Obstetrics and Gynaecology

Early Miscarriage: The Pain And Supporting Through the Stage

Early miscarriage defines the loss of a pregnancy during the first trimester or within 20 weeks of the gestation period. Most miscarriages occur before the 10 weeks of the gestation period. In contrast, some miscarriages may also happen earlier than this time. Miscarriage is a harsh and sad experience for about every woman. There is a greater ratio of about 10 to 20% of early miscarriages in pregnant ladies. About 1 to 4% of pregnant ladies may suffer from early miscarriages in a row.

In medical terms, early miscarriage concerns the failure of early pregnancy. It explains that the pregnancy failed to transform a fetus into a complete embryo. This article highlights the primary causes, symptoms, prevention, and other associated factors with early miscarriage. Focus on the article to get all the information related to early miscarriage.

What are the types of early miscarriages?

Early miscarriage is a general term that may relate to different events but not result in pregnancy loss. The common types are as follows:

Threatened miscarriage

Spotting or bleeding is common during the first trimester. In this condition, the patient and doctor are not sure about the miscarriage. Almost one-third of pregnant women normally bleed in the first trimester. But only one-half of them suffer from early miscarriage.

Complete miscarriage

In this condition, the entire pregnancy is passed out through the uterus. The common symptoms include bleeding and cramping. For such patients, only observation is required with no further treatment.

Incomplete miscarriage

The small pregnancy tissue is passed out through the uterus in this type. The remnant pregnancy tissue will pass on its own. Some women need immediate management to deal with heavy bleeding. Whereas, in others, only medicines can help pass out the rest of the pregnancy tissue. You need to wait until all the pregnancy tissue passes out of the uterus.

Anembryonic gestation

In this, the pregnancy is implanted but the embryonic tissue is unable to develop or started to develop but stopped.

Embryonic demise

In this type, the early embryo (10 weeks pregnant) stops growing and developing properly.

Missed abortion

It is quite an uncommon type of miscarriage. In missed abortion, the pregnancy failed to develop but the pregnancy tissue remains in the uterus for at least 4 weeks. Dark brown spotting or bleeding may occur with missed abortion but not heavy bleeding.

Septic miscarriage

As the name indicates, these miscarriages occur with an infection in the uterus. It is an emergency medical condition that requires immediate management to prevent shock or death. The patient usually suffers from fever, abdominal pain, heavy bleeding, and discharge with a foul odor. For such patients, antibiotics and suction evacuation are helpful to manage the patient.

What are the main symptoms associated with early miscarriage?

There are a variety of symptoms that are helpful to indicate an early miscarriage. We’ll discuss some of the prominent symptoms that confirm an early miscarriage. These are as follows:

Symptoms of early miscarriage
  • Bleeding – slight bleeding-like spotting is quite familiar with early pregnancy. But if you are suffering from heavy bleeding, the underlying cause may be an early miscarriage. The bleeding can vary from brownish discharge to heavy bleeding, including blood clots.
  • The passage of some inner body tissues through the vaginal opening also indicates a miscarriage.
  • A heavy flow of clear or pinkish vaginal fluid.
  • Pregnancy symptoms like nausea or breast tenderness are no more.
  • Lightheadedness or dizziness

If you are having the above-mentioned symptoms while pregnant, you must consult your doctor as soon as possible. Your doctor may go for an ultrasound examination to confirm either the pregnancy is going normal or you are having a miscarriage. Even if you think you have passed all the fetal tissue and are feeling normal, there is still a need to visit a doctor. In some cases, passing tissue is typical with ectopic pregnancy, which can be dangerous if not appropriately diagnosed.

What are the common causes associated with an early miscarriage?

Early miscarriage is associated with a variety of causes. Heavy work or preventing sex are not important causes for an early miscarriage. The most common causes of early miscarriage are as follows:

If the miscarriage occurs during the first trimester, the most common causes are associated with the fetus. Almost 3 miscarriages occur in every 4 pregnancies. Early miscarriages indicate the problems associated with the mother’s health. Late miscarriages are usually due to infectious agents or any other problems.

Causes of first-trimester miscarriages:

First-trimester miscarriages are the most common and mostly because of the chromosomal changes arising in the fetus. There are some of the main causes leading to early miscarriage. These are as follows:

Chromosomal disturbance

Chromosomes are the genetic material or the blocks of DNA. These chromosomes contain detailed information related to a variety of factors. These chromosomes decide which cells will be used during the developmental phases of the fetus. Sometimes, mutations arise in the chromosomes during the period of conception. The fetus may get an extra or deficient chromosome during this process. The reason is quite clear. However, the changes in the chromosome number may disturb the normal developmental stages of the fetus, resulting in an early miscarriage.

Placenta problem

The placenta is the organ that connects the fetus to the mother’s body. It supplies blood to the fetus by draining through the mother’s body. If there is any problem in the placenta, it may cause an early miscarriage.

Also read: Perplexing Menstrual Disorders: Period cramps but no periods

Causes of second-trimester miscarriage

Chronic or long-term health problems may cause miscarriage even in the second trimester. It is better to control these health problems to prevent miscarriage in the second trimester. The common health problems include:

  • Poorly maintained diabetes
  • High blood pressure
  • Kidney problems
  • Lupus
  • Antiphospholipid syndrome
  • Hyperactive thyroid gland
  • Hypoactive thyroid gland

Infections

If long-term infections are not treated, they may cause miscarriage even in the second trimester. Common infections include

  • Rubella virus infection
  • Cytomegalovirus
  • Bacterial vaginosis
  • HIV
  • Gonorrhea
  • Syphilis
  • Malaria
  • Chlamydia

Medicine

Some medicines used during pregnancy also increase the risk of miscarriage. The most common drugs include NSAIDs, retinoids, misoprostol, and methotrexate. Don’t go for any medication during pregnancy unless your doctor recommends safe medicine related to your problems.

Womb appearance

Abnormalities associated with the womb structure can also cause miscarriage in the second trimester. The most common problems include

  • Fibroids, which are non-cancerous growths in the womb.
  • Poorly shaped womb structure

Polycystic ovary syndrome

Polycystic ovary syndrome is related to ovaries that are larger than normal. It usually occurs due to hormonal changes in the ovaries. It is one of the most common causes of infertility. It is also one of the common causes related to miscarriage.

What are the common risk factors associated with an early miscarriage?

Besides the above-mentioned causes, several other factors can increase the risk of early miscarriage. It is better to avoid these things to prevent early miscarriage. The risk factors are as follows:

  • Age can also hurt pregnancy.
  • For women under 30 years of age, 1 miscarriage happens in every 10 pregnancies.
  • For women having the age group of 35 to 39, 2 miscarriages may occur in every 10 pregnancies.
  • For women of more than 45 years, 5 miscarriages may occur in every 10 pregnancies.
  • Heavy smoking may also cause early miscarriage.
  • Usage of illicit drugs specifically cocaine can also lead to early miscarriage
  • Uncontrolled diabetes
  • Hyperthyroidism or hypothyroidism
  • Drinking alcohol
  • Physical problems like fibroids or development problems involving the uterus

What is the treatment plan for early miscarriage?

All miscarriages don’t need treatment. The only thing you need is to wait for the pregnancy tissue to pass out from the uterus. The possible treatment plans include:

  • The most expectant management is just follow-up. With passing time, most women pass out the pregnancy tissue completely. The associated symptoms include heavy bleeding and severe abdominal cramping when the pregnancy tissue passes out.
  • The other management plan includes the use of medicine that causes cramping or bleeding. These medicines help in the natural passing of the pregnancy tissue out of the uterus. Most women pass out the pregnancy tissue within 24 hours after using the medication. If the pregnancy tissue does not pass out, you may repeat the medicine treatment.
  • Suction aspiration is also a treatment option to pass the pregnancy tissue of the uterus. The suction used is most commonly a syringe that creates a suction to aspirate the pregnancy tissue. This procedure is usually done under anesthesia.

Conclusion

Early miscarriage occurs during the first trimester of the pregnancy. In addition, early miscarriages are more common than late miscarriages. The most common causes include the problems associated with fetal problems. These problems include chromosomal disturbance and many other problems. This article described the symptoms, causes, and other details related to early miscarriage. Give it a thorough read to know the basic concepts related to early miscarriage.

FrequentAsked Questionsons (FAQs)

Does having one miscarriage increase the chance of having another miscarriage?

No, having one miscarriage does not increase the chances of miscarriage. The rate of miscarriage in the next pregnancy is generally the same as in the general population.

Can physical activities cause a miscarriage?

No, physical activities like exercise, work, or sex do not cause miscarriage.

Dr. Rahul Kushwaha

Rahul Kumar Kushwaha, MBBS, is an intern doctor at a prestigious college in Bangladesh, North East Medical College, situated in South SurmaPamila, on the outskirts of Sylhet, Bangladesh. He is one of the team members and Founder of WOMS and has been working since the beginning of WOMS. Similarly, he is also the founder of the pregnancy journey app and the auscultation world app.

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