Complete Abortion Miscarriage

Overview, Causes, & Risk Factors

A miscarriage occurs when a woman is pregnantand her womb expels the fetal tissue. It results from natural causes within the first 20 weeks ofpregnancy.

What is going on in the body?

A miscarriage takes place after the fetus and placenta stop growing. This makespregnancy hormone levels fall. The following symptoms of pregnancy may no longer appear:

  • breast tenderness
  • nausea
  • fatigue
  • A miscarriage starts when the womb begins to contract. This causes cramping anddiscomfort. It may also cause vaginal spotting or bleeding. A miscarriage is complete when the contentsof the womb are expelled. When no fetal tissue remains, the cervix willclose. The uterus will shrink in size. The bleeding will slow and then stop.

    What are the causes and risks of the condition?

    A fetus that fails to develop or is abnormal in some way is the most likely causeof a miscarriage that occurs in the first trimester ofpregnancy.

    Miscarriages in the second trimester are most often caused by factors linked to themother, such as:

  • an abnormal-shaped uterus
  • autoimmune disorders, in whichthe woman’s body creates antibodies to its own tissue, including fetal tissue
  • bacterial infections, such as the sexually transmitted diseaseChlamydia trachomatis\. Sexually transmitted disease refers to any contagious disease transmitted from one person to another during sexual contact. chlamydia
  • certain diseases and conditions, including diabetesor hypothyroidism
  • cervical incompetence, acondition in which the cervical opening from the womb does not stay closed throughthe whole pregnancy
  • cocaine use
  • drinking liquids, such as coffee, or eating foods, such as chocolate, that contain caffeine
  • exposure to pesticides, chemicals,or other toxins
  • noncancerous tumors in the uterus, which are also calledfibroids
  • hormonal disorders, such as a low level of the female hormone progesterone
  • polycystic ovary syndrome, acondition in which abnormal hormone levels cause growths within the ovary
  • posttraumatic stress disorder, also calledPTSD, which may occur after a major traumatic event
  • toxoplasma infection, also called toxoplasmosis \ \other infections, such as hepatitis B, syphilis, and herpes zoster, the virus that causes chickenpox \ \ rubella, the virus that causes German measles\ \ cytomegalovirus, or CMV\ \ herpes simplex virus, the cause of genital herpes \ TORCH infections in thefirst trimester of pregnancy
  • Herbal remedies cancause birth defects as well as a miscarriage. The March of Dimes recommends that pregnantwomen avoid all of the following unless recommended by their doctors:

  • dietary supplements
  • over-the-counter medicines
  • prescription medicines
  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    A pregnant woman having a miscarriage may experience these signs orsymptoms:

  • low back pain
  • passage of some tissue or clots from the vagina
  • pelvic or abdominal cramping
  • vaginal bleeding or spotting
  • Diagnosis & Tests

    How is the condition diagnosed?

    A blood or urine test will be done to confirm that a pregnancy exists.The level of the pregnancy hormone HCGmay be checked several times over a period of days or weeks. Rising levels suggestthat the fetus is growing. Levels that fall or stay steady suggest a malformed ordying fetus.

    Other tests can include the following:

  • a complete blood count, called CBC,if the woman is bleeding heavily
  • a pelvic exam to see if thecervix is open and whether there is any fetal tissue in the vagina or the cervix
  • a pregnancy ultrasound tocheck for any fetal movement and heartbeat and to rule out anectopic pregnancy,which occurs when the egg implants outside the uterus
  • a progesterone level to find out if enough of the hormone is being made to maintainthe pregnancy
  • a white blood cell countto rule out infection
  • Prevention & Expectations

    What can be done to prevent the condition?

    Not all miscarriages can be prevented. But taking certain actions can help.Several months before pregnancy and during the entire pregnancy, a woman should followthese guidelines.

  • Avoid alcohol andcaffeine.
  • Stay away from pesticides, and chemical solventssuch as paint thinners
  • .

  • Avoid all medicines unless recommended by the doctor. This includes those soldover-the-counter, prescriptions, and herbal remedies.
  • Eat a diet rich in folic acidand take multivitamins.
  • Maintain good control of diseases such as diabetesand hypothyroidism
  • .

  • Notify the doctor of any other risk factors, such asPTSD.
  • Report any symptoms of sexually transmitted diseaseto the doctor
  • .

  • Stop smoking
  • .

    If a woman has had infertility tests for imbalanced hormones, the doctor mayscreen her for hormone problems in the first trimester.If a problem is found, hormone pills can be prescribed.

    What are the long-term effects of the condition?

    The long-term effects of a miscarriage vary. There are many myths about whatcauses miscarriage. A woman may feel anxiety, fear, and guilt if she believes she didsomething to cause the miscarriage. She should discuss feelings or worries such as thesewith her doctor.

    What are the risks to others?

    A miscarriage is not catching. It poses no risk to others.

    Treatment & Monitoring

    What are the treatments for the condition?

    Some providers suggest that a woman try to collect any tissue that passes fromher vagina so it can be checked.

    Other treatments for miscarriage include:

  • antibiotics to prevent infection
  • dilation and curettage,or D & C, a procedure to remove any fetal tissue remaining in the uterus
  • medicines to help the uterus contract so that bleeding stops
  • Rh immune globulin, if the mother’s blood is Rh-negative
  • Sometimes, the woman may have an incomplete miscarriage.This means some fetal tissue stays in the uterus. To avoid infection, a procedure called aD & C willbe done. The D & C helps empty the uterus.

    What are the side effects of the treatments?

    A D & C may causebleeding, infection, and allergic reactionto anesthesia. Antibiotics andmedicines to help the uterus contract may cause rash,upset stomach, abdominal cramps, and allergic reaction.

    What happens after treatment for the condition?

    If a woman has a complete miscarriage without abnormal bleeding, she is senthome to get better. If a woman has a D & Cfor an incomplete miscarriage,she is usually able to go home within a few hours. She should rest in bed for 1 to 2 days.A woman should contact her doctor if she has any of these symptoms:

  • any other new or worsening symptoms
  • continued heavy bleeding
  • a fever
  • cramps that get worse or pain that won’t go away
  • Birth control should beused if the woman does not want to get pregnant again. If a future pregnancy is desired,the couple may try to conceive again after 2 to 3 months. They have an 85% chance of having asuccessful, full-term pregnancy after 1 year.

    How is the condition monitored?

    A woman’s doctor may do weekly blood tests to follow the HCG level until it isnearly zero. This ensures that the pregnancy has ended. Sometimes tests are done on thefetal tissue to learn about its genetic makeup. If a woman has had several miscarriages,her doctor may recommend a complete evaluation for infertility.

    Article type: xmedgeneral