Miscarriage: A Guide to Causes, Warning Signs, Risk Factors, Prevention

Miscarriage is the most commonly used word to indicate loss of pregnancy within 20 weeks of conception. About 10 to 20% of all pregnancies end in miscarriages mostly before the fetus survives past the 13th week. Different risk factors contribute to miscarriage while warning signs precede the end of pregnancy. Self-care and awareness about causes may help you prevent miscarriages and continue the pregnancy without any complications.

Miscarriage sign is a threat in early pregnancy.

Here is a detailed guide to causes, symptoms, risks, and warning signs of miscarriage, how to cope, tips to prevent, chances of conceiving, and risk of another miscarriage.

Miscarriage: The Medical Definition

In the medical annals, miscarriage refers to natural fetal death before the 20th week of pregnancy. It is the spontaneous loss of pregnancy, with vaginal bleeding with or without pain being the most visible sign.

When the fetal death occurs after the 20th week, it is termed as stillbirth. Abortion, another common term used for the loss of pregnancy, indicates termination or end of fetal development.

Miscarriage is a common yet unfortunate complication during early pregnancy. In many women, the presence of certain risk factors contributes to the recurrent loss of pregnancy.

Incidence of Miscarriage

About 10 to 20% pregnant women face the risk of miscarriages. Even those in good health and have better fertility have a chance of miscarriage due to several other factors. The risk increases with age and those becoming pregnant after 35 years have a 20-35% chance of spontaneous end of pregnancy. A previous pregnancy loss also puts you at an enhanced risk – one in four previous miscarriages lead to another one. Most miscarriages happen before the 13th week after conception.

Different Types of Miscarriages

  • Threatened miscarriage: Inevitable or possible miscarriage progression marked by continued pregnancy with bleeding, abdominal cramps, and a closed cervix.
  • Incomplete miscarriage: Vaginal bleeding along with cramps, backache, and an open cervix, as dead tissues remain in the cervix. It may lead to infections and persistent bleeding.
  • Complete miscarriage: The dead embryo slips out of the uterus following a short but visible pain and bleeding.
  • Missed miscarriage: Silent end of pregnancy with sudden embryonic death and without symptoms. Not recognizable until an ultrasound is done.
  • Chemical pregnancy: Loss of fetus within the first 5 weeks. The egg is fertilized but fails to survive thereafter.

Causes of Miscarriage

  • Chromosomal abnormality due to ineffective fertilization or zygote formation deformities.
  • Infections and pregnancy complications
  • Age of the mother
  • Hormonal problems
  • Lifestyle issues
  • Excessive malnutrition affecting the mother
  • Physical and mental condition of the mother
  • Failure of egg to properly attach to the uterine wall (ectopic, molar pregnancy)
  • Radiation exposure
  • Stress and frequent traveling
  • Reduced fertility
  • Defective embryo structure
  • Blighted ovum or failure of embryo to develop
  • Smoking, drinking, or drug abuse by the mother
  • Excessive caffeine intake
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Symptoms of Miscarriage

Vaginal bleeding and spotting are the most common indications of loss of pregnancy. It may be followed by abdominal cramps and pain. There may be moderate to heavy bleeding with or without brownish discharge for a few days.  Light vaginal bleeding is not a sign of miscarriage. There may be mild or sharp abdominal pain with pressure felt in the pelvic area.

Miscarriage Risk Factors

The following factors play a role in increasing the chance of miscarriages.

  • Age: Women more than 35 years have a greater chance of fetal chromosomal abnormality and reduced fertility.
  • Previous miscarriages: One in four women with prior loss of pregnancy has a chance to miscarry a fetus again.
  • Health problems: A variety of health disorders, such as diabetes, hypertension, blood clots issues, hormonal problems, vaginal infections, ovarian cyst, syphilis, viral hepatitis, thyroid imbalance, cervical insufficiency, parvovirus infection, gonorrhea, measles, and autoimmune diseases, contribute to the loss of pregnancy.
  • Perforated or weak uterus: A weakened uterus is not able to hold the embryo.
  • Lifestyle: Obesity, malnutrition, smoking, using drugs, high caffeine consumption, inactive lifestyle, and lifestyle disorders also increase the risk of miscarriages.
  • Medications: Prescription medications, including antidepressants and a number of NSAIDs, may contribute to the loss of pregnancy.
  • Environmental factors: Living in a toxic or stressful environment also poses the risk of pregnancy loss. Try to avoid arsenic, radiation, and anesthetic substances around your home. Father exposed to mercury is likely to have weak sperms while women subject to radiation face the risk of reduced fertility.
  • Pregnancy factors: Implantation issues, such as ectopic pregnancy, blighted ovum, molar pregnancy.

Warning Signs of An Impending Miscarriage

If you have noticed any of the following signs during pregnancy, you may face the risk of miscarriage.

  • Rapid weight loss
  • A backache with pelvic pressure
  • Fever and chills
  • Abdominal cramps with vaginal discharge
  • Discharge of white-pink mucus from vagina
  • Lower abdomen contractions
  • Light vaginal bleeding with light brown spotting
  • Sudden decline in pregnancy signs

What Happens After Miscarriage

Your doctor may make a detailed analysis of symptoms and suggest you undergo ultrasound test. It helps assess the heartbeat of the fetus. If there is no heartbeat, the miscarriage is confirmed. You may feel like having menstrual cramps for a day. Either the tissue is naturally passed off or removed to avoid any infection.

There may be light to severe bleeding based on the patient’s condition. The patient may experience fever, vaginal discharge, feeling of weakness, and stress for a few days. You have to take rest for a few weeks and avoid rigorous activities.

Self-Care, Treatment of Miscarriage

Treatment following miscarriage focuses on preventing too much bleeding and any kind of infection. If the fetal tissue is expelled from the body on its own, the miscarriage follows a natural progress. It ends on its own and does not need any medical intervention. However, when dead fetal tissue remains inside, medical procedures are resorted to prevent any chance of infection. Too much bleeding also requires intervention, including dilation and curettage, to avoid hemorrhaging.

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The first 24 hours are more important and the patient requires medical attention. Depending on the condition, doctors prescribe medication. The recovery may require a few days to weeks.

Conceiving Again After Miscarriage

In most cases, a woman starts ovulating two weeks following a miscarriage. You are fully fit to conceive again after your next menstrual date that comes in the next four to six weeks. Until then avoid having sex.

Though physical recovery is fast, emotional recovery from the loss of pregnancy may need time. It is better to recover emotionally and wait until you are psychologically ready for pregnancy.

The Chance of Another Miscarriage

There may or may not be another chance of miscarriage when you become pregnant again. Three in four women with previous miscarriage do not face any risk of pregnancy loss and successfully give birth to healthy babies. Therefore, one loss of pregnancy does not mean you can not think of becoming pregnant again.

To avoid its reoccurrence, you may analyze the risk factors and take adequate medical precaution. Change your lifestyle and dietary habits to improve your fertility.

Tips To Prevent Miscarriage

  • Maintain and improve your fertility
  • Get yourself treated for any chronic health condition before pregnancy
  • Keep yourself and your partner healthy and fit to minimize the risk of chromosomal abnormalities
  • Avoid being putting on too much weight
  • Do regular gentle exercises to keep your BMI in a healthy range
  • Maintain a healthy lifestyle
  • Ensure your pregnancy diet meets your nutritional intake
  • Avoid stressful and polluted environment
  • Increase folic acid intake while limiting the consumption of caffeinated drinks
  • Avoid smoking or drinking
  • Do not take any medication without prescription
  • Keep yourself away from toxic chemicals, radiation, and infections
  • Maintain the required vitamin D and vitamin B levels in your body
  • Ensure your emotional health remains unaffected
  • Keep thyroid balance
  • Make sure you have no sexually transmitted diseases
Ravneet Kaur
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Ravneet Kaur

Ravneet is a proficient author on mindful parenting, child psychology, and pregnancy-related issues. Her practical writing focuses on helping parents develop a compassionate understanding of child behavior and build strong family bonds. She also researches and writes on women’s health, pregnancy problems, relationship issues, teens, and child development and education.
Ravneet also blogs at www.wellnessguide.com
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