Miscarriage Cause, Symptoms & Treatment

MISCARRIAGES are caused by your baby / fetus (fee-tuss) exiting the womb before it is mature enough.

In the above picture (not drawn to scale): 1 is the fetus comfortably living in the womb; 2 is the womb - also known as the uterus (you-ter-russ); and 3 is the exit to the womb called the cervix (sir-vicks). Any abnormality with 1, 2, or 3 can cause a miscarriage. Problems with the fetus are usually genetic abnormalities or malformations. Problems with the womb can be abnormal shapes, or abnormalities in function. The most common problem for the cervix is one which is does not close tightly enough to prevent the growing fetus from squeezing out before its time.

Types of Miscarriage:

• Threatened Miscarriage -- This is where the fetus is still in the womb but has begun to show signs such as a vaginal bleed, that it may be on its way out.
• Incomplete Miscarriage -- This means that the fetus has come out but left behind belongings like the placenta and minor tissues.
• Complete Miscarriage -- All of the fetus and its allied tissues have exited.
• Missed Miscarriage -- This is when the fetus has passed away in the womb quietly without any bleed or other standard alert symptoms. It may first be noted by your obstetrician when s/he finds that your womb has not grown over successive visits.

The SYMPTOMS of a MISCARRIAGE while pregnant are:

• Bleeding from the vagina.

• Pains that feel like a period pain.

• Passing fleshy material from the vagina.

If blood loss has been heavy then you may also feel dizzy or faint.

Things you need to pay attention to are how much blood you have lost - did you see clots passing, how many sanitary pads did you need to use before getting to your doctor. You also need to make a careful note of whether you see any fetal looking tissue pass. This information presented to your obstetrician is of enormous value in helping him/her form an initial impression of your case.

After chatting with you, your doctor will then need to pass an instrument called a speculum into your vagina which allows them to see your cervix. Depending on the state of the cervix they can then provide a diagnosis prior to treatment.

Miscarriage Treatment:

The TREATMENT for all forms of MISCARRIAGE except threatened miscarriage, is to remove any remaining fetal tissue that's left in the womb. This is sometimes called informally a 'womb scrape' and involves using an obstetrical series of instruments like spoons, inserted through the cervix, to scrape out whatever material is left. This is an important step because left inside, this material makes an excellent soup for bacterial growth i.e. infection. The procedure itself is done in about half an hour under general anesthesia.

In threatened abortions the fetus is still inside the womb intact and can be saved. Therefore the first step in treatment is to get an ultrasound of the womb to see if the fetus is still alive. Bed rest and sex abstinence are the mainstay of treatment - except in cases where previous miscarriages are thought to be from to a cervix which does not remain closed as long as it should and needs to be surgically tied closed until the baby is due (cervical cerclage).

Rare cases of miscarriage because of an underlying medical problem such as connective tissue diseases are treated as above while paying attention to also bringing the causative disease under control.

At the first sign of miscarriage you should see your obstetrician for help to keep your pregnancy to term.

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