early miscarriage Early abortion How to stay healthy during pregnancy

Early abortion
How to stay healthy during pregnancy



Threat of spontaneous abortion

Threat of spontaneous abortion

Early abortion. A miscarriage is the spontaneous loss of a pregnancy during the first 20 weeks of pregnancy. It is also called spontaneous abortion or premature pregnancy loss.

Miscarriage is very common. Almost 30% of women will experience one, usually before they even stop menstruating or before they realize they are pregnant. Most early spontaneous abortions are the result of a developing fetus that is not healthy and does not have a chance of surviving until the end of pregnancy.

Some known causes of spontaneous abortion are:

    Chromosomal anomalies Studies show that 50% to 60% of all spontaneous abortions are caused by chromosomal abnormalities in the fetus. Of these cases, almost half are caused by the presence of an extra chromosome, as in the case of trisomy 21, also called Down syndrome.
    Uterine abnormalities. Structural defects in the uterine cavity that interfere with the blood supply to the uterus can also cause spontaneous abortion. These include some types of myomas, uterine septa, scarring and possibly large polyps.
    Infections and diseases. Some bacterial and viral infections may contribute to a miscarriage, particularly in the second trimester. These include viral infections such as cytomegalovirus, bacterial infections such as streptococci or, in rare cases, parasitic infections such as toxoplasmosis. Diseases such as undiagnosed diabetes can also cause a miscarriage.
    Mother's age The rate of spontaneous abortion increases with the age of the mother. Almost half of pregnancies in women over 40 end in abortion. This is largely due to the increasing rate of chromosomal abnormalities seen in the ovules of older women.
    Autoimmune diseases It is believed that regulatory problems in the immune system contribute to spontaneous abortions, although there is little evidence to support this hypothesis. The presence of certain complex antibodies such as lupus anticoagulant and anticardiolipin antibodies is sometimes higher in women who have spontaneous abortions, although this may be due to an effect on coagulation. No randomized controlled trial has shown that treatments aimed at modifying the immune system to prevent spontaneous abortions have any beneficial effect. The influence of these factors is not very clear and there is no consensus on their effective treatment.
    Coagulation problems Thrombophilia, or propensity to clot, is a more common cause of miscarriage in the second trimester. The use of anticoagulants such as low molecular weight heparin and acetylsalicylic acid (aspirin) may be beneficial, but should only be used with caution or under the care of an experienced physician.
    Other possible causes Chronic diseases, exposure to environmental toxins (such as certain metals) and stress. Examples include thyroid problems (either hyperthyroidism or hypothyroidism), poorly controlled diabetes or intrauterine adhesions (commonly caused by infections or previous procedures such as dilation and curettage). Radiation and chemotherapy in high doses are known toxins that can cause pregnancy loss. Industrial employees who work with chemicals such as dyes, metals or solvents are at greater risk. Stress from the mother and excessive consumption of tobacco, alcohol and drugs can also be determining factors.


Frequently women are blamed for having a miscarriage. It is important to remember that, in the vast majority of cases, there was something fundamentally altered with regard to how the fetus was formed and nothing the mother had done could have changed it. And keep in mind that suffering a miscarriage does not necessarily mean that you are going to have another. The chances that you can complete a future pregnancy are very high.
How do I know I have this condition?

If you are pregnant and have any of these symptoms, call your doctor immediately:

    Vaginal bleeding Extremely heavy bleeding with expulsion of clots.
    Abdominal pain. Severe or persistent pain in the pelvis or lower back.
    Blood clots. If you remove tissue at home, your doctor will probably order you to pick it up and place it in a clean container or plastic bag for medical inspection.
    Early termination of nausea of ​​pregnancy and loss of breast tenderness. Many women experience these symptoms in the first trimester, but at the beginning of the fourth month of pregnancy they usually decrease. When women experience a loss of these symptoms before the second trimester and if the symptoms suddenly subside, a miscarriage may have occurred.

Your doctor will listen to see if there are beats of the fetus and perform a pelvic exam. If no heartbeat is heard or your cervix is ​​dilated or widened, or if your membranes have ruptured, then it is very likely that the miscarriage is beginning or has already happened. This is called "inevitable abortion." If beats are detected in the fetus and your cervix is ​​still closed, you may have suffered a "threatened abortion." In this case, you will have vaginal bleeding, but the fetus will still be alive. In a threatened abortion, the bleeding may go away and the pregnancy may continue until a normal term delivery. However, any time you have bleeding during pregnancy, be sure to check with your doctor to see if you need to take a medicine called Rhogam. Depending on the type of blood, an injection of this medication may be necessary to prevent you from developing antibodies against blood cells in future pregnancies.

An ultrasound and a physical exam can help identify what is happening. An ultrasound emits high-frequency sound waves that penetrate the uterus to reveal an image of the fetus on a monitor. If you do not see any image of the fetus or if you can see fetal tissue moving through the dilated cervix, then you may have had a miscarriage or it is starting. If the fetus is intact and the uterus is still widened, then it may have had a threat of abortion. Some women do not experience any symptoms after miscarriage, which is called retained abortion. When this happens, the miscarriage may go unnoticed for several weeks until the next prenatal visit. If no beat of the fetus is heard after eight to 10 weeks of gestation and there is no sign of uterine growth, then there was probably a miscarriage.

Many spontaneous abortions happen before a woman realizes she is pregnant. These abortions can be confused with uncommon strong and intense menstruations. Premature bleeding in pregnancy before an intrauterine pregnancy has been confirmed may be a sign of ectopic pregnancy. If you have any concerns about your last period, talk with your doctor.
How is it treated?

The options for treatment include:

    Dilation and curettage. The cervix is ​​dilated or widened and a curette or curette is used to scrape the remaining tissue from the lining of the uterus.
    Curettage of the uterus by aspiration. A mechanical pump is used to suction the remaining tissue and remove it from the uterus.
    Clinical treatment: The woman receives medication that causes uterine contractions. Most women will end the pregnancy within 24 hours of taking the medications. If spontaneous abortion does not occur, the woman undergoes a surgical treatment (dilation and curettage or curettage by aspiration).

Bleeding may continue for several weeks after a miscarriage and may change from bright red to pink or brown. You may also experience abdominal cramping.


If the bleeding becomes stronger after a few weeks instead of decreasing, contact your doctor. If you get a fever or if the vaginal discharge has a strange or unpleasant odor, tell your doctor. Avoid having sex, douching and using tampons for at least two weeks and then gradually resume normal activities such as exercise.
How can I prevent it?

In most cases, nothing can be done to prevent a miscarriage. If you know you are pregnant, make sure you get adequate prenatal care and talk to your doctor about a proper diet and prenatal vitamins. However, most of the time, spontaneous abortions occur because the embryo did not form in the right way. Miscarriage is really the way your body naturally eliminates a pregnancy to give you a chance of a future healthy pregnancy.

After a threatened abortion, relax for a few days and avoid having sex for a few weeks. Most likely, you can complete your pregnancy. Remember, it is very normal for women to bleed in the early stages of pregnancy and it is certainly not always an indication that the fetus is sick or that you are going to have a miscarriage. In fact, some women bleed throughout the pregnancy. This should be discussed with the doctor, since bleeding can be associated with other problems such as uterine fibroids, abnormal implantation of the placenta, and chronic (relatively rare) detachment. Talk to your doctor about any concerns you have.
Frequent questions

Q: If I already had an abortion. Is it very likely that he has another?

A: Having an abortion does not increase the chances that you will have another. If you have had only one previous abortion, the rate of spontaneous abortion in a subsequent pregnancy is similar to the overall index of the general population.

Q: After having an abortion, how long should I wait before trying to conceive again?

A: It is suggested to wait for two normal menses (about eight weeks) before you try to conceive again. That responds in large part to the need to allow her to recover emotionally from her pregnancy. If you do not conceive before having had two normal periods, you do not have a greater risk of having problems with your next pregnancy. If you want to wait for some cycles to pass, keep in mind that ovulation can be resumed approximately two weeks after having an abortion, so you should immediately use effective contraception.

Q: Being too active can cause an abortion?

A: No. Working, exercising and having sex do not increase the risk of abortion.

Q: I have had two miscarriages. Should I have a special test?

A: Because most abortions are caused by defects in a particular fertilized egg, most experts do not recommend special tests until you have had three miscarriages. At this point, abortion is called "recurrent" or "habitual" and additional tests may be necessary. Studies have shown that after a woman has experienced three consecutive miscarriages, she has almost a 50% chance of having a miscarriage later.

Content: 12/1/2010

Revised version by: Zev Williams MD, PhD, FACOG, Reproductive Medicine and Infertility, Weill-Cornell Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.