Miscarriage

Here is what I'll be discussing today: Miscarriage.

< Overview >

Understanding Miscarriage and Its Probability

Recurrent Miscarriage

Types of Miscarriage

Post-Miscarriage Recovery

Mindset

 

After a miscarriage, knowing and treating the cause is important, but I believe the most crucial aspect is recovering emotionally and mentally from the loss.

 

Understanding Miscarriage and Its Probability

Natural miscarriage is the body's response to expelling an abnormally developing fetus.

 

Based on 20 weeks:

Before 20 weeks is classified as miscarriage, after as premature birth.

Using 10 weeks as a basis:

Before 10 weeks is early miscarriage, after is late miscarriage.

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Early miscarriages are primarily due to chromosomal abnormalities, while late miscarriages are caused by chromosomal abnormalities, immunological factors, and antiphospholipid antibody syndrome.

 

The probability of miscarriage is around 10-20%.

80% of miscarriages belong to the early miscarriage category, so after 10-12 weeks of pregnancy, one can feel a bit relieved.

 

The risk of miscarriage starts increasing significantly at the age of 35.

Age	Miscarriage Risk (%)
30~34	10~21
35~39	17~28
40~	34~52

 

Experiencing a miscarriage once can affect subsequent pregnancies.

Therefore, considering pregnancy planning at a younger age is crucial due to varied miscarriage risks associated with age.

 

Recurrent Miscarriage

Habitual miscarriage refers to the repetition of miscarriage occurring 2 to 3 times or more.

When miscarriages recur, it's crucial to identify the cause.

While opinions may vary among doctors, after around 2 occurrences, recommending tests to determine the cause is common.

The causes can be immunological, endocrine-related, or anatomical.

Immunological causes account for 20-60%:

This involves the mother's immune system considering the fetus as a threat and attacking it, resulting in miscarriage.

Endocrine-related causes cover around 17-20%:

These could include conditions like hypothyroidism, polycystic ovarian syndrome, among other reasons.

Anatomical causes make up approximately 12-16%:

These relate to difficulties in the uterine environment where the embryo or fetus struggles to develop.

 

Types of Miscarriage

Notable types include chemical miscarriage, threatened miscarriage, incomplete miscarriage, complete miscarriage, and missed miscarriage.

 

1. Chemical Miscarriage

It might be more accurate to use the term 'chemical pregnancy.' It occurs when sperm and egg unite but fail to implant. Pregnancy hormone levels may indicate pregnancy, but during ultrasound, no gestational sac is visible. As it often appears similar to a regular period, many might not realize it occurred.

 

2. Threatened Miscarriage

This type happens when the cervix is closed, but the uterine lining around the gestational sac collapses, leading to vaginal bleeding, discharge, and abdominal pain, with a 50% chance of miscarriage.

 

3. Incomplete Miscarriage

Some fetal or placental tissue exits the uterus, causing severe abdominal pain and vaginal bleeding.

 

4. Complete Miscarriage

Both fetal and placental tissue exit the uterus in this scenario.

 

5. Missed Miscarriage

There are two scenarios:

- Pregnancy exists, but due to developmental issues, only the gestational sac forms, and fetal growth stops.

- The deceased fetus remains inside the uterus.

 

Around a quarter of missed miscarriages involve bleeding in the early stages.

If bleeding occurs before confirming a heartbeat, the risk of miscarriage increases.

 

Once a missed miscarriage is confirmed, choosing a treatment method becomes necessary

Natural expulsion

Medication

Surgical (Dilation and Curettage - D&C)

 

 

Natural expulsion typically resolves in 2 months for 80% of cases, but there's a chance of trauma for the mother resembling human-like features, if the fetus remains, sepsis can occur.

 

Medication results in 75% expulsion after about 3 days, but it can induce fever, vomiting, and diarrhea.

 

Both natural expulsion and medication methods, if tissue remnants remain, may cause inflammation and prolonged bleeding, requiring additional surgery for removal.

Sepsis
Systemic symptoms due to microbial infection.

 

Surgery is the cleanest and time-saving method, but being a manual procedure, there's a possibility of side effects such as scarring.

 

Typically, after treatment for missed miscarriage, it's advisable to wait around 3 months before attempting another pregnancy

 

Post-Miscarriage Recovery

Following a miscarriage, hormonal changes and physical changes like uterine scarring occur. Please consider and manage the following precautions

 

1. Expelling Residual Matter in the Uterus

Merely lying down isn't helpful for expelling remnants; light walking is advisable.

 

2. Rest for about a week is essential

 

3. Avoid Cold Exposure

During miscarriage, even in early pregnancy, hormones that loosen joints and ligaments are secreted. Exercise is preferable after 3 weeks or after the first menstruation.

 

Since cold can easily penetrate the skin, exposure to cold foods or environments should be avoided. Inadequate care might lead to prolonged chills or skin numbness.

 

4. Be cautious of Vaginal Infections, Pelvic Inflammatory Disease, and Cystitis

Vulnerability to bacterial infection due to uterine scarring. Until the first menstruation, avoid exposure to unclean substances such as public baths.

 

5. Plan the next pregnancy after 3 months

Provide time for the recurring cycle of uterine lining growth and shedding for recovery.

 

6. Essential Nutritional Supply

Seaweed aids in wound healing, blood circulation, and reducing swelling, recommended at least once a day for 3 months.

Winter melon is excellent for wound recovery due to its rich dietary fiber, preventing constipation.

Bananas are low in calories but rich in iron and potassium. Particularly green bananas contain ample prebiotics, useful in preventing diarrhea caused by antibiotic intake after surgery.

 

 

7. Avoid Coffee and Alcohol

Diminished sleep quality slows down recovery.

 

8. Adequate Hydration

Maintain proper blood circulation by consuming enough water.

Drinking water every 30 minutes aids in supplying nutrients during blood circulation, expediting recovery.

 

Mindset

Endurance isn’t the only solution. It's essential to cry enough, feel sorrow, accept it, and guide yourself to a better place.

 

This concludes the discussion on miscarriage. Next time, I'll post about early pregnancy symptoms.