Miscarriage (abortion) is spontaneous, intentional or inadvertent termination of pregnancy before the start of the 28th week of pregnancy (counting from the first day of the last menstrual period). After that time, spontaneous premature ending of pregnancy ends with the birth of a dead baby, or premature birth if the baby is alive. The termination of pregnancy is commonly known as ”abortion”, although doctors call it ”termination of pregnancy”.
Abortion may occur due to fetal abnormality or hormonal disorders in baby’s mother. Abortions caused by a fall or similar minor accident are rare because the fetus is well protected in the uterus.
Abortions can be classified into several groups. In some women, the so-called threatened abortion can occur in early pregnancy. The sign of threatened abortion is usually slight bleeding from the vagina. In many cases, pregnancy then progresses normally.
On the other hand, in the ”unavoidable” abortion the fetus died, regardless of any measures taken after the occurrence of abortion symptoms, and pregnancy should be terminated.
The term ”incomplete” abortion is applied to abortion in which the parts of the fetus and placenta remain in the uterus.
The term ”missed abortion” (abortion retentus) means the condition in which the child died in the uterus, although there are no noticeable symptoms.
”Repeated” abortions occur mainly in women with a sex hormone balance disorder. Such abortions usually occur in early pregnancy, but may occur even after the third month (in this case they are the consequence of the so-called incompetent cervix).
The first noticeable symptom is bleeding from the vagina. Bleeding that can occur in the form of a few drops or be very abundant. The bleeding starts without warning, but can also be preceded by a brown discharge. Threatened abortion is often painless. However, if the fetus is squeezed and abortion is ”inevitable”, the uterus begins to shrink and the pregnant woman will feel the pain in the lower abdomen or back. Pain can be dull and persistent, or severe and occasional. During the abortion, a solid substance may come out of the vagina; the doctor should examine it
In the case of incomplete abortion, bleeding and pain may last for several days continuously or occasionally. In missed abortion there is often no bleeding or pain, but the symptoms of early pregnancy will cease, and the feeling of fullness in the breast will go away.
About 10% of pregnant women go to the doctor for miscarriage annually.
Abortions are usually not harmful to mother’s health. However, if you had an incompelte abortion and you don’t go to your doctor, anemia will develop after some time and the tissue in the uterus can also be infected.
What to do?
If you are pregnant and if you bleed from the vagina, with or without pain, inform your doctor and lie down. If the bleeding stops or is light, your doctor may only advise you to rest. If the bleeding is severe, and accompanied by severe pain, the doctor will probably send you to the hospital. There, your doctor will do another pregnancy test and possibly send you an ultrasound scan to confirm your pregnancy. Avoid sexual intercourse a few weeks after bleeding.
Repeated abortions caused by hormone balance disorders can be diagnosed by blood tests as well as microscopic examination of cervical mucosa specimens. In the event of a threatening abortion there is nothing more to be done, so your doctor will probably advise you to stay in bed more.
In the case of unavoidable, incomplete and missed abortion, the remains of the fetus and placenta are usually removed from the uterus under general anesthesia. If you have repeated abortions, you will be referred to a gynecologist. Sometimes the cause of such abortions is the lack of sex hormones, so you will get the appropriate hormone preparation to restore the balance.
After the abortion you will probably be depressed due to the loss of the child. However, you can still get pregnant whenever you want, although it would be best to wait at least one normal menstrual period because the physician will then be able to more accurately determine the probable birth date.