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How to
deal with Miscarriage after
infertility treatment
Spontaneous
abortion (SAB) or miscarriage
is the term used for a pregnancy
that ends on it's own, within
the first 20 weeks of gestation.
Often the medical name spontaneous
abortion (SAB) gives many women
a negative feeling, so throughout
this information we will refer
to any type of spontaneous abortion
or pregnancy loss under 20 weeks
as miscarriage. Miscarriage
is the most common type of pregnancy
loss, according to the American
College of Obstetrics and Gynecology(ACOG).
Studies reveal that anywhere
from 10- 25% of all clinically
recognized pregnancies will
end in miscarriage. Estimations
of chemical pregnancies or unrecognized
pregnancies that are lost can
be as high as 50-75%, but many
of these are unknown since they
often happen before a woman
has missed a period or is aware
she is pregnant. Most miscarriages
occur during the first 13 weeks
of pregnancy. Pregnancy can
be such an exciting time, but
with the great number of recognized
miscarriages that occur, it
is beneficial to be informed
on miscarriage, in the unfortunate
event that you find yourself
or someone you know faced with
one.
There
can be many confusing terms
and moments that accompany a
miscarriage. There are different
types of miscarriage, different
treatments for each and different
statistics for what you chances
are of having one. The following
information gives a broad overview
of some of the confusing parts
of miscarriage. This information
is to help equip you with knowledge
so that you might not feel so
alone or lost if you face a
possible miscarriage situation.
As with most complications with
pregnancy, remember that the
best person you can usually
talk with and ask questions
of, is your health care provider.
Why do
miscarriages occur?
The reason
for miscarriage is varied and
most often, the cause can not
be identified. During the first
trimester, the most common cause
of miscarriage is chromosomal
abnormality-meaning that something
is not correct with the baby's
chromosomes. Most chromosomal
abnormalities are the cause
of a faulty egg or sperm cell
or due to a problem at the time
that the zygote went through
the division process. Other
causes for miscarriage include
(but are not limited to):
-
Hormonal problems,
infections or health problems
in the mother
-
Lifestyle (i.e. smoking,
drug use, malnutrition, excessivecaffeine
and exposure to radiation
or toxic
substances)
-
Implantation
of the egg into the uterine
lining does not occur properly
-
Maternal Age
-
Maternal trauma
Factors
that are not proven to cause
miscarriage are sex, working
outside the home (unless in
a harmful environment) or moderate
exercise.
What
are the chances of having a
Miscarriage?
For
women in childbearing years,
the chances of having miscarriage
can range from 10-25%, and in
most healthy women the average
is about 15-20% chance.
-
An increase in maternal age
changes the chances of
miscarriage
-
Women under the age
of 35 yrs old have about a
15% chance of miscarriage
-
Women aged 35-45 yrs
old have a 20-35% chance of
miscarriage
-
Women over the
age of 45yrs old can have
up to a 50% chance of miscarriage
-
A woman who has
had a previous miscarriage
has a 25% chance of having
another (only a slightly elevated risk than
for someone who has not had
a previous miscarriage)
What
are the Warning signs of Miscarriage:
If
you experience any or all of
these symptoms, it is very important
to contact your doctor or get
to a medical facility as soon
as possible:
-
Mild to severe back
pain (often worse than normal
menstrual cramps)
-
Weight loss
-
White-pink mucus
-
True contractions (very
painful happening every 5-20
minutes)
-
Frequent bowel movements
-
Brown or bright red
bleeding or spotting with
or without cramps (20-40%
of all pregnancies can
experience some
bleeding in early pregnancy,
with about 50% of those resulting
in normal pregnancies)
-
Tissue with clot like
material passing from the
vagina
-
Nausea
-
Decrease in signs of
pregnancy or loss of breast
tenderness
The
different types of Miscarriage:
Miscarriage
is often a process and not a
single event. There are many
different stages or types of
miscarriage. There is also a
lot of information to learn
about healthy fetal development
so that you might get a better
idea of what is going on with
your pregnancy. Understanding
early fetal development and
first trimester development
can aide you in knowing what
things your health care provider
is looking for when there is
concern of a miscarriage occurring.
Most
of the time all types of miscarriage
are just called Miscarriage,
but you may hear your health
care provider refer to other
terms or names of miscarriage
such as:
Threatened
Miscarriage:
Some degree of early pregnancy
uterine bleeding accompanied
by cramping or lower backache.
The cervix remains closed. This
bleeding is often the result
of implantation.
Inevitable
or Incomplete Miscarriage: Abdominal
or back pain accompanied by
bleeding with an open cervix.
Miscarriage is inevitable when
there is a dilation or effacement
of the cervix and/or there is
rupture of the membranes. Bleeding
and cramps may persist if the
miscarriage is not complete.
Complete
Miscarriage:
A completed miscarriage is when
the embryo or products of conception
have emptied out of the uterus.
Bleeding should subside quickly,
as should any pain or cramping.
A completed miscarriage can
be confirmed by an ultrasound
or by having a surgical curettage
performed
Missed
Miscarriage: Women can experience
a miscarriage with out knowing
it. A missed miscarriage is
when embryonic death has occurred
but there it not any expulsion
of the uterus. It is not known
why this occurs. Signs of this
would be a loss of pregnancy
symptoms and the absence of
fetal heart tones found on an
ultrasound.
Recurrent Miscarriage
(RM): Defined as 3 or more consecutive
first trimester miscarriages.
This can affect 1% of couples
trying to conceive.
Blighted
Ovum: Also called an anembryonic
pregnancy. A fertilized egg
implants into the uterine wall,
but fetal development never
begins. Often there is a gestational
sac with or without a yolk sac,
but there is an absence of fetal
growth.
Ectopic
Pregnancy:
A fertilized egg implants itself
in places other than the uterus,
most commonly the fallopian
tube. Treatment is needed immediately
to stop the development of the
implanted egg. If not treated
rapidly, this could end in serious
maternal complications.
Molar
Pregnancy: The result of a genetic
error during the fertilization
process that leads to growth
of abnormal tissue within the
uterus. Molar pregnancies rarely
involve a developing embryo,
but often entail the most common
symptoms of pregnancy including
a missed period, positive pregnancy
test and severe nausea.
Treatment
of Miscarriage:
The
main goal of treatment during
or after a miscarriage is to
prevent hemorrhaging and/or
infection. The earlier you are
in the pregnancy, the more likely
that your body will expel all
the fetal tissue by itself,
and will not require further
medical procedures. If the body
does not expel all the tissue,
the most common procedure performed
to stop bleeding and prevent
infection is a dilation and
curettage, known as a D&C.
Drugs may be prescribed to help
control bleeding after the D&
C is performed. Bleeding should
be monitored closely once you
are at home and if you notice
an increase in bleeding or the
onset of chills or fever, it
is best to call your physician
immediately.
Prevention
of Miscarriage:
Since
the cause for most miscarriages
is due to chromosomal abnormalities,
there is not much that can be
done to prevent them. One vital
step is to get as healthy as
you can before conceiving to
provide a healthy atmosphere
for conception to occur.
-
Exercise regularly
-
Eat healthy
-
Manage stress
-
Keep weight in healthy limits
-
Take folic acid daily
-
Do not smoke
Once
you find out that you are pregnant,
again the goal is to be as healthy
as possible, to provide a healthful
environment for your baby to
grow in:
-
Keep your abdomen safe
-
Do not smoke or be
around smoke
-
Do not drink alcohol
-
Check with your doctor
before taking any over-the-counter
medications
-
Limit or eliminate
caffeine
-
Avoid environmental hazards
such as
radiation, infectious disease
and x-rays
-
Avoid contact sports
or activities that have risk
of injury
Emotional
Treatment:
Unfortunately,
miscarriage is not prejudice
in whom it touches. It can affect
any couple or family. Often
women are left with unanswered
questions regarding their physical
recovery, their emotional recovery
and trying to conceive again.
It is very important that women
try to keep the lines of communication
open with family, friends and
health care providers during
this time.
Some
helpful websites that deal with
miscarriage and pregnancy loss
include:
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