Early miscarriage: Causes, signs, instructions for follow-up

The article was professionally consulted by Specialist Doctor II Tran Thi Mai Huong - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital

Early miscarriage is not uncommon. The cause is usually related to an abnormality in the chromosomes. Vaginal bleeding and severe abdominal pain are the two most common early signs of miscarriage in most cases.

Premature miscarriage, or spontaneous abortion, is what happens when a pregnant woman loses a pregnancy during the first 13 weeks of pregnancy (about the first trimester).
Early miscarriage is quite common for pregnant women. It occurs in about 10% of known pregnancies.

About half of early miscarriages are due to a random event that occurs when an embryo receives an abnormal number of chromosomes during fertilization.
Chromosomes are structures inside cells that carry genes. Most cells have 23 pairs of chromosomes for a total of 46 chromosomes. Similarly, each sperm and egg cell also has 23 pairs of chromosomes. During the process of egg and sperm meeting to fertilize, the two sets of chromosomes combine to create an embryo. If the egg or sperm has an abnormal number of chromosomes, the resulting embryo will also have a change in the number of chromosomes. Subsequent embryonic development will not occur normally, sometimes leading to an early miscarriage.
Smoking, drinking alcohol and consuming too much caffeine have been studied as causes of early miscarriage. Some studies show that smoking increases the risk of chromosomal abnormalities. Alcohol use during the first trimester may slightly increase the risk of an early miscarriage. However, these studies do not have enough evidence to draw clear conclusions. However, in all cases, it is best for pregnant women to avoid smoking and drinking alcohol during pregnancy. Consuming less than 200 mg of caffeine per day (about two cups of coffee) is not thought to increase the risk of early miscarriage.
Besides, the possibility of an early miscarriage also increases for older women. It occurs in more than one-third of pregnant women over the age of 40.

Vaginal bleeding, severe abdominal pain and cramps are the most common symptoms of an early miscarriage. However, these signs can also indicate other problems during pregnancy, such as an ectopic pregnancy. Many pregnant women have bleeding during pregnancy, but it usually goes away on its own, and the baby continues to develop normally. If you notice any signs or symptoms that suggest an early miscarriage, go to a medical facility for timely diagnosis and treatment.

When examining you, your obstetrician will often ask questions about when the bleeding started, how much blood is coming out, whether you have abdominal pain or cramps... Ultrasound can It may be ordered by your doctor to check if an embryo is developing normally in the uterus or to check the baby's heartbeat.
In addition, you may have to have a test to measure the level of hCG in your blood. This substance is produced in parallel with the development of the placenta. Low or decreasing hCG levels are more likely to have a miscarriage.

Early miscarriage is like a "fatal blow" to the spirit of the pregnant mother, who is in a state of eagerness to have a baby. Therefore, in the case of miscarriage, family members need to actively reassure the pregnant mother and help them overcome the pain of loss.
Besides, after a miscarriage, there will be some fetal tissue in the uterus that needs to be removed. The doctor will choose the appropriate treatment method for each pregnant mother. Some possible risks, including infection and heavy bleeding. Regardless of treatment, there is a risk of serious complications, but the incidence is usually quite rare.

Deciding how early to treat after a miscarriage depends on each person's prognosis. If you have no signs of infection, your doctor will encourage you after an early miscarriage to wait a while for the pregnancy tissue to be removed naturally. This usually takes no more than 2 weeks, but can take longer in some special cases. In addition, drugs can be used to actively remove the remaining fetal tissue.
When the fetal tissue is eliminated, bleeding will occur. This condition is usually worse with menstrual bleeding and lasts longer. Cramps, abdominal pain, diarrhea, and nausea are also likely. Your doctor may prescribe a pain reliever for you. In an early miscarriage, the fetal tissue will look like blood clots. After the pregnancy tissue is removed, your doctor will order an ultrasound or hCG blood test to check that all of the fetal tissue has been completely removed. If not, you may need to continue with surgical treatment.

Surgery is recommended for early miscarriage if you have signs of infection, heavy bleeding, or some other condition. Several surgical options may be available, including:
Vacuum aspiration : For this surgery, the doctor will use a thin tube, which is attached to a vacuum device and inserted into the uterus to collect take tissue. You may be given local anesthesia and sedation. Dilation and curettage (D&C): During a D&C surgery, the cervix is ​​dilated and an instrument is used to remove the fetal tissue. Your doctor may administer general or regional anesthesia. After surgery, you should not insert anything into your vagina (such as using tampons or having sex) for 1 to 2 weeks afterward to prevent infection from occurring. Any of the following symptoms should be noticed immediately:
Heavy bleeding for more than 2 hours in a row Fever Chills Severe pain

Early miscarriage in the first trimester usually only happens once. Most women who have an early miscarriage will be successful in their next pregnancy. It is very rare for multiple miscarriages to occur. Your doctor will perform an examination and evaluation to try to find the cause and remedy if you have had multiple miscarriages.

Ovulation will return and you can continue to get pregnant 2 weeks after an early miscarriage. If you don't want to get pregnant right away, use birth control, such as an IUD. In addition, you can also wait until the next menstrual period for the body to return to its normal physiological rhythm, in order to best prepare for the next pregnancy.
For women who are pregnant for the first time, early miscarriage is really a very heavy psychological shock. Therefore, family members should stay by their side to best take care of both the health and psychology of the woman. Besides, if this unfortunate thing happens to you, don't hesitate to share your feelings and thoughts with everyone, because that will help your mood be more comfortable. And most of all, success will surely come to you in the next pregnancies.

For pregnant women who have had a miscarriage and want to get pregnant again, they should check their reproductive health 3-5 months before becoming pregnant so that doctors can examine and assess your body condition and health. suitable for pregnancy or not. Because women with a history of miscarriages will have a higher risk of health problems for both mother and baby. You should:
Get vaccinated before becoming pregnant (especially to prevent rubella because rubella in pregnancy is extremely dangerous ) Genetic testing to screen for genetic diseases before pregnancy Check for gynecological infections avoid affects the health of mother and fetus, especially women over 35 years old, if they want to become pregnant (especially if they have never been pregnant), they will have to have a very detailed health check because pregnancy at this age often encounters complications. problems: Ovarian failure, premature birth, higher risk of birth defects, placenta previa, preeclampsia. Vinmec currently has many comprehensive health care programs for couples, pregnant mothers and their unborn babies, including basic pre-marital examination packages, advanced pre-marital examination packages, and maternity packages. . Vinmec has a team of experienced doctors in the fields of obstetrics and gynecology, IVF, stem cells, gene technology, capable of synchronously and comprehensively deploying the most advanced assisted reproductive techniques today. For specific information about fertility and maternity packages at Vinmec, please contact the hospitals and clinics of Vinmec health system nationwide.

Reference source: Acog.org