Missed abortion is a non-induced fatal death or embryonic passage of products of conception before 20 weeks (140 days) of gestation. It’s also defined as a clinically recognized pregnancy. In this process, there is an extraction of an embryo weighing 500g or less. This abortion occurs in at least 15-20% of every recognized pregnancy as it is purely accidental that is spontaneous and these can be subdivided into inevitable abortion, missed abortion, septic abortion, threatened abortion, incomplete abortion, and recurrent spontaneous abortion. Ultra-sonography is the only way that is used to diagnose spontaneous abortion. There are chances of having an abortion at the beginning of the pregnancy and they include few topics like:
Miscarriage (an early pregnancy loss) is when the baby dies in the uterus before 20 weeks of gestation and the medical term which is generally used for miscarriage is missed abortion. The miscarriage occurs within the first three months of gestation and if you have a miscarriage in a row it is caused by an unknown cause, the repeated miscarriage is also known as recurrent spontaneous pregnancy loss. According to the march of dimes, 50% of pregnancy ends in the miscarriage from the day the woman misses her menstrual period or even when she is pregnant.
Symptoms of Miscarriage
· The most general sign of miscarriage is vaginal bleeding. But having common bleeding or spotting before the 10 weeks so this type of bleeding doesn’t mean that you are having a miscarriage.
· Even you may pain in the lower abdomen or cramps. Losing your weight and also having the expulsion of the white-mucus during pregnancy.
· Passing of tissue with clot like material from the vaginal area, experiencing an unexpected downfall in symptoms of pregnancy. But if you experience any bleeding in pregnancy with or without pain you should concern your doctor or visit the hospital immediately.
Types of Miscarriage
· Threatened miscarriage: In a threatened miscarriage you may experience the vaginal bleeding, mild cramps, half of the time bleeding stops and your pregnancy goes normally.
· Incomplete miscarriage: Experiencing abdominal or back pain by bleeding with an open cervix this sign to incomplete miscarriage which leads to having no chances of continuing the pregnancy. So to get a successful result you need to have the follow-up treatment to remove the remaining tissue from the uterus.
· Complete miscarriage: In this type, all the pregnancy tissues come out of your uterus and you don’t need to for any other treatments or any follow-up.
Treatments after Miscarriage
The most recommended treatment of miscarriage are-
· Dilation and curettage: It is also called a D&C. The procedure to remove the remaining tissue for the uterus. In this treatment, the professional dilates (widen) your cervix and removes the tissue with an instrument called a curette.
· The second treatment is by using the medicine in which the guide will provide you with the medicine that will help your body to pass the remaining tissues that still in the uterus.
Pregnancy: The First Trimester
At first, deciding and having a baby is one of the blissful times in a women’s life. In the first trimester, there are several things to consider and plan to help you out. The pregnancy starts from the day you miss your regular menstrual period. The most important factor that matters is the age and health of the women as every pregnancy stage carries its risk. The first trimester is generally the crucial stage where a woman needs to think about several things as she has risks during the first trimester period. The first-trimester pregnancy is about 10 weeks (70 days) long where your provider will guide you from the start of your pregnancy and about the estimated due date.
Changes that Happen in the First Trimester
In the first trimester, a women’s body goes through many changes. These changes in the body may give a positive and negative effect on the body and release hormones that affect almost every single organ in the body. The main signs that you may expect during the first trimester:
· Morning Sickness: It is the most common change that you may expect during the first trimester. To cure this effect you can drink ginger tea or drops that help to reduce the sickness and it may occur in the initial period of pregnancy and also after the 6 months. If it gets severe then you should consult your doctor for medications to treat such symptoms.
· Mood Swings: In the initial period of pregnancy, you might experience mood swings in the first three months of your pregnancy and even after 7 weeks at in the first trimester and also again in the 7th week of being pregnant and these mood swings may also make you crave food and aversion.
· Increase urination: In this case, you may experience urination more often than normal as the level of blood increases which causes your kidney to process additional fluid that is in the bladder. These are the major changes you may expect while first-trimester pregnancy.
During the first trimester pregnancy, there are several chances of having the miscarriage and the classifications are-
· Missed miscarriage: In missed miscarriage, you don’t have an experience of bleeding or cramps. This miscarriage is recognized by the ultrasound where it shows the fetus without a heartbeat or a vacant pregnancy sac of an embryo but in this treatment, you need to treat the miscarriage.
Prevention of miscarriage: Women who want to prevent themselves from miscarriage must have a healthy life and should avoid few things while her pregnancy – should not smoke cigarettes or do illegal drugs, no consuming alcohol, and a little no to caffeine. All these things may reduce a little risk of miscarriage and most important you should not come in contact with the people who have a serious infection or illness when you are pregnant.
Early Pregnancy Failure
Early pregnancy failure is also known as miscarriage, this early pregnancy generally ends by itself in the first 10 weeks of pregnancy. The experts have reported that 12- 14 % of women who missed a menstrual period and had a positive result on the test has experienced the loss of pregnancy. Approximate 25-50 % of women go through a miscarriage at least formerly during their reproductive stage but in this, the majority of cases are of having a miscarriage at the early pregnancy. The failure of early pregnancy may cause stressful and emotional times for the women and their partners. Several reasons may lead to the failure of early pregnancy like incomplete, missed recurrent, threatened, or complete carriage. Also, there are other reasons which may result in an early pregnancy failure-
· Chemical Pregnancy: This miscarriage occurs usually in the initial weeks after the conception but the chromosomal abnormalities keep the fetus developing normally and the tissue passes usually from the womb at the make time of your menstrual period. So during the process, many females are not aware of their pregnancy or when chemically a miscarriage occurs.
· Ectopic Pregnancy: This happens when the well-fertilized egg is instilled in the fallopian tube or somewhere other than the womb. This may cause a serious effect on the mother (the pregnant women). The treatment for miscarriage like this is usually by doing surgery as it is necessary to remove the tissue as soon as possible.
· Blighted Ovum: This type of pregnancy is also understood by the term embryonic pregnancy and it occurs when the fertilized egg is introduced in the wall of the uterus but there is no development seen in the fetus.
· Molar Pregnancy: It is not a feasible pregnancy and it occurs rarely. This starts with a genetic problem at the time of fertilization which leads abnormal tissue to grow instead of the embryo. But women may experience symptoms like regular pregnancy. This type of pregnancy may also include a missing menstrual period, nausea, and positive pregnancy result.
Management of Early Pregnancy Failure
There are three options or management ways for management of early pregnancy failure (EPF).
· Expectant management: In this way of management, it consists of no mediation just waiting for the tissues to pass naturally through the vagina.
· Medical management: In this way, they use the medication to expel the uterine tissue for completing the early pregnancy failure process. This method is considered safe and effective than the expectant management or surgical management as in this the patient is allowed to avoid surgery and anesthesia.
· Surgical management: This method is defined by the automated by using instruments to remove the tissue from the uterus.
Successful management depends on the complete expulsion of the uterus but the success results depend on several factors like the gestational age, type of loss (feeling pain or without pain symptoms). Most of the patients choose the second method of management as it is less painful and has a higher success rate than the Expectant management and surgical management.
Early Gestation Miscarriage
An early pregnancy miscarriage means having the termination/miscarriage before 10 weeks (70days) that is the first trimester period. This miscarriage is divided into two parts chemical pregnancy and clinical pregnancy. Untimely pregnancy is recognized by rising levels of circulating Human Chorionic Gonadotropin (hCG) which is produced by placental trophoblast cells of the conceptus.
Methods used for confirming early pregnancy termination miscarriage
· Clinical pregnancy: This type of gets confirmed by checking both high levels of hCG (pregnancy hormone) and Ultrasonography confirmation of a gestational sac or the fetal pole (heartbeat). But in some cases, the pregnancy ends in miscarriage before having confirmation with the ultrasonography, such type of pregnancy results in a spontaneous abortion. It can only be detected by five or six weeks of pregnancy. The symptoms include fatigue, nausea, or tender breasts these symptoms do not confirm the clinical pregnancy but it can also cause by illness, regular premenstrual, and stress.
· Chemical pregnancy: The miscarriage that is recognized at the very early week of gestation (two weeks) after conception or after four weeks of being pregnant is termed as a chemical pregnancy. In this case, the fetus can be visibly detected on ultrasound well before. The pregnancies affected due to miscarriage are 75%. This pregnancy cannot be recognized, seen, or heard. In chemical pregnancy, there are no other symptoms other than late menstruation. In rare cases, the patient might expect heavier menstrual bleeding than usual with a chemical pregnancy.
Repercussion after the Clinical and Chemical Pregnancy
· Clinical Pregnancy: It is necessary to have regular follow up appointments and tests after clinical pregnancy as they will guide you on how to recover and how to contact if you have any consequences. During the follow-up, they will check if your hCG is normal. Within 8 weeks in case you are going down slowly, then you have to continue your follow up until the result comes at the normal HCG level, after that you have to follow up for 6 months after the surgery.
· Chemical Pregnancy: This pregnancy generally happens earlier than the normal period; hence this slightly affects the women’s body. There are no barriers to having sexual intercourse immediately after the miscarriage but you may need to consult the doctor with possibilities of having a recurrent miscarriage. Spontaneous cessation of a clinical or chemical pregnancy is stated as a Miscarriage or Spontaneous abortion.
It is difficult to recognize spontaneous abortions as there are various types of miscarriages and also different ways to recognize their types. Few miscarriages may show some signs and symptoms during a spontaneous abortion and some may not. It completely depends on the trimester stage and conditions of the woman, hence the best and recommended way is to concern the doctor before you attempt any home remedies and make an appointment with the doctor to get the best and safe service which is not harmful to your health in any way.