Understanding Miscarriage

Imagine this: A woman discovers she is expecting a child. She tells the happy news to her spouse, friends and family, daydreaming about the child she will soon hold in her arms. Then suddenly, she discovers symptoms that tell her all is not well with the pregnancy. She may have pain, cramps and bleeding. She is rushed to the doctor, where she is told that the pregnancy will not continue normally, she will lose her unborn child. She may have to undergo surgery or take medicines to get her body back to its pre-pregnancy state.

This condition, commonly called a 'miscarriage' may have happened to you, or someone you know. Doctors estimate that 1 out of every 4 pregnancies run the risk of miscarriage. Understandably, it is a time of grief and loss for the expectant woman and her family. She may even ask herself: Why me? What did I do wrong? What have I done to deserve this?

 

In some cultures, there are many superstitious beliefs that blame miscarriage on a number of external factors like watching a scary movie or having a bad dream, being startled suddenly, walking in a particular area at a certain time, eating some specific kinds of food or someone casting a spell or an 'evil eye'. It is natural for an expectant woman to unconsciously blame herself for a miscarriage and old wives' tales like these may make her feel even worse. 

 

Causes

Medically speaking, there are a number of reasons why a woman may suffer a miscarriage. Some of the physical factors that can cause miscarriage are:

 

    •       Genetic Defects

Sometimes, a couple may suffer from genetic defects which are transferred to the unborn fetus. Genetic defects do not show up in ordinary ultrasonographs and a couple must undergo a special blood test called 'karyotyping' to see if their children are at risk.

    •       Endometriosis

This is a common condition of the uterus which affects 1 out of every 5 women. About 43 percent of women diagnosed with endometriosis may have miscarriages due to hormonal imbalances.

    •       Luteal-Phase Defects

This is a common cause of spontaneous abortions, and usually happens very early in the pregnancy due to lack of production of progesterone. 

    •       Uterine Defects

There are certain malformations of the uterus that can contribute to miscarriage, such as unicornuate uterus, septate uterus, and bicornuate uterus. These conditions can be diagnosed by a doctor and treated surgically once they are diagnosed, to avoid recurrent miscarriages.

    •       Adhesions

Adhesions are abnormal growths in the ovaries and uterus which may cause miscarriages. However, they can be treated surgically.

    •       Fibroids

Fibroids are muscular growths inside the uterus that can cause spontaneous abortions. A medical procedure called 'myomectomy' can remove the fibroids from the uterus and prevent miscarriages.

    •       Incompetent Cervix

This is a defect of the cervix which prevents the pregnancy from going to its full term and causes late miscarriages.

Apart from these physical causes of miscarriages, there are many other reasons like infections, exposure to hazardous chemicals at the workplace or household pesticides and lifestyle factors like stress that may cause miscarriages. A recent study says women who consume more than 200 milligrams of caffeine are at greater risk of miscarriage, as are older mothers (from the age of 35 upward).

 

Pre-conception care and prevention

Women cannot do much about some risk factors, such as previous miscarriages and advanced maternal age. However, there are steps that women of all ages can take to lessen other potential risks. Sometimes, a woman may undergo a miscarriage even before the first pre-natal medical checkup, so pre-conception care goes a long way in promoting a healthy pregnancy and preventing miscarriage. 

 

Doctors advise women to take prenatal vitamins and minerals like folic acid and Zinc and avoid second-hand smoke. Women are advised to maintain an ideal body weight since obesity is believed to increase the risk of miscarriage. Eating undercooked meat or fish and fish with high levels of mercury and certain soft cheeses which may contain bacteria should be avoided in early pregnancy.

 

Cleaning the litter of household pets or exposure to patients suffering from communicable viral diseases like chicken pox and rubella can increase the risk of exposure to potentially deadly parasitic infections leading to miscarriage. Sometimes multiple or frequent pregnancies and assisted reproductive technologies such as in vitro fertilization may cause recurrent miscarriages.