Miscarriage: Types, Symptoms, and When to Seek Help

Miscarriage is a deeply personal and devastating mishap that impacts countless women and their families, generally leaving profound emotional and physical setbacks. According to the Indian Journal of Medical Research, about 10-15% of known pregnancies in India end in miscarriage. That’s why it is important for would-be mothers and their families to understand the different types and symptoms of miscarriage, as this knowledge prepares them for timely intervention and effective medical care. Read on as we explore the various types and symptoms of miscarriage, and guide you on when to seek help. Let’s start with some basics.

What is a Miscarriage?

Simply put, a miscarriage, also known as spontaneous abortion, is the loss of a pregnancy before the 20th week. It occurs when an embryo or fetus is unable to survive outside the womb, typically due to chromosomal abnormalities, issues with the uterus or placenta, hormonal imbalances, infections, or other health conditions in the mother.

What are the Types of Miscarriages?

Miscarriages can vary in type and severity, each with distinct characteristics and implications. Understanding the different types of miscarriage is crucial for recognizing symptoms and seeking timely medical help.

• Threatened Miscarriage: This occurs when there is vaginal bleeding during early pregnancy, but the cervix remains closed. It does not necessarily mean a miscarriage will happen, but it points towards its possibility.
• Inevitable Miscarriage: In this type, vaginal bleeding is accompanied by an open cervix. It indicates that a miscarriage is inevitable and cannot be prevented.
• Incomplete Miscarriage: An incomplete miscarriage happens when some but not all pregnancy tissue is expelled from the uterus. This often requires medical intervention to remove the remaining tissue.
• Complete Miscarriage: This occurs when all pregnancy tissue is expelled from the uterus. After a complete miscarriage, the bleeding and cramping typically subside quickly.
• Missed Miscarriage: A missed miscarriage happens when the embryo or fetus has died, but the body does not expel the pregnancy tissue. It may be discovered during a routine ultrasound without any obvious symptoms.
• Recurrent Miscarriage: Defined as having three or more consecutive miscarriages. Recurrent miscarriage may indicate an underlying health issue that requires investigation and treatment.
• Chemical Pregnancy: This is an early miscarriage that occurs shortly after implantation, often before the woman knows she is pregnant. It is usually identified through blood tests showing a brief rise and fall in hCG levels.
• Ectopic Pregnancy: Although not a miscarriage in the traditional sense, an ectopic pregnancy occurs when a fertilised egg implants outside the uterus, typically in a fallopian tube. This condition can be life-threatening and requires immediate medical attention.

Understanding these types helps in recognizing symptoms early and seeking appropriate medical care, ensuring the best possible outcomes for health and future pregnancies.

What are the Symptoms of a Miscarriage?

Miscarriages typically occur before the 20th week of pregnancy, and the symptoms can vary. Here are the common signs to look out for:

• Vaginal Bleeding: The most common symptom is vaginal bleeding, which can range from light spotting to heavy bleeding. It may be accompanied by clots or tissue passing from the vagina.
• Cramping and Pain: Lower abdominal cramping or pain, similar to menstrual cramps, can indicate a miscarriage. The pain may also be felt in the lower back or pelvis.
• Fluid Discharge: A gush of clear or pink fluid from the vagina can be a sign of miscarriage.
• Loss of Pregnancy Symptoms: A sudden loss of typical pregnancy symptoms, such as nausea, breast tenderness, or frequent urination, may indicate a miscarriage.
• Weakness and Dizziness: Some women experience weakness, dizziness, or fainting, which can be related to blood loss.
• Severe Pain: Severe and persistent pain in the abdomen or back may signal a miscarriage and requires immediate medical attention.

If you experience any of these symptoms, it is essential to contact your healthcare provider promptly.

What Causes Miscarriage?

Miscarriage, or the spontaneous loss of a pregnancy before the 20th week, can result from a variety of factors. Understanding these causes is essential for both prevention and emotional coping.

• Genetic Abnormalities: The most common cause of miscarriage is genetic abnormalities in the embryo. These can occur due to random errors during cell division, resulting in a non-viable pregnancy.
• Hormonal Imbalances: Hormonal issues, such as thyroid disorders or insufficient levels of progesterone, can interfere with the pregnancy's progression and lead to miscarriage.
• Infections: Certain infections, including those caused by bacteria, viruses, or parasites, can increase the risk of miscarriage. Examples include rubella, cytomegalovirus, and listeriosis.
• Chronic Health Conditions: Maternal health conditions such as uncontrolled diabetes, high blood pressure, autoimmune diseases, and polycystic ovary syndrome (PCOS) can contribute to the risk of miscarriage.
• Lifestyle Factors: Smoking, excessive alcohol consumption, and illicit drug use are significant risk factors for miscarriage. Poor nutrition and exposure to environmental toxins can also play a role.
• Physical Trauma: Severe physical trauma or accidents that impact the abdominal area can potentially cause a miscarriage.
• Structural Abnormalities: Structural issues with the uterus or cervix, such as uterine fibroids, an abnormally shaped uterus, or an incompetent cervix, can interfere with pregnancy and lead to miscarriage.
• Maternal Age: Advanced maternal age increases the risk of miscarriage, particularly for women over 35. The quality and quantity of eggs decline with age, leading to a higher likelihood of genetic abnormalities.
• Immune System Issues: Some immune system conditions, where the body attacks its own tissues, can prevent a pregnancy from developing normally.
• Medications: Certain medications, especially when taken without medical advice, can increase the risk of miscarriage. It is crucial to consult a healthcare provider about the safety of any medication during pregnancy.
• Environmental Factors: Exposure to harmful environmental factors, such as radiation, heavy metals, and certain chemicals, can increase the risk of miscarriage. Minimising exposure to such hazards is crucial.
• Stress: While the relationship between stress and miscarriage is not fully understood, high levels of stress are believed to negatively impact pregnancy outcomes. Managing stress through relaxation techniques and support can be beneficial.

Understanding these causes can help in recognising risks and taking steps towards a healthy pregnancy. However, it is important to remember that many miscarriages are unavoidable and do not result from anything the mother did or did not do. Seeking medical advice and support can provide guidance and reassurance during this challenging time.

How is a Miscarriage Diagnosed?

Diagnosing a miscarriage involves several steps and medical evaluations to confirm the loss of pregnancy. If you experience any miscarriage symptoms, it is important to seek medical attention promptly. Here’s how a miscarriage is typically diagnosed:

• Medical History and Symptoms Review: The healthcare provider will first discuss your medical history and current symptoms. This includes the onset, duration, and severity of any bleeding or pain, as well as any previous pregnancies or miscarriages.
• Physical Examination: A physical examination may be conducted to check for signs of miscarriage. This often involves a pelvic exam to assess the cervix. If the cervix is open, it may indicate that a miscarriage is occurring or has already occurred.
• Ultrasound Scan: An ultrasound is one of the most reliable methods to diagnose a miscarriage. It can confirm whether the embryo or fetus has a heartbeat and if it is developing normally. If there is no heartbeat or if the fetus is not developing as expected, a miscarriage is likely.
• Blood Tests: Blood tests can measure the levels of the pregnancy hormone hCG (human chorionic gonadotropin). A decrease or abnormally low level of hCG may indicate a miscarriage. Blood tests can also check for other factors, such as progesterone levels, which are essential for maintaining pregnancy.
• Tissue Examination: If there has been any passage of tissue, it may be collected and sent to a laboratory for analysis. Examining the tissue can help confirm a miscarriage and may provide insights into the cause.
• Dilation and Curettage (D&C): In some cases, if a miscarriage is confirmed, a D&C procedure may be performed to remove any remaining tissue from the uterus. This procedure also allows for further examination of the tissue to understand the cause of the miscarriage.

Early diagnosis and medical intervention can help manage the physical aspects of miscarriage and provide necessary support for emotional healing.

What are the Treatments for a Miscarriage?

Experiencing a miscarriage can be physically and emotionally challenging. The appropriate treatment depends on the type and stage of miscarriage, as well as the woman's health and preferences. Here are the primary treatment options available:

• Expectant Management: For many early miscarriages, especially those that occur in the first trimester, the body may naturally expel the pregnancy tissue without medical intervention. This approach, known as expectant management, involves waiting for the miscarriage to complete on its own, typically within a few weeks. During this time, the woman is monitored for excessive bleeding or infection.
• Medical Treatment: Medications can be used to help speed up the process of expelling pregnancy tissue. Drugs such as misoprostol are often prescribed to induce uterine contractions and facilitate the passing of the tissue. This method is generally effective and can be done at home, but it requires follow-up appointments to ensure the miscarriage is complete.
• Surgical Treatment: In some cases, surgical intervention may be necessary. The most common procedure is dilation and curettage (D&C), where the cervix is dilated, and a special instrument is used to remove the remaining pregnancy tissue from the uterus. This procedure is usually quick and is done under general or local anaesthesia. It is often recommended if there is heavy bleeding, signs of infection, or if the tissue does not pass naturally or with medication.
• Emotional and Psychological Support: Miscarriage can have a significant emotional impact. Counselling and support groups can be invaluable for women and their families during this difficult time. Mental health professionals can provide coping strategies and support to help manage grief and emotional distress.
• Follow-Up Care: After a miscarriage, it is essential to have follow-up care to ensure that the uterus has cleared and to address any complications. The healthcare provider may perform an ultrasound or blood tests to confirm that the miscarriage is complete. Additionally, discussing future pregnancies and any necessary medical evaluations to prevent recurrent miscarriages may be part of the follow-up care.

Each woman’s experience with miscarriage is unique, and treatment should be tailored to her specific needs and circumstances.

How to Prevent a Second Miscarriage?

Experiencing a miscarriage can be an emotionally and physically challenging ordeal. Suppose you’ve had a miscarriage and are worried about the possibility of it happening again. In that case, there are several steps you can take to reduce the risk and support a healthy future pregnancy. Here’s how you can help prevent another miscarriage:

• Seek Medical Advice: Consult with your healthcare provider to identify any underlying causes of your previous miscarriage. They may recommend tests to detect genetic, hormonal, or structural issues that could be addressed to improve your chances of a successful pregnancy.
• Manage Chronic Health Conditions: Ensure that any chronic health conditions, such as diabetes, thyroid disorders, or high blood pressure, are well-managed. Regular monitoring and appropriate treatment can help maintain a healthy pregnancy.
• Maintain a Healthy Lifestyle: Adopting a healthy lifestyle can significantly impact pregnancy outcomes. Aim for a balanced diet rich in vitamins and minerals, regular exercise, and adequate hydration. Avoid smoking, alcohol, and illicit drugs.
• Achieve a Healthy Weight: Being either underweight or overweight can affect your chances of a successful pregnancy. Work towards achieving and maintaining a healthy weight through a nutritious diet and regular physical activity.
• Take Prenatal Vitamins: Taking prenatal vitamins, particularly those containing folic acid, can help prevent certain birth defects and support a healthy pregnancy. Your healthcare provider can recommend the best prenatal vitamins for you.
• Manage Stress: High levels of stress can negatively impact your pregnancy. Practice stress-reduction techniques such as yoga, meditation, or deep-breathing exercises. Seeking support from friends, family, or a counsellor can also be beneficial.
• Avoid Environmental Hazards: Minimise exposure to environmental toxins, such as radiation, heavy metals, and certain chemicals. This includes avoiding second-hand smoke and limiting contact with harmful substances.
• Follow Medical Advice on Medications: Consult with your healthcare provider before taking any medications, including over-the-counter drugs and supplements. Ensure that any prescribed medications are safe for use during pregnancy.
• Regular Prenatal Care: Attend all prenatal appointments to monitor the health of you and your baby. Regular check-ups can help detect and address any issues early on, ensuring the best possible outcome for your pregnancy.
• Consider Genetic Counselling: If you have had recurrent miscarriages, genetic counselling may be recommended. A genetic counsellor can help identify any genetic factors that may be contributing to miscarriages and discuss potential options.
• Ensure Adequate Rest: Getting sufficient rest and sleep is essential for a healthy pregnancy. Listen to your body and ensure you are well-rested to support your overall well-being.

Taking these steps can help reduce the risk of another miscarriage and increase your chances of a healthy pregnancy.

Final Words

Preventing another miscarriage involves proactive steps and comprehensive care. Max Hospitals can assist you with exceptional, tailored care provided by experienced specialists. With state-of-the-art facilities and a compassionate approach, Max Hospitals will guide you through every step of your pregnancy journey. If you’ve experienced a miscarriage and seek expert advice and support for your next pregnancy, you can trust Max Hospitals to help achieve a healthy outcome. Schedule a consultation with our dedicated healthcare professionals today and take the first step towards a brighter, healthier future. Partner with Max Hospitals, your trusted ally in the journey to parenthood.