02/01/2024
MISCARRIAGE
A miscarriage also known as spontaneous abortion and pregnancy loss is the natural death of an embryo or fetus before it is able to survive independently. Hence it refers to the disposal of the embryo or fetus before it is viable, it is usually the body's way of ending a pregnancy that has had a bad start.
About 80% of miscarriage occur in the first 12-20 weeks after fertilization. The underlying cause in about half of the cases involves chromosomal abnormalities. Most women that suffer a miscarriage dont ever experience another one and with every miscarriage, the chances of having another one does increase.
A miscarriage is one of the most emotionally painful experiences a woman can go through. Though a large number of women will experience a miscarriage at least once during a lifetime, many are never aware they even had one.
FIRST TRIMESTER MISCARRIAGE
In the first trimester, the risk associated with miscarriage in those under the age of 35 is 10% while it is about 45% in those over the age of 40 hence the risk increases around the age of 30 and above. Losses may be due to untreated or mistreated infections, exposure to environmental or industrial toxins, stress, carrying of heavy loads, intake of caffeinated drinks or alcohol, smoking and chromosomal anomaly.
SECOND AND THIRD TRIMESTER MISCARRIAGE
In the second and third trimester, losses may be due to maternal factors such as uterine malformation, growth in the uterus (fibroids) or cervical problems which may also contribute to premature birth. Unlike the first trimester miscarriage, second trimester miscarriages are likely to be caused by a genetic abnormality which includes obesity. Not only is obesity associated with miscarriage, it can result in sub-fertility and other adverse pregnancy outcomes hence, recurrent miscarriage is associated with obesity.
TYPES OF MISCARRIAGE
All types of pregnancy loss are typically called miscarriage, but there may be other terms being used to describe them, as there are different types of miscarriages. These various types of miscarriage range from the early stages, even before a woman realizes she is pregnant to complete miscarriages in which all of the pregnancy tissue is expelled from the uterus during any early to mid-stage of pregnancy.
a)Threatened miscarriage: this type of miscarriage generally begins in the first 20 weeks of pregnancy. The first symptoms of a threatened miscarriage is any va**nal bleeding beyond spotting and/ or abdominal pain.The bleeding associated with a threatened miscarriage is usually mild and in most cases, the cervical opening of the womb remains closed and no tissue passes from the womb.
In most of these cases the bleeding takes only a few days and the pregnancy can continue as normal. In many cases, bed rest is prescribed to avert a miscarriage.
b) Inevitable miscarriage: when a miscarriage is inevitable, bleeding is often heavier and abdominal pain is more severe. In this case, the cervical opening of the womb is open and the miscarriage cannot be stopped.
c) Incomplete versus complete miscarriage: most commonly known as an incomplete abortion, this type of miscarriage begins with the same symptoms as most va**nal bleeding and abdominal pain. At this stage, the cervix and pregnancy passage is open. While some pregnancy tissue may pass a large amount remains in the uterus. The precursor of a complete abortion, is that pregnancy tissue is expelled from the uterus. These types of miscarriage are often characterized by severe bleeding and abdominal pain. After the miscarriage, bleeding and abdominal pain can occur, however these symptoms typically stop by themselves in a short period of time.
d) Missed miscarriage: unlike other types of miscarriage, in a missed miscarriage, or missed abortion, there are no typical symptoms such as pain or bleeding and there is no ejection of tissue. This type of miscarriage is when the fetus dies in early pregnancy. If placenta is still releasing hormones, the woman may continue to experience pregnancy symptoms and not be aware of the fetusâ state. If the placenta has stopped developing hormones, pregnancy symptoms may begin to fade. Using an ultrasound, the physician can determine the miscarriage when an embryo is found without a heartbeat.
e) O**m Abortivum or Molen pregnancy : in this sub form of miscarriage, the gestational sac is empty in the uterus, even though a pregnancy test is positive. It is present in 50 to 90 percent of miscarriages in the second month of gestation. Symptoms of this type of miscarriage are absent, but spotting is possible.
CAUSES OF MISCARRIAGES
According to the American College of Obstetricians and Gynecologists (ACOG), roughly 50% of early pregnancy losses are a result of chromosomal abnormalities in the fetus or embryo. A chromosomal abnormality is when the number, or health, of chromosomes needed for fetal development, is not met. Most of these are chance occurrences. A few other causes for a miscarriage include:
*Age, especially at age 35 and older
*Exposure to dangerous chemicals or certain medicines.
*A history of recurrent miscarriage (three or more)
*Polycystic o***y syndrome which can cause ovulation problems, obesity, increased or decresed female hormone levels (progesterone) and increased risk of diabetes
*Certain bacterial or viral infections
*Damage or problems to the structure of the uterus or the placenta
*Use of alcohol, cigarette smoking or co***ne during pregnancy
*A blood clotting disorder such as antiphospholipid antibody syndrome
*Exposure to Toxic Substances (i.e. Radiation)
*Improper Implantation of egg
*Genetic defects of the Father and malformed s***m.
*Heavy caffeine use during pregnancy
SYMPTOMS OF A MISCARRIAGE INCLUDE:
* Vaginal bleeding that may be light or heavy, constant or irregular. Although bleeding is often the first sign of a miscarriage, first-trimester bleeding may also occur with a normal pregnancy but bleeding with pain is a sign that miscarriage is more likely.
*Pain: You may have pelvic cramps, belly pain, or a persistent dull ache in your lower back. Pain may start a few hours to several days after bleeding has begun.
*Blood clots or grayish (fetal) tissue passing from the va**na.
It is not always easy to tell whether a miscarriage is taking place hence a miscarriage often does not occur as a single event but as a chain of events over several days. One woman's physical experience of a miscarriage can be very different from another woman's experience.
* A pelvic exam, which allows the doctor to see whether the cervix is opening (dilating) or whether there is tissue or blood in the cervical opening or the va**na.
* A blood test, which checks the level of the pregnancy hormone called human chorionic gonadotropin (hCG). Your doctor may take several measurements of hCG levels over a period of days to learn whether your pregnancy is still progressing.
* An ultrasound, which helps your doctor find out whether the amniotic sac is intact, detect a fetal heartbeat, and estimate the age of the fetus.
RECURRENT MISCARRIAGE(S): If you have three or more miscarriages, your doctor can test for possible causes these include:
* Testing your blood for antibodies to check for antiphospholipid antibody syndrome.
* Using a karyotype to test your blood for parental chromosome abnormalities.
* Testing hormone levels to check for polycystic o***y syndrome .
*Running a Hystero salphinogram examination or pelvic ultrasound to check for problems with uterine structure.
There is no treatment that can stop a miscarriage. As long as you do not have heavy blood loss, fever, weakness, or other signs of infection, you can let a miscarriage follow its own course, this can take several days.
If you have an Rh-negative blood type, you will need a shot of low-dose Rhogam. This prevents problems in future pregnancies. Your doctor can do a blood test to see if you are Rh-negative.
If a miscarriage is causing intense pain or bleeding or is taking longer than you are comfortable with, talk to your doctor about using medicine or surgery (a procedure called dilation and curettage, or D&C ) to clear the uterus.
If you have va**nal bleeding but tests suggest that your pregnancy is still progressing, your doctor may recommend:
*Resting: You will be advised to temporarily avoid s*xual in*******se (pelvic rest) and heavy activity. Your doctor may recommend bed rest .
* Taking progesterone: You may be treated with the hormone progesterone to help maintain the pregnancy.
* Avoiding NSAIDs: You will be advised to avoid aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Using only acetaminophen, such as Tylenol, for nonprescription pain relief is adviced.
Sometimes all or some of the fetal tissue stays in the uterus after a pregnancy miscarries. This is called an incomplete miscarriage or missed spontaneous abortion. If your doctor determines that you have had an incomplete miscarriage, you will have one or more treatment options which includes:
*Watchful waiting: This period of waiting, called expectant management, allows the miscarriage to end naturally while your doctor watches for and treats any complications.
*Medicine: Using misoprostol causes the uterus to empty.
*Dilation and curettage (D&C): Dilation and curettage or vacuum aspiration clears the uterus of tissue. These surgeries offer the quickest treatments for a miscarriage.
AVOIDANCE AND PREVENTION OF MISCARRIAGE
1. Prepare for Conception: the first step is to prepare your body with fertility
cleansing. Fertility cleansing helps to support the liver in cleansing the body of old toxins and excess hormones while encouraging the uterus to cleanse itself of âoldâ contents, increasing uterine circulation and tone.
2. Eat a Nutrient Dense Fertility Diet: the next step is to nourish and build up your body to be a healthy, baby-friendly body. This can easily be done through eating a nutrient dense Fertility Diet. What you eat has an impact on:
*The health of your eggs
*Your hormonal balance
*Creating a healthy placenta
*Decreasing chances of a miscarriage
*Building nutrient storage for the baby
*Creating a healthy reproductive system
You will want to make sure you are eating a fertility diet consistently for at least 90 days before you begin trying to conceive for your best chances of creating a healthy pregnancy.
3. Apply Fertility or Abdominal Massage: another important element of promoting a healthy conception is to increase circulation to the uterus.
Modern lifestyles are often high stress and busy, but lack in exercise and usually have us sitting at a desk all day (the left leg and the uterus share the same major artery, so avoid sitting with your legs crossed), which can decrease circulation to the uterus. High stress levels leave us living in a state of fight or flight which signals our bodies to send all the blood to the muscles and brain in preparation for running away or fighting, the results of which decreases circulation to the uterus.
There are two options for massage when it comes to supporting reproductive circulation. You can find a massage therapist who specializes in abdominal massage (or better yet a fertility massage therapist), or you can learn how to apply Self Fertility Massage at home.
Through applying a simple massage method called Self Fertility Massage you are able to increase the circulation to the uterus, clear adhesions and congestion (If you have endometriosis, PCOS, clotty and dark periods, and heavy cramps during your period you will have to add this technique to your program).
4. Build a Healthy Foundation: one of the major foundational steps to increasing your chances of having a healthy pregnancy is to take some basic vitamins, minerals, and Essential Fatty Acids (EFAâs). There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation.
Building a healthy foundation is a two punch step. You will want to be taking a multivitamin and an omega-3 supplement, but the key here is not just to take any multivitamin. The best multivitamin to take for fertility and pregnancy is a prenatal multivitamin but be careful when you are choosing which one to take.(medical application is adviced).
NOT ALL SUPPLEMENTS ARE CREATED EQUAL. Make sure you are taking a whole food prenatal multivitamin. You also need to make sure your prenatal vitamin contains B6, B12 and folic acid (folate). This combination has been shown to help prevent miscarriages due to high homocysteine levels.
Essential fatty acids are also extremely important for miscarriage prevention. EFAâs, specifically omega-3âs, are responsible for regulating inflammation response, improving cellular integrity and maintaining hormonal balance, all these key factors aid the body to prevent miscarriage.
SUMMARY
There are many different reasons someone may experience miscarriage or recurrent miscarriages, hence, a healthy approach is to find a doctor who has experience with miscarriage or recurrent miscarriages and get testing(s) done. If a cause for the miscarriage(s) is found, you can focus on treatment and use the guidelines we have suggested to help support your body. If no cause has been found, then the guidelines suggested are the next option for you to explore.
