Mark Zuckerberg spoke recently about the three miscarriages his wife suffered before their successful pregnancy. Most people prefer not to talk about it, but, as Dr Chandan Dubey, obstetrician and gynaecologist, says, it’s fairly common with one in five pregnancies ending in miscarriage.
Loss of a pregnancy before 24 weeks is called a miscarriage. It is a common occurrence. One in every five confirmed pregnancies ends in a miscarriage. For these women the result is emotional and mental stress, which is often suffered in silence.
Why do miscarriages happen?
Most miscarriages occur in the first three months of pregnancy. Commonest cause for these is a chromosomal error in the baby. This can happen due to various reasons and is usually a random event. Usually it does not reflect a problem in the parents’ chromosomes or genes, with excellent chances of a subsequent healthy pregnancy.
Other causes of miscarriage are:
- disorders in the mother, like uncontrolled diabetes, thyroid hormonal disorders, chronic renal disease, lupus or infections like rubella, syphilis, herpes, cytomegalovirus etc.
- disorders of shape or structure of uterine cavity due to congenital causes or fibroids
- weakness of the cervix or neck of the womb.
Related Reading: How to cope with miscarriage and pregnancy loss
What are the symptoms?
Bleeding from the vagina with or without cramping or dull aching pain in the first five to six months of pregnancy is the commonest symptom. A gynaecologist needs to be consulted immediately. A mild bleeding or spotting in the initial 3 months of pregnancy without pain may not always indicate a miscarriage but expert advice is still needed.
What is the treatment?
The gynaecologist will do an internal examination and an ultrasound to decide the status of pregnancy. If the neck of the womb is closed and the baby is alive on ultrasound, a conservative management is done and the pregnancy may continue. This is a "threatened" miscarriage in medical terms and many times the pregnancy will continue and ultimately the woman will deliver a healthy baby.
If the neck of the womb is open on internal checkup or the ultrasound shows that the baby is not alive, then the loss of pregnancy is inevitable and the choices may be:
- wait for natural expulsion of the pregnancy to happen
- medicines to hasten the process of expulsion from the womb
- a minor surgical procedure to complete the process of abortion.
Which is the better option: medical or surgical treatment?
Medical method is less invasive, does not need anaesthesia, hence a choice for women apprehensive of both surgery and anaesthesia. This is a longer process and may require an additional surgical procedure in 5% cases where it fails.
Surgical method is a one-time procedure and avoids the pain associated with the medical method.
What are the chances of having a subsequent miscarriage?
One in five confirmed pregnancies end in miscarriage. Despite this fact the chances of a subsequent healthy pregnancy are very high. The chance of three or more successive miscarriages, called "recurrent" miscarriage, is one in 100 and needs to be investigated by a gynaecologist. Even in women with recurrent miscarriage the chances of a subsequent healthy pregnancy are very high.
Related Reading: Wrong to shame women for miscarriage
Can miscarriage be prevented?
Most miscarriages are not preventable and not due to any fault of the parents. A single random miscarriage does not need to be investigated for a cause, and with excellent chances of a subsequent healthy pregnancy. Only recurrent miscarriages need to be investigated for a cause and treated if a cause is found.
A healthy lifestyle and diet, folic acid supplementation, abstaining from smoking, alcohol and drugs will increase the chances of a healthy pregnancy outcome.
Must Read: Pre-conception Care For A Healthy Pregnancy
