Miscarriage is not only a physical trauma for a woman, but also a moral one. For this reason, the maximum amount of information about the diagnosis, causes, symptoms, treatment, and prevention of spontaneous miscarriage was collected in the article below.
Miscarriage in the early stages is a very sad and, unfortunately, quite commonplace phenomenon. According to statistics, every eighth woman has a pregnancy terminated in the first twelve weeks. Most of them survive a miscarriage, without suspecting that they were pregnant. And some talk about the possibility of losing the fetus already at the first consultations and are advised to lie down for preservation.
Medical termination of pregnancy is considered the least affecting the reproductive function and health of a woman. It is very important not to miss the deadline.
Abortion may not be noticed by a woman in the early stages. Postponement of menstruation is simply attributed to a delay, and afterwards heavy bleeding begins, which is accompanied by a sensation of pain. When the fetus comes out completely, bleeding and pain cease, the woman may still not know that she was pregnant.
If the fetus does not come out completely, which causes prolonged bleeding, women, as a rule, turn to a specialist who ascertains miscarriage. Most doctors, in order to restore the female body, after such an event prescribe a course of therapeutic therapy.
Causes
The causes of miscarriage can be as follows:
- Hormonal disbalance.
- Genetic abnormalities.
- Infectious diseases.
- Rhesus factor.
- Medications.
- Injuries.
- Abortions in the past.
The threat of termination of pregnancy in the second trimester is noticeably reduced. According to statistics, in the second trimester a miscarriage occurs only in every fifty woman.
So, we consider in more detail the above causes of miscarriage.
Hormonal disbalance
In the female body, hormones and their proper balance are a prerequisite for the normal course of the pregnancy process. In some cases, a malfunction in the hormonal background can result in a breakdown. Experts distinguish progesterone as a very important hormone, which is required to maintain pregnancy. If his lack was detected in a timely manner, the woman is prescribed this hormone in the form of medications, as a result, the fetus can be saved.
In addition, the balance of androgens affects the safety of the fetus. With their excess in the body of a pregnant woman, the production of estrogen and progesterone is inhibited, and this is also the threat of miscarriage.
Infectious diseases
In preparation for pregnancy, a woman should engage in the treatment of all existing chronic diseases. In addition, it is recommended to avoid infectious diseases. After all, if the pathogen enters the female body, the temperature can rise sharply, which will also provoke miscarriage.
A separate threat to the fetus are diseases that are sexually transmitted. Therefore, future parents in preparation for pregnancy should undergo examination and pass tests for these diseases. Due to the fact that this type of infection enters the fetus through the blood, in most cases, in the presence of pathology, miscarriage is diagnosed.
Genetic abnormalities
The lion's share of all miscarriages occurs precisely for this reason. Doctors call the figure 73% of the total. In the modern world, this factor plays a huge role. Poor quality products, radiation contamination, polluted ecology - all this affects the female body every day.
Today, preparing for pregnancy, many women are trying to leave the polluted noisy city and spend this time in the most suitable environment. Although these factors are not easy to eliminate, mutations associated with them are not considered hereditary, the next pregnancy can be successful.
Rhesus factor
This factor almost always provokes abortion in the early stages. For this reason, if a woman has a Rhesus factor negative and a man has a positive one, this state of affairs can provoke a Rhesus conflict and, as a result, miscarriage.
To date, medicine has learned to cope with this problem by introducing progesterone into the female body. Thus, the fetus protects itself from the aggressive female immune system. However, in this case, the problem of miscarriage may occur.
Medications
Experts recommend avoiding taking medications during this period, especially in the early stages. It is very important to exclude all analgesics and hormonal drugs. It is also undesirable to use folk recipes, in which St. John's wort, nettle, cornflower and parsley are present as ingredients.
Stress factors
Sudden grief, quarrels in the family or stress at work are all causes of miscarriage in the early stages. These factors should be minimized or, if possible, avoided. An important role in creating a calm environment for a woman belongs to a man. If stressful factors cannot be avoided, then doctors prescribe light sedatives.
Bad habits
Even before conception, you must stop taking alcohol and stop smoking. Smoking can adversely affect the fetal cardiovascular system. It is recommended to build a consistent system of healthy nutrition, with a set of essential minerals and vitamins. It is also necessary to adjust the daily routine.
Injuries
Along with the factors listed above, miscarriage in the early stages can provoke a strong blow, fall or lifting of heavy objects. Therefore, you should behave as carefully as possible.
Abortions in the Past
This is not only an argument used to intimidate young women, but also a real factor in future problems. In some cases, abortion can lead to infertility and provoke chronic miscarriage.
Diagnosis
Miscarriage is a multifactorial disease in which in many patients it is combined with several pathogens at the same time. For this reason, the examination of patients should be carried out comprehensively and include all modern laboratory, instrumental and clinical methods.
In the process of examination, not only the causes of spontaneous miscarriage are established, but also the state of the reproductive system is assessed for the subsequent prevention of the appearance of such a condition.
Screening before pregnancy
The history includes clarification of the presence of somatic, oncological, hereditary diseases and neuroendocrine pathology. A gynecological history makes it possible to determine the presence of a viral infection, inflammatory diseases of the genitals, especially reproductive and menstrual functions (spontaneous miscarriages, childbirth, abortions), treatment methods and other surgical interventions, gynecological diseases.
During the clinical examination, an examination is carried out, an assessment of the condition of the skin, thyroid gland and the degree of obesity in accordance with the body mass index. According to the hirsut number, the degree of hirsutism is determined, the state of internal organs, as well as gynecological status, are assessed. The absence or presence of ovulation, the functional state of the ovaries are analyzed according to the menstrual calendar and rectal temperature.
Laboratory and instrumental methods of research
Diagnosis of miscarriage consists of the following studies:
- Hysterosalpinography - performed after the menstrual cycle on days 17-13, eliminates intrauterine synechia, malformations of the uterus, ICN.
- Ultrasound - determines the presence of adenomyosis, cysts, uterine fibroids, evaluates the condition of the ovaries. Clarifies the condition of the endometrium: endometrial hyperplasia, polyps, chronic endometritis.
- Infectious screening - it includes a microscopic examination of smears of the vagina, urethra, cervical canal and bacteriological examination of the contents of the cervical canal, PCR diagnostics, a virus carrier test.
- Hormonal study. It is carried out on the 5th or 7th day of the cycle, subject to regular menstruation, in patients with oligo- and amenorrhea - on any day. The content of 17-hydroxyprogesterone, DHEA sulfate, cortisol, testosterone, FGS, LH, prolactin is determined. Progesterone can be determined only in patients with a regular cycle: in the first phase of the cycle for 5-7 days, in the second phase of the cycle for 6-7 days of a rise in rectal temperature. In women with adrenal hyperandrogenism, a small test is performed with dexamethasone in order to determine the optimal therapeutic dose.
- To determine the risk of miscarriage, it is necessary to determine the presence of anticardiolipin antibodies, anti-CG and to analyze the features of the hemostasis system.
- If there is a suspicion of endometrial pathology and / or intrauterine pathology, diagnostic curettage is carried out under the control of hysteroscopy .
- If there is a suspicion of adhesion stress in the pelvis, tubal pathology, genital endometriosis, and sclero-polycystic ovaries and uterine fibroids, surgical laparoscopy is indicated.
- Examination of a man includes a determination of a hereditary history, analysis of a detailed spermogram, the presence of neuroendocrine and somatic diseases, as well as clarification of inflammatory and immune factors.
After the causes that cause habitual miscarriage are determined, a set of therapeutic measures is prescribed.
Pregnancy Screening
Monitoring during pregnancy should begin immediately after its onset, and it consists of the following research methods:
- Definition of DHEA sulfate and DHEA.
- Periodic determination of chronic hepatitis C in the blood.
- Ultrasound scan.
- If necessary, consult with a psychotherapist and psychologist.
Prevention
According to statistics, the frequency of spontaneous miscarriage is 1 case per 300 pregnancies. Despite the fact that the probability of miscarriage decreases with an increase in the term, in the last trimester this indicator is about 30%. It also often happens that preterm birth and miscarriage in women occur more than once. The result is a diagnosis of habitual miscarriage (treatment will be discussed below).
The causes of this disease are manifold, in most cases a complex of them leads to premature birth or miscarriage. Moreover, their action can be both sequential and simultaneous. A woman who has tedious work in conjunction with nervous and physical overloads or a low socio-economic situation automatically falls into the risk group.
In addition, the factors that increase the likelihood of pathology include diabetes mellitus, kidney disease, bronchial asthma, vascular and heart diseases, regular intoxication with narcotic substances, alcohol, and tobacco smoke. If a woman has pregnancy complications or an obstetric history is burdened, this also applies to risk factors for spontaneous miscarriage or termination of pregnancy. It is important to remember that for short periods spontaneous abortion can be a biological mechanism of natural selection, for this reason a miscarriage is not a harbinger of a subsequent unsuccessful pregnancy.
In fact, the prevention of miscarriage comes down to two main points:
- Timely examination of the body of a woman and a man.
- Healthy lifestyle.
It is very important to determine the presence of hereditary diseases and infections in a man, to analyze sperm and complete the treatment of all existing problems.
A woman is faced with a more difficult task. It should be clarified whether there were somatic, neuroendocrine, oncological diseases, as is the case with hereditary pathologies.
Also, in the framework of prevention, the features of reproductive and menstrual function are studied, the presence of obesity and its degree are determined, the condition of the skin is assessed.
It is advisable to apply for instrumental examinations. Quite informative is the hysterosalpingography, which is carried out in the second half of the menstrual cycle. As a result, it is possible to find out whether the patient has intrauterine pathologies. Results of ultrasound of the pelvic organs allow you to diagnose the presence of endometriosis, fibroids, cysts, as well as assess the condition of the ovaries.
It is important to examine smears from the urethra, cervical canal and vagina. Hormonal research is preferably performed in the first half of the menstrual cycle. In addition, it is necessary to think about conducting a blood test, which will include coagulation indicators. This will determine the presence of antibodies such as anti-CG, anticardiolipin and lupus.
Treatment
Treatment of miscarriage occurs in the following sequence: finding out and subsequent elimination of the cause.
One of the reasons is infection of the fetus resulting from infection of amniotic fluid or penetration of pathogens through the placenta. In this case, spontaneous abortion occurs subsequently contractile activity of the uterus, triggered prematurely as a result of acute intoxication or the outflow of amniotic fluid, which is due to a change in the structure of the membranes under the influence of pathogens. Treatment in this situation can be successful, since the child's ability to withstand negative factors increases with increasing gestational age.
In measures to prevent this ailment, it is necessary to include consultations of an endocrinologist, since hormonal insufficiency can lead to pathological rearrangement of the endometrium and its depletion, which is also considered a prerequisite for miscarriage. Hyperandrogenism (pathological condition) is also characterized by a hormonal nature and can be the cause of spontaneous interruption.
Acquired or congenital organic pathology of the organs of the reproductive system is also the cause of miscarriage. In addition, the causes of this disease include psychological overload, stress, the effects of certain drugs, diseases of a different nature, an intimate life during pregnancy.
Even with the diagnosis of habitual miscarriage, the possibility of spontaneous abortion can be significantly reduced, subject to constant monitoring by specialists and comprehensive prevention.