Womens Health Blog

Sometimes called spontaneous abortion, this refers to the loss of a fetus before 24 weeks of pregnancy. The use of the word “abortion” sometimes leads to misunderstanding, but doctors use it to describe any pregnancy that ends suddenly, whether artificially or from natural causes.

Spontaneous abortions are much more common than is generally thought. Many miscarriages go undetected and many more go unreported. In fact, up to one third of all first pregnancies miscarry. Excluding unrecognized miscarriages, spontaneous miscarriage occurs in about 15 percent of all conceptions. There is usually a very good reason why a miscarriage occurs during the first trimester of a pregnancy.

What Causes It?

A spontaneous abortion can result because of parental, fetal, or combined factors. These include:

• Defect in the egg or sperm resulting in an abnormal fetus.
• Abnormally shaped uterus which cannot sustain a pregnancy because of some anatomical problem.
• Uterine fibroids.
• Incompetent cervix in which the cervix opens rather than remains closed until labor begins; this is often the result of an unskilled induced abortion or a previous rapid labor.
• Placental insufficiency; the placenta fails or does not develop properly and so cannot nourish the fetus.
• Uncontrolled diabetes or very severe high blood pressure.
• Rhesus incompatibility.
• Maternal infections - bacterial or viral such as syphilis or rubella.

Should I See The Doctor?

If you know you are pregnant, or think you might be, and experience any vaginal bleeding and/or cramping pain at any time, call your doctor immediately. While you are waiting for your doctor, go to bed and keep your feet raised. Wear a sanitary napkin if necessary. Do not flush away any of the discharge because your doctor will want to examine it.

What Might The Doctor Do?

• With a threatened abortion, you will be advised to go to bed for 24 hours to wait and see bed rest helps by increasing the flow of blood to the uterus.
• Low hormonal levels usually lead to a miscarriage; you will be advised to rest, although unfortunately it probably won’t make any difference to the outcome.
• An ultrasound scan will determine whether the fetus is still alive or not, or whether there is any tissue left inside your uterus. In some cases of miscarriage there may be heavy blood loss, necessitating a blood transfusion.

What Is The Surgical Treatment?

• If some products of conception remain after an incomplete abortion , you will need to be admitted to hospital for an ERPC to remove it. (ERPC stands for “evacuation of the retained products of conception.”)
• If there is a “missed abortion,” the fetus will have to be removed surgically or by an induced labor. If you miscarry several times, you will have tests to try to find the specific cause.
• You may be given a hysterosalpingogram to check out the condition of your uterus and fallopian tubes.
• Your doctor will examine the aborted fetus and placenta as well in order to treat you appropriately. In some cases, you may be referred to an infertility expert.
• If you have a septic abortion, which means that your internal organs have become infected, you will be given antibiotics in large doses to combat infection, which is the most frequent cause of maternal death following abortion.
• An ERPC will be essential to remove the infected material because infertility can result from such an infection.

What Can I Do?

• Whatever the reason for the miscarriage and whatever the treatment your doctor prescribes, the emotional effects can be devastating. In addition to the natural feelings of grief, you will probably feel angry that your body has let you down.
• The one emotion you must try to combat is guilt. It is not your fault and, although you may feel like hiding yourself away and perhaps punishing yourself, this is not the way to get back to normal. Do not isolate yourself and try to be positive about what you can do in the future.
• Anxiety is one of the emotional factors that can result in a failure to conceive. Your doctor should give you an honest answer as soon as possible about whether you can successfully carry a baby to full term without medical treatment. If he says it’s possible, keep trying, but try not to become obsessive. If you have a problem that can be treated, don’t waste time seek treatment.
• A miscarriage is a true bereavement and is very difficult to cope with. Counseling might help and is available. If you think you’d benefit from this, ask your doctor to put you in touch with a counselor.
• You can usually resume sexual intercourse within about three weeks, when the bleeding has stopped and the cervix has closed. You will probably be advised to wait for at least two complete menstrual periods before trying to conceive again.

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