Miscarriage: Symptoms, Causes, and Treatment

A miscarriage occurs when an expectant mother loses the baby early in the pregnancy, usually before Week 20.

Around 26% of all pregnancies result in a miscarriage, meaning the fetus stops developing and passes naturally. Approximately 80% happen within the first trimester.

A miscarriage can happen in several different ways:

• It is possible for you to have miscarried but have no awareness of it. The miscarriage is only discovered during an ultrasound or when you get your next period.
• In some cases, the fetal tissue passes out of the body through heavy bleeding, and the uterus becomes completely empty. This can be confirmed through an ultrasound.
• At times, there are signs of a potential miscarriage; bleeding and cramping occur, the cervix starts to dilate, and amniotic fluid leaks out. This means that it is highly possible you might miscarry. Alternatively, the cervix remains closed, and bleeding and pelvic cramps are experienced. Known as a threatened miscarriage, your medical provider will closely monitor the situation in such a case.
• When the foetus is lost before week 10, it is referred to as an early miscarriage.
• In some cases, expectant mothers may continually miscarry three times in a row.

Miscarriage symptoms

During pregnancy, it’s important to be alert to certain signs of a miscarriage. If you observe these miscarriage symptoms, it is best to visit your medical practitioner right away:

• Bleeding that starts off light and gradually gets heavier
• Extreme cramps and belly aches
• Fatigue and weakness
• Extreme back pain
• Fever along with other miscarriage symptoms
• Sudden weight loss
• Chills
• Whitish pink mucus-like vaginal discharge
• Tissue resembling blood clots passing through the vagina
• Contractions

You may also experience mild symptoms like spotting and a slight fever. Your doctor will examine you and guide you on the next course of action.

What causes miscarriage?

The reasons for miscarriage may be many. Certain chromosomal abnormalities or congenital disabilities often cause miscarriages up to 13 weeks.

The fetus grows abnormally due to certain factors such as infection, drug exposure, exposure to radiation, or genetics. Examples include Down syndrome and sickle cell anaemia.

A chromosomal abnormality may also be triggered during the fertilization stage. Two sets of chromosomes are joined when the egg and sperm come together. If the egg and sperm have fewer chromosomes than normal, it may cause the cells to divide and multiply many times, leading to miscarriage.

Several other factors may lead to a miscarriage, including hormonal imbalances, exposure to smoking, drinking, alcohol, and recreational drugs, infections, uterine abnormalities, immune system disorders like lupus, kidney disease, thyroid issues, uncontrolled diabetes, and exposure to certain medicinal drugs and malnutrition.

It can also be caused by torch infections, which are conditions that can be passed on from the mother to the baby, including rubella and herpes.

Diagnosing a miscarriage

Your medical practitioner will perform a pelvic exam and ask you to undergo an ultrasound for further confirmation of a miscarriage.

Besides that, they will test for fetal heartbeats. They may also do a blood test to measure Human Chorionic Gonadotropin (hCG). This hormone is produced by the placenta, an organ that grows in the uterus during pregnancy.

The role of the placenta is to provide nutrients and oxygen to the fetus and expunge waste from the baby’s blood. Low hCG levels can suggest a miscarriage.

Treatment for miscarriage

After a miscarriage is confirmed, your medical practitioner checks if your uterus has expelled all fetal tissue. Often, the body removes all fetal tissue on its own. However, if this is not the case, they will proceed to remove all the fetal tissue present to prevent infection and any other complications.

In some cases of early miscarriage, your gynaecologist will recommend a waiting period during which the fetal tissue will pass on its own. Sometimes this process may take several days.

During this time, they will prescribe medication and bed rest, and in some cases, overnight hospitalization for observation. Once the bleeding stops, you will be able to resume regular activities. However, if the cervix is dilated, they may perform a procedure to close the cervix.

In some cases, your gynaecologist may diagnose that it is unsafe to wait for a number of days for the pregnancy to pass on its own.

In this case, they may perform a dilation and curettage (D&C). This is a minor surgical procedure in which the tissue is removed from your uterus. The cervix is dilated, and old pregnancy-related tissue is removed from the uterus while you are under anaesthesia.

The takeaway

No medical evidence exists to prove that occurrences of miscarriage lead to infertility. However, research indicates that those accessing reproductive assistance to get pregnant may be at a greater risk of having a miscarriage.

Hence, it is important to ensure that you consult an experienced fertility specialist when pursuing reproduction assistance as part of your fertility goals.

To seek the best treatment for infertility concerns, visit your nearest Birla Fertility and IVF centre or book an appointment with Dr Deepika Mishra.

FAQs

Is a miscarriage the same as losing a baby?

A miscarriage happens when the foetus is still in the womb and stops developing. It usually happens before 20 weeks of pregnancy, when the foetus is not a fully formed baby. The foetus, along with the placenta, passes in the form of tissue and bleeding. After week 10, the growth of the foetus accelerates.

What exactly happens in a miscarriage?

When a miscarriage occurs, the foetus gets expelled from the uterus on its own.

Typical signs of a miscarriage include heavy bleeding, abdominal cramps, and tissue resembling blood clots in the vagina. However, sometimes symptoms of miscarriage are subtle with spotting and light cramps.

How painful is a miscarriage?

The levels of pain during miscarriage can vary. Some women experience extreme abdominal pain, while for others, it is painless. Some may also experience severe lower back aches and extreme fatigue.

How do miscarriages start?

The genesis of the miscarriage may occur as early as the fertilization stage when either the egg or the sperm has fewer chromosomes. Hence, when they are joined together, the embryo develops with chromosomal abnormalities. This causes the fetus to stop growing.

Other triggers include exposure to harmful radiation, drugs, smoking, other external factors, or pre-existing diseases and medical conditions.