It’s believed that 75percent of all pregnancies end in miscarriage. However, most miscarriages go unnoticed because they happen so early. The victim might feel it like a normal period, slightly delayed though says Dr.Mirudhubashini Govindarajan, Clinical Director, Women’s Center by Motherhood. Experts believe that 15 to 20 percent of women will experience a miscarriage which is clinically recognized. “This happens due to genetic, infective, immunological, endocrine or environmental causes or structural defects,” she adds. According to her, 50 percent of early miscarriages could be attributed to genetic causes when fetus cannot survive due to genetic or chromosomal defect.
This miscarriage is a random event. “But, most such women will achieve normal pregnancy subsequently,” avers Dr.Mirudhubashini. As for immunological causes, it is finally the clots in blood which result in the demise of the fetus. “Antibodies which some women carry in their blood may attack their own cells,” informs Dr.Mirudhubashini, adding “some of these antibodies may attack the placenta or promote formation of blood clots in the placenta”. The clots can slow down the fetal growth leading to eventual miscarriage.
Miscarriage can also occur due to anatomic causes because some women may have a septum (wall) within the uterus. It could come in the form of a double or half uterine cavity or a similar defect which leads to miscarriage. Presence of large fibroids, particularly, those encroaching upon the uterine cavity can also preclude a successful pregnancy outcome.
Miscarriage can also occur due to infections. Many types of bacteria, viruses or parasites can cause pregnancy loss. But, this is not very common.
Elaborating on endocrine causes, Dr.Mirudhubashini says that women with irregular periods or Polycystic Ovarian Syndrome (PCOS) run a higher risk of early pregnancy loss because the multiple maternal hormones fail to provide an ideal environment to the developing embryo.
We can’t do much about many of these causes. But, miscarriages occurring due to certain environmental causes like intake of harmful substances like drugs, alcohol, smoking or excessive caffeine can definitely be prevented to a great through abstention.
Miscarriage is never a pleasant experience. The agony could have a prolonged effect. Bleeding is the first symptom of a miscarriage. It could range from spotting to heavy bleeding (haemorrhage). A miscarriage resulting in haemorrhage is generally not life-threatening if good medical help is available. “But, in the long run, a woman could become anaemic due to blood loss. She needs to be given adequate iron supplements and vitamin-rich diet to take care of nutritional deficit” advises Dr.Mirudhubashini.
A woman suffering from miscarriage must get adequate rest and if she is working, it is advisable to take a few days off thus allowing the bleeding to taper off in a week. But, persistent bleeding or heavier than normal period is a definite indication that you should visit a doctor, says
Dr.Mirudhubashini. “You should also avoid intercourse during this time. This is not good because the uterus is still healing. One should remember that infection might occur at any point because the mouth of the uterus is open from a few hours to days making it vulnerable to bacterial attack. Frequent change of sanitary napkins should be strictly followed. This along with adequate rest prevents infection in most cases” she explains.
So, how would one know in the case of infection?
“It’s a good question. There’re a few symptoms which include pelvic pain, fever, foul-smelling discharge, burning and/or pain while passing urine besides vomiting, body ache or lethargy,” she confirms.
So, how long one should wait before attempting the next pregnancy after a miscarriage?
Experts says a couple should plan their next pregnancy from the third month after the miscarriage since it takes about six weeks for a woman’s body to come back to normal after the miscarriage. “But before that the couple should undergo a thorough medical investigation to rule out any possible causes of repeated miscarriages,” cautions Dr.Mirudhubashini. In the event of detecting the cause, it should be treated before attempting another pregnancy. In the case of a first miscarriage, basic testing is done to rule out infection or endocrine causes. A second miscarriage, however, will need a detailed testing while a third miscarriage warrants detailed counselling including genetic counselling and detailed probe to detect possible causes.
A woman who has suffered from miscarriage in the past should undergo pre-pregnancy counselling and start on folic acid supplements. The physician treating her should also need to correct her nutritional and mental health as the situation demands. In essence, any woman with a past history of miscarriage would do better in her next pregnancy with extra medical monitoring.
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