Miscarriage: Causes, Symptoms, Complications, and Treatment

Miscarriage is the loss of a pregnancy before the 20th week of gestation. It is a common health issue, affecting an estimated 10-20% of known pregnancies.

I. Causes of Miscarriage

• Genetic factors: Approximately 50% of miscarriages are thought to be caused by chromosomal abnormalities in the fetus.
• Hormonal imbalances: Progesterone deficiency, thyroid dysfunction, etc.
• Uterine abnormalities: Fibroids, polyps, uterine malformations, etc.
• Infections: Genital tract infections, sexually transmitted diseases, etc.
• Age: Women over 35 have a higher risk of miscarriage.
• Lifestyle: Smoking, alcohol consumption, drug use, stress, etc.
• Chronic medical conditions: Diabetes, high blood pressure, lupus, etc.
• Other factors: Use of certain medications, exposure to toxic chemicals, etc.

II. Symptoms of Miscarriage

• Vaginal bleeding: This can range from light to heavy, and the color of the blood can vary from light pink to dark red.
• Abdominal pain: The pain can be mild to severe, and it is usually located in the lower abdomen.
• Uterine contractions: You may feel the uterus contracting strongly, which can be painful.
• Vaginal discharge: You may have a mucus-like or watery discharge.
• Loss of pregnancy symptoms: Your breasts may become less tender, and you may stop experiencing nausea and vomiting.

III. Complications After Miscarriage

• Retained products of conception: This occurs when part or all of the placenta remains in the uterus after the fetus has been expelled.
• Hemorrhage: Excessive vaginal bleeding after a miscarriage.
• Infection: Infection of the uterus or reproductive organs.
• Missed miscarriage: The fetus dies in the womb but is not expelled.

IV. Distinguishing Between Inevitable Miscarriage and Miscarriage in Progress

Inevitable Miscarriage

• Severe abdominal pain, often cramping.
• The fetus descends lower, and the uterus contracts strongly.
• Vaginal examination reveals a soft uterus, open cervix, ruptured membranes, and potentially visible fetal parts.
• Ultrasound shows the fetus is no longer alive and the fetus may have already left the uterus.

Miscarriage in Progress

• Milder abdominal pain, which may be dull.
• Less vaginal bleeding.
• Vaginal examination reveals a closed cervix with no signs of fetal detachment.
• Ultrasound shows the fetus is no longer alive, but it is still within the uterus.

V. DIC in Missed Miscarriage

DIC (Disseminated Intravascular Coagulation) is a serious complication of missed miscarriage that occurs when the body releases too many clotting factors into the bloodstream.

Causes

• Prolonged missed miscarriage
• Large fetus
• Infection

VI. Polyhydramnios in the Second and Third Trimester

Polyhydramnios: There is more amniotic fluid in the uterus than normal.

Differences between polyhydramnios in the second and third trimester

• Second-trimester polyhydramnios: Usually caused by fetal birth defects, infections, or maternal diabetes.
• Third-trimester polyhydramnios: Usually caused by fetal conditions, such as digestive tract abnormalities, infections, or maternal diabetes.

VII. Important Notes

• If you suspect you are having a miscarriage, seek immediate medical attention.
• Miscarriages can occur at any point during pregnancy, but they are most common in the first trimester.
• Miscarriage is not your fault.
• You will need to be monitored and treated promptly after a miscarriage to prevent complications.
• It takes time to heal both physically and emotionally after a miscarriage.

VIII. Treatment for Miscarriage

• Medical management: Antibiotics to treat infection, pain relievers, iron supplements, etc.
• Surgical management: Dilation and curettage (D&C), vaginal delivery, or cesarean section, depending on the condition of the fetus and mother.

IX. HCT and White Blood Cells During Pregnancy

• HCT (Hemoglobin) levels are typically lower during pregnancy due to increased blood volume.
• Increased white blood cells (12-16) are a natural response of the body to pregnancy.

X. Conclusion

Miscarriage is a common condition that can be physically and emotionally challenging for a woman. Regular prenatal care, routine health screenings, and seeking medical attention for any unusual symptoms are essential to reduce the risk of miscarriage.