bleeding continues to be heavy, cramping or fever continues to persist.
Losing a pregnancy especially when you were hoping for it can be upsetting. Miscarriage is not your fault. Take support from your partner, family or even the doctor or a counselor. Many have continued to have successful pregnancies even after a miscarriage.