First miscarriage: possible consequences.

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07.09.2019

Medical statistics indicate that in Lately there are frequent cases of threatened abortion in the early stages, so each future mother you need to know its symptoms, as well as what are its causes that can provoke a miscarriage. A miscarriage is a spontaneous abortion that occurs during the first 22 weeks of gestation. If interruption occurs after this turning point, then doctors diagnose not a miscarriage, but childbirth that occurred before the appointed time (in the fifth month and later).

Symptoms of threatened miscarriage in the early stages

According to doctors, in 20% of conceptions, an involuntary abortion occurs, which sometimes many women do not even notice, believing that the appearance of bleeding signals that menstruation has begun.

In accordance with these data, several types of abortion are distinguished.:

  • Incomplete / complete abortion;
  • Threatened abortion;
  • Non-developing pregnancy;
  • Initiated abortion.

These processes differ in their dynamics, although such a division can be called superficial, conditional. Complete miscarriage suggests that the uterus rejects not only the fetus, but also the fetal bladder, and water. Incomplete abortion is characterized by complete or partial rejection of the fetus, while the amniotic membrane remains in the uterus, which requires special surgical intervention.

The started abortion accompanies heavy bleeding And pain, over a long period of time.

During this period, the pregnant woman may begin contractions and dilatation of the cervix, that is, one can state a peculiar onset of childbirth. Threatened abortion manifests itself in weak uterine contractions and little bleeding, but in most cases this quickly passes and the pregnancy remains intact. The release of the uterus from a fertilized egg is considered defense mechanism. If this process occurs before the 12th week of the term, then an early miscarriage is diagnosed, if after the 12th week, then a late miscarriage occurs. In the case when the pregnancy stops after 22 weeks, we can talk about premature birth.

The main causes of miscarriage in early pregnancy

It is rather difficult to determine the reasons why a self-abortion occurred at the beginning of the term, since there is a need for a comprehensive examination with the subsequent delivery of all the required tests. Basically, the causes of involuntary abortion are divided into two large groups: medical and socio-biological.

The first group of reasons includes the following factors:

  • Heavy physical exercise;
  • Age;
  • Wrong lifestyle;
  • Severe stress, anxiety, nervous breakdown;
  • Unfavorable living conditions;
  • Accidents.

Thus, a miscarriage is provoked as a result of strong stressful experiences of the mother, her smoking, alcoholism or drug addiction, as well as as a result of injury. In addition, the mother's age also has a serious influence on the pregnancy process - than older woman, the greater the likelihood of abortion, as well as her living conditions (financial situation, ecology, etc.).

Medical causes of miscarriage include a woman's health problems, as well as:

In addition, one of the reasons for termination of pregnancy can be an arbitrary abortion performed earlier, which can provoke a variety of complications, as well as cause secondary infertility. Medical treatment can lead to miscarriage, independent use medicinal plants or drugs. The threat of interruption can also occur in a situation of Rhesus conflict, in such cases the probability of miscarriage is very high.

How does a miscarriage happen?

In early pregnancy, it is very difficult to differentiate what causes a miscarriage, so most experts believe that it is caused by genetic factors.

The interruption process itself takes place in several stages.:

  • Threat of interruption;
  • Started miscarriage;
  • incomplete abortion;
  • Complete abortion.

At threatened abortion placental abruption begins, which is accompanied by the appearance of primary symptoms of interruption: bloody issues and severe pain in the lower abdomen. If a woman manages to notice these signs in time, then the likelihood of maintaining a pregnancy is much higher.

However, if the pregnant woman failed to understand the signals of her body, the placenta exfoliates, which leads to the death of the fetus, that is, the phase of an inevitable abortion begins, which cannot be prevented.

As a result of an incomplete abortion, the placenta is completely exfoliated, and the embryo dies, after which the body begins to reject it. And there comes the stage of complete abortion, during which the elimination of the place and the fetus from the uterus and genital tract occurs. Thus, the pregnancy is finally terminated.

Recommendations: how to recognize the signs of a miscarriage in early pregnancy

The whole process of pregnancy, especially in the first or second month, includes several critical periods.

It is during these periods that there is a threat of interruption:

  1. Fetal implantation begins at 2-3 weeks of gestation, but if there are scars, injuries or abnormalities in the structure of the uterus, this process is disrupted, resulting in a threat.
  2. The most vulnerable embryo becomes at 4-6 weeks, when developmental anomalies can begin to form, preventing it from living and developing further.
  3. At 8-12 weeks, the placenta is actively developing, so there is a high risk of pathologies in its structure. And a miscarriage at this stage may be associated with a lack of progesterone in the body of a woman.

Information: what does an early miscarriage look like

It is quite difficult to independently determine that a miscarriage has occurred, since it can only be accurately distinguished as a result of a comprehensive medical examination.

At the same time, you can recognize the signs of a miscarriage in a short time:

  • Brownish discharge or bleeding with varying intensity;
  • The embryo comes out through the genital tract;
  • Pain in the lower abdomen;
  • The amniotic fluid has broken;
  • Strong convulsive contractions begin;
  • The temperature rises sharply and the general health of the pregnant woman worsens.

In the early stages, the symptoms of a miscarriage may appear as a period that appears after a slight delay. If a woman has undergone a rapid pregnancy test after her period has disappeared and is able to receive positive result, then with the sudden onset of the menstrual cycle, a miscarriage can be diagnosed.

The first signs of a miscarriage: treatment and consequences

Conception can occur quite safely, however, soon the fetus may attach to the uterine wall and freeze in development, in which case it can be argued that the pregnancy process is false. To avoid the threat of termination of pregnancy, every woman must do all the necessary procedures (for example, ultrasound), pass all the tests and undergo the required examinations.

As soon as a woman managed to get pregnant, a miscarriage may be suspected, in which case experts give the following recommendations:

  • Bed rest and maximum reduction of physical stress on the female body;
  • Complete removal of the possibility of experiences, worries, stresses, emotional upheavals, etc.;
  • Taking hormonal drugs (as prescribed by a doctor);
  • Rejection of bad habits;
  • Diet correction.

You need to consult a doctor when the first negative symptoms appear, since in the event of a threatened miscarriage, the pregnancy can be saved, but for this you need to accurately determine what the main cause of the threat is. A woman should not make hasty conclusions, since any emotional shock or experience can only aggravate the situation.

At the same time, you need to understand that the absence of any action can lead to negative consequences:

  1. The introduction of infection into the female body, in the presence of blood clots and the remains of a dead fetus.
  2. Particle Delay gestational sac in the uterus, which leads to increased uterine contractions, and, consequently, bleeding, through which the uterus tries to remove a foreign body from the body.
  3. Dysfunction of the hormonal background, due to a sharp interruption of the pregnancy process.

Therefore, it is very important to go through the “cleansing” process, during which the remnants of the fetus, particles of the unformed placenta and blood clots will be removed from the female body. When determining the cause of a miscarriage, a pregnant woman undergoes a course of prevention of subsequent pregnancies.

Signs of an early miscarriage (video)

In most cases, the pregnancy process proceeds safely, but sometimes certain difficulties occur in the form of a threat of termination of pregnancy and miscarriage. It is impossible to determine exactly why this happens to a certain woman, in a certain situation. Therefore, it is very important for the expectant mother to go through everything necessary examinations to prevent any deviation from the normal course of the pregnancy process.

In this article:

Pregnancy is a wonderful period in a woman's life. But not always she is destined to end with the birth of a child. Sometimes the body itself decides to expel the emerging life from the female womb. In most cases, miscarriage occurs at the very beginning of pregnancy - in the first trimester. But why and how does a miscarriage occur? There are many reasons - from bad habits of the mother to chromosomal pathologies in the fetus.

According to statistics, every fifth pregnancy ends in spontaneous abortion. To avoid this, a woman should know the symptoms and signs of a miscarriage, as well as what to do if she finds herself in a similar situation.

How does pathology develop?

How a miscarriage occurs is a question that worries every woman who is faced with the threat of abortion. The body rejects the fetus as a result of the influence of negative factors. It is excreted from the uterus either completely, which is typical for the first weeks of pregnancy, or partially. Often, women completely overlooked the symptoms of a miscarriage, not noticing their condition.

Depending on the cause, for example, the presence of an acute infectious and inflammatory process in the body (flu, rubella, etc.), the immune system begins to show aggression towards a developing pregnancy, as a result of which a miscarriage may occur. The formation of the connection between the mother and the unborn child is disrupted, it ceases to function, the fetus is deprived of support and nutrition.

As a result, the fetal egg is torn away from the uterine mucosa and leaves it along with bleeding. Depending on the mechanism of development of a miscarriage, experts determine its causes.

Types of miscarriages

Consider the main ones:

  • Incomplete miscarriage , also called inevitable. In this case, the woman notes pain in the sacrum and in the lower abdomen, which is accompanied by bleeding and dilation of the cervix. If we are talking about an inevitable miscarriage, then in this case there was a rupture of the membranes. For an incomplete miscarriage, the symptoms of pain and spotting are constant.
  • Complete miscarriage means that the fetal egg or fetus is completely expelled from the uterine cavity. In such a situation, bleeding may stop on its own, like other symptoms.
  • Missed miscarriage . The embryo or fetus dies, but remains in the uterine cavity. Usually this condition is called missed pregnancy, and it is discovered by chance during a routine ultrasound examination or examination by a gynecologist.
  • Anembryony . Despite the fusion of the germ cells of a man and a woman, the fetus does not begin its development in the uterus. In this condition, signs of pregnancy can be noted and even diagnosed by ultrasound, the gestational sac and corpus luteum, but the child is absent in it, curettage is necessary, as after a miscarriage.
  • Repeated miscarriage is diagnosed in a woman if she had at least three spontaneous abortions one after another. This violation occurs rarely, no more than 1% of families. Usually it is included in the group of consequences after a miscarriage.
  • chorionadenoma . This violation is also preceded by fertilization, but during it, the chromosomal information breaks down, and instead of the embryo, tissues develop in the uterus, which eventually grow and increase in volume. Pathology may end spontaneously as a miscarriage, or cleaning of the uterine cavity will be required.

Causes

About 20% of pregnancies end in miscarriage. Most often, this happens at a time when the woman herself does not yet know about her position. But this can also happen with those who planned pregnancy and managed to rejoice at its onset. Why is this happening?

The causes of miscarriage in early pregnancy (mainly before 12 weeks, since it is the first trimester that is the decisive link in this matter) will be as follows:

  • Chromosomal problems in the fetus . Experts believe that approximately 73% of pregnancies are terminated solely due to genetic disorders. At the same time, chromosomal mutations are not always inherited at the genetic level; negative factors can influence their occurrence. environment such as radiation, viruses and more. It is believed that in this case, the pregnancy is terminated according to the type of natural selection, that is, initially such an embryo is not viable. Therefore, we are talking about such a condition as a micro-miscarriage, which occurs much earlier than at 12 weeks of gestation. Many women do not even know that they were pregnant, perceiving unexpectedly heavy periods for menstrual irregularities.
  • Hormonal disorders . Fluctuations in the hormonal background in the early stages of pregnancy often lead to its interruption. Usually the culprit is progesterone - a hormone aimed at supporting pregnancy. If the problem is detected in time, then the fetus can be saved. Also, an excess of male hormones - androgens, which inhibit the synthesis of progesterone and estrogen, can also provoke a spontaneous abortion. This usually results in multiple recurring miscarriages.
  • Immunological problems . Most often occur in the blood of the mother and fetus. In this case, the child inherits the father's Rh factor with a "+" sign, while the mother's Rh factor is "-". The woman's immune system perceives positive rh embryo for foreign bodies, starting an active struggle with them.
  • infections . The causative agents of cytomegalovirus, herpes, chlamydia and other pathogenic bacteria and viruses infect the fetal membranes and the fetus itself in the uterine cavity, causing a miscarriage. To avoid this, you need to prepare for pregnancy and treat any infectious and inflammatory processes in the body in time. Common infectious diseases are also fraught with a threat to the development of the fetus, these include influenza, rubella, etc. All these diseases occur with intoxication of the woman's body and a strong increase in body temperature, which can cause spontaneous abortion.
  • Past abortions . It is not simple medical procedure aimed at removing the fetus and membranes from the uterus. It is also a serious stress for a woman's body, which can give complications. For example, a dysfunctional disorder of the ovaries, changes in the functions of the adrenal glands, inflammation in the reproductive system. In the future, all this leads to infertility and problems with bearing subsequent pregnancies.
  • Taking medicines and medicinal plants . Almost all pills and other drugs in the first trimester are dangerous, as it goes active formation fetus. Most drugs provoke fetal malformations or disrupt the formation of the placenta, all of which can lead to spontaneous abortion. Tablets, due to which it may be, for example, at week 12 - hormonal preparations, analgesics of a narcotic series, etc. Not only a medicine can cause a miscarriage, but also some medicinal herbs, quite harmless at first glance mint, parsley, nettle, tansy and much more.
  • Stress . Any mental shock is dangerous for pregnancy. If it was not possible to avoid stress, it is important to seek help from a specialist in order to prevent the possibility of a miscarriage.
  • Bad habits . Alcohol abuse, smoking, drug addiction can cause early pregnancy termination. If a woman wants to have a healthy and strong child, she must give up addictions at the planning stage of conception and ask her partner about it.
  • Excessive exercise . Violent sexual intercourse, falling, lifting weights sometimes become a trigger for a miscarriage. Pregnancy is a time when you need to take care of your own health as much as possible.

Symptoms

What are the symptoms of a miscarriage? The first symptom is abdominal pain, which is soon followed by spotting. Painful sensations are not always localized in the lower abdomen, many women note that it gives off most intensively to the sacrum.

Discharge from the genital tract can be different, varying according to color scheme and intensity. But their detection, in any case, requires a doctor's consultation. Smearing weak discharge may indicate a threat of miscarriage and the possibility of saving the pregnancy. Abundant uterine bleeding, especially with tissue particles and clots, speaks for itself - the fetus is dead, and cleaning is needed after a miscarriage.

These signs are typical for any period of pregnancy, so it doesn’t matter what week they appeared. It is more important to know what symptoms are characteristic of the loss of a child, and what measures should be taken in this situation.

There are 4 stages of miscarriage, let's look at them briefly:

  1. threatened miscarriage . The woman complains of pain in the lower back and lower abdomen. There may be slight spotting from the vagina. In this case, the pregnancy can still be saved.
  2. Started miscarriage . The pain grows and becomes like contractions. The divisions are intensifying. There is weakness and dizziness. The chances of saving the fetus are minimal.
  3. Miscarriage in progress . The pain intensifies, the bleeding is significant. Fetal death at this stage is obvious. The fetus may leave the uterus with bloody discharge completely, or cleaning will be required after a miscarriage.
  4. Completed miscarriage . The fetus and its membranes are expelled, there is a contraction of the uterus after a miscarriage. The bleeding stops. It is necessary to conduct an ultrasound to determine the condition of the uterus and the presence of remnants of the fetal egg.

At what time does a miscarriage occur?

Usually pregnancy is terminated in the first trimester due to the fact that the fetus is not viable. More often this happens during the period of the expected onset of menstruation, and then the woman may not even know that she was pregnant. If this happened later, the fetal egg rarely comes out completely, it is necessary vacuum cleaning uterus after miscarriage.

Much less often, pregnancy is interrupted in the second trimester. This condition is called a late miscarriage.

Diagnostics

Diagnosis of miscarriage for a specialist is not difficult. The doctor examines the patient on a gynecological chair, determining the correspondence of the size of the uterus to the gestational age, the presence of tone, the condition of the cervix and the nature of the discharge. For the final assessment of the woman's condition, an ultrasound is prescribed. With its help, the specialist sees the localization of the fetal egg, the presence of detachment or its complete absence.

Based on the diagnostic examination, the subsequent tactics of therapeutic actions are decided. If the pregnancy can be saved, the woman is referred to a hospital. If we are talking about the death of the fetus, the patient needs cleaning after a miscarriage and treatment.

Is it possible to independently determine that there was a miscarriage?

Self-determine that a miscarriage is occurring , it is difficult if the gestational age is short and the woman did not know anything about her; it is another matter if the spontaneous abortion occurred later, for example, at 12 weeks. In this case, the woman simply will not be able to miss the symptoms associated with the death and expulsion of the fetus. This situation requires a mandatory visit to the doctor, as cleaning will be required after a miscarriage.

Therapy

Therapeutic measures are completely dependent on the results of ultrasound and the clinical manifestations of the pathology. With a threatening and incipient miscarriage, a woman is prescribed treatment aimed at maintaining the pregnancy.

If the fetal egg exfoliates and bleeding begins, then the pregnancy has already terminated, and cleaning or scraping is necessary after a miscarriage.

With a miscarriage for more later dates, for example, at 28 weeks, funds are needed to reduce the uterus and artificially induce contractions (Oxytocin). After the expulsion of the fetus, so that the uterus contracts better and the bleeding decreases, an ice pack is placed on the woman's stomach.

Treatment after a miscarriage does not end there. A woman should undergo an examination to determine the cause of spontaneous abortion: ultrasound of the small pelvis, diagnosis of infections, hormones, cytogenetic examination of the fetal egg, etc. For up to 6 months, a woman is discharged oral contraceptives to restore the reproductive system and prevent unwanted pregnancy, since sex shortly after a miscarriage can lead to a recurrent situation. The body needs time to heal.

Complications after a miscarriage

Complications after a miscarriage are often associated with the fact that the situation can repeat itself. Therefore, it is important to go through rehabilitation and find out why the failure occurred and when it is possible to become pregnant again.

If treatment after a miscarriage is ineffective, a woman may experience the following complications:

  • the development of inflammation in the organs of the reproductive system, followed by a chronic process in endometritis, salpingo-oophoritis, adhesive process etc.;
  • hormonal disorders;
  • problems with conception and secondary infertility.

Besides, frequent consequences after a miscarriage - severe stress, depression, psychological experiences of a failed mother.

Prevention

It is impossible to prevent a miscarriage at 12 or any other week of pregnancy due to genetic factors - it is impossible to influence genetics. But every woman who wants to have children can adjust her lifestyle, take care of her health.

So, how to minimize the likelihood of miscarriage and complications after it:

  • plan pregnancy in advance, while adjusting nutrition, give up bad habits, undergo examinations and treatment;
  • after the onset of pregnancy, direct all efforts to preserve it, for example, put it in a timely manner if there is a threat of miscarriage;
  • avoid stress, physical and psycho-emotional overwork, visit a gynecologist on time.

Since complications after a miscarriage can be serious, it is recommended to plan a new pregnancy six months after the failure. At this time, doctors advise using hormonal contraceptives, in which the body recovers faster.

According to statistics, sex after a miscarriage already on the twelfth day of the cycle can lead to the onset new pregnancy. Some women take advantage of this, wanting to quickly forget a failed pregnancy. Thus, they expose themselves to a new blow, because a weakened body can again reject the fetus. Do not rush, only time and effort will help to set up reproductive system to expect a child.

Useful video about early miscarriage

Spontaneous abortion in the 1st trimester of pregnancy is a sudden termination of pregnancy, which is accompanied by pain and bleeding. In many cases, the condition threatens the life of a woman, so its timely treatment is necessary.

Frequency of occurrence

Early miscarriage occurs in 10-25% of all diagnosed pregnancies. Sometimes a woman does not even know about her condition, or she has recently been diagnosed with pregnancy. According to some reports, up to 75% of pregnancies end early interruption, and the disease proceeds unrecognized, accompanied by the release of the mucous membrane during the next menstruation. To prevent spontaneous abortion, it is necessary to prepare for pregnancy, plan it, examine the reproductive system of a woman and her partner in advance, and cure existing diseases.

The probability of pathology increases with each subsequent such case. After the first miscarriage - by 15%, and after two - by 30%. This is especially true for women who never gave birth. healthy child. Severe consequences First of all, the risk of pregnancy loss after three consecutive miscarriages is up to 45%, so examination and treatment is extremely necessary after the second episode.

Most a large number of interruption occurs in the first 12-13 weeks of gestation.

Causes

The answer to the question of why spontaneous abortion occurs sometimes remains unclear. It is believed that half of the cases are associated with genetic mutations leading to non-viability of the fetus.

Causes of miscarriage in early pregnancy:

  • genetic anomalies that are inherited or occur spontaneously (aneuploidy, trisomy, monosomy, in particular, Turner syndrome, tri- and tetraploidy, parental chromosomal abnormalities) - 50% of cases;
  • immune processes (antiphospholipid syndrome) - 20% of cases, although this pathology more often causes miscarriage at a later stage of pregnancy;
  • developmental anomalies (septa) or tumors (benign - leiomyoma, polyp - or malignant) or;
  • adverse external factors (impact ionizing radiation, vapors of paints, gasoline, chemicals at work and at home) - up to 10% of cases;
  • endocrine diseases: poorly controlled diabetes, autoimmune thyroiditis, insufficiency of the luteal phase of the follicle;
  • hematological disorders that cause microthrombosis in the vessels of the chorion (dysfibrinogenemia, factor XIII deficiency, congenital hypofibrinogenemia, afibrinogenemia, sickle cell anemia);
  • mother's diseases - Marfan's syndrome, Ehlers-Danlos, homocystinuria, elastic pseudoxanthoma.

In most cases, this is a combination of several reasons.

What can cause a miscarriage:

  • sexual infections (rarely lead to abortion);
  • mechanical factor - (more often causes miscarriage in the 2nd trimester);
  • acute infections;
  • chronic kidney disease or of cardio-vascular system at mother;
  • smoking, drinking alcohol, caffeine or drugs;
  • stress and strenuous exercise.

All these conditions can lead to the death of the fetal egg and its expulsion from the uterus. Sometimes a viable embryo is also removed due to increased contractions of the myometrium.

An early miscarriage after IVF is often triggered by a missed pregnancy and subsequent rejection of a non-viable embryo. At the same time, the frequency of spontaneous abortions reaches 30%, and if a woman is already over 40 years old, the pathology develops even more often.

The frequency of spontaneous abortion depends on the age of the woman:

  • patients under the age of 35 have a 15% risk;
  • 35-45 years old - from 20 to 35%;
  • older than 45% of years - 50%.

There are diseases that in all cases end in spontaneous interruption of gestation:

  1. . The embryo does not implant in the wall of the uterus, but in the tube, cervix or abdominal cavity. The result is painful cramping and bleeding, reminiscent of the symptoms of a miscarriage. However, more serious complications are possible, in particular, rupture fallopian tube. Therefore, in case of bloody discharge from the vagina, in any case, it is necessary to consult a gynecologist.
  2. Molar pregnancy. If there are chromosomal abnormalities in the egg, after fertilization, it can be implanted in the endometrial wall. Despite the fact that a full-fledged fetus does not develop, a woman's hormone levels increase, there may be early signs pregnancy. This condition always ends in miscarriage.

Symptoms

The disease begins against the background of signs of a normal pregnancy. Nausea, taste perversion, increased sense of smell are possible. It is noted.

Against this background, in the early stages of gestation, signs of miscarriage suddenly appear:

  • intense cramping pain in lower section abdomen
  • bleeding from the vagina of varying severity - from spotting discharge on early stages to intense blood loss during abortion in the course.

Vaginal bleeding occurs in 25% of cases spontaneous miscarriage. Such selections do not always mean that an interrupt has begun.

Pain in the lower abdomen can occur during implantation of an egg, but during a miscarriage they have a different character - constant, aching, exhausting a woman. Their intensity is stronger than during normal menstruation. A frequent sign the onset of an abortion is back pain.

Depending on the location of the fetal egg, the following stages of the pathological condition are distinguished:

  • a miscarriage that has begun;
  • abortion "in progress";
  • incomplete miscarriage;
  • complete abortion.

The patient's condition is often satisfactory, but can reach a more severe degree. Pallor of the skin, accelerated heartbeat is noted. The abdomen is soft on palpation, painful in the lower sections. With significant blood loss, the symptoms of a miscarriage include dizziness, low blood pressure, weakness, and fainting.

When the termination of pregnancy has begun, it is no longer possible to stop this process. Therefore, when initial signs threatened miscarriage should be urgently sought medical care.

stages

Spontaneous miscarriage at an early stage is diagnosed primarily according to the data of a gynecological examination.

With the onset of abortion, the embryo and its membranes partially exfoliate from the uterine wall. Bloody discharge occurs, the uterus begins to contract, which causes pain in the abdomen. The pharynx is ajar, the neck is shortened.

During an abortion during the course, the embryo is completely separated from the endometrium and is located behind the internal opening of the cervical canal or already in its lumen. Characterized by intense bleeding and severe abdominal pain. The cervix is ​​open and passes a finger.

How does an early miscarriage occur?

With an incomplete abortion, the embryo is no longer in the uterine cavity, so the cramping pain and bleeding subside. However, part of the chorion and decidua remain in the uterus. The cervix gradually acquires normal elasticity, the pharynx remains ajar.

After the expulsion of all parts of the fetus, they speak of a complete abortion. This condition is rare. After cleansing the uterine cavity, it contracts, acquires a normal shape and size, bleeding and pain stop.

What does an early miscarriage look like?

This is a bloody clot of tissues, consisting of membranes and the fetal egg itself. Sometimes such an abortion resembles painful periods with the release of large fragments of the endometrium, for example, with. Well, if such a fragment can be saved. Sometimes there is a need for its further laboratory research.

Complications

As a result of spontaneous abortion at an early stage, the following adverse consequences may occur:

  1. Posthemorrhagic anemia caused by blood loss and manifested by constant weakness, pallor, dizziness.
  2. that occurs when infectious pathogens enter the inner surface of the uterus and is accompanied by high temperature, abdominal pain, vaginal discharge, deterioration of the general condition.
  3. Placental polyp - the remnant of tissue of the fetal egg with insufficient surgical treatment, which can cause severe bleeding.

Diagnostics

If you suspect pathological condition carry out gynecological examination and order blood tests. noted slight decrease hemoglobin and hematocrit levels, slight increase the number of leukocytes and ESR.

To reliably determine an early miscarriage, transvaginal ultrasound is used. It is used to determine:

  • fertilized egg, embryo;
  • localization of the chorion;
  • embryonic heartbeat;
  • detachment of the chorion;
  • signs of accumulation of blood between the chorion and the wall of the uterus.

Transvaginal ultrasound examination

The level of hCG after an early miscarriage decreases rapidly. After a few days, its short-term increase is possible, but after a month the amount of this substance in the blood becomes normal. By increased number HCG in the blood in the absence of a fetal egg in the genital tract of a woman can retrospectively recognize an interrupted pregnancy.

Required differential diagnosis with cervical canal polyp and nascent.

Additional studies needed to find out the exact causes of miscarriage:

  1. Analysis of the chromosome set of parents, family history genetic abnormalities, chromosomal material of abortus in case of recurrent miscarriage.
  2. Determination of signs of antiphospholipid syndrome with the analysis of anticardiolipin antibodies, lupus anticoagulant and antibodies to beta-2-glycoprotein.
  3. Imaging methods for diagnosing abnormalities in the development of the uterus:, sonohysterography,.

The diagnosis of antiphospholipid syndrome with recurrent miscarriage is based on the presence of at least one clinical and one laboratory criterion.

Clinical Criteria:

  • vascular thrombosis (arteries or veins);
  • 3 or more consecutive unexplained miscarriages;
  • 1 or more cases of unexplained fetal death after the 10th week of pregnancy;
  • 1 or more cases premature birth(before 34 weeks) associated with severe preeclampsia or placental insufficiency.

Laboratory Criteria:

  • anticardiolipin antibodies: IgG and / or IgM is found in medium or high titer at least twice within 6 weeks;
  • prolonged phospholipid-dependent coagulation time in screening tests;
  • inability to normalize blood coagulation tests with platelet-deprived plasma;
  • normalization of coagulation with the addition of phospholipids;
  • exclusion of other bleeding disorders.

Treatment

The goal of treatment is to remove the remnants of the embryo from the uterus and stop bleeding. Therefore, treatment after an early miscarriage is complex and includes medications and surgical intervention.

Is cleaning necessary after a miscarriage?

Curettage of the walls of the uterus is carried out in all cases of the disease, except for a complete abortion, which is extremely rare.

Medical therapy

At any stage of spontaneous abortion, medicines that reduce the uterus and stop bleeding, as well as antibiotics and antifungal drugs:

  • Oxytocin intramuscularly or intravenously drip;
  • Etamzilat intramuscularly;
  • antibiotics (Amoxicillin, Cefazolin, Metronidazole) in combination with antifungal agents (Fluconazole).

Drugs used in the treatment of early miscarriage

Surgical intervention

It is carried out with an incomplete abortion, an abortion in progress, a miscarriage that has begun with profuse bleeding. The goal is to cleanse the uterus of the remnants of the embryo and stop bleeding. The operation is performed under anesthesia. Usually the patient's condition requires emergency care, so intravenous anesthesia is used. It provides complete anesthesia and the absence of consciousness of the patient.

Stages of surgical intervention:

  1. Probing of the uterine cavity to determine the correct direction of insertion of instruments and prevention of uterine perforation.
  2. Exfoliation of the fetal egg with a curette.
  3. Removing it through the cervical canal with an abortsang.

During the removal of the fetal egg, bleeding increases due to damage to the vessels of the chorion, but after the walls are completely cleansed, it stops. If atonic bleeding develops, and the uterus does not contract under the influence of oxytocin and other drugs, the question of its removal is raised.

If the patient is hospitalized already with a complete abortion, surgery is not performed on her.

The recovery period after a miscarriage is 10 days.

Recovery

The rehabilitation period depends on how long the pathology occurred. The following symptoms may appear:

  • bleeding from the vagina, reminiscent of menstruation;
  • pain in the lower abdomen;
  • discomfort and engorgement of the mammary glands.

Menstruation after a miscarriage usually comes in 3-6 weeks. After the restoration of the cycle, a woman is able to become pregnant, but still it is necessary to protect herself for some time to fully restore health.

A woman can restore her physical and sexual activity when she feels that she has enough strength for this. Here you need to focus on your well-being and not do anything “through force”. It is important to give the body time to physically and emotionally recover. Sexual intercourse is not recommended for 2 weeks to avoid infection in the uterus.

Usually after an early miscarriage emotional condition suffer more than the physical. There are sleep disturbances, loss of appetite, anxiety, loss of strength. The patient often cries, does not see the meaning of life. Without timely assistance this condition can lead to depression.

Further observation

What to do after an illness? A woman needs to be examined to clarify the causes of miscarriage:

  • tests for sexual infections;
  • exclusion of antiphospholipid syndrome;
  • study of the hormonal background depending on the phases of the cycle;
  • Ultrasound of the uterus and ovaries.

These studies are carried out 2 months after the termination of pregnancy.

Depending on the detected cause, it is eliminated. Pregnancy after a miscarriage is recommended not earlier than six months later, subject to good preparation for it.

If it is proved that the cause of the pathology was a genetic anomaly, the couple is shown a consultation with a geneticist, and in difficult cases- pre-implantation genetic diagnosis.

At antiphospholipid syndrome complex treatment is prescribed, including:

  • subcutaneous administration of Heparin;
  • low dose aspirin;
  • Prednisolone;
  • immunoglobulins.

With anomalies in the development of the uterus, surgical correction of defects is possible, with myoma - removal of the node (conservative).

If the patient's age is habitual miscarriage is 35 years or more, during a subsequent pregnancy, she is offered either a chorionic biopsy to detect genetic abnormalities.

In 85% of women who have had this disease, a second normal pregnancy occurs. Only 1-2% have recurrent cases, which is usually associated with immune causes.

Prevention

Not all spontaneous abortions can be prevented. However, the presence of the latter in history does not mean infertility in the future. Only a small number of patients have 2 or more cases of pathology, of course, with proper treatment.

How to avoid miscarriage in early pregnancy:

  1. Quit smoking, alcohol and drug use.
  2. Keep physical activity to maintain a good supply of blood and oxygen to the fetus.
  3. Maintain the correct weight.
  4. Limit caffeine to 200 mg per day (1 cup) or less.
  5. Take special vitamins to prepare for pregnancy, and then for pregnant women.
  6. Eat in a balanced way enough vegetables and fruits.
  7. Visit a doctor regularly.

However, in most cases, this disease cannot be prevented.

Early miscarriage is a fairly common condition, usually associated with a genetically determined non-viability of the fetus. Less commonly, it occurs under the influence of a variety of internal and external factors. The condition is accompanied by pain and bleeding. In most cases, surgical intervention () is required, followed by examination and identification of causes.

Pregnancy is one of the most beautiful periods in the life of every woman. Future mothers are especially beautiful, and their eyes radiate so much happiness and warmth that one could warm the whole world. Unfortunately, not every pregnancy proceeds normally and ends with the birth of a healthy baby. Sometimes it happens that the pregnancy is unexpectedly terminated, and the dreams of a failed mother are not destined to come true. Why is this happening? Let's try to understand in more detail.

What is a miscarriage and what types does it occur?

In order to understand how a miscarriage occurs, you must first know what it is.

4. The cause of recurring miscarriages can also be the so-called polycystic ovary syndrome. One recent British study showed that 44 to 56% of patients who had multiple miscarriages in a row had polycystic ovary syndrome, characterized by irregular or no menstrual cycles. Most often, this syndrome is observed in overweight women.

5. Rhesus incompatibility ( hemolytic disease), which occurs when the mother has a positive Rh factor, and the father is negative.

6. Disorders of the immune system are the cause of 5-10% of miscarriages. This is due to the fact that the immune system of a pregnant woman, programmed to fight bacteria and viruses, fails and attacks healthy body cells. One of the most well-known disorders immune system- antiphospholipid antibody syndrome. It appears when the body mistakenly believes that phospholipids are foreign elements. As a result, antibodies are produced that cause the formation of blood clots in the placental vessels, interrupting the supply of oxygen and nutrients from mother to fetus.

7. Other causes: features of the anatomical structure of the uterus, viral and bacterial infections, anti-drug and anti-stress medications, exposure to harmful substances.

What symptoms indicate a miscarriage?

Every woman worries about how a miscarriage occurs. Symptoms that indicate an impending or ongoing miscarriage are of great importance for timely medical intervention and the prevention of spontaneous abortion. The most common symptoms include the following:

Sudden weight loss;

The disappearance of such signs of pregnancy as nausea, swelling of the breasts, drowsiness;

False contractions, called Braxton-Hicks contractions;

Real contractions (painful, with a frequency of 5-10 minutes);

The appearance of blood spots;

Light, painless bleeding (although this is not always a symptom of a miscarriage);

Severe bleeding with or without clots, accompanied by convulsions and severe pain in the abdomen or lower back;

Vaginal discharge that is not accompanied by pain or bleeding.

Molar pregnancy, damaged egg or ectopic pregnancy will eventually lead to a miscarriage. The symptoms are similar, except that in the case of a molar pregnancy, the size of the uterus may be larger than usual, and the level of hCG (pregnancy hormone) is increased.

Signs and features of a miscarriage in the early stages

In the first weeks of pregnancy, only after learning about your interesting position, women become very sensitive, and it is not surprising that they are visited by a variety of thoughts related to their well-being and the health of their future babies. The slightest changes occurring in the body make them worry. They see everything as signs of an early miscarriage. Therefore, it is very important to have information. How to understand that a miscarriage has occurred? Does it really make sense and reason to worry? Are these feelings justified? How does a spontaneous miscarriage happen? It is impossible to answer these questions unambiguously. Each case, like each organism, is absolutely individual, and they should be considered separately.

It is almost impossible to identify the causes of most miscarriages in the early stages (more than 60%). It is assumed that this genetic causes. When an embryo is formed, half of its genes are taken from the sperm, the other half from the egg. Sometimes, without any apparent motive, something goes wrong and the pregnancy is terminated. A miscarriage can occur two to three weeks after the death of the fetus. Obstetrician-gynecologists call the following main causes of miscarriage on initial stage pregnancy:

The embryo does not implant in the uterus as it should;

Hormonal problems;

Chromosomal abnormalities;

Diseases of the uterus or cervix;

Various intrauterine infections;

Viral infections, such as the flu;

Strong blows to the stomach of a pregnant woman;

Multiple pregnancy;

Miscarriages that have taken place in the past.

Signs of an early miscarriage:

Strong convulsions.

Bleeding.

Blood clots.

At what stage of pregnancy can a miscarriage occur?

Most often, a miscarriage occurs at the earliest possible time (2-3 weeks). In most cases, a woman does not even suspect that something similar has happened to her. Early spontaneous miscarriages are often confused with normal menstruation. This is due to the fact that the main manifestations of a miscarriage at the beginning of pregnancy are identical to normal menstruation: vaginal bleeding and pain in the lower abdomen. This is the answer to the question of how a miscarriage occurs.

Less common are miscarriages in later pregnancy (before the 20th week). Spontaneous abortion that occurs after the 20th week is called dead birth child.

How does a miscarriage happen?

Due to lack of awareness, many women sometimes do not even suspect that something terrible has happened to them - the loss of a child. They have no idea how quickly a miscarriage occurs and what follows after that. In order to be fully equipped, you need to remember the following:

1. Spontaneous abortion, fetal death and rejection by the body usually do not occur at one moment, but last for several hours or even days. The process proceeds in several stages: the threat of miscarriage, imminent (started) miscarriage, incomplete abortion and, finally, complete abortion.

2. The threat of miscarriage is characterized by the onset of placental abruption and the appearance of the first signs of a miscarriage (pain in the lower abdomen and slight bloody discharge from the vagina). At this stage, the uterus is closed, and the pregnancy can still be saved.

3. An imminent (started) abortion is characterized by placental abruption and, accordingly, further fetal death. An imminent abortion cannot be stopped.

4. With an incomplete abortion, the placenta exfoliates, the fetus dies, and the process of its rejection by the body begins.

5. During a complete abortion, the fetus and place are eliminated from the uterus, as well as from the female genital tract.

Is it possible to independently determine that a miscarriage has taken place?

Becoming registered with a antenatal clinic, women and even their husbands often ask doctors how to find out that a miscarriage has occurred. Unfortunately, it is almost impossible to determine this on your own. If there is a suspicion that a miscarriage has occurred, you should immediately consult a doctor or call an ambulance. Only after medical examination women can say with complete certainty whether a miscarriage has occurred or not. In order to determine this, the doctor will refer the patient to an ultrasound.

In addition, an analysis that will determine the level of hCG in the blood can tell about a miscarriage that has occurred. HCG is a hormone produced by the body exclusively during pregnancy. It can be detected in the blood one week after ovulation, when a fertilized egg is implanted in the uterus. In the first three weeks of pregnancy, the hCG level should double every 2-3 days. When this level remains unchanged, a spontaneous miscarriage may have occurred.

Doctors also resort to measuring the heart rate (HR) of the fetus. To do this, they use a special device that allows them to listen to the heart rhythms of the fetus in the mother's abdomen from 7-12 weeks of pregnancy. If the heartbeat of the fetus is heard, then there can be no talk of a miscarriage. Remember that if you do a regular pregnancy test, it can show its presence even after interruption. Therefore, you should not waste precious time and wonder how to determine that a miscarriage has occurred. At the slightest sign, go straight to your gynecologist.

How can you induce a miscarriage?

Not every pregnant woman is delighted with the fact that she will soon become a mother. Each has its own reasons. Some pregnant women seek medical help and terminate the pregnancy in the hospital, while others prefer to go on their own and learn all the possible ways to have a miscarriage on their own. Since ancient times, various herbs have been used for this, such as tansy. It was boiled and taken orally, which almost 100% guaranteed rejection of the fetus.

There are many such cases when women, in order to get rid of an unwanted child, took and continue to take hot baths to this day. Some try to bring the body to exhaustion with heavy physical exertion. Young girls even manage to drink milk to which iodine is added. More "advanced" young ladies do not risk experiencing folk ways. They prefer more modern means such as hormone pills.

Only a few think about the consequences of such methods and experiments. As a result, rash actions can lead to very disastrous results. Any attempt to have a miscarriage at home threatens the health and even the life of a pregnant woman. None folk remedy, which can provoke an abortion, does not guarantee that bleeding will not begin and any infection will not be introduced.

Most in a safe way get rid of unwanted pregnancy on your own is the so-called medical abortion. Required condition- the minimum time from conception (up to two weeks from the delay of menstruation). In this case, most likely, the miscarriage will occur quickly and painlessly, and the uterus will be completely cleaned. In addition, complications are practically excluded. However, it should be noted that drugs that are used for medical abortion are not sold in pharmacies. Only doctors who have a special license are entitled to prescribe such drugs to their patients. In addition, the cost of such drugs is quite high and not every girl can afford it.

Instead of thinking about how to have a miscarriage and get rid of the fetus, maybe you should imagine what it will look like future baby and how much joy and happiness will he bring to the house? The decision is up to each parent. Responsibility for all actions lies entirely on their shoulders.

What to do after a miscarriage occurs?

What happens after a miscarriage is familiar to many. Some women who have had an abortion do well. However, others (in 4-10% of cases) show a number of complications. A period of treatment and rehabilitation follows, which lasts up to several weeks. In the first week after a spontaneous miscarriage, a woman may experience abdominal pain. In addition, bleeding may occur. In the first two weeks after an abortion, you must refrain from sex. Seek medical attention immediately if symptoms such as:

heavy bleeding;

Severe pain in the lower abdomen;

High fever and convulsions;

Cardiopalmus;

Nausea and vomiting.

Immediately after a spontaneous miscarriage, it is necessary to identify the reason why this happened. Today, there are a large number of specialized medical centers, by contacting which a woman will receive qualified recommendations on what needs to be done.

Experts recommend planning next pregnancy only two months after the miscarriage. In order not to become pregnant before this time, it is necessary to use reliable contraceptives. According to statistics, if a woman becomes pregnant immediately after a miscarriage, the likelihood of a recurrence of the situation increases several times. However, if pregnancy does occur, you should not panic. Under the close and constant supervision of doctors, the outcome can be positive.

Is it possible to protect yourself from spontaneous miscarriage?

In order to minimize the risk of spontaneous miscarriage, it is recommended:


A woman who has just learned about her interesting position needs to:

  1. Do not postpone for later, but go to the doctor as soon as possible, get tested and register for pregnancy.
  2. Give up all bad habits (smoking, alcohol and drugs) and reduce the amount of coffee and strong tea consumed.
  3. Reduce physical activity and avoid sports that can lead to injury.

A miscarriage is spontaneous interruption pregnancy up to 22 weeks. Medical statistics says that every fourth woman faces this problem in the early stages of pregnancy. Many of them were not even aware of their interesting situation, not to mention understanding that a miscarriage had occurred. On the one hand, this protects a woman from unnecessary worries about a failed pregnancy, but on the other hand, it makes it impossible to understand the reasons and prevent this from happening in the future, when the pregnancy is planned and desired. Therefore, it is necessary to know the main signs by which at home you can determine that a miscarriage has occurred, and understand what to do in such a situation.

Early miscarriage symptoms

Most women who miscarry early in their pregnancy at home confuse it with menstruation. Sometimes you can notice that after a delay, menstruation is accompanied by more soreness and more bleeding.

But, unaware of their situation, women do not associate this with a miscarriage. In order not to confuse a miscarriage with menstruation, and to prevent adverse consequences, you need to pay attention to certain signals from your body. Most frequent symptoms accompanying a miscarriage are bleeding and pain.

Discomfort begins with pain in the form of tingling in the lower abdomen. Gradually, the pain intensifies and spreads to the lower back.

Pain sensations are periodic in nature and are called cramping. Often a woman may note that the interval between pain attacks is approximately the same and begins to decrease over time.

An alarming signal may be an increase in the tone of the uterus. It is not always associated with the onset of a miscarriage, but only in cases where it causes discomfort to the expectant mother and is accompanied by pain.

Very dangerous symptom, indicating a threat or a miscarriage that has already occurred, is bleeding from the vagina. Even a single drop of blood should alert a woman. If in this case do nothing, then the bleeding may increase, which can lead not only to spontaneous abortion, but also pose a significant danger to the life of the woman herself.

stages of miscarriage

A miscarriage doesn't happen all at once. Having identified the symptoms of an incipient miscarriage at home, there is a chance to save the pregnancy if you seek help in a timely manner.

There are several stages of miscarriage, each of which is characterized by more bright manifestation any of these symptoms:


Diagnostics

What to do if a woman, while at home, suspects that she has started or has already had a miscarriage? The most important thing is not to panic, but to seek medical help immediately.

At home, it is quite difficult to assess the state of a woman’s health, so it would be better if she undergoes an examination in a medical institution.
The main diagnostic methods for threatened miscarriage are ultrasonography and a blood test for hCG.

Each woman reacts differently to the manifestation of certain symptoms, therefore, based only on visible signs, it is impossible to accurately understand whether she has a miscarriage and, if so, at what stage it is.

Ultrasound allows you to assess the condition of not only the female body, but also the fetus. According to its results, conclusions can be drawn about the possibility of maintaining a pregnancy.

Another method for diagnosing early pregnancy is to measure hCG levels in blood. Chorionic gonadotropin is a hormone that is produced in the body of a pregnant woman. In the absence of pregnancy, the level of this hormone ranges from 0 to 5 mU / ml. With a normal pregnancy, it gradually increases depending on the duration of pregnancy.

It is possible to determine the presence of pregnancy by this analysis already in the first week of conception. This indicator is informative for the diagnosis of miscarriage. In the event of an interrupted pregnancy, its level begins to fall rapidly.

Causes of miscarriage

It is very difficult to determine for sure what caused an early miscarriage. To do this, a woman will have to undergo a whole range of examinations, pass a lot of tests. It is necessary to do this, first of all, in order to exclude negative factors in the future. Medicine conditionally divided all the causes that provoke involuntary termination of pregnancy into two groups.

Subjective causes of early miscarriage

Conditionally considered subjective are those reasons that are directly related to the lifestyle and personality of a woman. To cope with them under the power of the future mother herself.

The first group includes the following factors:

  • Impact of adverse conditions. It could be like harmful production where a woman works, and living in an area of ​​high pollution. In addition, the unfavorable psycho-emotional state of the pregnant woman can also be attributed here - stress, quarrels at home, etc.
  • Wrong way of life. This includes how malnutrition and depletion of your body with various diets, as well as bad habits - smoking, alcohol and others.
  • Age. Doctors consider the optimal reproductive age for a woman to be 20-35 years. With age, the ability to become pregnant and carry a baby decreases.
  • Excessive physical activity. Pregnant women should give up hard physical work (this possibility is also provided for by labor legislation) and active sports.
  • Accident. Unfortunately, no one is immune from this. At the same time, all the body's defenses are aimed at restoring the health of the woman herself, so very often after such incidents a woman loses her unborn baby.

Medical causes of early miscarriage

If the subjective causes that provoke a miscarriage can be dealt with even without resorting to outside help, then the help of specialists is needed to eliminate medical causes.

If you correctly approach the issue of pregnancy planning, do everything that doctors recommend, then you can, if not exclude, then significantly reduce the risk of miscarriage, even in the presence of negative medical factors.

The second group of reasons includes the following factors:


Pregnancy is the greatest happiness for many women. Future mom should do everything to protect her unborn baby from negative factors that can provoke an early miscarriage. Proper nutrition, taking care of your health, regular visits to the doctor - these are the components that should accompany a woman on her way to motherhood. Listening to your body and responding to any unpleasant symptoms, you can save the pregnancy even if there is a threat of its spontaneous interruption.