Miscarriage or abortion is an unwanted termination of pregnancy within the first 23 weeks of pregnancy. The child shows no signs of life such as umbilical cord, heartbeat or breathing and his weight is less than 500 grams.

What is a miscarriage?

During pregnancy, the fetus is regularly examined for possible diseases and malformations. In most cases a potential miscarriage can be detected early on.

A miscarriage occurs when there is an unwanted abortion before the fetus is viable. It is classified according to the cause or the time of occurrence.

So it is spoken of a spontaneous abortion, if the abortion has a natural cause. Furthermore, there is the artificial abortion, which is caused by chemicals, drugs or abortion. An early disease site usually has genetic damage as a cause and often occurs together with the expected menstruation.

Sometimes the woman does not know at that moment that she was pregnant. She is only surprised by a delayed menstruation and possibly a strong blood drain. If the abortion occurs before the 12th week of pregnancy, we called it early abortion. A miscarriage after the 13th week of pregnancy is called late abortion.

causes

The reasons for a miscarriage can be varied and can rarely be revealed. Basically, they are differentiated into fetal, maternal and paternal causes.

Typical fetal causes of abortion are a mutation of the chromosomes, infections of the unborn child, and the effects of drugs or X-rays. Maternal causes include a malformation of the uterus, a malformation of the placenta, mechanical trauma such as a fall, infections of the mother, tumors, hormonal disorders, Rhesus intolerance, a strong caffeine intake and drug use.

However, a miscarriage can also be due to the father. These include different types of sperm abnormalities and genetic disorders. Furthermore, in addition to the mentioned causes, pregnancy-specific hormonal disorders of the mother or child, which can lead to endocrine miscarriage.

In general, therefore, the causes can be divided into six groups:

  • fetoplacental causes (Usa by the fetus): eg disorders of the genetic material, abnormalities of the umbilical cord, disorders of the placenta
  • Causes by the mother: eg Uterusruptur (uterine tear), premature placental solution or cervicitis
  • hormonal disorders
  • trauma
  • Infectious diseases: eg rubella
  • Poisoning: eg lead poisoning

Symptoms, complaints & signs

A miscarriage is usually indicated by very strong and labor-like pain. The pregnant woman feels stronger contractions in the abdomen, which usually occur convulsively. In contrast to normal labor activity, which first appears weak and then slowly increases, the labor pains that initiate a miscarriage usually begin very suddenly and violently.

If such strong contractions occur, although the date of birth has not yet been reached, a hospital should be visited as quickly as possible or an emergency doctor should be alerted. Another sign of impending miscarriage may be bleeding. These can vary greatly. Not every bleeding is directly associated with a miscarriage, but the symptoms should also be clarified by a doctor.

If the pregnancy has already progressed over the 15th to the 20th week, the expectant mother usually already feels the movements of the child. Even strongly changing child movements can be an indication of a threatened miscarriage. In most cases, the child movements are much weaker or stay completely off.

Most of the expectant mother herself has a very good sense of whether the child is resting or sleeping in her stomach, or whether something is actually wrong. Also, the health of the mother usually changes before a miscarriage. She feels bad and sick, beaten off and especially tired. In some cases, fever is added.

diagnosis

If the miscarriage occurs in the first weeks of pregnancy, some women do not notice it at all, as it is similar to menstrual bleeding. Depending on the week of pregnancy comes to the vaginal bleeding as a sign of an abortion also the onset of labor.

Using an ultrasound scan, the doctor can see if the fetus is still alive or not. If the heart sounds are still audible, a miscarriage can still be prevented by means of anti-bruising agents, magnesium and a strict chase. If this is no longer possible, the childbirth will be stopped as soon as possible by labor-inducing medicines as well as a reaming of the uterus.

With the help of another ultrasound examination, the doctor can determine to what extent still parts of the pregnancy are present after the miscarriage in the uterus.

complications

A miscarriage can cause a number of complications. Acute menses and a strong physical discomfort may occur after an abortion. Temporarily it can also come to indigestion and gastrointestinal disorders. Frequently, as a result of the death of the child, mental and emotional complaints also occur.

Affected women often suffer years of child loss, and have difficulty saying goodbye because of the usually rapid procedure. Often already born children suffer from this. Restlessness and sadness as well as sleep disturbances belong to the typical consequences for the closer family circle.

In addition, physical complaints may occur. Asherman syndrome causes adhesions of the uterine anterior and posterior walls, which can lead to menstrual cramps, premature birth and secondary sterility. Miscarriage generally increases the risk of premature birth during the next pregnancy.

If there is an undiagnosed miscarriage, circulatory disorders and life-threatening thrombosis may occur. The longer the abortion is not noticed, the greater the risk of serious complications. A pregnancy and especially a miscarriage should therefore always be discussed with the gynecologist and a psychological counseling.

When should you go to the doctor?

Often, women do not realize that they had a miscarriage. But if it does, a visit to the gynecologist is advisable. In addition, a miscarriage should always consult a doctor if the patient suffers from mental discomfort or depression. The life partner or relatives may also be affected and then also require treatment. Especially a visit to a therapist or a psychologist is recommended, although conversations with other women can also be helpful.

However, direct treatment of the miscarriage can not take place. A doctor should also be consulted if the person is suffering from a sudden vaginal bleeding during pregnancy. This usually occurs unexpectedly and relatively strong.

The complaint is accompanied by severe pain in the abdomen or vagina. This pain also indicates a miscarriage. An open cervix may also indicate a complaint. For these complaints usually a doctor must be consulted immediately. If the pain is very severe, call the ambulance.

Treatment & Therapy

The treatment of a miscarriage depends primarily on the stage of the abortion as well as a possibility for the pregnancy maintenance. Advisable is always a medical consultation.

An important medical therapy is the scraping of the prematurely deceased fruit and the remaining placental remains. After the 12th week of pregnancy, the fruit should usually be born naturally, requiring the presence of a midwife or nurse. This natural birth is more painful, but is preferred for emotional reasons usually a Ausschabung.

Both treatment options involve low risks. Which option is chosen is up to the woman. In addition to medical treatment, psychotherapeutic counseling can be useful. This can also be done in the form of a self-help group. This facilitates the funeral work and the processing of the traumatic experience.

If the woman suffers from various unwanted abortions, a human genetic counseling can be the solution. Within this framework, the causes are explored. If possible, not only both parents should be examined, but also the dead child of the miscarriage.

Outlook & Forecast

If no scraping is required, a choriocarcinoma or bladder mole may arise. Furthermore, a uterus with remnants of the fetus and blood is an ideal breeding ground for bacteria and germs.

In this context is also a possible uterine infection. In the worst case, even the peritoneum may be affected. Even a sepsis is conceivable in this case. Further adhesions and possibly infertility are the result.

A miscarriage leads to the death of the unborn child. This leads to emotional and psychological problems in most mothers, but also in the fathers-to-be. Depending on the personality of the parents, the miscarriage is processed individually. Accordingly, the prognosis should also be judged according to the personal circumstances of the persons affected.

Also to be considered are the history, the age of the parents, the intensity of the desire to have children and the circumstances that led to the miscarriage. With a little pronounced desire for children, the processing of what happened is often easier. Parents who have tried everything for years to produce offspring often have more difficulty optimistic and confident in future developments.

The miscarriage due to an accident, fall or by the application of external forces influences, is at the same time to perform a processing of the trigger. This process usually leads to a deterioration of the general condition and prolongs the healing process.

The prognosis improves when the support of a therapist is called upon and at the same time other aspects of the parents' lives have an important role to play. If there is nothing to prevent re-pregnancy for health reasons, a miscarriage is usually better processed. Unfavorable is the situation if the woman is infertile after the abortion and a desire to have children.

prevention

A miscarriage can be prevented primarily by a healthy lifestyle. Furthermore, the administration of hormones may be useful. Furthermore, reducing stress during pregnancy is important, which is why relaxation exercises are advised. Occasionally, however, a miscarriage can not be prevented because some causes can not be influenced.

aftercare

How the aftercare of a miscarriage depends on the shape of the abortion. Sclerotherapy of the uterus (curettage) is often not necessary. It is recommended to wait a few days before such surgery. Those affected can accept the situation so much better. Often, the tissue is repelled naturally.

The progress of the departure should be monitored medically. Even after a curettage, it should be checked in the course of a check-up to see if all tissue remnants have been removed and excreted. Basically, about two weeks later at least one ultrasound examination is performed. Often, the hCG value is also checked, which the affected person can determine by means of a pregnancy test.

In any case, the affected woman is under the care of a midwife. This can not only accompany the physical process, but also help to deal with the grief. It is still possible and customary to consult a midwife months after the abortion. Many sufferers perceive the miscarriage as a strong psychological burden.

It is therefore sometimes advisable to seek psychological help. The next ovulation after the miscarriage takes place two to eight weeks after the miscarriage. If the affected person does not feel ready for a new pregnancy, it is advisable to take appropriate preventive measures.

You can do that yourself

A miscarriage (abortion) is a dramatic experience in a woman's life. This event can not be influenced in many cases. Nevertheless, there are some things that a woman can do in everyday life in the context of self-help, either to avoid a miscarriage or to get as soon as possible after an abortion physically and mentally.

The averting of a threatened miscarriage is often associated with rest and protection. In addition to the doctor's visit at first signs and a possible medical treatment, the pregnant woman relaxes most of the day in a reclining or sitting position.

Physical efforts such as carrying heavy objects, cycling and also sexual contact should be avoided. Also from hot baths and alcohol is not recommended. A sufficient intake and high-fiber diet support digestion and help to avoid heavy pressing in the toilet.

After a miscarriage, women are often physically resilient again. Because of medical advice may be waived for a few days on the bathing or sexual intercourse. An abortion that has been associated with heavy bleeding can lead to a significant deterioration in iron levels, so iron therapy is helpful.

A sufficient amount of drinking helps to stabilize the circulation. Herbal sedatives, conversations with a therapist or confidant, dosed exercise in the wild, or yoga are suitable for the mental processing of miscarriage.

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