Menu
homeCorporate

After a miscarriage when. Pregnancy after a miscarriage: how not to break down and find the long-awaited joy of motherhood

In our life, we are not always able to control the course of things and sometimes it happens that situations occur that we prefer not to even think about. This also applies to spontaneous miscarriage - a bereavement for future parents in most cases.

This is especially hard for couples who have been trying to conceive a child for a long time or have been long-term treatment from infertility. But life goes on, over time, the pain of loss is replaced by humility and calmness, there is a desire to live and build your happiness. Today we will look at planning a pregnancy after a miscarriage.

Concept of miscarriage

Doctors understand a miscarriage as a spontaneous abortion that occurred during the period of gestation for early dates(I and II trimester). In this case, the embryo or fetus is rejected for some reason and leaves the uterine cavity, losing viability.

Depending on the period at which the abortion occurred, there are early miscarriages (up to 12 weeks) and late miscarriage(up to 22-28 weeks of gestation). Moreover, most spontaneous abortions occur in the first 5-8 weeks of pregnancy, and sometimes a woman is not even aware of her situation, referring to heavy periods or their delay.

Unfortunately, miscarriage is a common occurrence. According to statistics, every 5th pregnant woman (about 20% of all pregnancies) faces this problem. The figures are very serious, but it is rather problematic to regulate them, because a lot depends on the woman herself.

However, situations arise that an arbitrary abortion becomes a regularity with a new attempt to become pregnant and another new life ends without having had time to begin. Similar state characterized as habitual miscarriage pregnancy. The phenomenon is extremely rare, but it has a place to be. In this case, with each unsuccessful attempt to carry the fetus, the chances of a successful completion of the pregnancy tend to zero, i.e. the more miscarriages a woman has, the less her chances of becoming a mother.

However, the question is: “Is it possible to get pregnant after a miscarriage?” for a woman may be relevant. We can safely say that it is POSSIBLE to get pregnant after a miscarriage, because even after two or three unsuccessful attempts, there are good chances of becoming a mother - about 50%. Therefore, you should not put an end to your motherhood, but rather pull yourself together and approach planning a new stage in your life with full responsibility.

Causes of arbitrary abortion

As for the reasons for such a sad outcome, there can be a great many of them, but the vast majority lies precisely in any disturbances in the mother's body or in the developmental processes of the fetus.

Many doctors are skeptical of the popular belief that a miscarriage can be caused by severe emotional upheavals or physical exertion. Of course, it is necessary to avoid unwanted effects, but in extremely rare cases, they directly affect the termination of pregnancy. Often or exorbitant loads only trigger a long chain of changes that develop into something more if there are violations in the mother's body. If everything is fine with the health of the expectant mother, then it makes no sense to talk about such risk factors.

So, let's look at what is a possible cause of a miscarriage:

Genetic anomalies in the development of the fetus

When female and male gametes are combined, a fetal egg is formed, which grows every day using the mechanism of division at the cellular level. Chromosomes also undergo division - a kind of carriers of genetic information. As a result of their division (mitosis), anomalies are formed that cause multiple mutations of the fetus that are incompatible with life. Thus, nature "corrects" its mistakes through natural selection, striving to create viable children with pure genetic material.

It is the malformations at the genome level that are the cause of half of the miscarriages in the first trimester. Most often this happens at 5-6 weeks of the gestational period, and sometimes the woman has not even had time to understand what she was wearing under the baby's heart.

In such situations, the possibility of studying the rejected gestational sac practically negligible due to its small size and the woman's possible ignorance of her position. But, if the embryo was still saved for research, this is very good, since the method of cytogenetic analysis can determine the possible cause of miscarriage and take appropriate measures in the future.

Hormonal disruptions

In this case, the cause of abortion without medical intervention is the unstable hormonal background of the woman, which is the cause of malfunctioning of the ovaries or chronic diseases associated with hormone-producing organs. In such cases, a miscarriage is expected if the woman has not taken appropriate measures to normalize hormone synthesis.

The reason for this development of events is a decrease in the concentration of hormones responsible for the course of pregnancy: progesterone and estrogen. In some cases, the corpus luteum of the ovary in the early stages does not produce enough progesterone to maintain pregnancy, while in others, male sex hormones (hyperandrogenism) predominate in the woman's body.

In any case, a miscarriage does not occur unexpectedly, first there is a long-term threat of termination of pregnancy in the form aching pains in the lumbar region, bleeding of varying degrees. At the initial stages, the embryo can be saved in a hospital, but pronounced hormonal disruptions and untimely assistance lead to such a sad outcome.

Pathologies of the female genital organs

They are a very common cause of miscarriages at any time. These include, most often, anomalies in the development of the uterus in the form of its atypical shapes and sizes (bicornuate, sickle-shaped, infantile) or non-specific structures in the cavity (fibroids, polyps, septa).

The fact is that in such a uterus it is very difficult for a fetal egg to gain a foothold when leaving the fallopian tubes, and if this is still possible, then anatomical features and foreign formations interfere with the growth and development of the fetus. A rapidly growing baby becomes cramped and the body simply cannot cope, solving the problem by terminating the pregnancy.

In such cases, resolving the issue better side unfortunately not always possible. With congenital malformations of the uterus in the form of its abnormal form, bearing a child is impossible under any circumstances. In other cases, all benign formations and septa are removed surgically.

Isthmic-cervical insufficiency

Possible causes of miscarriage include incompetence of the cervix (isthmic-cervical insufficiency). Weak and loose neck simply does not hold amniotic sac with a developing baby, the baby literally falls out of the womb. This is complicated by the fact that due to leakage of the uterus through the cervix, infection with pathogenic microflora from the vagina can occur and, as a result, an extensive infection and miscarriage in the future (mainly in the second trimester). The cause of this condition may be previous abortions with curettage, mechanical injuries and an excess of male hormones.

This problem can be solved if timely measures are taken to preserve the pregnancy. Appropriate treatment is prescribed in case of infection or hormonal imbalance, in some cases a small surgical intervention in the form of suturing the neck to secure it or a special ring - a pessary.

Women's blood clotting disorder

It happens that a woman's blood is prone to more rapid clotting than normal, which is the risk of microthrombi in the capillaries of the placenta. As a result, the nutrition of the fetus is disrupted, which dies from hypoxia and exhaustion. This condition may be a possible cause spontaneous interruption pregnancy, but corrected in the future.

Incompatibility of partners and Rhesus conflict

Our immune system is designed to protect the body from foreign agents that threaten its normal functioning. But it happens that the system works "against its master" and crashes. Yes, yes, even in the human body, as in high-precision technology, malfunctions can occur. As a result of such “malfunctions”, the woman’s immune system perceives the fetus as a foreign body, which it tries to get rid of with all its might.

Such a condition can occur when spouses are incompatible or, conversely, due to their excessive “similarity” at the cellular level. In this case, the mother's body perceives the future little man as its own cells, with which "something is wrong."

The cause can also be a Rh conflict - a condition in which the Rh factor of the mother and the Rh factor of the child are incompatible, for this reason antibodies are produced that destroy the erythrocytes of the fetus and lead to the development of pathologies or death in the womb.

The conflict occurs only in those women whose Rh factor is negative (“Rh-”, meaning the absence of the D antigen on the surface of red blood cells). If the fetus has Rh +, then the mother's body accumulates antibodies to it, rejecting the "foreign" organism. As a rule, complications do not occur in the first pregnancy, however, if the second pregnancy or there was a miscarriage before, then the likelihood of complications increases. In this case, the conflict develops ONLY when Rh negative in the mother and positive in the child.

Intrauterine infections

Well, the final reason for interrupting the gestational period is intrauterine infections. That is why it is so important to monitor your health during the period of bearing a baby and, if possible, minimize the risk of infectious diseases. It is impossible not to pay attention to STIs (gonorrhea, chlamydia, herpes, etc.), which can penetrate into the uterine cavity and then infect membranes, amniotic fluid. As a result of infection of any type, mutations and anomalies in the development of the fetus that are incompatible with life occur.


When can you start over?

Regardless of the reasons for the sad end of a previous pregnancy, you should not give up trying to become parents. But thoughtlessly approaching the issue is also not recommended. This time it is necessary to do everything possible so that the baby is not only born alive, but also completely healthy.

“How long to plan a pregnancy after a miscarriage?”- this thought is born in the head of the parents some time after the sad event. From a physiological point of view, this is possible already during the period of the first ovulation, literally 2-3 weeks after spontaneous abortion. There were cases that women found themselves in a position almost immediately, while giving birth to healthy babies. But relying on "maybe" is very frivolous, because it is important to take into account not only the physical readiness of a woman, but also the moral aspect.

(advertising2)

Some couples experience the loss so hard that they may recover in a few months or even years. Experts advise not to rush into trying to conceive a child and wait about a year. During this time, the woman's body will recover in all respects, at the same time there will be enough time to pass full examination, prepare for parenthood thoroughly.

Restoring the functions of the body and its ability to bear a child is also extremely important. Therefore, planning for pregnancy after an early miscarriage (with or without a cleansing) and trying to get pregnant after a miscarriage in the second trimester are somewhat different.

If the abortion occurred in the early stages, then the body recovers faster. Cleaning or scraping allows you to remove dead tissue to avoid infection if they have not left the uterine cavity on their own. But this is fraught with mechanical damage. The need for cleaning after a miscarriage is determined after the results of the ultrasound. Termination of pregnancy in the period from 12 to 28 weeks requires a long recovery of hormonal levels, normal sizes uterus, menstrual cycle, etc.

Often, new attempts to get pregnant immediately after a miscarriage end similarly sadly, after which the woman only stresses herself more and finds herself in a difficult situation. depressed state Moreover, each unsuccessful attempt minimizes the possibility of a favorable outcome of pregnancy. So what to do?Let's take a closer look.

  • Survive a difficult moment for as long as necessary. When thinking about planning a pregnancy after a miscarriage, it is important to be ready for a new stage in your life, to try to become parents without fear of previous failures. It is after you overcome all fears, let go of the past, you can again think about the baby.
  • Review your lifestyle. Sometimes we do not take into account that some factors, insignificant in our opinion, can indirectly affect health and the course of pregnancy as well. Go in for sports, yoga, learn the art of meditation, learn to relax, it will only benefit.

Healthy is the key to the perfect functioning of the body. You'll be surprised at the tide vitality after giving up fast food, canned food and convenience foods. Wherein proper nutrition in no way does it mean restricting oneself in food, counting calories or something else. What matters is the quality of the food.

Get positive emotions, do what you have long dreamed of: travel, go to an exhibition, to the theater. Endorphins - hormones of joy - key moment in preparation for a new phase.

Alcohol, and even more so tobacco, should not be in your life. There are many scientific works about the harmful effects of smoking and drinking alcohol during pregnancy, why step on the same rake again?

  • To undergo a full examination, and together with her husband, you need to make sure that the future parents are completely healthy. Routine blood tests, urine tests, ultrasonography, sometimes there is a need for additional methods diagnostics.

Be that as it may, the survey should be comprehensive and involve both spouses. It is important to exclude the possibility of repeated situations that led to a miscarriage last time. Therefore, a consultation with a gynecologist is indispensable. In some cases, in-depth studies and consultations, an endocrinologist, a surgeon and third-party specialists are necessary.

To stop possible genetic disorders and identify the causes of abortion, special studies of the chromosome set of parents may be required, as a result of which subsequent recommendations may be given.

If the reason for the previous unsuccessful attempt to bear the baby was hormonal changes in the body (polycystic ovaries, diabetes mellitus, ovarian dysfunction, thyroid gland etc.), hormonal therapy and correction of hormone synthesis can be prescribed, and further correction of the hormonal background, if necessary.

With anomalies in the development of the genital organs of women can be used surgical methods treatment, if possible.

If the cause of the previous miscarriage was immunological problems, then special immunotherapy is prescribed, depending on the type of disorder. In some cases, the correction of the work of the protective system of the woman's body is possible when planning the next pregnancy.

If during pregnancy planning were identified infectious diseases, they are treated before conception, even if they were not the cause of the previous abortion. In the presence of chronic diseases in a woman, appropriate therapy is carried out aimed at eliminating acute form disease and subsequent control of the stage of remission.

Summing up

In our life we ​​never know what will happen to us tomorrow, we cannot be sure that all misfortunes will bypass us. But, it is in our power to reduce this probability to a minimum, making certain efforts for this. Even if at some point life “beat”, as it seems to us, a lot, it’s worth asking yourself: “Why is that?” And think not about how sinful or unfortunate we are, but about the fact that we may be doing something wrong. Life, through bitter mistakes, guides us on the right path and saves us from the worst, even with such harsh methods.

Surviving the loss of an unborn baby is a heavy burden, but even it should not slow down and become an obstacle to achieving the goal. On the contrary, it is an impetus to new achievements with even greater self-confidence and a responsible approach! You will succeed, and the reward for your efforts will be a new nascent life under your heart! Good luck!

How to approach the process of planning a pregnancy after a miscarriage, what tests you need to pass, when you can conceive and what difficulties may arise in the process of bearing - these are the questions that a woman who has lost a child before he was born faces. Spontaneous abortion is always accompanied by great stress for expectant parents. Some immediately after the first failure again actively attempt to conceive, while others fear the onset of pregnancy, as they are afraid that the situation will repeat itself. Which of them is right?

Why miscarriage occurs

It is worth saying right away: spontaneous abortion is not a reason to deny yourself the joy of motherhood. Many women manage to successfully endure pregnancy after a miscarriage and give birth to a healthy baby. However, before planning a conception again, you should understand why previous pregnancy ended fatally, and try to eliminate the causes of this outcome.

So, doctors associate the onset of a miscarriage with the following factors:

  • Natural selection. If the embryo develops with defects incompatible with life, female body expels it in the first weeks of pregnancy. In this case, the so-called biochemical pregnancy takes place;
  • Venereal diseases. Chlamydia, mycoplasmosis, gonorrhea, herpetic infection- these and other STDs provoke strong inflammatory processes. During pregnancy, they become aggravated, lead to inflammation of the endometrium of the uterus, on which the fetal egg is attached, and melt its mucous membrane. Sexually transmitted diseases can result not only in spontaneous abortion, but also in difficulties with re-conception after a miscarriage;
  • Operations on the genital organs and abortions, which resulted in mechanical damage uterus, its deformities and adhesions. As a rule, a miscarriage occurs as a result of a weakening of the uterine cervix, which is not able to hold the embryo inside. Sometimes the bend of the uterus leads to an unsuccessful outcome;
  • Hormonal imbalance. The course of pregnancy is influenced by hormones produced by the thyroid gland, pituitary gland, adrenal glands. Hormonal disorders can provoke a miscarriage at any gestation period;
  • Chronic diseases of the cardiovascular system, metabolism, as well as overweight or underweight. Women who are obese or anorexic are much less likely to get pregnant after a miscarriage.

When can you get pregnant after a miscarriage

Gynecologists advise waiting at least 4-6 months before getting pregnant after a miscarriage again. In addition, spouses in such a situation are advised to weigh the pros and cons again. It often happens that a man, after a miscarriage that happened to his wife, is categorically against new attempts to have a baby, especially if the spontaneous abortion has been repeated more than once. He does not want the woman he loves to have to Once again go through the pain and suffering that accompanies the previous unsuccessful attempts not to mention the fact that the loss of a child is a serious psychological blow for a couple.

In any case, the body will need time to recover, and so that pregnancy after a miscarriage does not occur immediately, it is worth deciding for yourself the issue of protection. Talk to your doctor about which method is best for you. As a rule, doctors advocate barrier contraception and spermicides, but sometimes it may be appropriate to take hormonal drugs, which, in addition to the contraceptive effect, can eliminate endocrine problems.

Planning for pregnancy after a miscarriage

To next pregnancy did not turn into a tragedy, both spouses must undergo a full examination before re-conception. As a rule, it includes:

  • A woman's blood test for hormones, and urine for ketosteroids. In particular, the gynecologist is interested in the concentration of male sex hormones in the blood of the expectant mother. However, the problem can be suspected outward signs: with an increased content, there is excessive hair on the legs and arms, the presence of antennae above upper lip And dark hair lower abdomen;
  • Analysis of the work of the thyroid gland and adrenal glands of a woman. An important step in planning pregnancy after a miscarriage is the elimination of dysfunction of the organs of the endocrine system;
  • Examination of a couple for the presence of sexually transmitted diseases;
  • Ultrasound of the uterus and appendages. The study allows you to identify anomalies in the structure of the female genital organs, see growing neoplasms, and also assess the state of the endometrium.

Of course, if spontaneous abortion was the result of existing diseases, a complete recovery will be a prerequisite for successful conception. But if doctors have not found problems, it is worth reconsidering your lifestyle.

  1. Forget about bad habits. In order for the next pregnancy after a miscarriage to end safely, both parents will have to give up smoking and alcohol;
  2. Minimum medication. Limit your medication as much as possible. If you use any of them constantly, consult your doctor about this. Perhaps drugs can be dispensed with or replaced with dietary supplements;
  3. Complete nutrition. If you have a thin figure, eat more foods rich in protein and healthy fats (olives, avocados, valuable fish, flax seeds). If there are problems with overweight not associated with hormonal disorders, include as many vegetables and fruits in your diet as possible.
  4. Take folic acid and vitamin E. These substances will help the body prepare for childbearing, they are also necessary for correct formation fetus in early pregnancy.

A miscarriage is one of the most painful and unpleasant situations which can only happen to a woman. Many women, after suffering a spontaneous abortion, become depressed, they have thoughts that they will never be able to have children, and so on. Some women are afraid of a possible pregnancy, and some, on the contrary, seek to get pregnant as soon as possible after a miscarriage. Is this step justified and what is the danger of a pregnancy that occurs immediately after a miscarriage? Or maybe you should listen to the recommendations of doctors and postpone a new pregnancy for a while?

Miscarriage and its causes

A miscarriage is called a spontaneous abortion for up to 28 weeks, and according to new data up to 22 weeks (a child at this time can already survive outside the mother's womb with special equipment). On this basis, miscarriages are early, that is, those that occurred before 14 weeks, and late - in the period from 14 to 28 weeks.

By the way, miscarriages also include missed pregnancy. They say about a missed pregnancy when the fetus died in utero, and the uterus for some reason could not push it out (missed miscarriage).

Reasons for miscarriage:

  • genetic and chromosomal abnormalities fetus (in this case, nature itself is in a hurry to get rid of the unviable little man);
  • acute infectious diseases of the mother (flu, rubella, chickenpox and others);
  • severe chronic genital and extragenital diseases of a woman;
  • malformations of the uterus;
  • sexually transmitted infections;
  • pregnancy against the background of an intrauterine device;
  • immunological causes;
  • taking some medicines(glucocorticoids, anticonvulsants, antibiotics);
  • Rhesus conflict;
  • isthmic-cervical insufficiency (incompetence of the cervix);
  • hard physical work.

Why are doctors against pregnancy immediately after a miscarriage?

Many women who become pregnant immediately after a miscarriage receive a certain portion of reproaches, dissatisfaction, and sometimes even threats from a doctor in antenatal clinic. As women write on the forums, they say that doctors do not understand anything about how they want to have a baby. Well, where are they?

And gynecologists swear not out of their malice, but out of fear for the woman's health and her pregnancy. For so a short time(usually this month - two after a miscarriage) the body has not yet had time to recover, gain strength before the next pregnancy.

As you know, during pregnancy, the strongest hormonal changes occur, and a sudden termination of pregnancy leads to hormonal disruptions. So, against the background of an unsteady hormonal balance, the risk of repeated spontaneous abortion is very high.

In addition, miscarriages are often accompanied by massive blood loss, which leads to the development of posthemorrhagic anemia, and a pregnancy that develops against the background of a lack of hemoglobin will not receive required amount oxygen and nutrients, which is fraught with a lag of the fetus in growth and development. The possibility of ectopic pregnancy (infections, chronic diseases of the uterus and appendages) is not excluded.

Also, during this period - from the day of a miscarriage to a new pregnancy - a woman simply does not have time to pass necessary examination to find out the cause of the abortion and, if possible, eliminate it.

What to do?

If it really happened, and a woman accidentally or accidentally became pregnant immediately after a miscarriage, you should not be upset in the first place, especially if the pregnancy is desired. Pregnancy after its previous spontaneous termination must be maintained, whether it is desired or not. Each new abortion reduces a woman's chances of getting pregnant again and bearing a healthy baby.

First of all, with the onset of pregnancy immediately after a miscarriage, it is necessary to limit physical activity and lifting weights (as they say, do not lift anything heavier than a spoon).

Secondly, the diet should be dominated by fresh fruits and vegetables, and as soon as a woman finds out about her pregnancy, she should immediately start taking folic acid(prevention of malformations neural tube). The doctor in the antenatal clinic will recommend preventive therapy (possibly in a hospital) in order to maintain the pregnancy.

You should not refuse hospitalization, because the first task of a woman is to maintain and endure pregnancy. Preventive treatment includes antispasmodic drugs that relax the muscle tone of the uterus (no-shpa, spazgan, papaverine).

A drug such as Magne-B6 is very effective. It contains magnesium, which has an antispasmodic effect, and vitamin B6, which serves as a conductor of magnesium into the cell. Also appointed hormonal preparations(progesterone analogues) Duphaston and Utrozhestan (both for enteral administration and for insertion into the vagina). Courses of preventive therapy for the entire pregnancy are carried out repeatedly, in critical deadlines: 6 - 8 weeks, 10 - 12 weeks, 14 - 16, 18 - 20, 22 - 24 and so on.

Anna Sozinova


According to statistics, spontaneous miscarriage is from 10 to 20% of all diagnosed pregnancies. After failure, many women try to conceive again. How does a new pregnancy proceed after a miscarriage?

Causes of miscarriage

Spontaneous miscarriage is the termination of pregnancy before the fetus reaches a viable term (22 weeks). The birth of a child after 22 weeks is called premature birth. In the latter case, the newborn is provided with all needed help so that the child can survive outside the mother's womb. For up to 22 weeks, resuscitation is not carried out.

Possible causes of miscarriage:

  • chromosomal pathology of the fetus;
  • intrauterine infection;
  • pathology of the blood coagulation system;
  • immunological disorders;
  • malformations of the uterus;
  • endocrine disorders.

According to statistics, about 80% of all miscarriages occur for up to 12 weeks. The first trimester is considered the most dangerous for the embryo, because at this time any impact can be fatal for him. Very early miscarriages are associated mainly with fetal chromosomal abnormalities. After 6 weeks, there is an increased chance of infections and hormonal disorders How possible causes termination of pregnancy. If a miscarriage occurs after 12 weeks, the cause should be sought in the hemostasis system.

Finding out the exact cause of a miscarriage is not always possible. It is believed that early termination of pregnancy is the result of natural selection. The woman's body is trying to get rid of the initially defective embryo in the only way available to it. That is why in European countries it is not customary to keep a pregnancy in the early stages. Domestic experts adhere to a different tactic and fight for every life, regardless of the gestational age.

In most cases, during a miscarriage, the already dead embryo is rejected. It happens that the fetus dies in utero, but its expulsion does not occur. A failure occurs, as a result of which the uterus does not contract, and the dead embryo long time stays inside. This condition is called regressive (non-developing) pregnancy and occurs in 20% of all cases of successful conception.

Factors provoking spontaneous miscarriage:

  • woman's age (after 35 years, the risk of miscarriage is 20%, after 40 years - 40%);
  • the number of births and abortions (women with two or more pregnancies in the past have a greater risk of miscarriage);
  • spontaneous abortions in the past;
  • hormonal disorders;
  • bad habits (smoking more than 10 cigarettes per day increases the risk of miscarriage in the first trimester);
  • trauma;
  • fever (an increase in body temperature above 37.5 degrees increases the risk spontaneous miscarriage);
  • taking medications (especially anti-inflammatory drugs);
  • lack of folic acid;

When does pregnancy occur after a miscarriage?

For most women, a new pregnancy occurs 3-12 months after the miscarriage occurs. The likelihood of successful conception increases if the miscarriage has passed without complications. In the absence of other health problems, pregnancy can occur again in the next month.

Spontaneous miscarriage is a condition accompanied by large blood loss. Bleeding is a direct threat to a woman's life, so doctors do not recommend waiting for the independent release of the fetal egg. The chance that the embryo will come out completely along with the membranes is not so great. With the development of bleeding against the background of a miscarriage, vacuum aspiration of the fetal egg and curettage of the uterine cavity are performed.

The procedure for removing the embryo along with the membranes is not always successful. After manipulation, the following complications are possible:

  • massive bleeding;
  • infection of the uterus;
  • hormonal disbalance;
  • retention of parts of the fetal egg.

After the procedure, some women experience menstrual irregularities. Against this background, the onset of a new pregnancy may be delayed. It may take more than 6 months for the body to recover. In some cases, a woman needs to undergo a course of rehabilitation therapy before thinking about conceiving a child. If pregnancy does not occur within 12 months, it is necessary to be examined by a specialist.

Planning for pregnancy after a miscarriage (preconception preparation)

Doctors advise not to rush to conceive a child immediately after a spontaneous abortion. The minimum period for which the body has time to recover and prepare for pregnancy is 3 months. In some recommendations, a period of at least 6 months sounds. The duration of this interval depends on how the operation to remove the fetal egg went. With the development of complications after the procedure, you should wait at least six months before thinking about a new pregnancy.

Before conceiving a child, a woman should must be examined by a specialist:

  • tests for STIs;
  • blood hormones;
  • hemostasiogram;
  • autoimmune antibodies;
  • karyotype;
  • Ultrasound of the pelvic organs;
  • genetic counseling.

PPI screening includes testing for the main infectious agents reproductive system. These include:

  • chlamydia;
  • mycoplasma and ureaplasma;
  • gardnarella;
  • herpes simplex virus;
  • cytomegalovirus;
  • gonococci;
  • trichomonas;
  • yeast-like fungi;
  • other conditionally pathogenic flora.

To identify pathogens, it is enough to pass bacteriological culture from the cervical canal and a swab from the vagina and urethra. With the help of bakposev, it is also possible to assess the state of the normal microflora of the genital tract. Your doctor may also recommend a blood test for antibodies to the herpes virus, cytomegalovirus, rubella, and toxoplasma. Antibodies are determined by ELISA during venous blood sampling.

Hormonal examination includes:

  • luteinizing hormone (LH);
  • follicle stimulating hormone (FSH);
  • prolactin;
  • estradiol;
  • progesterone;
  • testosterone;
  • 17-OPK;
  • cortisol;
  • DHEA-S.

These hormones are without fail you need to pass to those women who in the past had problems with conceiving or bearing a child. Sex hormones are taken on the 1-3 day of the menstrual cycle in the morning on an empty stomach. The exception is progesterone, which is given on the 21st-22nd day of the cycle (with a regular cycle of 28 days). If menstrual cycle not regular, you should check with the gynecologist for the exact time of the test.

According to indications, tests for other hormones are prescribed:

  • thyroid hormones (TSH, T3, T4);
  • antibodies to TSH receptors;
  • 17-ketosteroids;
  • other hormones in the direction of narrow specialists.

Of great importance in diagnosing the cause of a miscarriage is the analysis of the blood coagulation system. All women whose pregnancy was terminated in the early stages should pass a hemostasiogram. If abnormalities are detected, it is necessary to get a consultation with a hemostasiologist. The doctor, according to the analysis, will give his recommendations on planning a new pregnancy. You may have to undergo treatment or take drugs that change the properties of the blood throughout the next pregnancy.

Detection of autoimmune antibodies - milestone in preparation for the conception of a child. We are talking about the detection of APS (antiphospholipid syndrome). This disease is one of the common causes of miscarriages after 10 weeks. If a woman has had 2 or more spontaneous abortions in the past, an APS antibody test is mandatory.

Fetal karyotyping is an analysis, the material for which must be taken directly during the operation for a miscarriage. During the procedure, the doctor not only removes the elements of the fetal egg, but also takes the tissues of the embryo for examination. According to the results of the analysis, the doctor can confirm or refute various chromosomal abnormalities of the fetus.

When identifying chromosomal pathology When karyotyping, a woman must definitely visit a geneticist. This should also be done if 2 or more miscarriages have occurred (even without a karyotype study). The doctor will make an individual genetic map and evaluate possible risks for subsequent pregnancy. You should be aware that all the conclusions of a geneticist are only advisory in nature. A woman will have to make a decision about the possibility of a new pregnancy on her own, taking into account all the results of the examination and the risks involved.

For women with Rh negative blood tests for Rh antibodies are added to the examination. Immunological conflict occurs when Rh negative woman becomes pregnant with a fetus with a Rh-positive blood group. When antibodies appear in a woman's blood, high risk spontaneous miscarriage. Find out if there are dangerous antibodies in the blood before a new pregnancy.

Ultrasound of the pelvic organs is performed for all women 7 days after a spontaneous miscarriage. According to the indications, a second ultrasound examination in a month may be required. If a year or more has passed after the miscarriage, it makes sense to do an ultrasound again with a good specialist. If any pathology is detected, it is necessary to undergo an examination and treatment by a gynecologist.

Further examination and treatment will depend on the detected pathology. When identifying hormonal problems It is recommended to visit a gynecologist-endocrinologist. In case of violations of the blood coagulation system, a woman has a direct road to a hemostasiologist. In some cases, before planning a new pregnancy, you need to undergo surgical treatment by a gynecologist.

The cause of spontaneous miscarriage may be an exacerbation of chronic diseases (hypertension, diabetes mellitus, and others). In this case, even before the conception of a child, it is worth visiting the appropriate specialist and achieving remission. When a new pregnancy occurs, you will also have to periodically visit a doctor so as not to miss an exacerbation of the disease. With proper supervision of a specialist, a woman has every chance to keep her pregnancy and give birth in due date healthy child.

The course of pregnancy

A new pregnancy after a spontaneous abortion in the past is a great joy for any woman. Unfortunately, this period does not always go well. A woman who once experienced a miscarriage is at risk for the development of a variety of complications. If in the past the expectant mother had 2 or more abortions, the risk of an unsuccessful outcome increases several times.

In the early stages, there is a high probability of recurrent miscarriage. The risk of spontaneous termination of pregnancy increases in women who have not received the necessary preparation before conceiving a child. Often, a repeated miscarriage occurs at the same time as the previous one. When the first signs of a threatened abortion appear, a woman should immediately see a doctor and start conservation therapy.

In the second half of pregnancy, the risk of spontaneous miscarriage is significantly reduced. Here other problems appear that can significantly affect the course of the II and III trimesters. Many expectant mothers have fetoplacental insufficiency, as a result of which the baby suffers from a lack of oxygen and nutrients. In severe cases, fetal growth retardation and the birth of a child with low body weight and various health problems are possible.

Women who have had a miscarriage in the past have several increased risk premature birth . generic process also proceeds not always safely and may end in a caesarean section. It is impossible to predict the likelihood of such an outcome. For many expectant mothers, pregnancy proceeds quite well, and nothing prevents the baby from being born at the time programmed by nature.

The prognosis for the course of a new pregnancy after a single miscarriage is quite favorable. The risk of another loss of the fetus increases by 20%, but even in this situation, many women safely bear and give birth to healthy children. Competent preconception preparation significantly increases the chance of a successful outcome, even in the case of multiple miscarriages in the past.