The first signs of a miscarriage are early. How to prepare for a new pregnancy. Miscarriage: an overview of spontaneous abortion

A miscarriage is a spontaneous interruption of gestation (carrying a pregnancy) during the first 20-22 weeks, which is determined by the viability of the fetus. Spontaneous abortion occurring after 22 weeks is called preterm birth. According to statistics, 15-20% of all pregnancies end in miscarriage, of which 80% of pregnancies are interrupted during the first 12 weeks. What does a miscarriage look like? How to determine the beginning of a miscarriage? Is it worth it to keep the pregnancy when the miscarriage has begun?

Miscarriage: an overview of spontaneous abortion

Regardless of the reasons that provoked a miscarriage, spontaneous abortion occurs according to the same pattern: the action of a factor that provokes a miscarriage, detachment of the fetus from the uterine wall, removal of the fetus from the uterine cavity. Most early miscarriages are not diagnosed as such, but are perceived by women as a natural onset of menstruation. The probability of miscarriage decreases in direct proportion to the gestational age - the longer the gestational age, the less likely it is to spontaneously terminate.

There are two main types of miscarriages:

An accidental (sporadic) miscarriage is a manifestation of natural selection, when special mechanisms reject a deliberately unviable fetus. Accidental miscarriages in most cases are caused by genetic disorders of the fetus;
Habitual miscarriage is the condition of a woman with a history of 2 or more miscarriages in a row. One of the signs is miscarriages at approximately the same time.

There are a number of factors that can trigger a miscarriage:

Multiple pregnancy;
Hypertension;
Hyperthyroidism;
STDs;
Genital herpes of the mother and its recurrence in early pregnancy;
The use of alcohol, nicotine, caffeine;
Uncontrolled use of drugs and self-medication;
Hormonal imbalance;
The age of the woman;
Polycystic ovary syndrome (Stein-Leventhal syndrome).

It is important, if possible, to exclude risk factors when planning pregnancy. To prevent miscarriage chronic diseases, pregnancy must be planned under the close supervision of doctors, as well as properly prepared for conception (a complete examination of sexual partners and necessary treatment). Also with special attention pregnancy planning should be considered for women with 2 or more miscarriages in history.

To reduce the risk of developing genetic abnormalities in the fetus, it is important to be aware that the effects of many drugs can significantly affect the development of pregnancy. It is important to inform the doctor about all types of treatment, drugs that a woman took within six months before pregnancy.

What does a miscarriage look like?

Every woman who finds out about her pregnancy needs to know what a miscarriage looks like. With a miscarriage, the symptoms are:

Pain in the lower abdomen of a pulling, stabbing, aching character;
Back pain in the lumbar region;
Bloody, bloody, brown discharge in any amount;
Profuse bleeding;
Isolation of blood clots.

In 50% of cases, women who applied for medical care with bleeding in the early stages, pregnancy ends in miscarriage. Therefore, every woman, both planning a pregnancy and pregnant, needs to know what a miscarriage looks like. When planning a pregnancy, doctors recommend carefully monitoring changes in the body, diagnosing pregnancy in a timely manner, so that if necessary, take the necessary measures to preserve it.

If symptoms of a miscarriage appear, a woman should immediately consult a doctor. Also, the reason for an immediate visit to the gynecologist before pregnancy is detected is:

Severe pain in the lower abdomen, accompanied by minor spotting before the expected date of menstruation;
Bloody discharge in the middle of the cycle;
Long or very short menstrual bleeding significantly different from normal in each individual case.

These symptoms may indicate a miscarriage before pregnancy is diagnosed. In such cases, pregnancy can be saved extremely rarely, however, this situation is an alarming reason for undergoing an additional examination in case of pregnancy planning and complete examination in case of sporadic miscarriage during an unplanned pregnancy.

With sporadic miscarriages, symptoms may long time not manifest if fetal death occurs first. Fetal death is diagnosed by conducting an analysis of hCG over time ( chorionic gonadotropin human), ultrasound monitoring. If the research data allow us to establish that the pregnancy is intrauterine and alive, the fetal heartbeat is diagnosed, and its development corresponds to the term, then in most cases such a pregnancy is successfully maintained and ends with the birth of a child.

Miscarriage: causes of spontaneous abortion

In most cases, unfortunately, the causes of miscarriage remain unidentified. Most common causes spontaneous abortion are genetic disorders of fetal development. A biological individual is not capable of producing 100% quality cells (sperm and eggs). Healthy seminal fluid contains up to 2 million abnormal spermatozoa for every 1 ml. Female ova laid in the ovaries at 20 weeks prenatal development fetus, and unlike sperm, female germ cells do not renew themselves throughout life. Any negative factors, both external and internal, affecting the health of a woman, in the same negative way affect her sex cells. The probability that a pathological germ cell will participate in the process of fertilization is quite high. Therefore, there are natural mechanisms for selecting viable individuals for early stages fetal development leading to miscarriage.

The reasons for the habitual termination of pregnancy (2 miscarriages or more) are violations in the female body. Such causes of miscarriages are difficult to identify. These violations do not prevent conception, but provoke interruption in the early stages. The body of a woman in this case is not able to create normal conditions for gestation.

With habitual miscarriages, the reasons may be the following:

Physiology of the uterus, violation of its structure - adhesions in the uterus, bicornuate uterus, septum in the uterus;
Immune disorders (autoimmune, alloimmune), when the female body rejects the fetus as foreign body by producing antibodies to it;
Miscarriages of unknown origin (for unknown reasons);
Endocrine disorders;
Lifestyle.

Is it worth it to keep the pregnancy when the miscarriage has begun? In the early stages, it is extremely difficult to diagnose fetal pathologies. It happens that after maintaining the pregnancy, the fetus reveals complex pathologies that are not compatible with normal life.

According to statistics, 15-20% of all pregnancies end in miscarriages. In most cases, this happens when a woman does not yet realize that she is pregnant. But sometimes it happens to those who have already become attached to their belly-maker and fell in love with him.

How to console a woman in this case? Only next pregnancy. But those who have had such a misfortune in their lives, and those who have not yet known the bitterness of loss, should go through a small educational program on issues related to miscarriage. The most important thing is to know what factors can cause miscarriage, and what can be done to prevent miscarriage.

The conversation will focus on early miscarriages that occur for up to 12 weeks, because the vast majority of them happen during this period. So, the most common causes of miscarriages in early pregnancy:

1. Genetic disorders in the fetus

According to statistics, about 73% of miscarriages occur for this reason. As a rule, these genetic defects are not hereditary in nature, but are the result of single mutations that occurred in the germ cells of the parents under the influence of harmful environmental factors (radiation, occupational hazards, viruses, etc.). Termination of pregnancy for this reason is a kind of natural selection - getting rid of weak, non-viable offspring.

It is almost impossible to prevent such a miscarriage, you can only reduce the risk of genetic abnormalities even before conception, by protecting yourself from the effects of mutagenic factors as much as possible. But at modern ecology the probability of mutations still remains, because miscarriages that occur for this reason can be considered a boon, because they save a woman from many problems and troubles in the future.

2. Hormonal disorders

When the balance of hormones in the body of a woman is disturbed, abortion often occurs on early term. Most often this happens with a lack of the main hormone of pregnancy - progesterone. With the timely detection of this problem, pregnancy can be saved with the help of progesterone preparations.

An excess of male sex hormones can also cause early miscarriage They suppress the production of estrogen and progesterone. Androgens are often the cause of recurrent (habitual) miscarriages. The hormones of the adrenal glands also influence the formation and development of pregnancy. thyroid gland. Therefore, dysfunction of these glands can also cause miscarriage.

3. Immunological causes

As a rule, this happens with an Rhesus conflict. Embryo inherits positive rh father, while the mother's Rh-negative organism rejects embryonic tissues that are foreign to him. To prevent miscarriage in case of immune conflict, progesterone preparations are used, which in this case have an immunomodulatory effect.

4. Sexually transmitted infections

Sexually transmitted infections: trichomoniasis, toxoplasmosis, syphilis, chlamydia, as well as herpetic and cytomegalovirus infection often cause miscarriage.

Pathogenic bacteria and viruses cause infection of the fetus, damage membranes, resulting in a miscarriage. To prevent this from happening, it is advisable to treat infections before pregnancy.

5. Common infectious diseases and inflammatory diseases of the internal organs

All diseases accompanied by intoxication and an increase in body temperature above 38 ° C can lead to miscarriage. Rubella is the leader in this list, viral hepatitis, flu. Even a banal sore throat can become fatal at 4-10 weeks of pregnancy. And pneumonia, pyelonephritis, appendicitis are a serious risk to the fetus. That is why, when planning a pregnancy, it is worth going through the full medical examination, identify and treat all foci of chronic infection.

6. History of abortion

Abortion is not just a medical manipulation: it is a huge stress for female body that can cause dysfunction of the ovaries, adrenal glands; developmental inflammatory processes in the genitals. This can cause infertility and habitual miscarriages in the future.

7. Medicines and herbs

In the first trimester of pregnancy, it is advisable to avoid taking medications altogether. Many of them can cause abortion or cause the formation of developmental defects in the fetus. For example, narcotic analgesics or hormonal contraceptives often become the culprits of abortion. You also need to be careful with medicinal herbs: parsley, nettle, cornflower, St. John's wort, tansy - are contraindicated in early pregnancy.

8. Stress

Strong fright or unexpected grief, resentment or prolonged mental overstrain are dangerous for little creature in your womb. If you, by the will of fate, are forced to be under the influence of stress, discuss with your doctor the possibility of taking sedatives, at least the same valerian.

9. Unhealthy lifestyle

Alcohol, drugs, smoking, excessive coffee consumption, improper and inadequate nutrition are all allies of a miscarriage. It is better to correct your lifestyle even before conception.

10. Falls, heavy lifting, sexual intercourse

Physical activity, heavy lifting, light falls, contrary to popular belief, by themselves rarely lead to miscarriage. They can be - and often are - a "trigger" of spontaneous abortion if any of the above problems are present. However, if the mother's body is healthy and the genetic program of the fetus is normal, then a fall or physical overload must be truly terrible in order to harm the fetus.

Signs of a miscarriage

If you notice the first signs of an impending miscarriage in time, you can usually save the pregnancy. Pain in the lower abdomen or in the lower back, especially cramping, spotting, bleeding - if any of these symptoms appear, immediately consult a doctor, call an ambulance. In such situations, every minute counts. Bleeding with pieces of tissue suggests that a miscarriage has already occurred.

You still fit into tight jeans without difficulty, have not yet faced morning sickness, age spots, stretch marks on the abdomen. But you already have a test with two red stripes - the main proof of your belonging to the happy class of pregnant women.

Your treasure is still quite tiny. Only the most sensitive equipment can detect its presence in your womb. But this does not prevent you from coming up with a name for him, talking to him and stopping at stores with children's clothes to look for something for the unborn, but already existing baby. But this joyful prospect, this rainbow illusion can be interrupted overnight by a terrible and inexorable word Miscarriage.

According to statistics, 15-20% of all pregnancies end in miscarriages.

In most cases, this happens when a woman does not yet realize that she is pregnant. But sometimes it happens to those who have already become attached to their belly-maker and fell in love with him. How to console a woman in this case? Only next pregnancy. But those who have had such a misfortune in their lives, and those who have not yet known the bitterness of loss, should go through a small educational program on issues related to miscarriage. The most important thing is to know what factors can cause miscarriage, and what can be done to prevent miscarriage.

The conversation will focus on early miscarriages that occur for up to 12 weeks, because the vast majority of them happen during this period.

The most common causes of miscarriages in early pregnancy

Genetic disorders in the fetus
According to statistics, about 73% of miscarriages occur for this reason. As a rule, these genetic defects are not hereditary in nature, but are the result of single mutations that occurred in the germ cells of the parents under the influence of harmful environmental factors (radiation, occupational hazards, viruses, etc.). Termination of pregnancy for this reason is a kind of natural selection - getting rid of weak, non-viable offspring. It is almost impossible to prevent such a miscarriage, you can only reduce the risk of genetic abnormalities even before conception, by protecting yourself from the effects of mutagenic factors as much as possible. But with modern ecology, the probability of mutations still remains, because miscarriages that occur for this reason can be considered a boon, because they save a woman from many problems and troubles in the future.

Hormonal disorders
When the balance of hormones in a woman's body is disturbed, early pregnancy termination often occurs. Most often this happens with a lack of the main hormone of pregnancy - progesterone. With the timely detection of this problem, pregnancy can be saved with the help of progesterone preparations. An excess of male sex hormones can also cause an early miscarriage - they suppress the production of estrogen and progesterone. Androgens are often the cause of recurrent (habitual) miscarriages. The adrenal and thyroid hormones also influence the formation and development of pregnancy. Therefore, dysfunction of these glands can also cause miscarriage.

Immunological causes
As a rule, this happens with a Rh-conflict. The embryo inherits the Rh-positive father, while the mother's Rh-negative body rejects embryonic tissues that are foreign to it. To prevent miscarriage in case of immune conflict, progesterone preparations are used, which in this case have an immunomodulatory effect.
Sexually transmitted infections: trichomoniasis, toxoplasmosis, syphilis, chlamydia, as well as herpetic and cytomegalovirus infection often cause miscarriage.
Pathogenic bacteria and viruses cause infection of the fetus, damage to the membranes, resulting in a miscarriage. To prevent this from happening, it is advisable to treat infections before pregnancy.

Are common infectious diseases and inflammatory diseases of internal organs.
All diseases accompanied by intoxication and an increase in body temperature above 38 ° C can lead to miscarriage. Rubella , viral hepatitis , flu are in the lead in this list . Even a banal sore throat can become fatal at 4-10 weeks of pregnancy. And pneumonia, pyelonephritis, appendicitis are a serious risk to the fetus. That is why, when planning a pregnancy, it is worth undergoing a complete medical examination, identifying and treating all foci of chronic infection.

History of abortion
Abortion is not just a medical manipulation: it is a huge stress for the female body that can cause dysfunction of the ovaries, adrenal glands; contributing to the development of inflammatory processes in the genital organs. This can cause infertility and habitual miscarriages in the future.

Medications and herbs
In the first trimester of pregnancy, it is advisable to avoid taking medications altogether. Many of them can cause abortion or cause the formation of developmental defects in the fetus. So, for example, narcotic analgesics or hormonal contraceptives often become the culprits of abortion. You also need to be careful with medicinal herbs: parsley, nettle, cornflower, St. John's wort, tansy - are contraindicated in early pregnancy.

stress
Strong fright or unexpected grief, resentment or prolonged mental overstrain are dangerous for a small creature in your womb. If you, by the will of fate, are forced to be under the influence of stress, discuss with your doctor the possibility of taking sedatives, at least the same valerian.

unhealthy image life
Alcohol, drugs, smoking, regular coffee consumption, improper and malnutrition - all of these are allies of a miscarriage. It is better to correct your lifestyle even before conception.

Falls, heavy lifting, sexual intercourse
All this, although rare, can become a trigger for abortion, so take care of yourself, and therefore your baby!

Spontaneous abortion in the 1st trimester of pregnancy is a sudden termination of pregnancy, which is accompanied by pain and bleeding. In many cases, the condition threatens the life of a woman, so its timely treatment is necessary.

Frequency of occurrence

Spontaneous miscarriage at an early stage occurs in 10-25% of cases of all diagnosed pregnancies. Sometimes a woman does not even know about her condition, or she has recently been diagnosed with pregnancy. According to some reports, up to 75% of pregnancies end early interruption, and the disease proceeds unrecognized, accompanied by the release of the mucous membrane during the next menstruation. To prevent spontaneous abortion, it is necessary to prepare for pregnancy, plan it, examine in advance reproductive system woman and her partner and cure existing diseases.

The probability of pathology increases with each subsequent such case. After the first miscarriage - by 15%, and after two - by 30%. This is especially true for women who never gave birth. healthy child. Severe consequences First of all, the risk of pregnancy loss after three consecutive miscarriages is up to 45%, so examination and treatment is extremely necessary after the second episode.

Most a large number of interruption occurs in the first 12-13 weeks of gestation.

Causes

The answer to the question of why spontaneous abortion occurs sometimes remains unclear. It is believed that half of the cases are associated with genetic mutations leading to non-viability of the fetus.

Causes of miscarriage in early pregnancy:

genetic anomalies that are inherited or occur spontaneously (aneuploidy, trisomy, monosomy, in particular, Turner syndrome, tri- and tetraploidy, parental chromosomal abnormalities) - 50% of cases;
immune processes (antiphospholipid syndrome) - 20% of cases, although this pathology more often causes miscarriage for more late term pregnancy;
developmental anomalies (septa) or tumors (benign - leiomyoma, polyp - or malignant) or;
adverse external factors (exposure to ionizing radiation, paint fumes, gasoline, chemicals at work and at home) - up to 10% of cases;
endocrine diseases: poorly controlled diabetes, autoimmune thyroiditis, insufficiency of the luteal phase of the follicle;
hematological disorders that cause microthrombosis in the vessels of the chorion (dysfibrinogenemia, factor XIII deficiency, congenital hypofibrinogenemia, afibrinogenemia, sickle cell anemia);
mother's diseases - Marfan syndrome, Ehlers-Danlos syndrome, homocystinuria, elastic pseudoxanthoma.

In most cases, this is a combination of several reasons.

What can cause a miscarriage:

sexual infections (rarely lead to abortion);
mechanical factor - (more often causes miscarriage in the 2nd trimester);
acute infections;
chronic kidney disease or of cardio-vascular system at mother;
smoking, drinking alcohol, caffeine or drugs;
stress and strenuous exercise.

All of these conditions can lead to death. gestational sac and expelling it from the uterus. Sometimes a viable embryo is also removed due to increased contractions of the myometrium.

An early miscarriage after IVF is often triggered by a missed pregnancy and subsequent rejection of a non-viable embryo. At the same time, the frequency of spontaneous abortions reaches 30%, and if a woman is already over 40 years old, the pathology develops even more often.

The frequency of spontaneous abortion depends on the age of the woman:

patients under the age of 35 have a 15% risk;
35-45 years old - from 20 to 35%;
older than 45% of years - 50%.

There are diseases that in all cases end in spontaneous interruption of gestation:

. The embryo does not implant in the wall of the uterus, but in the tube, cervix or abdominal cavity. The result is painful cramping and bleeding, reminiscent of the symptoms of a miscarriage. However, more serious complications are possible, in particular, rupture fallopian tube. Therefore, in case of bloody discharge from the vagina, in any case, it is necessary to consult a gynecologist.
Molar pregnancy. If there are chromosomal abnormalities in the egg, after fertilization, it can be implanted in the endometrial wall. Despite the fact that a full-fledged fetus does not develop, a woman's hormone levels increase, there may be early signs pregnancy. This condition always ends in miscarriage.

Symptoms

The disease begins against the background of signs of a normal pregnancy. Nausea, taste perversion, increased sense of smell are possible. It is noted.

Against this background, in the early stages of gestation, signs of miscarriage suddenly appear:

intense cramping pain in the lower abdomen;
bleeding from the vagina of varying severity - from spotting discharge on early stages to intense blood loss during abortion in the course.

Vaginal bleeding occurs in 25% of miscarriages. Such selections do not always mean that an interrupt has begun.

Pain in the lower abdomen can occur during implantation of an egg, but during a miscarriage they have a different character - constant, aching, exhausting a woman. Their intensity is stronger than during normal menstruation. A frequent sign the onset of an abortion is back pain.

Depending on the location of the fetal egg, the following stages of the pathological condition are distinguished:

a miscarriage that has begun;
abortion "in progress";
incomplete miscarriage;
complete abortion.

The patient's condition is often satisfactory, but can reach a more severe degree. Pallor of the skin, accelerated heartbeat is noted. The abdomen is soft on palpation, painful in the lower sections. With significant blood loss, symptoms of a miscarriage include dizziness, decreased blood pressure, weakness, fainting.

When the termination of pregnancy has begun, it is no longer possible to stop this process. Therefore, when initial signs threats of miscarriage, you must urgently seek medical help.

stages

Spontaneous miscarriage at an early stage is diagnosed primarily according to the data of a gynecological examination.

With the onset of abortion, the embryo and its membranes partially exfoliate from the uterine wall. Bloody discharge occurs, the uterus begins to contract, which causes pain in the abdomen. The pharynx is ajar, the neck is shortened.

During an abortion during the course, the embryo is completely separated from the endometrium and is located behind the internal opening of the cervical canal or already in its lumen. Characterized by heavy bleeding and strong pain in a stomach. The cervix is open and passes a finger.

How does an early miscarriage occur?

At incomplete abortion the embryo is no longer in the uterine cavity, so the cramping pains and bleeding subside. However, part of the chorion and decidua remain in the uterus. The cervix gradually acquires normal elasticity, the pharynx remains ajar.

After the expulsion of all parts of the fetus, they speak of a complete abortion. This condition is rare. After cleansing the uterine cavity, it contracts, acquires a normal shape and size, bleeding and pain stop.

What does an early miscarriage look like?

This is a bloody clot of tissues, consisting of membranes and the fetal egg itself. Sometimes such an abortion resembles painful periods with the release of large fragments of the endometrium, for example, with. Well, if such a fragment can be saved. Sometimes there is a need for its further laboratory research.

Complications

As a result of spontaneous abortion at an early stage, the following adverse consequences may occur:

Posthemorrhagic anemia caused by blood loss and manifested by constant weakness, pallor, dizziness.
that occurs when infectious agents enter the inner surface uterus and accompanying high temperature, abdominal pain, vaginal discharge, deterioration of the general condition.
Placental polyp - the remnant of tissue of the fetal egg with insufficient surgical treatment, which can cause severe bleeding.

Diagnostics

If you suspect pathological condition conduct a gynecological examination and prescribe blood tests. There is a slight decrease in hemoglobin and hematocrit levels, a slight increase in the number of leukocytes and ESR.

To reliably determine an early miscarriage, transvaginal ultrasound is used. It is used to determine:

fertilized egg, embryo;
localization of the chorion;
embryonic heartbeat;
detachment of the chorion;
signs of accumulation of blood between the chorion and the wall of the uterus.

Transvaginal ultrasound examination

The level of hCG after an early miscarriage decreases rapidly. After a few days, its short-term increase is possible, but after a month the amount of this substance in the blood becomes normal. By increased number HCG in the blood in the absence of a fetal egg in the genital tract of a woman can retrospectively recognize an interrupted pregnancy.

Required differential diagnosis with cervical canal polyp and nascent.

Additional studies needed to find out the exact causes of miscarriage:

Analysis of the chromosome set of parents, family history genetic abnormalities, chromosomal material of abortus in case of recurrent miscarriage.
Determination of signs of antiphospholipid syndrome with the analysis of anticardiolipin antibodies, lupus anticoagulant and antibodies to beta-2-glycoprotein.
Imaging methods for diagnosing abnormalities in the development of the uterus:, sonohysterography,.

The diagnosis of antiphospholipid syndrome with recurrent miscarriage is based on the presence of at least one clinical and one laboratory criterion.

Clinical Criteria:

vascular thrombosis (arteries or veins);
3 or more consecutive unexplained miscarriages;
1 or more cases of unexplained fetal death after the 10th week of pregnancy;
1 or more cases premature birth(before 34 weeks) associated with severe preeclampsia or placental insufficiency.

Laboratory Criteria:

anticardiolipin antibodies: IgG and / or IgM is found in medium or high titer at least twice within 6 weeks;
prolonged phospholipid-dependent coagulation time in screening tests;
inability to normalize blood coagulation tests with platelet-deprived plasma;
normalization of coagulation with the addition of phospholipids;
exclusion of other bleeding disorders.

Treatment

The goal of treatment is to remove the remnants of the embryo from the uterus and stop bleeding. Therefore, treatment after an early miscarriage is complex and includes medications and surgical intervention.

Is cleaning necessary after a miscarriage?

Curettage of the walls of the uterus is carried out in all cases of the disease, except for a complete abortion, which is extremely rare.

Medical therapy

At any stage of spontaneous abortion, medicines that reduce the uterus and stop bleeding, as well as antibiotics and antifungal drugs:

Oxytocin intramuscularly or intravenously drip;
Etamzilat intramuscularly;
antibiotics (Amoxicillin, Cefazolin, Metronidazole) in combination with antifungal agents (Fluconazole).

Drugs used in the treatment of early miscarriage

Surgical intervention

It is carried out with an incomplete abortion, an abortion in progress, a miscarriage that has begun with profuse bleeding. The goal is to cleanse the uterus of the remnants of the embryo and stop bleeding. The operation is performed under anesthesia. Usually the patient's condition requires emergency assistance Therefore, intravenous anesthesia is used. It provides complete anesthesia and the absence of consciousness of the patient.

Stages of surgical intervention:

Probing of the uterine cavity to determine the correct direction of insertion of instruments and prevention of uterine perforation.
Exfoliation of the fetal egg with a curette.
Removing it through the cervical canal with an abortsang.

During the removal of the fetal egg, bleeding increases due to damage to the vessels of the chorion, but after the walls are completely cleansed, it stops. If atonic bleeding develops, and the uterus does not contract under the influence of oxytocin and other drugs, the question of its removal is raised.

If the patient is hospitalized already with a complete abortion, surgery is not performed on her.

The recovery period after a miscarriage is 10 days.

Recovery

The rehabilitation period depends on how long the pathology occurred. The following symptoms may appear:

bleeding from the vagina, reminiscent of menstruation;
pain in the lower abdomen;
discomfort and engorgement of the mammary glands.

Menstruation after a miscarriage usually comes in 3-6 weeks. After the restoration of the cycle, a woman is able to become pregnant, but still it should be protected for some time to full recovery health.

A woman can restore her physical and sexual activity when he feels that he has enough strength for this. Here you need to focus on your well-being and not do anything “through force”. It is important to give the body time to physically and emotionally recover. Sexual intercourse is not recommended for 2 weeks to avoid infection in the uterus.

Usually after an early miscarriage emotional condition suffer more than the physical. There are sleep disturbances, loss of appetite, anxiety, loss of strength. The patient often cries, does not see the meaning of life. Without timely help, this condition can cause prolonged depression.

Further observation

What to do after an illness? A woman needs to be examined to clarify the causes of miscarriage:

tests for sexual infections;
exclusion of antiphospholipid syndrome;
studying hormonal background depending on the phases of the cycle;
Ultrasound of the uterus and ovaries.

These studies are carried out 2 months after the termination of pregnancy.

Depending on the detected cause, it is eliminated. Pregnancy after a miscarriage is recommended not earlier than six months later, subject to good preparation for it.

If it is proved that the cause of the pathology was genetic anomaly, a couple is shown a consultation with a geneticist, and in difficult cases, pre-implantation genetic diagnosis.

For antiphospholipid syndrome, complex treatment, including:

subcutaneous administration of Heparin;
low dose aspirin;
Prednisolone;
immunoglobulins.

With anomalies in the development of the uterus, surgical correction of defects is possible, with myoma - removal of the node (conservative).

If the patient's age is habitual miscarriage is 35 years or more, during a subsequent pregnancy, she is offered either a chorionic biopsy to detect genetic abnormalities.

In 85% of women who have had this disease, there is a repeated normal pregnancy. Only 1-2% have recurrent cases, which is usually associated with immune causes.

Prevention

Not all spontaneous abortions can be prevented. However, the presence of the latter in history does not mean infertility in the future. Only a small number of patients have 2 or more cases of pathology, of course, with proper treatment.

How to avoid miscarriage in early pregnancy:

Quit smoking, alcohol and drug use.
Keep physical activity to maintain a good supply of blood and oxygen to the fetus.
Maintain the correct weight.
Limit caffeine to 200 mg per day (1 cup) or less.
Take special vitamins to prepare for pregnancy, and then for pregnant women.
Eat a balanced diet with plenty of fruits and vegetables.
Visit a doctor regularly.

However, in most cases, this disease cannot be prevented.

Early miscarriage is a fairly common condition, usually associated with a genetically determined non-viability of the fetus. Less commonly, it occurs under the influence of a variety of internal and external factors. The condition is accompanied by pain and bleeding. In most cases, surgical intervention () is required, followed by examination and identification of causes.

In the first weeks of pregnancy, a miscarriage may occur, but the woman may not know that she was pregnant. A miscarriage is a serious stress for the hormonal and immune systems female body. Pregnancy failure (miscarriage) before delay menstrual cycle usually occurs due to a violation of the process of implantation of embryonic cells into the endometrial cavity at the very beginning of pregnancy. Menstruation with such a failure occurs with a slight delay or on time, so it is difficult for a woman to understand whether there was a miscarriage. In this case, all the signs of pregnancy that could already appear, the woman most often takes for the symptoms of an ordinary pregnancy. premenstrual syndrome. No one knows exactly how often miscarriages occur in the first or second week of pregnancy. However, whether there was a miscarriage, some symptoms can still be determined.

Signs of a miscarriage at 2 weeks pregnant

To understand whether there was a miscarriage in early pregnancy, you need to carefully listen to your body. In many women, a miscarriage is accompanied by heavy menstrual flow with blood clots. Sometimes you can see separate fragments in them. fruiting egg pearl grey.

Blood after a miscarriage at the very beginning usually has a brownish tint. With increased bleeding, spotting acquires a bright scarlet color. Bleeding during a miscarriage can be moderate or very intense.

Blood after a miscarriage can stand out one to two weeks. With prolonged bleeding, it is imperative to consult a doctor so that the pregnancy can be maintained.

To find out if there was a miscarriage, a blood test will help. The level of hCG in the blood plasma remains high for another ten days after the miscarriage. Define hCG level at home, you can use the usual test. Even a barely noticeable second strip may indicate that there was a pregnancy.

Measurement basal body temperature It will also help determine if you have had a miscarriage. A frequent sign of a miscarriage at the 2nd week of pregnancy is a decrease in basal temperature to normal.

Termination of pregnancy may be accompanied by pain syndrome. The pain may come and go again. With a miscarriage, pain most often covers the abdomen and back.

However, to accurately determine whether there was a miscarriage, only by painful sensations it is forbidden. Indeed, in some cases, the rejection of the fetus occurs completely painlessly.

The main stages of a miscarriage

Doctors distinguish several stages of spontaneous abortion. In the first stage, aching most often appears. pain in the abdomen and lower back. A little later, bloody discharge may appear from the genital tract. If you seek medical help at this stage and find out in a timely manner whether there has been a miscarriage, then in most cases the pregnancy can be saved.

In the second stage of a miscarriage, pain may be cramping. There is severe dizziness and weakness. However, even at this stage of miscarriage, pregnancy can be saved. Timely prescribed hormonal treatment will help eliminate the factor that provokes a miscarriage.

At the next stage of miscarriage, severe pain is accompanied by bleeding in a significant amount. At this stage, the fertilized egg dies, and it is no longer possible to continue the pregnancy. In medicine, the phenomenon is also known incomplete miscarriage when the fetal egg leaves the uterine cavity not entirely, but in separate parts.

On last stage termination of pregnancy, the fetal egg is completely rejected from the uterine cavity. The uterus contracts and gradually restores its former size. To make sure whether the miscarriage was complete, it is necessary to carry out ultrasonography. After all, sometimes the fetal egg dies, but remains in the uterine cavity. All the symptoms of pregnancy in a woman disappear, but at the same time the state of health worsens (frozen pregnancy). In this case, to eliminate the fetal egg, they resort to curettage of the uterine cavity.

Curettage must be done in a timely manner to prevent inflammation of the appendages and the development of endometritis. After all, such complications can lead to impaired ovarian function and further development of infertility.

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