Know the possible causes of miscarriage
Spontaneous abortion happens when a pregnancy terminates before the fetus has reached a viable gestational age. The World Health Organization (WHO) defines the event as the expulsion of an embryo or fetus weighing 500 g or less. This usually corresponds to a gestational age of 20 to 22 weeks or less.
Spontaneous abortion is the most common complication of early pregnancy. The frequency decreases with increasing gestational age. 8 to 20% of clinically recognized pregnancies less than 20 weeks' gestation will undergo abortion, 80% of which in the first 12 weeks of gestation. There is still the loss of the baby without the mother realizing it, which total between 13 and 26% of all pregnancies.
There is still the loss of the baby without the mother realizing, which totalize between 13 and 26% of all pregnancies .
Multiple risk factors are associated with an increased risk of pregnancy loss, such as:
Advanced maternal age is the most important risk factor for spontaneous abortion in healthy women. The effect of maternal age on the outcome of pregnancy was illustrated in a review of more than one million pregnancies. The overall abortion rate was 11%. The approximate frequency of clinically recognized abortions according to maternal age is:
20-30 years - 9-17%
35 years - 20%
40 years - 40%
45 years - 80%
Previous Spontaneous Abortion - Photo Getty Images
Previous Spontaneous Abortion
The obstetric past is an important outcome parameter of the next pregnancy. The risk of miscarriage in future pregnancies is approximately 20% after one abortion, 28% after two consecutive miscarriages and 43% per cent after three or more consecutive miscarriages. In comparison, abortion occurred in only 5% of women in their first pregnancy or in whom the previous pregnancy was successful.
Heavy smoking (more than 10 cigarettes per day) is associated with an increase in risk of loss of the baby, but the mechanism is not known. Partner smoking can also increase the risk of pregnancy loss. Observational studies have generally reported - but not consistently - that moderate or high alcohol intake increases the risk of miscarriage. Alcohol withdrawal should be recommended for general health benefits.
As an example, in one study there was an increased risk of miscarriage in women who drank more than three drinks per week in the first 12 weeks of pregnancy.
Chromosomal abnormalities account for approximately 50% of all abortions. who plan to become pregnant should avoid drinking alcohol as alcohol is a known teratogen (causing malformations) and because a safe level of consumption has not yet been established at this stage.
The use of cocaine is associated with premature birth and may also be a risk factor for spontaneous abortion.
Non-hormonal anti-inflammatory drugs
The use of non-hormonal anti-inflammatory drugs may be associated with an increased risk of miscarriage. The proposed mechanism is that these anti-inflammatories act as inhibitors of the so-called prostaglandins, which play an important role in the implantation of the egg into the uterus at the beginning of gestation, thus potentially leading to abnormal implantation. Although data are scarce, it is reasonable to suggest that women attempting to become pregnant should consider avoiding the use of NSAIDs to minimize the risk of miscarriage.
Fevers of 37.8 ° C or higher may increase the risk of miscarriage.
Controlled studies have reported an association between caffeine consumption and spontaneous abortion, especially at high levels of consumption. However, these studies have multiple limitations, since the mechanism for increasing the rate of abortion with caffeine intake may be related to maternal metabolism in relation to the substances in the beverage.Maternal weight - Photo Getty Images
Pre-gestational body mass index below 18.5 kg / m² or above 25 has been associated with a higher risk of infertility and abortion
Untreated celiac disease may be associated with an increased risk of miscarriage. Chromosomal Abnormalities Chromosomal abnormalities account for approximately 50 percent of all miscarriages. The earlier the gestational age at the time of abortion, the greater the occurrence of genetic defects. The most common types of abnormalities detected are: Trichomoniasis - 52%
Monosomy X - 19%
Polyploidy - 22%
Other - 7%
Trisomy 16 - most common and is
Congenital anomalies are caused by genetic or chromosomal abnormalities, and are often fatal.
Congenital abnormalities are caused by genetic or chromosomal abnormalities. exposure to teratogens. Potential teratogens include maternal disorders such as diabetes; drugs such as isotretinoin; physical stress caused for example by fever and environmental chemicals such as mercury.
Intrauterine invasive procedures, such as corial villus biopsy and amniocentesis, increase the risk of miscarriage
Congenital or acquired uterine anomalies, such as the uterine septum, may interfere with the optimal implantation and growth of pregnancy. Acute maternal infection, such as herpes, can lead to miscarriage. Maternal endocrinopathies, such as thyroid dysfunction, may contribute to a suboptimal host environment. A state of hypercoagulability due to inherited or acquired thrombophilia and abnormalities of the immune system leading to immune rejection or placental damage are active areas of investigation.
The cause of chromosomal and structurally normal embryo abortion in apparently not clear. As discussed above, genetic abnormalities not detected by normal karyotype analysis are responsible for an indefinite proportion of miscarriages.
Women who are actively in the process of miscarriage usually have a history of menstrual delay, vaginal bleeding and pelvic pain
Threat of abortion
Bleeding with the opening of the uterus closed in the first half of pregnancy is quite common and is called the threat of abortion. The bleeding is usually painless, but can be accompanied by minimal or mild pain in the foot of the belly. Fetal heart beats are detected by ultrasound if the pregnancy is sufficiently advanced. The exact etiology of bleeding often can not be determined.
Between 90 and 96% of pregnancies from 7 to 11 weeks of gestation with threatened abortion will result in a normal pregnancy.
Treatment should be individualized and take into account multiple factors. The most important is to keep a pre-pregnancy medical follow-up, if possible, for proper pregnancy planning and follow-up to any threat of abortion.
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Miscarriage is a terrible personal experience that unfortunately affects about 15% of clinically identified pregnancies and is one of the most common obstetric complications. Unfortunately, the reason that led to the loss of the fetus is quite difficult to determine. However, in recent years, studies have shown that genetic alterations play a key role in this complication.