Early miscarriage - can it happen again, how to act after it? The first signs and symptoms of an early miscarriage Can a miscarriage occur if

Women often have missed periods, but they do not yet assume that they are pregnant. This fact becomes obvious to them when two strips appear on a test bought at a pharmacy. Except for the woman herself, none of the relatives and friends around her know about the pregnancy, she is not yet noticeable and vulnerable. Almost a fifth of the total number of pregnancies that occur end unsuccessfully when some negative circumstances arise.

Causes of miscarriages in early pregnancy - at what time does a miscarriage occur?

In a large percentage of women, termination of pregnancies occurs at the very beginning of their development, even before the moment when women find out that they are in an interesting position. This can happen due to severe disorders at the genetic level, which have an extremely negative impact on the subsequent development of pregnancy.

In pregnancy from 2nd to 4th week there may be no signs by which this condition can be assumed - that is why a miscarriage is taken by a woman for regular menstruation, but - more abundant than usual.

Even if a woman has a desired pregnancy up to 12 weeks, the problem of miscarriage may affect her.

It will be hard for a failed mother to drown out the pain of loss, she will stay with her for a long time. In order to avoid problems of this kind, it is necessary to familiarize yourself with the causes and incipient symptoms of spontaneous abortion in order to prevent the loss of a child.

There are two scenarios for miscarriage. Spontaneous miscarriage (complete or incomplete), and non-developing pregnancy, in which it can be distinguished: anembryony - the phenomenon of the absence of an embryo in a fetal egg. Either the embryo did not form initially, or its development stopped at the most early dates(no later than the 5th week of gestation). And the death of the fetus / embryo, the development of which was normal, but for some reason was interrupted. With this option, the ultrasound does not show signs of vital activity.

They also distinguish the concept of biochemical pregnancy, when hCG is determined in the blood - these are, in fact, the first days of delay, but it does not develop before clinical pregnancy (before visualization of the fetal egg on ultrasound). cases biochemical pregnancy difficult to track, often a woman does not even know about it, since menstruation comes with a delay of 2-3 days.

Most cases - up to 80% - occur in the first trimester, up to 12 weeks; up to 80% of pregnancy losses before 8 weeks of gestation are associated with genetic and chromosomal abnormalities of the embryo.

Background: Defining the problem of early miscarriages

Spontaneous miscarriage, when it comes to early term, is considered a state when pregnancy is terminated before the 14th week. Much less often, pregnancy is interrupted at a later date.

There are objective reasons for gestation to be interrupted in the early stages. They need to be considered in detail.

If the embryo has genetic abnormalities in development, leading to severe congenital anomalies, deformities and diseases, then it usually dies, which causes spontaneous abortion during early pregnancy.

Gene mutations occur due to external influences on germ cells, but nature, by terminating a pregnancy, helps to get rid of severe gene pathologies so that they do not accumulate in populations. Such miscarriages cannot be prevented.

To avoid similar situations in the future, when planning a child, you need to undergo a medical genetic examination at the clinic and consult with a specialist.

Causes of early miscarriage - what can lead to early miscarriage?

Consider a number of reasons that can provoke a miscarriage in the early stages.

Hormonal problems as the cause of early miscarriages

Often during pregnancy, the hormonal background of a woman is disturbed, progesterone deficiency, which leads to problems during gestation. The hormone progesterone is responsible for maintaining pregnancy and, if problems with the hormone are detected at the very beginning of the term, then the consequences can be eliminated.

Progesterone preparations are prescribed to prevent spontaneous miscarriage.

There is another problem that leads to a miscarriage at the beginning of development: androgen levels, this is a group of male sex hormones (testosterone and analogues). With an increase in their level, the synthesis of the required amount of estrogens and progesterone is suppressed, due to the fact that they are considered antagonists. This conflict leads to the fading of pregnancy.

In addition to these hormones, the gestation process is affected by hormones produced in the adrenal cortex, thyroid gland. If pregnancy occurs, but there is a hormonal deficiency, it can create conditions that provoke abortion.

If a woman is going to become a mother, then it is necessary to consult a doctor, carefully check the hormonal levels - and, if necessary, receive the necessary medication.

Immunological factors that provoke miscarriages in early pregnancy

When the immune system fails, this can also lead to a miscarriage, because the female body, perceiving the fetus as a 50% foreign object, tries to reject it.

In such situations, doctors prescribe hormonal drugs to the woman, which additionally have an immunomodulatory effect. Sometimes it is required to enter a special immunoglobulin.

Infectious factors that provoke miscarriages in the early stages

To date, there are many diverse general infections, as well as genital ones, which lead to disturbances in the development of pregnancy and spontaneous abortion.
Early miscarriages, up to 20% of their number, are due to toxoplasma, chlamydia, syphilis and herpes with cytomegaly.

Women should understand that many infections have a latent nature that does not manifest itself before pregnancy, but when planning they need to be identified - and preventively treated.

If infections are not detected and persist, this will lead to damage to the fetus and its membranes in the initial three months, infection of the tissues of the fetus, which causes deformities incompatible with life.

Deviations in somatic status may be the cause of early miscarriage

If a woman had chronic diseases before the start of pregnancy, or in the first months she suffered an infection with intoxication and a rise in temperature, then there is a threat of spontaneous abortion.

Influenza, rubella, hepatitis are especially dangerous. But the danger is also angina, runny nose, if future mom fell ill at an early age.

If kidney disease and pneumonia occur, this can seriously affect the further course of pregnancy. Somatic pathologies provoke quite serious complications that can cause spontaneous abortion.

When a woman plans her pregnancy, she needs to be carefully examined to identify a chronic infection and treat its foci.

At the beginning of pregnancy, contact with infected people should be avoided in order not to get sick.

If the first signs of the disease appear, you should seek qualified help from a doctor.

Intrauterine surgery may cause early miscarriage

There are other reasons that can terminate a pregnancy - these are earlier abortions, diagnostic curettage of the uterine cavity, surgical procedures, operations.

Separately, abortions can be distinguished, after which serious hormonal disruptions occur, with damage to the uterus itself and its cervix. Because of this, inflammatory processes can occur in the body of the uterus, which will interfere with the bearing of the child.

Spontaneous abortion can occur due to deviations in the structure and shape of the genitals, in the uterine cavity there may be partitions, endometrioid lesions, fibroids, scars after caesarean section.

The influence of medicines, including herbal ones, has a detrimental effect on pregnancy in the early stages

There are medications that can adversely affect the bearing of the fetus, they penetrate to it through the placenta.

Medicines become especially dangerous if taken at the beginning of fetal development. when its vital organs are laid. Under the influence of the substance in the preparations, mutations can occur and irreversible processes can occur in the development of vital systems and tissues of the fetus, leading to termination of pregnancy.

The most dangerous drugs are considered drugs containing codeine, antibiotics, contraceptives with high doses of hormones. If a woman took such medications, but did not yet know about pregnancy, she should tell the doctor in order to be examined in detail.

Many pregnant women try not to use pills - but, at the same time, they use traditional medicine, for example, herbs. This is very dangerous because many herbal extracts cause miscarriage even more than medications. Often folk remedies have a negative effect on the condition of the mother, leading to disturbances in the development of the fetus.

Tansy, as well as nettle, St. John's wort is considered the most dangerous at the beginning of pregnancy. The use of parsley should be limited, as it increases the uterine tone.

The negative impact of stress on early pregnancy

If the woman has a mental disorder, or nervous system fails, it can cause a miscarriage. Especially often the causes of acute and chronic disorders in pregnant women are stresses as a result of divorces, deaths of relatives, home and work problems.

Stress can change the hormonal background of the expectant mother, leading to a decrease in the hormone progesterone. Since progesterone is the pregnancy hormone that keeps it going, a decrease in it can put the pregnancy at risk.

Therefore, it is so necessary for a pregnant woman to protect herself from stressful situations. It is worth avoiding strong emotions and experiences, taking care of an unborn baby.

If you still find yourself in a stressful situation, then you can take sedatives only as directed by your doctor.

Drugs, of course, will put your nerves in order, removing strong excitement.

But the independent use of any medications and drops is prohibited! It must be remembered that this negatively affects the fetus and its condition.

Excessive exercise and early miscarriages

A serious threat when carrying a baby is working with difficult physical conditions: it disrupts the uterine tone and increases intra-abdominal pressure, which leads to detachment of the fetal egg. This happens infrequently, but such a situation cannot be ignored.

Attention! Do not overload your body, do not do hard work, do not carry heavy objects, rest more.

You can not lift weights of more than five kilograms, including your child, and leave the transfer of heavy things, bags, strollers, sleds to your husband.

Falls and injuries during pregnancy can cause early miscarriage

Often there are cases of falling pregnant women, leading to the loss of a child. This situation is very dangerous.

The fall leads to stress with the release of adrenaline, the pressure inside the peritoneum changes dramatically, so the pregnancy of any period can be interrupted.

The fetus of a short period in such a situation does not suffer so often - it is protected by the surrounding waters. But in a pregnant woman, detachment of the placenta and the fetal egg can occur.

To identify a threat to pregnancy after a fall, you need to visit a doctor.

Thermal procedures (visiting saunas, baths, baths) negatively affect early pregnancy

Sometimes the reason for the provocation of a miscarriage can be a visit to the sauna, or taking hot baths.

When body temperature rises, special substances - interleukins - are activated, which upsets the balance of pregnant women's hormones.

But - you can not completely refuse hot baths, you just need to reduce the intensity of the temperature and the time of their exposure.

A woman's lifestyle and bad habits of a pregnant woman, as one of the causes of early miscarriage

The course of a normally developing pregnancy can be changed by smoking and drinking alcohol, which in the early months can cause spontaneous abortion.

Alcohol, nicotine poison the cells of the female body and the fetus, so the body tries to get rid of the embryo, which can be damaged.

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Unfortunately, not every pregnancy ends with the birth of a child. According to medical statistics, about 15-20% of women in the early stages (up to 12 weeks) experience a miscarriage. At the same time, not every girl has cause for concern, because she does not even suspect that she was pregnant.

Signs of a miscarriage

The first manifestations of a miscarriage - bloody spotting. Since the eruption of the deceased fetus can occur gradually, this condition can last up to two weeks. But most often, a miscarriage is evidenced by heavy bleeding, which is often confused with menstruation. Together with the blood, a clot should be released, outwardly resembling a burst bubble. The following symptoms may also appear:

• nausea,
• diarrhea and other disorders of the gastrointestinal tract,
• pain in the abdomen and lumbar region.

Diagnosis of spontaneous abortion

If you notice signs of an incipient miscarriage, you should immediately seek medical help. Even if it is not possible to save the fetus, the doctor will conduct a thorough diagnosis, identify the causes that provoked a spontaneous abortion, and give recommendations on how to avoid a dysfunctional pregnancy in the future. To determine whether a miscarriage has occurred or not, a gynecologist will be able to do a routine examination. If the specialist has doubts, the woman will be sent for an ultrasound.

Causes of early miscarriage

1. Infectious and venereal diseases- rubella, chlamydia, syphilis, in which infection occurs, causing the death of the fetus.

2. Having a history abortion, which can cause serious disturbances in the normal functioning of the reproductive system.

3. Genetic abnormalities of the fetus- an element incompatible with life develops in one of the chromosomes, as a result of which the fetus is rejected. The development of the anomaly occurs due to poor ecology, occupational hazards, and viral diseases.

4. Depression, stress- Violation of the psycho-emotional state of a pregnant woman can also adversely affect the condition of the fetus.

5. Hormonal disorders- deficiency of progesterone or an excessive amount of the male hormone, which is not able to maintain the normal course of pregnancy.

6. Rhesus conflict- observed in women with a negative Rh in the event that the positive Rh of a man is inherited by the embryo. The mother's body perceives the fetus as foreign body and rejects him.

7. Fever- if the body temperature of a pregnant woman is above 38 degrees and lasts for several days, intoxication of the body begins, which leads to its weakness and deprives the ability to hold the fetus.

8. Uncontrolled use of drugs- Antibiotics, potent painkillers, which a woman took not prescribed by a doctor, can also cause a miscarriage.

9. Wrong lifestyle- alcohol consumption, active sports, malnutrition.

What to do if you are in danger of losing a child

If, after a routine examination, the doctor noticed the threat of miscarriage, the woman is shown bed rest. Do not ignore the recommendations of the gynecologist. If the specialist insists, undergo treatment in a hospital. Under regular medical supervision, it is much easier to control the condition of a woman and provide her with emergency assistance in unforeseen situations.

With a strong threat of miscarriage, the doctor prescribes to the woman hormonal preparations based on progesterone, which are responsible for the development of the placenta and endometrium. It is strictly forbidden to take medicines without a doctor's prescription! Self-medication can harm not only the fetus, but also the woman herself. You should also refrain from traveling long distances, especially air travel.

It should be remembered that a miscarriage can happen not only in the early stages, so it is necessary to monitor your health throughout your pregnancy.

Consequences of a miscarriage

If the miscarriage was arbitrary, and not under the influence of drugs, there is no serious threat to the woman's body. But in any case, it is necessary to undergo a medical examination, since the fetal egg may not come out completely - then cleaning will be needed. Otherwise, there is a risk of developing an inflammatory process, which will lead to profuse bleeding and blood poisoning.

To avoid miscarriage in the future, it is necessary to find out what reasons provoked the termination of pregnancy and neutralize them.

If the pregnancy was terminated spontaneously before the 22nd week of gestation, then we are talking about a miscarriage. Such miscarriage can be diagnosed for various reasons. There are many provoking factors, besides, today's statistics are not encouraging, because we are talking about 17-18% of all desired pregnancies.

Termination of pregnancy can be different, they distinguish: threatening abortion, as well as begun, complete, infected, habitual, failed and abortion in progress.

Miscarriage in early pregnancy

Scientists believe that early miscarriages are a kind of natural selection. Approximately 75% of all embryos that were examined after spontaneous abortion had chromosomal abnormalities.

Causes of miscarriage

Even experienced and competent doctors cannot always determine the causes of a miscarriage. The thing is that most often the reasons are mixed. Initially, it is worth highlighting social factors in the form of unfavorable working conditions and bad habits.

It has been proven that smoking and drinking alcohol negatively affects all systems of the human body. The same can be said about production reasons. Here it is worth noting constant vibrations, temperature changes, chemical influence, etc.

Among the causes of miscarriage, medical factors also play an important role. These are infectious diseases, uterine development disorders, malfunctions of the endocrine system, conception with IVF, etc. Doctors also note such possible reasons miscarriage:

• genetic anomalies in the development of the embryo;
• hormonal imbalance (lack of progesterone, malfunction of the adrenal glands or ovaries, placental insufficiency);
• infectious diseases of the genital tract;
• neoplasms of the uterus;
• severe stress, constant nervous tension;
• trauma and even Rhesus conflict.

The age of the expectant mother also affects pregnancy. Too young girls and women over 35 years of age may experience difficulties with bearing.

A miscarriage can start in different ways. There are three main options for the outcome of events:

• the uterus contracts, then detachment of the fetal egg is observed;
• the fetal egg exfoliates from the wall of the uterus, then the organ contracts;
• detachment of the fetal egg and uterine contractions occur simultaneously.

The symptoms of a miscarriage can vary. Doctors distinguish a pain symptom in the lower abdomen and / or sacrum, spotting, which can be profuse or just spotty. If the warning signs are not pronounced, then it is possible that the situation can still be saved and the process of rejection has not yet begun. It is important to seek help from your gynecologist who is leading the pregnancy.

But emergency cases should also be taken into account, when the help of competent medical specialists is urgently needed. An ambulance should be called immediately if heavy bleeding and / or sharp pains begin. The task in this situation is to save the life and health of a woman, because an untimely response can lead to irreparable consequences.

Threatened abortion: threatened miscarriage

Considering the threatening spontaneous interruption, it should be noted increased contractile uterine activity. With such a threat of miscarriage, the embryo retains its connection with the uterine wall.

Signs of a threatened abortion are most often a minor pain symptom in the lower abdomen or in the lumbar region. There are no discharges with an admixture of blood. Gynecological examination reveals increased tone uterus, although the organ itself corresponds in size to the gestational age. The external os of the cervix in some cases can pass one finger, the internal os is closed.

Treatment for threatened abortion

With the threat of miscarriage, treatment is prescribed exclusively by the attending physician. Most often, therapy is aimed at maintaining pregnancy. A gynecologist may prescribe vitamin E, painkillers, and a sedative. Bed rest is also recommended, it is desirable to exclude any nervous tension.

If the threat of miscarriage begins after 20-21 weeks of pregnancy, b-agonists are often prescribed. In case of hormonal failure, medical correction is carried out.

If amniotic fluid leaks (if the problem is diagnosed in the first 12 weeks of pregnancy), it is not advisable to continue the pregnancy.

The process in which detachment of the fetal egg from the uterine wall is traced is called the abortion that has begun. Bloody discharge from the vagina appears, pain in the lumbar region or just above the pubis may disturb. The pain symptom often resembles contractions and appears with a certain frequency and intensity. At gynecological examination, as a rule, the uterus is not enlarged.

If you do a pregnancy test with a miscarriage that has begun, it will show positive result. On ultrasound examination, the fetus is in the uterine cavity, detachment of the chorionic membrane is noticeable.

Treatment of an abortion

If the doctor diagnoses an abortion that has begun, then most often the therapy is directed to maintaining the pregnancy. Vitamin E, sedatives and antispasmodics are prescribed. As an addition, Ascorutin and Etamzilat are recommended.

If the doctor detects insufficiency of the corpus luteum in the first 12 weeks of pregnancy, then gestagens are prescribed. If a woman suffers from hyperandrogenism and there is a threat of miscarriage, then corticosteroid therapy is used.

Abortion in progress

With this diagnosis, a pregnant woman may complain of pain in the abdomen or lower back. The symptom is most often presented in the form of contractions and can have different intensity. Bleeding is usually profuse.

The picture is specific. The fetal egg exfoliates, is rejected from the wall of the uterus and moves to the lower part of the organ, sometimes even to the cervical canal. This condition can end in incomplete or complete miscarriage.

If the abortion is incomplete, then after the detachment of the fetal egg, its particles may remain in the uterine cavity, including elements of the placenta and fetal membranes. Residual particles are determined by ultrasound. In addition, a pregnancy test in such a situation can still remain positive.

When viewed on a gynecological chair, the cervix is ​​ajar and easily passes a finger. The uterus itself in size most often does not correspond to the gestational age, it is reduced. Bloody discharge can have different intensity.

Treatment for incomplete abortion

Incomplete spontaneous miscarriage is treated only with instrumental removal of the fetus. The mucous membrane of the uterus is scraped off.

Treatment of this kind is similar to artificial termination of pregnancy. During the operation, the cervical canal does not expand. Medical instruments are involved - a large curette, abortsang, as well as a small sharp curette No. 5 and No. 6.

If the bleeding is insignificant, then a vacuum aspirator is often used. Also, during the operation, therapy will be performed aimed at enhancing the contractile function of the uterus and stopping bleeding.

Complete abortion

A complete expulsion of the fetal egg from the uterine cavity is a complete abortion. This condition can be observed only after the formation of the placenta, that is, after approximately 12 weeks of pregnancy. If a spontaneous miscarriage occurred before the 12th week of pregnancy, then there is no certainty that the uterus has completely emptied.

If you suspect a spontaneous miscarriage, namely a complete abortion, a gynecological examination is performed on the armchair and ultrasound. The uterus may be slightly enlarged or have a normal size. Discharges with an admixture of blood are noticeable.

A failed miscarriage is a situation in which the fetus dies, but there are no signs of termination of pregnancy. An inanimate embryo can stay in the uterus even for 20-30 days or more, undergoing necrosis. Uterine contractions may not be observed due to failures in the neurohumoral regulation of the genital system.

The symptomatology of a missed miscarriage is special. Discharges with blood impurities may appear, the fetal heartbeat is not audible (on ultrasound), the uterus may have a dimensional discrepancy (reduced).

If a dead fetus has been in the uterine cavity for too long, it is important for doctors to examine the body's reactions that are aimed at stopping the bleeding. The blood group is determined. If the gestation period is short, up to about 12-14 weeks, then the fetus is removed using vacuum aspiration. This procedure allows you to remove the fetal egg at once.

If the terms are more significant, then a specific therapy is prescribed, consisting of Oxytocin, a prostaglandin. Recommend in the complex gel Dinoprostone.

habitual miscarriage

Habitual pregnancy loss (RPB) is an interruption, spontaneous miscarriage, recurrent undeveloped pregnancy. PPB is not common among pregnant women, however, this problem cannot be called too rare. Modern physicians distinguish the term "fetal loss syndrome", the clinical criteria of which are one or more spontaneous miscarriages for a period of 10 weeks or more; neonatal death morphologically normal newborn as a complication of premature birth due to severe preeclampsia or placental insufficiency; stillbirth, etc.

Fetal loss syndrome is considered a generalizing definition, since it is characteristic of all stages of pregnancy, including the latest ones. In the course of medical research, it was found that miscarriage is possible in subsequent pregnancies. Diagnosis is necessary to identify the causes of repeated fetal loss. Habitual miscarriage is based on violations of the reproductive function of the body. Among other factors of PPB, it should be noted:

• endocrine disruptions of the reproductive system;
• diseases of the uterus (synechia, endometritis);
• dysfunction of the immune system;
• complications of the gestational process (multiple pregnancies, uterine infections, premature birth);
• tissue damage to the endometrium.

The presence of chronic diseases such as diabetes mellitus, arterial hypertension or infectious lesions can also cause a habitual miscarriage. Chromosome pathology is another cause of PPB, but this phenomenon is extremely rare. Timely, well-chosen diagnostics increases the chances of eliminating influencing factors and maintaining pregnancy.

One of the important causes of PPB is age: women in their 20s and 30s are half as likely to have a miscarriage as women in their 40s. The causes of PPB are quite similar to the factors for the occurrence of sporadic disruption, but with PPB, an anomaly of the reproductive function is more pronounced.

For a healthy pregnancy (in the presence of any complications), it is necessary to constantly resort to examining the condition of the embryo and the reproductive organs of a woman, to drug therapy and some preventive measures. effective methods. Such measures will increase the chances of having a healthy baby without complications.

As a rule, four groups of main factors provoking miscarriage are distinguished. A correct assessment of the risk factors for relapse is one of the components of the diagnosis, through which it is possible to establish the cause of the termination of pregnancy and determine the methodology that will be effective for preserving the fetus.

Socio-biological conditions of parents can cause miscarriage. It can be noted here:

• low financial income, which affects the nutrition of the expectant mother;
• stressful situations, constant depression;
• emotional and physical stress.

Maternal age younger than 18 years or older than 30 years also often affects the development of pregnancy, as a result of which there may be a risk of failure. A similar factor can cause premature birth, which will lead to complications during possible future pregnancies.

The presence of any chronic or extragenital pathologies, such as diabetes, viral infections or bacterial diseases, intoxication of the body as a result of taking alcohol, drugs, as well as chronic diseases (for example, bronchitis, asthma) can serve as a cause of fetal loss.

Complications during the gestational process are often the cause of premature birth, which in most cases leads to the complete loss of the fetus. Among these complications, multiple pregnancy, previous preterm birth, intrauterine infections, uterine diseases, breech presentation of the fetus, and violation of the structure of the placenta should be noted.

Although there are a number of reasons for miscarriage, in some cases it is not possible to determine which factors led to the loss of the fetus.

As a rule, surveys are carried out on more than later dates pregnancy, which is sometimes the reason for the belated detection of existing pathologies. This often does not make it possible to establish and timely eliminate certain disorders, although pregravid therapy used in such cases is quite effective. As a result, in almost half of the cases, pregnancy has a fatal outcome for the fetus and early miscarriage.

Genetic Causes of Recurrent Pregnancy Loss

Thanks to modern methods of genetic research, specialists have a broader understanding of the causes of spontaneous abortion. There is a chance of relapse due to genetic factors, but it is very small and amounts to only 3-6%. Most genetic disorders are:

• a change in the proper number of chromosomes (usually the loss of a chromosome);
• trisomy (appearance of an extra chromosome);
• polyploidy (an increase in the number of chromosomes in a complete haploid set), which is formed as a result of the fertilization of one egg by a pair of sperm.

The genetic factor in miscarriages is usually trisomies. Less likely causes of miscarriage are polyploidy and Shereshevsky-Turner syndrome.

There are also structural genetic pathologies, among which intrachromosomal and interchromosomal are distinguished. Such changes are manifested in the structure of chromosomes when a segment of one is in place of a segment of another, non-homologous chromosome. In some cases, inversions and ring-shaped chromosomes are possible.

As a result of genetic abnormalities of this type, the fetus may be born unviable or with chromosomal abnormalities (Down syndrome, color blindness and other chromosomal diseases). Occasionally, when studying the chromosome set of parents, one can find genetic abnormalities in the form of rearrangement of chromosomes.

Genetic abnormalities can also appear after a recurrence of an interrupted gestational process, which often affects subsequent pregnancies. In such cases, the process of fertilization, bifurcation of chromosomes is difficult for parents, which as a result leads to a violation of the genetic structure of the fertilized gametes.

If parents have karyotype disorders, then there is a chance that the child will be born with chromosomal abnormalities. In the presence of genetic abnormalities in the mother or father, the objective possibility of having a child with such abnormalities does not reach 10%. And in subsequent pregnancies, the risk of chromosomal pathology is only 1%.

Diagnosis of genetic factors in the genesis of unreasonable disruption is the study of the karyotype (chromosomal set) of each of the parents, cytogenetic analysis, the study of the karyotype of a stillborn child or in cases of neonatal death.

There are several significant endocrine causes of miscarriage, including diabetes and thyroid disorders. These diseases can provoke repeated miscarriages, but in the case of diabetes, the situation is solved by its compensation. Several conditions caused by hormonal imbalances are not corrected therapeutically.

At the same time, a woman may experience polycystic ovaries, insufficient development of glands and blood vessels, a lack of glycogen and proteins, dysplasia and other pathologies that provoke misdevelopment fertilized egg, which eventually leads to miscarriage. Hormonal disorders that provoke a miscarriage can be different, but hyperandrogenism is the most common among them. This pathology is due to a change in androgen metabolism.

Hyperandrogenism may be polycystic ovary syndrome. This pathology is characterized by infertility, menstrual cycle disorders, obesity. Pathology affects not only the ovaries, but also the adrenal glands. Although the causes of the pathology are not fully understood, it is assumed that the disease begins during adrenarche. During this period, the adrenal glands are stimulated, which provokes an accelerated production of androgens and, as a result, an excessive accumulation of estrogens on the skin and fatty tissues.

From the adrenal glands, the pathological syndrome passes to the ovaries, which also begin to produce androgens in large quantities. As the process of disorders develops, the pathology, affecting the ovaries, leads to the appearance in them of various functional and structural disorders. This, in turn, causes even more complex mixed pathologies. The severity of the pathological process makes it very difficult to diagnose and, accordingly, treat and subsequently manage pregnancy in women.

Stress, a number of diseases, various infections and mechanical injuries are essential in the manifestation of such disorders, which become the initial cause of the pathology in women who have problems associated with the genetic background. There is evidence that women suffering from adrenal hyperandrogenism belong to the primary stage of this disease. Clinically, this is expressed by mild symptoms of androgenization and minor hormonal disorders. At this stage, it is easier to diagnose the problem, moreover, adequate treatment leads to complete rehabilitation.

infectious causes

Today there is no doubt that the infectious factor plays a significant role in miscarriage. If the gestational age at which the infection entered the body is still small, there is a risk of developing feto- and embryopathies that are not compatible with life and provoke a miscarriage. The likelihood that the infection will reactivate at such times and provoke repeated miscarriages tends to zero. Studies show that in most patients with PPB and chronic endometritis, the endometrium is dominated by 2 types of viruses and other harmful microorganisms.

Viral infections such as herpes simplex, Coxsackie (A and B), entero- and cytomegalovirus are observed in women with PPB much more often than in patients who do not have complications of a gynecological history. Bacteria and viruses that infect the endometrium lead to the fact that a woman's immunity loses the ability to adequately fight harmful microorganisms.

Diseases of a viral nature (influenza, measles, polio, rubella, mumps, hepatitis, parvovirus, and others) that develop during pregnancy often lead to fetal malformations and miscarriages. The gestational age at which infection occurred is great importance. The smaller it is, the higher the probability of the above consequences becomes. Infection affecting the fetus in the later stages of its development, as a rule, does not lead to serious pathologies, but it can disrupt the normal functionality of tissues and cells.

The placenta protects the fetus. Being a physiological obstacle to infection getting to the fetus, it does not always cope with its task. In particular, in the early stages of pregnancy, a trophoblast is formed, with a rapid division of its cells and, accordingly, an acceleration of metabolic processes. This becomes an ideal environment for the spread of viruses. In turn, the replication of pathogens can damage the placenta, and it loses its protective abilities.

Viruses can penetrate the placenta to the fetus in the event of all kinds of damage to the placental tissue caused by the threat of disruption, autoimmune disorders, and toxicosis. A bacterial infection develops after the pathogen enters through the birth canal. This path is also characteristic of fungi such as Candida, chlamydia and mycoplasmas.

Before childbirth, amniotic fluid has antimicrobial properties, but they are not very pronounced and can only delay the spread of microorganisms, but not eliminate and suppress the pathogen. At the same time, the membrane remains permeable to a number of pathogens that can enter the amniotic fluid, after which they begin to actively multiply. As a result, an infected environment is formed in which the fetus is found. This leads to consequences such as:

• infection of the fetus;
• vasculitis (premature placenta);
• oligohydramnios and polyhydramnios;
• placental insufficiency (delayed fetal development);
• miscarriage;
• rupture of the membranes of the fetus;
• respiratory disorders in the newborn.

The most sensitive period to the influence of negative factors is the first 3-6 weeks of pregnancy. Infectious lesions of the fetus that occur during this period lead to deformity, since they affect tissues that are in the process of rapid formation. Since all the internal organs of the fetus are laid at different periods of pregnancy, the prevalence and severity of the lesion depends on the duration of the negative factor.

In the period from 13 to 27 weeks, the fetus acquires sensitivity to pathogenic microorganisms that provoke the development of intrauterine infections. In this case, there is also a possibility of developing pathologies. Negative processes provoke the narrowing of certain openings and channels, as a result of which the subsequent development of an already formed organ is disrupted. After 27 weeks, the fetus can already respond to the pathogen with various changes, which leads to a number of dysfunctions.

A bacterial and viral infection, often mixed and in a chronic form, observed in women with PPB, stays in the body for a long time without showing any symptoms, but subsequently leads to autoimmune and other problems, including the death of the fetal egg and its rejection, miscarriage .

The anatomical factors of PPB include the following pathologies:

• congenital defects in the development of the uterus (double uterus; two- or unicornuate, as well as a saddle uterus; the presence of a septum inside the uterus);
• acquired anomalies (sinechia, fibroids);
• cervical insufficiency.

Anatomical defects of the reproductive system in patients with PPB are rare (10 to 16% of cases). In most of these patients, uterine development anomalies are combined with hormonal disruptions, menstrual irregularities. The mechanism of miscarriage in the abnormal development of the uterus is the incorrect implantation of the fetal egg, malformations of the endometrium and other pathologies.

Often, pregnancy is interrupted due to uterine hypoplasia due to infantile genitalia. This is a private symptom of a severe pathological process, which is characterized by underdevelopment of the genital organs and all kinds of disorders of the uterus, ovaries, pituitary gland and hypothalamus.

The reasons why genital infantilism develops are not clearly defined. However, many complications are associated with this pathology, such as menstrual and reproductive disorders. When a pregnancy is terminated as a result of genital infantilism, the factor of uterine pathologies plays the main role:

• the endometrium is not prepared enough;
• the myometrium of the infantile uterus is excessively excitable;
• close relationships in the space of the uterus.

The threat of miscarriage in this case exists throughout the pregnancy. In the second third of pregnancy, such patients often have a complication in the form of cervical insufficiency. In the later stages, there is an increased tone of the uterus, placental insufficiency may develop. Simultaneously with these defects, the impact of other adverse factors leading to spontaneous miscarriage is often observed.

As for uterine fibroids, the reproduction of many women with this problem is absolutely normal, pregnancy, like childbirth, is not fraught with any complications. However, in these patients there is still a risk of abortion, often in cases where the size of the uterus is not suitable for healthy gestation. In addition, the location of large myomatous nodes can deform the uterine cavity and create negative conditions for the growth of the fetus and the formation of the placenta.

If a woman suffering from fibroids has any hormonal disorders, this becomes an additional negative factor that can lead to miscarriage even in early pregnancy. It is assumed that uterine fibroids are often accompanied by progesterone deficiency, which potentially contributes to spontaneous breakdown.

Often the threat of miscarriage is due to swelling, malnutrition of fibroids, tumor necrosis. The treatment recommended to maintain pregnancy in women with uterine fibroids is selected on a case-by-case basis. The doctor takes into account the age of the patient, the duration of the disease, hereditary factors, the presence of other defects.

Immunological causes

On this moment it is known that approximately 80% of all PPB, which could not be explained before (with the exception of factors of a genetic, endocrine, anatomical and infectious nature), are caused by disorders of the immune system. There are two types of such disorders - autoimmune and alloimmune.

With autoimmune problems, the immune system directs aggression to the tissues of the mother's body, that is, antibodies begin to attack their own antigens. In this case, the fetus suffers doubly, as the tissues of the woman are damaged. With an alloimmune factor, the patient's immune response is directed against the antigens of the fetus, which are received from the father and are perceived by the mother's immunity as foreign.

Usually in patients with PPB there are such autoimmune disorders as the presence in the serum of autoimmune antibodies - antiphospholipid, antithyroid and antinuclear. The detection of these antibodies is the reason for a more thorough examination, which will detect the autoimmune process and formulate a diagnosis.

The most dangerous autoimmune problem leading to fetal death is Hughes syndrome, or antiphospholipid syndrome. Clinically, it is manifested by several criteria:

• miscarriage;
• thrombophilias resulting from genetic disorders;
• so-called sticky platelets and other anomalies.

Alloimmune disorders that provoke pregnancy loss appear as a result of a couple having an increased number of common antigens in the histocompatibility system, which often happens when marriage is between blood relatives. In addition, an insufficient content of blocking factors in the serum of a woman leads to alloimmune problems.

There is no definitive therapy for this problem. To date, progesterone is considered the most effective immunomodulatory drug used in early pregnancy.

Several miscarriages or two or more preterm births in a woman's history can be considered habitual miscarriage. There can be many reasons for the development of such a problem. In particular, experts in the medical field highlight disruptions in the endocrine system, infectious diseases, uterine pathologies, genetic and autoimmune factors.

Before pregnancy, a woman with habitual miscarriage must undergo a thorough examination. The hormonal background, the virological status of the woman, the karyotype of the future mother and father are taken into account. It is necessary to perform an ultrasound examination of the genital internal organs, salpingography (assessment of the patency of the uterine tubes) and hysteroscopy (examination of the uterine cavity).

Therapy for habitual miscarriage should be prescribed before the moment of conception. In addition, the emphasis is on exactly the cause of the problem.

If the reproductive system refuses to fully function against the background of endocrine disorders, then hormonal drugs are prescribed. A complete hormonal correction is carried out.

• If an excess of androgens is formed by the adrenal glands, then the attending physician will prescribe individual treatment with the use of glucocorticoids. Most often it is Dexamethasone.
• If androgens were produced in excess by the ovaries, then medications with an antiandrogenic effect are recommended. It could be Diane-35 and Androkur. Each drug is prescribed according to a strict scheme. So, for example, Androcur must be taken for several months (starting from the first and ending with the tenth day of the menstrual cycle). If therapy does not give the desired result after 3-4 months of treatment, then Clostilbegid or Clomiphencitrate is used to artificially stimulate ovulation.
• If in the body of a woman androgens are produced in excess by both the adrenal glands and the ovaries, then this form of the disease is considered mixed. In such a situation, before the desired pregnancy, the patient should get rid of excess weight. The doctor will try to normalize carbohydrate and lipid metabolism before conception. If insulin and glucose are normal, then in the second phase of menstruation, Dufaston or Utrozhestan is prescribed along with Dexamethasone. Ovulation is stimulated by Clostilbegid.

In the event that a woman with recurrent miscarriage has problems with the luteal phase, hormonal combined medications are prescribed that combine progestogen and estrogen. It can be Femostan, Silest and others. They are taken for 2-3 months in a certain period of time, or rather 20 days, starting from the fifth day of the onset of the menstrual cycle.

During therapy, ovulation slows down, but after the treatment is canceled, the process of the release of the egg from the follicle resumes, as well as the development of the corpus luteum. If the effect is not observed, then Clostilbegid 50 mg is most often prescribed.

If in the blood of a woman who is diagnosed with habitual miscarriage (permanent miscarriage or premature birth), the level of prolactin is increased, then Bromkriptin is prescribed. The treatment regimen is determined on an individual basis. Moreover, the entire period of therapy is controlled by analyzes that determine the level of prolactin.

If a woman cannot bear a fetus, she has a history of 2 or more miscarriages, and the causes of this pathology are associated with an infection, then treatment may include antibiotic therapy. Also, eubiotics, immunomodulators (Viferon) and antimycotics, for example, Diflucan, can be prescribed in the complex.

If the cause of miscarriage is a viral infection of the body, then the treatment regimen will depend on the type of process. If the viral infection is active and often relapses, then the attending physician may prescribe chemotherapy (up to 10 days) with Acyclovir and Valaciclovir.

If persistent miscarriages are a consequence of autoimmune disorders, then Metipred (glucocorticosteroid hormones) may be prescribed in small doses shortly before the planned conception. If autoimmune disorders are traced in combination with the preserved activity of the virus, then antiviral drugs and immunomodulators are recommended.

If the pregnancy is terminated on its own due to uterine adhesions, septa or other pathologies of the uterus, then surgery is prescribed. In any case, only a competent doctor can prescribe adequate treatment for habitual miscarriage. The specialist will take into account the age of the patient, her obstetric portrait, the presence of chronic systemic diseases and other nuances that may be important. Any self-medication is fraught negative consequences, especially since they don’t joke with health, even if you are sure of the diagnosis.

If a woman has a diagnosis - habitual miscarriage, then during a subsequent pregnancy she must undergo a standard examination scheme. As an addition to the diagnosis of the condition is prescribed:

• Tests to determine the level of hormones in the first 12 weeks after conception. Including chorionic gonadotropin, testosterone, progesterone, estradiol, etc.
• Culture for bacteria from the cervical canal, which connects the vagina and the uterine cavity.
• Laboratory analysis of the mucus of the cervical canal for the detection of pathogens of an infectious nature.
• Ultrasound diagnosis of the state of the cervix (starting from the second trimester).
• Cardiotocography to monitor uterine contractions and the heartbeat of the unborn child (every week, one month before the expected date of birth).
• Dopplerometry (according to individual medical indications).

A pregnant woman who has had several miscarriages in her history should be constantly under the supervision of the attending (leading) gynecologist. Any changes in well-being should be the reason for an urgent visit to a specialist. In no case should you experiment with medications, change the prescribed treatment regimen, it is undesirable to miss scheduled visits to the gynecologist or endure the symptoms of any disorders.

Therapeutic measures

Even if a woman diagnosed with recurrent miscarriage does not have any health problems during a subsequent pregnancy, treatment can be prescribed according to the indications of the attending (leading) doctor. A therapeutic bias can be made in the following areas:

• Symptomatic treatment of threatened miscarriage.
• Treatment aimed at preventing fetal hypoxia and placental insufficiency.
• Drug effects, for example, aimed at normalizing metabolism, increasing the reactivity of the immune system, as well as correcting malfunctions in the internal organs.

This kind of treatment should be applied only according to the indications of the attending physician. The results of laboratory tests are also taken into account, which confirm the excess of a particular hormone or its deficiency. In the case when miscarriages occur due to endocrine disorders in the body, hormonal therapy is recommended.

Treatment with glucocorticoid drugs is prescribed, as a rule, at critical stages of pregnancy, namely at 12-13, 24 and 28 weeks. The fact is that it is during this period of time that a spontaneous increase in the production of androgens by the ovaries or adrenal glands may appear. In the event that the level of the hormone has increased precisely because of the functioning of the adrenal glands, Dexamethasone is prescribed. If hyperandrogenism is provoked by the ovaries, then the doctor will prescribe gestagens, for example, Utrozhestan.

If an increased level of androgens appeared due to the work of the ovaries and adrenal glands, then the violation is of a mixed nature, therefore Dexamethasone and progestogens are also prescribed.

To prevent the activation of the infectious process in women who take glucocorticoids, several courses of immunoglobulin are prescribed, which is administered intravenously.

If luteal phase deficiency is diagnosed, the doctor may recommend vaginal suppositories or Utrozhestan capsules for oral administration. This medication has a special active substance, the corpus luteum hormone - progesterone.

Before prescribing glucocorticoids to a pregnant woman, the doctor must evaluate the ratio of benefits and harms to the fetus. After all, synthetic drugs of this group (Metipred or / and Dexamethasone) easily penetrate the placenta and affect the fetus. Glucocorticoids can lead to fetal growth retardation (activation of the hypothalamic and pituitary systems of the unborn child is possible with a slowdown in the production of nucleic acids and proteins). A child is often born with clear signs of morphofunctional immaturity.

Also, these medicines may Negative influence on the fetal brain. The size of the hippocampus (part of the limbic system) is reduced. So there is a memory deficit, behavioral disorders in adulthood are possible.

Long-term glucocorticoid therapy can provoke the development of type 2 diabetes mellitus and arterial hypertension (persistent increase in blood pressure) in adults.

In the event that a pregnant woman with a diagnosis of "recurrent miscarriage" (several miscarriages in history) suffers from urogenital infections, individually selected treatment is carried out, taking into account the manifestation of the disease. The age of the patient, the results of laboratory tests and the symptoms of the disease are taken into account. Therapy must be comprehensive. As a rule, eubiotics are prescribed, for example, Bifidumbacterin, as well as antibiotics and, of course, desensitizing treatment.

If a pregnant woman has several miscarriages caused by autoimmune disorders in the body, then therapy may consist of a whole range of medications, including immunomodulators, glucocorticoids, anticoagulants and antiplatelet agents. The course of treatment and the regimen depend on the individual characteristics of the patient. Only a doctor can prescribe or cancel medications. Any self-medication is fraught with negative consequences, both for the expectant mother and for the fetus.

If a pregnant woman is diagnosed with congenital defects in hemostasis or simply has violations of the complex of reactions that are aimed at stopping and preventing bleeding, treatment with atcoagulants and, possibly, antiplatelet agents is recommended. Depending on the disorders, the doctor may prescribe Clexane, Heparin for injection or / and Trental and even Aspirin.

Symptomatic therapy for threatened interruption

If a woman has a threat of miscarriage, then symptomatic treatment is also prescribed. Also, much attention is paid to placental insufficiency, or rather its prevention.

It is worth noting the importance of modern diagnostics and corrective manipulations aimed at isthmic-cervical insufficiency in the prevention of miscarriage.

Isthmic-cervical insufficiency is a violation that is reflected in the inability of the internal os to keep the fetal egg in the uterine cavity. Diagnose this problem with the help of ultrasound. The dimensions of the cervix, its length and width in the region of the internal os are taken into account.

On ultrasound, a picture of isthmic-cervical insufficiency is clearly visible. Normally, the pharynx should be closed, but if it is disturbed, it is expanded, the neck is reduced. Ultrasound diagnostics with habitual miscarriage (several miscarriages) is important to carry out more often. Additionally, a study is prescribed at 16-17 weeks of gestation for the diagnosis of isthmic-cervical insufficiency, so that sutures can be applied in time.

A doctor can prescribe an operation for suturing the cervix if the cervix is ​​shortened by more than 2 cm, and the pharynx is expanded by more than 1 cm.

Correction of the aforementioned insufficiency is carried out according to the McDonald method. Sutures are applied with special mersilene threads or silk. They are removed at the onset of labor or closer to the term of 35-36 weeks.

Any diagnosis in case of a threatened miscarriage, as well as the treatment of miscarriage, should be selected on an individual basis. There is no universal therapy for all cases. Any alarming symptoms during gestation should be a reason for urgent medical attention. Pain, bleeding are the main signs of disorders that can be a signal indicating an irreversible process has begun. The sooner a pregnant woman sees a doctor, the greater the chance of a successful outcome. You should not experiment on your health and the health of the unborn baby, even any one.

A miscarriage is a spontaneous termination of pregnancy in the first or second trimester, before the 22nd week. At this time, the fetus reaches a mass of 500 g, which means that even if the pregnancy ends before the 40th week, it can be saved. Therefore, from the 22nd week they talk about premature birth.

Miscarriages happen frequently.

According to various estimates, 15-20% of all pregnancies end early.

But these are only those cases when women already knew about the pregnancy. It happens much more often that they don’t even know about the pregnancy when it is interrupted. How many people are affected by or at risk for pregnancy loss or miscarriage?.

Miscarriages are divided into two types:

1. Spontaneous, or sporadic, when a woman has had 1-2 miscarriages.
2. Habitual. This means that three or more pregnancies ended in miscarriages, usually at the same time. One woman in a hundred experiences recurrent miscarriages.

Why miscarriages happen

In most cases, miscarriages are the law of nature. No one knows exactly how the mother's body determines that it is not worth bearing this fetus, but arguing with this process is usually pointless. It is also not always possible to predict a miscarriage: we can only assume what happened.

Chromosomal abnormalities of the fetus

Three out of four miscarriages occur in the first trimester of pregnancy, that is, in the first three months. At this time, the most common cause of an interrupted pregnancy is fetal anomalies.

Chromosomes are structures that are made up of DNA, that is, genes. Genes are the instructions by which all processes in our body go. Genes determine how and when the fetus will develop, how it will become a child and how it will live later, what the blood type will be, and even what sweets it will like more than others.

When the cells of mom and dad meet, fertilization occurs, after a few hours the fertilized egg divides for the first time. This is a very complex process, and things can go wrong. For example, it turns out that the embryo has an extra chromosome or, conversely, one is missing. But whatever the breakdown, the result is the same: the fetus is not viable. Here the body rejects it, this is a natural mechanism You Asked: What Causes a Miscarriage?.

In most cases, a woman does not even notice that a miscarriage has occurred.

Chemical changes in the body are insignificant, and not everyone feels them. The delay is also small, so it can be attributed to natural changes in the cycle, and outwardly such a miscarriage is no different from.

About two thirds of all early miscarriages are just such anomalies. They cannot be predicted, prevented or cured. Of course, the quality of the sex cells of mom and dad affects the viability of the embryo. But anomalies occur even in perfectly healthy parents with normal eggs and sperm.

If the pregnancy was established by tests, analyzes and even ultrasound, then it can still end in a miscarriage due to fetal abnormalities.

Empty fertilized egg

Some pregnancies end because anembryony develops. This is a phenomenon when there is a fetal egg, but there is no embryo formed in it. This is also a consequence of breakdowns after conception. Miscarriage.

Problems with the placenta

In order for the fetus to develop, it must attach to the wall of the uterus and begin to feed with the help of the placenta. The placenta is a special organ that connects the organisms of the mother and fetus. This organ is formed before the 14-16th week of pregnancy. And if during this period something went wrong and the placenta “failed”, the pregnancy will be terminated, because the fetus cannot be carried without a placenta.

chronic diseases

In the second trimester, the risk of miscarriage can be affected by the health of the mother, and in particular some chronic diseases:

1. Diabetes mellitus (if not controlled).
2. Autoimmune diseases.
3. Diseases of the kidneys.
4. Disorders in the work of the thyroid gland.

infections

Some infections can harm the fetus and cause miscarriage. These are HIV (if left untreated and controlled), chlamydia, gonorrhea, syphilis, rubella, toxoplasmosis, and cytomegalovirus, if you get the last three during pregnancy. Please note that this list does not include ureaplasmosis and any changes in the vaginal flora.

Medications

Many medicines, including natural ones (herbs, the same coltsfoot), can affect the course of pregnancy. Therefore, you can take any medication only if it is safe and agreed with your doctor.

Features of the structure of the uterus

The shape, structure, and position of the uterus can affect how a pregnancy progresses. But anomalies that can actually lead to a miscarriage are extremely rare.

Sometimes the muscular ring of the cervix is ​​weaker than necessary for bearing the fetus. This condition is called isthmic-cervical insufficiency. Because of it, the cervix opens before childbirth, a miscarriage occurs Causes of miscarriage. This anomaly should be noticed by a gynecologist who will suggest treatment options.

Polycystic ovaries

A syndrome that leads to enlarged ovaries, difficulty conceiving, and an increased risk of miscarriage What causes pregnancy loss/miscarriage?, although no one knows for sure how PCOS affects pregnancy. Many women with this problem carry the fetus until the 40th week.

What increases the risk of miscarriage

1. Mother's age. The risk of miscarriage in women aged 20-24 years is 8.9%, after 45 years - 74.7% Maternal age and fetal loss: population based register linkage study.
2. Bad habits. Smoking and drugs (in any quantities), alcohol (more than 50 ml of strong drinks per week).
3. Caffeine. A small amount of caffeine does not affect the fetus, so up to 200 mg of caffeine per day can be taken. Usually this rate is twice as high. how much caffeine is in tea and coffee, so as not to get confused.
4. Obesity.

What does not affect miscarriage

Contrary to many myths, pregnancy cannot be prevented by:

1. Stresses and experiences of a pregnant woman, fear.
2. Any daily activity Early Pregnancy Loss, including work (if it is not initially related to harmful activities).
3. Sports and, if there are no contraindications to them, which the gynecologist will tell about.
4. Spicy food.
5. Flying.

What to do if a miscarriage occurs

In any case, you need to visit a doctor to check if there are any unnecessary tissues left in the uterus. As a rule, the body gets rid of everything superfluous itself. Sometimes the uterus needs help: either take a medicine that opens its cervix, or resort to surgical methods.

To find out the cause of the miscarriage, you need to take a complete blood count, check for infections and examine the uterus. Together with a partner, you can get checked by a geneticist and identify chromosomal abnormalities. However, it is not a fact that these analyzes and examinations will tell something: there are still too many mysteries in this matter.

One of the most difficult tasks after a miscarriage is to cope with the feeling and not blame yourself for what happened. Everyone experiences problems differently, but just in case, remember:

1. If the pregnancy was interrupted, then most likely the fetus had no chance, no matter how cynical it may sound.
2. We are not to blame for the fact that the human body is so complex and so difficult to reproduce.
3. Miscarriages are common, and after them, most women get pregnant and give birth without much difficulty.
4. Worrying and being sad is normal.
5. If you find it difficult, you can always seek psychological help.

What can we do to prevent miscarriage

Sadly, almost nothing.

If the miscarriage is due to genetic causes, then we are powerless. If infections are to blame, then we can (for example, from rubella and influenza) or try to avoid infection. If chronic diseases are to blame for the miscarriage, then we can treat them or at least control them.

But in most cases, a miscarriage is not the fault of the parents, but a complex, albeit terrible, from our point of view, selection mechanism.

According to statistics, out of 100 pregnancies, 15-20 end in miscarriages. Most often this happens when a woman is not yet aware of her position. But if the expectant mother is already aware that conception has occurred, then a miscarriage becomes a terrible loss for her. Therefore, information regarding miscarriage will be useful both for those who are at the planning stage and for women who are already expecting a baby. Knowing the causes and symptoms of spontaneous abortion in the early stages, you can prevent the threat of losing a child, as well as avoid unpleasant consequences.

What is a spontaneous abortion

Miscarriage (spontaneous or spontaneous abortion) is the rejection of the fetus by the mother's body for reasons beyond her control for up to 28 weeks.

Statistics of pregnancy gestation by women in Russia

There are three types of spontaneous abortion (depending on the period at which the miscarriage occurred).

1. Termination of biochemical pregnancy (up to 3 weeks). For unknown reasons, the embryo detaches from the walls of the uterus and comes out along with blood clots. Bleeding at these times in most cases is perceived as the beginning of menstruation, since the woman does not yet know about her pregnancy.
2. Early miscarriage, or spontaneous abortion. Termination of pregnancy occurs before the third trimester.
3. Premature birth, or late miscarriage. The reasons may be various fetal pathologies, circulatory disorders, preeclampsia in the mother, etc. In most cases, with a miscarriage in the later stages, the child can be saved.

In each period of pregnancy, there are periods during which the threat of miscarriage is most likely. The highest risk of losing a child occurs in the first month after conception, especially from 14 to 21 days.

In addition, you must be extremely careful in the following periods: 8-12, 16-20, 28-32 weeks. During these periods, a woman should rest more, avoid stress, listen to her feelings and visit a doctor in a timely manner.

If signs of an incipient miscarriage are found, a woman should immediately seek qualified medical help. Timely measures taken increase the chances of maintaining pregnancy and safe delivery at the appointed time.

The threat of miscarriage - how to keep the pregnancy (video)

Types

Miscarriages are divided into several types:

1. Inevitable (incomplete). He is accompanied by severe pain covering the lower back and lower abdomen. Accompanied by dilatation of the cervix and uterine bleeding. A miscarriage is considered inevitable when a fissure of the fetal bladder forms and the internal os of the uterus opens. Incessant pain and discharge are signs of an incomplete miscarriage.
2. Complete - spontaneous termination of pregnancy, in which the embryo or fetus is completely expelled from the uterine cavity. After complete cleansing of the organs, pain, spasms and bleeding disappear. Rarely, surgery is required.
3. Missed miscarriage or miscarriage. The dead fetus remains in the uterus, at first no symptoms are observed. Most often diagnosed at a scheduled appointment with a gynecologist or ultrasound. Surgical intervention is required.
4. Repeated miscarriage. It happens to about one in a hundred couples. When a woman has three pregnancies in a row end in an arbitrary termination in the early stages.
5. Anembryony. Fertilization and attachment of the egg occur, on examination, an increase in the uterus is observed, a fetal egg is formed, and other symptoms of pregnancy are also present. But the fetus either does not develop or dies at the initial stage.
6. chorionadenoma. It develops due to genetic disorders. In place of the fetal bladder, a simple piece of tissue is formed, which gradually increases in size.

With the early diagnosis of these conditions, a woman is required to have an abortion for medical reasons.

Features in the early stages

In most cases, complete or incomplete miscarriages occur in early pregnancy.

1. With a complete miscarriage, the uterus rejects the fetus completely, along with the waters and the fetal bladder.
2. In the case of an incomplete miscarriage, most often only the embryo is rejected, and the amniotic membranes remain in the uterine cavity. The embryo can come out either completely or partially.

In order to avoid the severe consequences of an incomplete miscarriage, a woman is cleaned, and hemostatic, hormonal, antibacterial drugs that cause uterine contractions are prescribed.

Without fail, after cleaning, it is necessary to conduct an ultrasound to make sure that there are no blood clots and fetal tissues left, and the uterine mucosa is restored.

Causes

Most often, the causes of miscarriage are genetic abnormalities and fetal malformations that are incompatible with life. That is why some doctors prefer not to keep the pregnancy up to 12 weeks, arguing that this is natural selection. In some cases, it is suggested to have an abortion for medical reasons.

If a woman is hospitalized for preservation, then in most cases, doctors manage to prevent a miscarriage. At the same time, if possible, a complete examination of the fetus for the presence of genetic abnormalities is carried out. And only then a decision is made on further tactics of pregnancy management or a referral is issued for its termination.

The main causes of miscarriage in the early stages:

1. Genetic Defects:
   • anatomical (congenital and acquired malformations);
   • infectious (chronic endometritis);
   • genetic (structural or quantitative change in chromosomes);
   • endocrine;
   • thrombophilic;
   • immunological (autoimmune and alloimmune).
2. Violation of the level of hormones and the performance of the thyroid gland.
3. Diseases of the reproductive system, sexually transmitted infections.
4. Viral and infectious diseases (flu, tonsillitis, rubella, chickenpox, toxoplasmosis).
5. Violation of blood flow between mother and child;
6. Severe pathologies of the internal organs of the fetus.
7. Bad habits of the mother (smoking, alcohol, drugs).
8. Transferred stress, nervous tension.
9. Physical activity, weight lifting, injury.
10. History of abortion, scars on the uterus and abdomen.
11. Taking medications that are contraindicated during pregnancy.
12. X-ray radiation.

The causes of early fetal rejection can also be attributed to a later period, although in the second and third trimesters, miscarriage is most often provoked by inflammatory processes in the uterine cavity or placenta.

Early symptoms

The following symptoms signal the threat of a miscarriage:

• pain in the lower abdomen;
• vaginal bleeding (scarlet or brown discharge, spotting or heavy);
• convulsions.

In the early stages, pregnancy is not always known, so the symptoms of a miscarriage can be mistaken for the onset of a new period. It is worth noting that there are secondary signs of spontaneous abortion that distinguish it from critical days, in particular:

• vomiting and frequent loose stools;
• pain in the form of spasms;
• weight loss;
• bleeding alternating with mucus;
• aching pain in the lumbar region.

If you are aware of the pregnancy, and even slight bleeding has begun, you should urgently seek medical help.

There is such a thing as a frozen pregnancy, or a failed miscarriage. This is the cessation of fetal development and its death for up to 28 weeks. Signs of this condition:

• lack of toxicosis;
• decrease in basal temperature;
• weakness.

In addition, the symptoms of a miscarriage may differ depending on the stage of its course.

Symptoms depending on the stage of miscarriage (table)

Stage	Clinical picture
State of threat of termination of pregnancy	This stage is accompanied by aching pains in the lower abdomen and in the lumbar region. In some cases, there are spotting spotting.
	During the second stage of miscarriage, the pain becomes cramping, there is general weakness and dizziness. With each movement, the bleeding increases, clots are present in the discharge.
Miscarriage in progress (or in progress)	Symptoms of a miscarriage in progress are a sharp pain that spreads throughout the abdomen and lower back, significant blood loss and the release of the fetal egg from the uterus. In some cases, a woman may see a small gray bubble in the discharge, most often this happens if the fetus died a few days before the development of the main symptoms.
Completed miscarriage (completed abortion)	Bleeding gradually becomes less intense, but spotting may still continue for several days.

Timely diagnosed threat of miscarriage and the onset of spontaneous abortion (first and second stages) with adequate treatment leave chances for saving the child. The next stages are irreversible and lead to termination of pregnancy.

Stages of spontaneous miscarriage (gallery)

Bleeding after a spontaneous abortion can last from 4 to 10 days Some time later, the ovum and placenta are expelled from the uterus. The clinical picture of a miscarriage: bleeding, accompanied by spasm and pain in the lower abdomen, pain in the lumbar region

Spontaneous abortion or period?

It is possible to determine that an abortion has occurred, and the next menstruation has not come, using control hCG levels in the blood and measurements of basal body temperature.

Basal body temperature is the lowest body temperature that is measured immediately after sleep, without getting out of bed.

Prevention

Even a completely healthy woman is not immune from spontaneous miscarriage. It is not always possible to detect genetic mutations, hereditary or chronic diseases, which often manifest themselves during pregnancy.

But you can follow simple rules that will allow you to conceive healthy child and increase the chances of a successful pregnancy. Among them:

• moderate and healthy eating, weight control;
• complete rejection of alcohol and cigarettes;
• taking multivitamins;
• exclusion of stress and overload;
• frequent and long walks in the fresh air;
• gymnastics or physical education;
• complete rest;
• scheduled doctor visits.

After an early miscarriage, a woman should undergo a full examination, treatment, and only with the permission of a doctor begin planning a new pregnancy.

2 out of 10 pregnancies, according to statistics, end in spontaneous miscarriage. Therefore, it is necessary to carefully monitor your well-being while carrying a child. If you experience specific symptoms, seek medical attention immediately. Timely diagnosis and treatment will save your pregnancy and minimize the risks of its termination.