We all are familiar with the term abortion and many have experienced it also. But don’t we have a little and limited knowledge about this? Don’t worry! Scroll down and get all the important facts, causes, diagnosis, and treatment for spontaneous abortion that will help you prevent it in the future or for creating awareness among people.
Spontaneous abortion, in simple words, is generally the death of the fetus before 20 weeks of gestation, naturally. It can also be described as the word “miscarriage”. It happens with 20 to 30% of women with confirmed pregnancies. Spontaneous abortion refers to the loss of early pregnancy in the first trimester. 20% confirmed pregnancies spontaneously abort because of the incident in pregnancy due to the late menstrual period.
Classification of abortion
Abortions are classified in many types. Let’s get through them:
- Early: removal of unwanted tissues in the first trimester generally in the 10-14th week of confirmed pregnancy, through pills.
- Late: abortion carried out after the 24th week of pregnancy. Mostly induced abortion.
- Spontaneous: embryonic or fetal death before 20 weeks of pregnancy.
- Induced: abortion which is intentionally performed to remove unintended pregnancy.
- Threatened: vaginal bleeding that occurs in the first trimester which gives the sign of possible miscarriage.
- Inevitable: intrauterine pregnancy with worse cramps, high vaginal bleeding, and cervix dilation that results in miscarriage.
- Complete: during the 8th week, when all the tissues leave the body and pass through the vagina with bleeding.
- Incomplete: when some of the tissues leave the body and some products stay in the body.
- Recurrent: considered as 3 consecutive pregnancy losses occur in 20 weeks.
- Missed: when the fetus didn’t form and has died but the tissues remain in the uterus.
- Septic: a uterine infection that can spread to the placenta and fetus before and after induced abortion and can develop sepsis in the uterus, placenta, fetus, and vital organs.
Now you know all the types of abortion so don’t get confused in all. We will further continue with spontaneous abortion or miscarriage.
Causes of Spontaneous Abortion
There is no specific cause of spontaneous abortion. It can happen due to multiple reasons. This doesn’t mean that there is something you did or you didn’t do but it is typically difficult in maintaining pregnancy which further results in miscarriage or abortion.
Spontaneous abortion is a result of multiple problems that can be either due to:
- Several viruses such as cytomegalovirus, herpesvirus, parvovirus, and rubella virus
- Chromosomal and genetic abnormalities
- Defects in phases also cause miscarriages
- Immunologic abnormalities
- Major trauma
- Uterine abnormalities like fibroids, adhesions also cause spontaneous abortion
- Placental defects
- Retroverted uterus
- Cervix problems
- Hormonal problems in mother
- Uncontrolled diabetes
- Thyroid disorders
- Abnormal fetal growth
For chromosomal and genetic abnormalities, there comes:
- Intrauterine fetal demise (stillbirth)
- Blighted ovum (no embryo formation)
- Molar pregnancy (no fetal development)
- Partial molar pregnancy.
These errors in genes and chromosomes of the mother or father occur naturally and promote no fetal growth. Damaged cells, embryo division, or damaged sperm cells are also natural causes of abortion.
Risk factors of spontaneous abortion
Risk factors of spontaneous abortion that can be avoided to prevent abortion or miscarriage. Certain risk factors that can lead a woman to miscarriage are:
- Age > 35
- History of spontaneous abortion
- Cigarette smoking
- Use of alcohol, drugs (eg, cocaine)
- A poorly controlled chronic disorder (eg, diabetes, hypertension, overt thyroid disorders) in the mother
- High intake of caffeine
- Uterine and cervix problems
- Excess weight
- Invasive prenatal tests
- Poor diet, or malnutrition
- Advanced maternal age
- Abnormally shaped uterus
- Severe high blood pressure
- Food poisoning
- Exposure to toxins like arsenic, lead, etc
- Certain medications
How to prevent miscarriage? Is it possible to prevent it?
Is it possible to prevent miscarriage? Yes! Miscarriage is natural but taking extra care can prevent it from happening. Before using anything ask your doctors about the effects of the thing on the mother or fetus. Discuss with the physician what things to avoid and what to take at the start of a pregnancy. Do not take any medication or supplement without asking the doctor or it can give severe effects on the baby or the mother. Be sure all the things the mother is taking during pregnancy are safe for the mother and fetus both. Some tips for avoiding a miscarriage are:
- Exercise regularly. Not heavy exercise but daily exercises like jogging, walking, or cycling.
- Regular prenatal follow-ups
- Avoid smoking, drug use, alcohol intake.
- Take a prescribed multivitamin
- Limit or avoid caffeine intake during the whole pregnancy period
- Maintain a healthy weight
- Eat a healthy and balanced diet with all nutrients and minerals in every meal
- Stay healthy and avoid things that develop infections
- Include fruits and vegetables in your daily diet
- Manage stress
- Be happy and keep yourself calm
Rate of miscarriage by weeks
The rate of miscarriage risk is high at the start of pregnancy when there is a start of fetal growth and embryo formation. Mostly, miscarriages happen in the first trimester i.e. the first 12 weeks of gestation period. The earliest weeks of pregnancy before the 20th week is the time when women are at the highest risk of a miscarriage. However, as the pregnancy reaches the 6th week of pregnancy, the risk starts to drop.
Weeks from 13th to 20th of pregnancy, the risk of miscarriage drops further. Although it’s an important note to keep in mind that miscarriage risk does not change after this and the complications can arise at any point in the whole pregnancy period.
Risk of miscarriage according to age
50% of miscarriages are due to chromosomal or hormonal issues. The rate of miscarriage increases with the age. Pregnancies after the age of 28 or 30 can be complicated and can leave effects on further life. The rate of miscarriage with age is:
- At the age of 30, the risk of miscarriage is 20 to 30%
- At the age of 40, it is increased up to 40%
- At the age of 45, the rate is increased by up to 80%
Complications in pregnancy are also increased if it is conceived in adult age after 35 and results in miscarriages, fetal death, abortion, or other metabolic diseases in the child and mother after birth.
Signs and Symptoms of Spontaneous Abortion
The sign and symptoms of spontaneous abortion vary. Not every woman experience same symptoms as their causes and type of abortion will be difficlut but they will relate to eachother. Signs and symptoms of spontaneous abortion are:
- Heavy cramping
- Heavy spotting
- Pelvic pain
- Worse bleeding with pain
- Discharge of tissue in bleeding.
- Gush of fluid
- Dilated cervix
- Heavy vaginal bleeding
- Condition of sepsis
- Moderate or severe back pain
Sometimes some of these symptoms occur in a normal pregnancy but the patient should go to the doc to make sure everything is fine. If somebody passed tissue mass with bleeding, put it in a container and report it to the doctor and emergency laboratory. Not every time these symptoms cause miscarriage but doctor checkups and tests are important to make surgery possible.
Diagnosis of spontaneous abortion
Diagnosis of spontaneous abortion is made on symptoms and multiple tests. Transvaginal ultrasonography, transabdominal ultrasonography, and serum hCG tests are done to diagnose and confirm the miscarriage. Physical and clinical examination is also done for the dilation of the cervix. Some other tests that are done to diagnose spontaneous abortion are pelvic examination, blood test, chromosomal test, tissue tests.
Treatment for spontaneous abortion
The treatment for spontaneous abortion has multiple surgical tissue evacuation options which depend on which type of abortion the woman had. If the abortion is complete then no surgery is needed but if there is any tissue left it is removed so it does not cause any septic abortion or any other infection. Commonly for women who have an abortion except complete have 3 treatment managing options:
- Expectant management: the type of treatment in which doctors wait for the rest of the tissue to pass out naturally.
- Medical management: this treatment option requires medicines to remove the remaining tissue out of the body
- Surgical management: this treatment option requires a surgical procedure to remove the tissues remains.
Women should first discuss with their doctor which treatment to choose. Although, all these options have no complications or little complications that won’t affect further pregnancies if done properly. After treatment, the woman would experience spotting, pain, or discomfort.
What does not cause miscarriage?
What does not cause miscarriage and are safe while in pregnancy period are:
- Sexual intercourse
- Workout and exercise, but not heavy weight lifting.
- Daily working. Unless you are exposed to toxins.
Before you leave!
Abortion is a one-time happening thing. The main thing in spontaneous abortion is emotional support. Which is important to give to the parents, especially the mother. So she won’t take the stress on her. Spontaneous abortion is natural and its main cause is unknown but there can be a reason. Try to avoid things in pregnancy and be careful with all the things you eat or do in these 9 months. Don’t worry! Sexual intercourse doesn’t cause a miscarriage, you are safe with it. But do avoid it just after having a miscarriage, at least wait for 4 to 6 weeks. Do not conceive early after a miscarriage, wait for 3 to 6 months, or discuss your plan with the doctor. Before having another try be ready physically and mentally.
A student of Surgical Technology from Dow University of Health Sciences. She brings her expertise on surgical procedures, knowledge on Human Anatomy and Modern Day Surgeries to help students understand and learn easier ways and help patients understand hospital procedures before their surgeries.