Birth Defects

The Basics of Pregnancy Loss

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Miscarriage by definition is a pregnancy that spontaneously aborts or terminates and always means that the fetus is unable to survive outside of the womb. Once a fetus becomes “viable” usually after the 20th week or so, early delivery is usually termed preterm labor and all efforts are made to save the baby.

By: Nilutpal Gogoi

Spontaneous abortion or miscarriage can happen due to two main reasons. Miscarriage may occur if the mother has a physical condition or suffers an extreme injury that will not allow the pregnancy to continue to term. Miscarriage can also happen if the fetus fails to develop as it should within the womb. Repeated miscarriage can reduce the likelihood of a woman carrying to term in future pregnancies.

When Do Most Miscarriages Happen?
The vast majority of miscarriages take place during the first three weeks of pregnancy, before many women even realize they are pregnant. Some also happen between the fourth to 12th weeks of pregnancies. Medical researches have ascertained that miscarriages account for approximately 15-25% of all pregnancies.

Why Do Miscarriages Happen?
Some women have a natural tendency to miscarry for a variety of reasons including health conditions, prescription or illicit drug use, smoking, nutritional deficiencies or even being hostile to “foreign DNA” from the baby’s father. Multiple miscarriages reduce the likelihood of carrying future pregnancies to term so it is best to seek the advice of a professional if you have suffered more than one miscarriage.

If you experience any or all of these symptoms, it is important to contact your doctor or a medical facility to evaluate if you could be having a miscarriage:

• 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)
• Brown or bright red bleeding with or without cramps (20-30% 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
• Sudden decrease in signs of pregnancy - Americanpregnancy.org

Causes of Miscarriage
Miscarriages happen for many reasons. 50 per cent of the miscarriages have been attributed to either or both the unnatural development of the placental issue or of the embryo. These abnormalities can be due to three main reasons:

• Faulty sperm or egg cells (germ cells)
• Defective budding of the fertilized egg
• Other maternal problems such as psychological shocks including acute trauma or/and anxiety, diabetes and other systemic diseases like those of the kidney (nephritis).

Premature expulsion of the fetus can also take place also due to malfunctions of the uterine tract, the presence of cancerous tumors or specific health conditions in the mother such as toxemia or fifth disease.

Toxemia
Toxemia is an extremely serious condition which can result in the death of both the mother and the baby and it usually occurs late in pregnancy. Toxemia can degenerate into seizures, coma or death. The symptoms of preeclampsia (which leads to toxemia) are presence of protein in urine, excessive swelling (edema), rapid weight gain and high blood pressure. If severe toxemia happens, doctors generally opt for immediate deliveries to save both the child and the mother. Toxemia is cured automatically with birth.

Fifth Disease
Fifth disease is caused by parvovirus B19 and it can also lead to miscarriage. Though Fifth Disease generally affects children, it can happen in adults too, including pregnant women. Its effects are arthritis and joint pains and the most vulnerable adults are those who suffer from sickle cell anemia.

In most cases, there are no serious complications for an expectant woman who has fifth disease, and her unborn baby usually has no problems. In rare cases, however, fifth disease during pregnancy can cause the unborn baby to have severe anemia and may cause the woman to have a miscarriage. There is no universally recommended approach to monitor a woman dealing with both fifth disease and pregnancy; however, some healthcare providers may increase the frequency of doctor’s visits and perform tests (such as blood tests and ultrasound examinations) to monitor the health of the baby. Kids.emedtv.com

When Termination of Pregnancy Becomes Necessary
There is a vast difference between the connotations of the two terms: miscarriage (spontaneous abortion) and induced abortion. While the former happens naturally, the latter is carried out artificially. Induced abortions are brought on deliberately.

Periodically, a pregnancy has to be terminated intentionally simply because the pregnancy may be life threatening to the mother, the baby or both. If the fetus is mature enough then all efforts will be made to help the infant survive. Sometimes a pregnancy is intentionally terminated because the fetus died in utero and did not deliver naturally. If the pregnancy is less than seven weeks along then a chemical abortion may be performed. Terminations that happen later in pregnancy have to be performed surgically and they are commonly known as a D&C.

Mifeorustone & Chemical Abortions
If chemical abortion is chosen as an alternative to surgical abortions in the first seven pregnancy weeks, then many doctors prescribe Mifepristone or RU-486 to the patients to induce abortions. Nonetheless, chemical abortions cannot be possible if the pregnancy has entered the seventh week. On the other hand, surgical abortions can be done faster. They are completed in two visits to the hospital and do not pose problems in future pregnancies.

Miscarriage Treatment
The generally prescribed treatment to avert threatened miscarriages is bed rest. In cases of repeated miscarriages, total bed rest for the entire pregnancy term becomes indispensable. Often, hormone and vitamin therapy is also suggested. In extreme cases, the patient may even have to undergo surgeries to correct the uterine or cervical abnormalities.

Coping with Miscarriage
It is important to allow yourself time and space to grieve if you have suffered a miscarriage. Many people on the “outside” have no idea what you are going through and may make insensitive or even cruel remarks. If you lose a child, that pain will be with you forever, no matter how far along you were. Many women find internet support groups very helpful and will place banners and tributes to their “angels” online. Other women may plant a flower garden, create a memorial or have some sort of service to mark the passing of the child they will never hold.

Buy the Book: Something Happened: A book for children and parents who have experienced pregnancy loss.

About the author:
Nilutpal Gogoi is a writer and a freelance journalist having more than 18 years of service in several audio-visual and print media reputed organizations in North East India. He has published more than 1000 articles and a popular adventure book for children. For more information log on to
http://www.wellbeingwork.com/ http://www.awellnesshealth.com/
http://www.abouthealthonline.com/

Image Source: http://flickr.com/photos/_f1guy68_/1643679095/

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