What affects early miscarriage. Medical causes of early miscarriage. What to do after a miscarriage

Miscarriage, or spontaneous abortion, is called termination of pregnancy for up to 20 weeks. It may be complete or incomplete. At incomplete miscarriage parts of the embryo and its membranes remain in the uterus, while in order to avoid complications, it is necessary to curettage the uterus.

If fetal rejection has not yet occurred, but there is only a threat, the pregnancy can be saved.

The risk of miscarriage is highest in the early stages. Up to 8 weeks, a miscarriage is more often complete, its frequency at these times reaches 20% and then decreases. On average, miscarriages end up to 15% of all pregnancies.

What are the reasons for miscarriage?

Most common causes miscarriage is a genetic abnormality in the embryo. In the process of fertilization, maternal and paternal genes are combined and form a new genetic set of the child. If a gene is damaged or lost at this stage, then the embryo from the very beginning is not viable, it dies and a miscarriage occurs.

Sometimes a gene is lost that will be needed only in late pregnancy. In such cases, for some time the pregnancy develops normally, but then, when there is a need for a missing or altered gene, it is still interrupted.

Genetic failures occur randomly and usually do not recur with new pregnancies.

Other causes of miscarriages may include:

hormonal disorders, such as progesterone deficiency or elevated level androgens;
infectious diseases, including rubella;
bad habits: smoking, alcohol, stimulants;
unfavorable environmental conditions and others.

These factors, along with genetic abnormalities, are most often the causes of early miscarriages, while in the later stages there are more often other reasons:

isthmic-cervical insufficiency in the mother (dysfunction of the cervix);
chronic diseases (for example, kidney or heart disease) in the mother.

What are the symptoms of a miscarriage?

When a woman feels cramping pains in the lower abdomen, and she begins to bleed profusely, then most likely the miscarriage has already happened, and now the uterus has begun to expel the embryo. In this case, saving the pregnancy is usually not possible.

However, it is still necessary to consult a doctor, since in case of miscarriages, not only health, but also the life of a pregnant woman is often at risk.

Sometimes it happens that a woman retains all the signs of pregnancy, while the fetus has stopped developing or even died. This condition is called, and it can also pose a threat to a woman.

What to do if you suspect a miscarriage

At the first suspicion of a miscarriage, you should consult a doctor. If the bleeding and pain are severe, it is better not to wait for the next morning and go to the consultation, but to call ambulance and go to the hospital.

This is necessary to make an accurate diagnosis: the cause of bleeding can be not only a miscarriage, but also, for example, placenta previa. If the diagnosis of miscarriage is not confirmed, you will be allowed to go home.

If the miscarriage is confirmed, you may be offered curettage of the uterus. You should not refuse, because if at least part of the embryonic membranes remain in the uterus, bleeding can intensify and turn into shock, and an infection may develop.

How to prevent miscarriage?

Miscarriage is often due to uncontrollable factors. Therefore, it is impossible to completely protect yourself, especially in the early stages of pregnancy (up to 8 weeks).

In women whose pregnancy proceeds without special complications, life is not associated with frequent stress and physical exertion, the threat of miscarriage occurs infrequently.

An attentive attitude to your health during pregnancy will help reduce the risk of a threatened miscarriage or respond to this threat in a timely manner.

If you have had several miscarriages in a row, they probably have common cause. This should be found out by contacting a doctor in perinatal center your city. Hormone deficiency can be corrected with injections, uterine defects can be corrected surgically. Medicine knows the means of dealing with many common causes of miscarriages.

A miscarriage is a spontaneous termination of pregnancy at that stage of fetal development at which it is not viable outside the mother's womb. If the child can save vital functions with the help of specialists or on his own, such termination of pregnancy is called early birth.

Causes

Early pregnancy is characterized by the "all or nothing" principle. At this time, the expectant mother often does not know about her situation and leads habitual image life. She is subjected to strong physical and emotional stress, does not always eat healthy food, and does not think about the fact that smoking and alcohol are harmful to her health.

As a result negative impact the embryo often loses viability and dies. There is his rejection and exile. If it is successfully fixed in the endometrium and survives the first turbulent period, in the future, the gestation process usually proceeds normally. Therefore, a number of experts consider attempts to maintain gestation at a very early date not always justified.

The main causes of miscarriage in early pregnancy are considered to be:

Pathologies of the uterus that prevent the embryo from gaining a foothold and ICM (insufficiency of the cervix).
Pathologies of the embryo incompatible with life.
External factors that adversely affect the condition of the fetus.
Reasons related to the health of the mother.

Let's consider each reason in more detail.

Thinning of the endometrial layer due to frequent abortions.
Myoma nodes.
Anomalies in the structure of the uterus.
Malignant tumors of the uterus.
Gross cicatricial changes associated with surgical interventions on the uterus (including previous births by caesarean section).
PPI, in which the cervix dilates, flattens and shortens prematurely and cannot hold the fetus. Becomes the cause of the loss of the child in the first half of the second trimester.

The second category includes genetic mutations in the embryo that make it unviable. In this case, self-abortion plays the role defense mechanism and the function of natural selection, not allowing the birth of a child who is crippled or unable to fully live.

The rest of the reasons that provoke a miscarriage should be discussed in more detail. This knowledge can help avoid the loss of a child.

External factors

This group of causes affecting the development of pregnancy is the most extensive. A combination of several of these factors can provoke a miscarriage on early stage prenatal development. And this is even if the embryo received high-quality genetic material from both parents and had the opportunity to safely implant into the uterine wall.

This group includes:

Deep feelings or often repeated stressful situations in which the mother is forced to be.
Ecologically unfavorable area of residence.
X-ray exposure.
Falls, injuries and bruises of the lower back and lower abdomen.
Rough and violent sex.
Working conditions associated with serious physical exertion or occupational hazards.
Irrational nutrition, strict diets.
Tobacco smoking and addiction to drinking alcoholic beverages.
Application medicines, including plant origin.

Some herbs, including St. John's wort, oregano, tansy, and nettle, are used by women to stop unwanted pregnancy. This does not always bring the expected result. But it can negatively affect the course in the presence of other factors provoking its interruption.

In the initial gestational period, it is generally recommended to abstain from medicines. They do not necessarily cause self-abortion, but they can affect the laying of the baby's vital organs and cause disturbances in their structure and functioning.

Poor maternal health

The last group of reasons that can cause self-termination of pregnancy include various diseases mothers:

Hormonal disruptions.
Endocrine pathologies (diabetes, hypothyroidism and others).
Diseases of the cardiovascular system.
Blood pathologies.
Infectious diseases (measles, rubella and others) transferred after conception.
STDs (gonorrhea, lewis, gardnerellosis, mycoplasmosis).

Even a banal flu or SARS occurring with a temperature above 38 ° C and severe intoxication can cause the expulsion of the embryo. STIs can cause miscarriage even if the woman does not experience any discomfort and does not know she is ill. This happens with an asymptomatic course of the disease. Therefore, it is recommended to plan conception, and during the planning process, check for the presence / absence of STIs. If even a conditionally pathogenic microflora (gardnerella, myco- and ureaplasmas, fungi of the genus Candida) is detected, it is advisable to treat these infectious diseases until the moment of fertilization.

Another cause of miscarriage can be an Rhesus conflict. Usually, a blood conflict develops during pregnancy with a second or third child. Therefore, doctors strongly recommend that their Rh-negative patients keep their first pregnancy. In this case, the chance of giving birth healthy child significantly higher.

With unwanted conception, women do not always seek specialized help. And they try to cause a miscarriage on their own with the help of hot baths, taking abortive herbal remedies or special pills. It's better not to.

First, a hot bath can lead to more active implantation of the embryo. It will be difficult to remove with known minimally invasive methods and may require multiple scrapings.

Secondly, if you induce self-abortion at home, you can lose consciousness. If this happens in the bathroom, you can even choke. Severe bleeding is also possible, requiring hospitalization and treatment.

Terms of self-abortion

Early miscarriage most often occurs before the 13th gestational week. If the pregnancy is terminated at 4-5 weeks, the woman perceives the miscarriage as more painful and heavy periods.

It is believed that the maximum risk of losing a child in the early stages awaits the expectant mother:

At 4 weeks.
At 8 weeks.
At 12 weeks.

Starting from 13 gestational weeks to 20 there is a risk of fetal loss due to the development of ICM. At this time, abortion is already proceeding similarly to early birth, with the discharge of amniotic fluid and the expulsion of the embryo. By this time, the fetus has completed the laying of the main organs and has well-defined individual facial features.

Many women ask: "Will I get pregnant, and how quickly after a medical abortion or self-abortion in the first gestational weeks?" Usually, doctors recommend keeping the first pregnancy, because in obstetric practice, cases of post-abortal infertility are not uncommon. However, many women repeatedly and successfully conceive offspring after abortions or spontaneous cessation of the gestation process.

Get pregnant after an abortion in a medical way, you can already in 1.5-2 weeks. Therefore, it is advisable to take care of contraceptive methods in a timely manner.

Stages and signs

The whole process of self-abortion is usually divided into 4 stages. Moreover, with intervention at the first 2 stages, the embryo (fetus) can be saved.

Differentiate the process as follows:

The threat of self-abortion.
Started self-abortion.
Self-abortion in progress.
A completed miscarriage.

According to the symptoms of a miscarriage in the early stages of pregnancy, a woman is unlikely to be able to determine her condition on her own. The threat of interruption of gestation for up to 6 weeks is symptomatically similar to signs of embryo implantation or PMS. The woman feels:

Discomfort in the lower abdomen.
Pain in the lumbar region.
Observes signs of bleeding: usually mild, spotting discharge on linen.

If the pregnancy is planned and the woman is expecting conception, then when similar signs you should see a doctor. At this stage, the child can be saved in most cases.

When the process of self-abortion has begun, its manifestations become more pronounced. They cause severe discomfort in a woman. Signs of miscarriage in early pregnancy include:

Cramping and increasing pain in the lower abdomen.
An ache in the sacrum and lower back.
Increasing bleeding.
General weakness.
Dizziness.

optional, but possible signs are:

Vomit.
Diarrhea.
Weight loss.

In this situation, a woman needs emergency help. In some cases, the pregnancy can be saved. Refusal of hospitalization, as a rule, ends with the termination of pregnancy.

There is another situation worth considering. This is when a miscarriage is in progress, the fetus has already died, and there is no way to save the pregnancy. This stage of the process is characterized by:

Intense and very sharp pain in the lower abdomen.
Muscle tension in the lower abdomen (stone belly).
Severe pain in the lower back, making it difficult to move and sit.
Profuse loss of blood.

At this stage fertilized egg may be completely or partially removed with blood (incomplete miscarriage). In the latter case, scraping is required.

The last stage of the process is characterized by the expulsion of the fetus, the contraction of the myometrium, and the cessation of bleeding. At this stage, ultrasound monitoring of the state of the uterus is recommended. Ultrasound diagnostics will allow you to determine whether there are no blood clots left in the uterine cavity, membranes or fetus.

When the first signs of malaise appear, a woman should consult a specialist. If started severe pain and bleeding, then you should not make an appointment with a gynecologist, but call an ambulance.

Before the arrival of the ambulance, the woman needs to lie down, put a pillow under her hips, you can briefly apply cold to the lower abdomen. It is recommended not to remove linen soaked in blood, so that the doctor who came to the call could assess the amount of blood loss. At heavy bleeding The patient may need a blood transfusion. Therefore, if a woman knows her blood type and Rh, this information should be reported to the doctor.

Consequences

Early self-abortions usually resolve without physical consequences for the woman. A pregnant woman for a period of 4 to 6 weeks often does not know about her situation, and cannot even say how many gestations she has stopped during this period. But this does not mean that there is no need to visit a gynecologist if the woman was informed about her situation and about the termination of gestation. Only a doctor can determine if additional medical procedures to restore a woman's health or she only needs psychological help and understanding of loved ones.

The consequences of self-abortion include:

Incomplete removal of the fetus.
Inflammatory processes in the tissues of the uterus.
Hematometer, which can cause the formation of Coover's uterus and the need for amputation of the organ.
Infertility.

At incomplete removal of the fetal egg, curettage must be carried out. The remains of the embryo are sent for examination in order to find out the reasons for the termination of gestation. If it was possible to establish the reasons causing the cessation of gestation, before next conception it is desirable to eliminate them.

Despite the fact that a woman's body is able to recover in 1–1.5 months, doctors do not advise getting pregnant within six months after spontaneous cessation of gestation. You need to prepare for conception. Let the body recover not only physically, but also psychologically. Fear of recurrent miscarriage can prevent both conception and normal course gestation.

Prevention

No measures can guarantee the preservation of pregnancy. But a healthy lifestyle, proper nutrition, walking, avoiding stress will contribute to a healthy course of gestation. Importance has regular visits to an obstetrician-gynecologist who may notice early signs violations of the gestation process and intervene in a timely manner.

The normal course of pregnancy is facilitated by the implementation of the doctor's recommendations: taking specialized vitamin complexes, avoiding hot baths. If necessary, follow bed rest, refuse sex and take hormonal drugs that support pregnancy.

During the bearing of the baby during this entire period, you need to carefully monitor your own condition. In case of any discomfort, discomfort in the lower abdomen, it is worth hurrying for a consultation.

Often a woman, having become pregnant, is not able to immediately recognize her position and her body rejects the fetus in the first 2-3 weeks of pregnancy. But there are also situations when an unborn child dies in the womb already at a later date (up to 22 weeks), which greatly affects psychological condition . Before planning a new pregnancy, you need to figure out what the true cause of a miscarriage is and how to prevent it in the future.

Why miscarriage occurs

The cause of a miscarriage or missed pregnancy is not always unhealthy image the lives of failed parents. Proper Development fetus depends on many factors, and if a couple has lost a long-awaited child, this does not mean at all that in the future she will not be able to conceive healthy baby. First you should visit specialists, pass necessary tests and understand the causes of the tragic event, and then plan the birth of the baby.

Most often, a miscarriage occurs early - in the first 12 weeks of pregnancy. Main reasons :

Genetic failure, often of a hereditary nature. In the first weeks of pregnancy, the development of all the most important organs fetus, if in the process of this there is a change in the structure of the chromosomes of the parents (chromosomal mutation), the woman's body will reject the non-viable fetus, carrying out the so-called natural selection. It is practically impossible to influence a genetic failure in any way, because it happens for reasons beyond human control (radiation emissions, exposure to viruses, work in hazardous industries), but it is possible to minimize the risks of miscarriage and prevent it even before conception.
Hormonal reasons. If a future mother has a lack of the hormone progesterone or an excess of the male hormone, then the likelihood of a miscarriage increases significantly, most likely it will occur already in the first weeks of pregnancy. To prevent this from happening, a woman is prescribed a special hormonal therapy at the planning stage, which must be followed up to 16 weeks of pregnancy.
Causes associated with the conflict of Rh factors. Even at the planning stage, future parents should take a blood test to find out their compatibility. If the fetus inherits a positive Rh father Rh negative mothers, female body simply reject it as something alien.
Sexually transmitted diseases. If one of the parents is infected with chlamydia, toxoplasmosis, syphilis or other diseases, the fetus will gradually become infected with pathogenic microorganisms, as a result of which a miscarriage or miscarriage will occur.
Ailments that the mother suffers - illnesses thyroid gland, some forms of diabetes, heart disease, problems with the immune system.
One or more abortions are a great stress for the body and often cause inflammatory processes and infertility.
Medicines and herbs, the use of which can provoke the development of fetal pathology or spontaneous his rejection.
Stress, unhealthy lifestyle - malnutrition, smoking, alcohol.
Taking a hot bath.

Signs of a miscarriage

Experts distinguish several types of miscarriage:

If you experience the following symptoms, you should immediately seek help from your doctor:

early miscarriage

Early miscarriage, unfortunately, is a very common phenomenon today. If you have already learned about your situation, it is better to listen to your body. Any pain or vaginal discharge - a reason to contact medical institution. The doctor may suggest that the patient go to the hospital for preservation, it is necessary to give up everything for the sake of the baby's life.

The first stage of an incipient miscarriage is characterized by aching pains, contraction (tension) of the uterus. In this situation, all is not lost. If, with the threat of a miscarriage, measures are taken in time and treatment is started, there is a high probability of bringing the child to due date. With a lack of progesterone, the patient is prescribed hormone therapy, with bleeding - hemostatic drugs, with infection of the fetal egg, anti-inflammatory drugs are given.

During treatment, you must follow the following measures precautions:

First of all, this is bed rest, it is desirable that the pelvis be in an elevated position, this will reduce the load.
The second rule is the observance of complete sexual rest.
Thirdly, the patient should not be worried and worried, so as not to aggravate his situation.

When the miscarriage has passed into the second stage, the bleeding intensified, and the pain does not stop, the possibility of outpatient treatment disappears, the woman is placed on inpatient treatment, numerous injections and droppers are made, constantly monitoring the condition of the fetus.

late miscarriage

Unfortunately, late miscarriage is a fairly common problem. In Russia, obstetricians and gynecologists consider late miscarriage untimely termination of pregnancy without outside help in the period from 12 to 22 weeks, after this period, there is a possibility that the child can be saved and “come out”.

Factors influencing untimely termination of pregnancy at a later date:

How to survive a miscarriage

Approximately half of women experience the loss of an unborn child at least once in their lives. Each of them has questions “Why?”, “For what?” and “How to live after this?”. Psychological recovery after a miscarriage is not an easy task, requiring huge mental costs. What do psychologists advise in this situation?

Realize that this is not always the fault of the parents, because the main causes of miscarriage are chromosomal changes. Many women blame themselves for the loss of a baby, perhaps there is a logical explanation for this. But anyway, first of all, forgive yourself.
Try to find out real reasons happened. Pass all the necessary tests for infections and hormones, conduct research on the genetic compatibility of spouses, consult with several specialists. Only in this way can you minimize the risk of subsequent miscarriages.
Rest as much as possible. You have undergone a serious kind of psychological and physical test. If you have the opportunity to go on vacation, be sure to use it.
Understand that everything comes to an end one day, and your grief too. Work on yourself every minute, repeating that you can handle it, as you have come to terms with the loss of thousands of other women.
Watch your psychological state, every day noting changes for the better, achievements, plans and goals.
At the first thoughts of suicide, an obsessive restless state, hallucinations, immediately seek help from a specialist.

Pregnancy after a miscarriage

Physiologically, pregnancy after a miscarriage can occur within a month. However, doctors recommend that a woman postpone this issue for at least six months or a year in order to be able to psychologically and physically recover, because every time after an abortion, the ability to endure and give birth to a healthy baby will decrease.

Indications for which expectant mother It is worth doing a survey at the planning stage:

age from 35 years;
history of abortion;
infertility treatment;
threatened miscarriage or miscarriage in previous pregnancies.

During pregnancy planning:

Give up bad habits- alcohol and tobacco products can worsen the quality of genetic material, as well as, if possible, from taking potent drugs.
Eliminate stressful situations from your life, normalize your emotional state.
Intense physical activity during this period is prohibited.
Eat right, take vitamins and folic acid under the supervision of a physician.
Limit contact with viral and infectious patients.

Do you know that, according to medical data, a fifth of all pregnancies end in miscarriage? This is the lower bound. Because spontaneous abortion usually occurs when a woman is not yet aware of the emergence of a new life within herself. What causes a miscarriage in the first month? How to determine an early miscarriage? Is cleaning necessary in this case?

Why is this happening

There are several reasons why a miscarriage occurs on early stages pregnancy:

Genetic changes in the development of the embryo. According to medical observations, three-quarters of miscarriages occur because of this. Such processes are not subject to any regularity. Basically, they are random. We can say that such a miscarriage is a process of natural selection, when nature protects a woman from the appearance of non-viable offspring.

excessive exercise stress. 5% of all miscarriages are due to heavy lifting or strenuous exercise. The maximum allowable weight for lifting a pregnant woman is 5 kg.
Stress. Emotional condition women during pregnancy very often changes. Any, even the smallest offense, can cause great stress. And he, in turn, can cause an abortion.
Medicines and herbs. Medicines can penetrate the shell and have a detrimental effect on the fetus. Most dangerous time- these are the first 12 weeks, when the formation of organs and their systems occurs in the embryo. Medications can cause developmental defects and cause miscarriage. The most dangerous are painkillers, which contain codeine, and some antibiotics. Herbs can also negatively affect the body and the fetus, and the woman herself. Tansy, St. John's wort and nettle are considered especially harmful. Ordinary parsley can tone the uterus and, as a result, provoke a miscarriage.
abortion. Abortion is not only getting rid of the onset of pregnancy by surgery. This is a lot of stress for the body. After it, the activity of the adrenal glands or ovaries may be disrupted. Sometimes there are inflammations in the genitourinary system.
Chronic course of diseases and general weakening of the body. Any disease that leads to poisoning of the body and the appearance of high temperature, can cause miscarriage. Usually it is influenza, jaundice, rubella. Even sore throat or common cold considered dangerous. What can we say about inflammation of the kidneys, pneumonia or inflammation of the appendix.
Infectious diseases. There are many known infections that can cause even earlier. These include toxoplasmosis, chlamydia, trichomoniasis, syphilis, gonorrhea. Do not forget about herpes and cytomegalovirus. They are responsible for 20% of all miscarriages. Viruses pass through the membranes to the embryo and infect it.
Immunology. Differences in Rh factors are another reason for early abortions. It looks like this. Passed down from father to child positive rh factor while the mother is negative. Her body will perceive the fetus as foreign body which needs to be removed.
Problems with hormones. Most miscarriages occur when there is not enough progesterone in the mother's body. Hormones produced by the adrenal glands and the thyroid gland also have a great influence on the growth of the embryo.
Falls or injuries. Usually the fetus does not suffer in such situations. He has good protection in the form of water around, a bubble, mother's muscles and her own fat cells. However, in some situations, a miscarriage is quite real.
Taking a hot bath. In such situations, miscarriage is very rare, but still possible.
Bad habits. Cigarettes and alcohol are the first enemies of pregnant women. In second place is the lack of outdoor exercise, the wrong daily routine, as well as excessive consumption of caffeinated drinks.

Symptoms

Almost always, a miscarriage can be stopped. The main thing is to resort to the help of specialists in time. But when to sound the alarm? What are the symptoms of an early miscarriage?

Most main feature- bleeding from the uterus. Its intensity does not matter. Sometimes it a large number of secretions, and sometimes a few drops. At the very beginning, brown blood comes out. Gradually, it becomes bright scarlet. If you do not resort to surgical intervention, such bleeding can last quite a long time.
Pain sensations. Some believe that miscarriage is accompanied by severe pain, and this statement is partly correct. However, there are cases when abortion is painless. In most cases, it rolls in waves. If your stomach or back starts to hurt, you should immediately go to the hospital. Delay can have bad consequences.

Stages

Doctors warn that a miscarriage takes place in several stages.

Threat

The lower abdomen or lower back begins to hurt. The woman then remarks bloody issues. When moving, they become more abundant. It is very important to go to the hospital right away. If done on time, the pregnancy can be saved.

Abortion

It is characterized by cramping pains in the lumbar region and lower abdomen. The discharge becomes profuse, the head may feel dizzy. timely medical assistance able to keep the pregnancy even at this stage.

Treatment can be carried out at home, but most doctors prefer to observe the patient in the hospital. Do not refuse hospitalization - it can save the life of a child. Also, you do not need to refuse treatment with hormones. They'll help you sort it out. hormonal background, which could provoke the onset of a miscarriage.

Miscarriage

woman feels sharp pain, increased bleeding. At this stage, the fertilized egg becomes unviable. Even the help of specialists is not able to save the child. Sometimes the fertilized egg can die before the miscarriage begins. Then it comes out not completely, but in pieces. This miscarriage is called incomplete.

Completed miscarriage

The dead fertilized egg leaves the uterus. The uterus contracts and takes its usual size. The bleeding ends. It is important to undergo an ultrasound to examine the uterus to complete the process.

Sometimes it can happen miscarriage. The fertilized egg died, but did not leave the uterine cavity. With such a miscarriage, the symptoms of pregnancy completely disappear. The woman feels weak. Ultrasound shows the death of the fetus. In another way, this is called a frozen pregnancy. The fertilized egg does not come out of the uterus. The only way remove it - cleaning.

Is cleaning needed?

This question has been causing a lot of controversy and discussion for many years. Many women miscarry at home. They do not want to go to the hospital, considering the process completed. However, this is a dangerous mistake, because the complete expulsion of all elements is a rare occurrence. Therefore, you need to do surgical removal embryo and fetal membranes.

This must be done as quickly as possible, otherwise the embryo will begin to decompose and lead to inflammation.

Before cleaning begins, doctors prepare. They do an enema, remove hair in the pubic area. Next, the anesthesiologist together with the patient chooses the type of anesthesia. The main stage of cleaning is the scraping process. The gynecologist examines the uterus and its cervix. The anesthesiologist gives anesthesia: general or local according to indications. Using special tool, the doctor takes out the remaining particles of the germ and membrane. The cleaning process is completed.

Fetal tissue is usually sent to a laboratory for analysis. It will help to find out the reasons for what happened.

Recovery

In order for the body to fully recover and be ready for a new pregnancy, a number of very important measures must be taken.

Get tested for TORCH infection. These are ureaplasma, mycoplasma, herpes virus, cytomegalovirus.
Examine the karyotype. Analysis for both parents.
A man can do a spermogram.
Pass a vaginal smear, determine the amount of hormones in the blood, make an immunogram.
Monitor vaginal discharge.
Monitor your temperature. If it rises, an inflammatory process occurs in the body.
When washing, use antiseptic agents.

Early miscarriage is a common occurrence. Sometimes a woman may not notice it, mistaking it for painful menstruation. The most important thing is not to ignore the symptoms and seek medical help in time. In some cases it may be necessary surgical intervention- cleaning. After it, you need to conduct an examination and start restoring the body.

Miscarriage in early pregnancy- this is a spontaneous termination of the prolongation of pregnancy until the 12-week period of development of the embryo / fetus. Provoke a miscarriage (another name is spontaneous abortion) on small terms quite natural, physiologically justified reasons are capable.

Surely not all women know that not every fertilized egg that enters the uterus is transformed into a full-fledged one. Sometimes the uterus is released from the embryo so early that the spontaneous termination of a one- or three-week pregnancy goes unnoticed, and the onset of minor bleeding is regarded as a delayed next menstruation. This situation is part of a protective mechanism, because nature is interested in the reproduction of only healthy offspring, and if the embryo has serious deviations in development and is essentially unviable, prolongation of pregnancy is impractical.

It is statistically proven that a fifth of all miscarriages occur before the 12-week gestation period, that is, they are early. It should be reminded of existing difference between the equally used concepts of "miscarriage" and "". When the embryo (or already the fetus) leaves the uterus before the 12-week period, they speak of an early miscarriage, if such an event occurs later (from 12 to 22 weeks) - a late miscarriage. Spontaneous termination of pregnancy after 22 weeks is classified as preterm birth.

There is also the concept of "habitual miscarriage", it is used to state following friend after another three or more spontaneous interrupts pregnancies, each of which occurred before the 22-week period.

There are many reasons for early miscarriage, they can be conditionally classified into two large etiological groups, one of which is associated with developmental disorders of the embryo itself, and the other with the body of the pregnant woman. Each of the etiological groups will be discussed in more detail in the relevant chapters.

Contrary to the misconception common among patients, they cannot provoke a miscarriage during pregnancy in the early stages (that is, up to 12 weeks):

- correctly dosed physical activity and sports in reasonable options, moreover, adequate physical activity strengthens the muscles of the small pelvis and subsequently helps to give birth safely;

- air travel;

- active intimate life;

- slight blunt abdominal trauma;

— stressful situation;

- the presence of one interrupted early pregnancy in past.

It should be noted once again that the above circumstances are not dangerous only in the case of early pregnancy, in later periods of gestation, each of them has its own characteristics.

Unfortunately, even with a huge range of contraceptives and interruption methods, women still resort to independent attempts to provoke an early miscarriage, believing that the embryo is very vulnerable in the short term and is poorly “retained” in the endometrium. This opinion is erroneous: a healthy embryo has pronounced adaptive properties and is able to endure many negative influences, so even a successful attempt to get rid of it does not provoke a full-fledged miscarriage, but only partial detachment embryo and, as a result, dangerous massive bleeding.

Clinical signs of miscarriage in early pregnancy are not specific enough. These include contraction-like pain, bleeding, and sharp deterioration well-being. Other conditions may have similar symptoms:

In artificial insemination, “ready-made” embryos are implanted into the uterus after preliminary medical preparation endometrium. To increase the success rate, multiple embryos are used. At the same time, only one of them begins to fully develop in the uterine cavity, and the rest are eliminated by the type of early miscarriage. Unfortunately, with an unfavorable outcome, all implanted embryos leave the uterus.

The negative consequences of a miscarriage in early pregnancy are always associated with its cause.

Finally, some statistics:

- a pregnant woman who has overcome the 40-year milestone has high risk(50%) spontaneous early abortion due to the natural extinction of hormonal ovarian function;

- among all spontaneous miscarriages, 80% occur before the 13th week of gestation;

- up to 90% of early miscarriages are associated with accidental chromosomal abnormalities that never recur in the future and do not affect the outcome of subsequent pregnancies;

- most women who have experienced an early miscarriage safely endure next pregnancy and give birth to perfectly healthy children;

- if an early miscarriage is repeated repeatedly, the situation is classified as miscarriage and requires detailed diagnosis and serious therapy.

Early miscarriage: symptoms

If the miscarriage occurs very early, other than bleeding that resembles a normal period after a short delay, there may be no other symptoms. That is why most very early miscarriages go unnoticed.

Although the signs of a miscarriage in early pregnancy do not vary greatly, it never happens all at once. As a rule, after the onset of an early miscarriage, it can proceed according to several scenarios, therefore, several dynamic stages are distinguished:

- Threatened spontaneous abortion. There is a threat of premature termination of pregnancy, which can be eliminated and prolongation of gestation to the due date. Clinically manifested by sudden, labor-like pains in the absence of bleeding. Sometimes there may be minor.

- Incipient miscarriage. The embryo / fetus partially loses its anatomical connection with the uterine wall and begins to separate from it, but the pregnancy can still be saved, since the detachment of the ovum is only partial. Bloody discharge is more intense.

- Complete or incomplete miscarriage (abortion in progress). The pregnancy is terminated due to separation of the embryo from the endometrium. If the fetal egg has not left the uterine cavity, but has already almost separated from its wall, the miscarriage is classified as incomplete, if it came out with the blood - as complete or ended. Cramping pains with incomplete miscarriage are more intense, radiate to adjacent areas and the lower back, and bleeding becomes life-threatening.

A completed abortion implies an independent evacuation of the fetal egg from the uterus, therefore, as a result, the pain subsides, and the bleeding ends. However, if even a small piece of the fetal egg remains in the uterine cavity, the uterus will continue to bleed and contract.

A variation of abortion in the course is the so-called "cervical abortion", when the fetal egg, on the way out of the uterine cavity, "gets stuck" in the cervical canal along with the secreted blood and stretches the cervix.

Separately, a failed, “frozen” pregnancy is distinguished, when the embryo dies and continues to remain in the uterine cavity. A similar condition is indicated by the sudden disappearance of all signs (including laboratory) of pregnancy. This condition is considered as a variant of miscarriage. The reasons for a failed pregnancy are not always clear, but it is reliably known that two circumstances often provoke pathology:

- Violation correct distribution chromosomes during the fertilization of the egg, when the future embryo eventually has an extra chromosome, which causes multiple malformations. As a result, the embryo is not viable and dies.

- The embryo formed correctly, but subsequently was adversely affected and died. More often, pregnancy stops developing after infection of the embryo.

Often, a non-developing pregnancy is interrupted on its own like an early miscarriage, if this does not happen, the dead tissues are removed instrumentally. Any episode non-developing pregnancy requires a detailed study, since pregnancy after an early miscarriage due to fading can end in a similar way.

Early miscarriage: treatment

Therapeutic tactics for early miscarriage depends on at what stage of interruption it is diagnosed. Stopping an abortion is possible only in the very early stages of a miscarriage.

The threat of miscarriage in the early stages of pregnancy is often observed, but only a small part of such situations has a negative scenario, but when the fetal egg has almost completely exfoliated from the uterine wall, it is impossible to keep the pregnancy.

Diagnostic measures for symptoms of miscarriage include:

— Gynecological examination. During a miscarriage, the cervix behaves differently. It can shorten and “open up” (the external pharynx is able to let the obstetrician's fingers through, and hence the embryo), or it can remain in its original state.

- Ultrasound scanning. The fetal egg is visualized in the uterine cavity, starting from the 3rd - 4th week of gestation, and later it is even possible to detect the heartbeat of the embryo. If, in the presence of minor bleeding with a “closed” cervix, a non-exfoliated embryo is visualized and its heartbeat is detected, the pregnancy has a high (up to 97%) chance to survive.

When the embryo exfoliates from the underlying tissues, bleeding from damaged vessels occurs at the place of detachment, so the pregnant woman develops vaginal spotting. Then the vessels thrombose on their own, and the blood ceases to stand out. In such a situation, during the examination, a retrochorial hematoma is well visualized at the site of detachment. The size of the hematoma indicates the size of the area of detachment. A small hematoma is not dangerous and implies only observation. A significant detachment provokes a large hematoma, which is likely to lead to miscarriage and bleeding.

— Chorionic gonadotropin(hCG) in the blood. It is also called the "pregnancy hormone". According to the level of its concentration, the duration of pregnancy and the rate of its growth are judged. When the pregnancy is too small to be seen "on the monitor" (up to 4 weeks), the determination of this hormone helps to determine the presence of pregnancy. HCG grows with pregnancy, so when it is interrupted, tests performed at intervals of 48 hours help determine the miscarriage.

With a threatened miscarriage, if the embryo is normally attached to the endometrium, there is no significant detachment of the fetal egg and, accordingly, there is no significant bleeding, against the background of cramp-like pains that have appeared, it is necessary to suppress the excessive contractile activity of the uterine muscles and “calm down” the pregnant woman herself with medication.

Sometimes therapy is used to prolong pregnancy hormonal means, however, in the early stages, it has very limited capabilities and is used only in the presence of hormonal dysfunction as a cause of miscarriage. Since early miscarriages are more often provoked by genetic disorders, hormone therapy is unable to prolong the life of a non-viable embryo.

If the fetal egg has practically exfoliated from the underlying mucosa, the bleeding that has begun in short term can become a threat, therefore, it is necessary to immediately remove both the embryo and all surrounding tissues by scraping or vacuum aspiration. The same tactic is intended for abortion in progress, when a completely separated fetal egg continues to be in the uterine cavity.

A completed, complete, miscarriage does not require treatment. If the fetal egg is evacuated from the uterus, and the bleeding stops, it is believed that nature "coped" with the situation itself. After complete miscarriage it is recommended to take an analysis for hCG and undergo an ultrasound scan so that there is no doubt.

Consequences of miscarriage in early pregnancy more often similar to those in a conventional abortion due to an unwanted pregnancy, namely:

- Infection. The presence of a dead embryo and a significant amount of blood in the uterine cavity during a miscarriage create very favorable conditions for infection, especially in women with reduced immune defenses.

- Massive threatening bleeding against the background of the retention of a particle of the fetal egg in the uterus. The uterus tries to expel the "foreign body" by contracting strongly, which leads to increased bleeding.

- Hormonal dysfunction. Abrupt termination of pregnancy can provoke hormonal disruptions.

Even if the procedure for removing a non-viable fetal egg is completed successfully, it is necessary to undergo full examination to determine the cause of the miscarriage. If the cause is established, preventive therapy is carried out to prevent the recurrence of the negative scenario of a subsequent pregnancy. Antibacterial therapy and hormonal treatment are most often used.

The attention of patients should be drawn to the fact that independent attempts to cope with a threatened miscarriage are not only ineffective, but also dangerous. For any symptoms indicating possible miscarriage, even if they are mild, it is more correct to get qualified advice.

How does a miscarriage happen in early pregnancy?

The miscarriage scenario often repeats its stages, starting with threatened miscarriage and ending with a complete / incomplete abortion. However, sometimes the miscarriage scenario does not imply staging, and it happens very quickly.

A miscarriage, in fact, is the separation of the ovum from the uterine wall as a result of uterine contractions. In one situation, uterine contractions occur primarily and precede the death of the embryo, in another, the dead embryo provokes contractions.

With primary reflex contractions, a healthy embryo dies a second time due to the loss of communication with the endometrium.

Until the 4-week period, the size of the fetal egg is very small, so even non-intensive uterine contractions can completely separate it from the uterine wall and bring it out. Therefore, early miscarriages often occur quickly and imperceptibly, mimicking late menstruation. This situation is typical for a primary dead embryo, when the uterus receives a “signal” about the need to evacuate the dead tissues.

If the fetal egg is viable and has begun to separate from the uterine wall, a timely medical stop of uterine contractions can slow down the miscarriage and save the pregnancy.

The outcome of a threatened miscarriage is affected by the location of the fetal egg. More often, the fetal egg is implanted in the safest and most prosperous area - the uterine fundus. This area contains more blood vessels that will feed developing embryo. In addition, the muscles of the uterine fundus are "calmer" than in other parts.

Sometimes implantation is not entirely successful, and the embryo is in the lower uterine segment or very close to it. This zone has powerful muscles and is poorly adapted for bearing, so there is always a risk of premature termination of pregnancy.

How to avoid early miscarriage

Early miscarriages that occur due to embryonic anomalies are considered a natural protective process that cannot be interfered with from the outside - a non-viable egg dies, and the uterus rejects it.

Main preventive measure for healthy pregnant women in the early stages - an adequate attitude to their new condition. Proper nutrition and dosed physical activity will help the child get everything necessary for development without any drug treatment.

A first pregnancy raises a lot of questions about nutrition, how to rest, the ability to travel, and taking medication. All information is usually provided by a specialist who monitors pregnancy, but it will not be superfluous to recall the main thing:

- Pregnancy is not a disease, so you should not overprotect yourself and your child. However, it must be remembered that "life together" requires some changes in the usual rhythm of life and diet.

- should not be avoided physical activity especially in the early stages. When the body is in motion, and its muscles "work", blood circulation and oxygenation of the blood improves, which has a beneficial effect on the pregnant uterus.

- The mother's well-being is not always consistent with the well-being of the fetus. Unfortunately, often pregnant women categorically refuse preventive treatment, especially stationary, relying precisely on their good condition. Meanwhile, in this case, the embryo may suffer from oxygen deficiency or nutrients. Trusting relationship with their gynecologist help the pregnant woman to correctly relate to his recommendations.

- Any infection, even a banal one, can harm early pregnancy. Hypothermia and contact with patients should be avoided.

- Pregnancy has every chance of a successful completion if it proceeds in conditions of psychological comfort. constant stress and Bad mood, unreasonable anxiety provokes a constant vascular spasm, and can also provoke uterine contractions.

Unfortunately, the majority of pregnant women who have had an early miscarriage in the past are subject to unreasonable fear of a repetition of a negative scenario. Meanwhile, it is early miscarriages that infrequently tend to recur.

As a rule, after an early miscarriage, a full examination is carried out in order to find its cause, and then a rehabilitation course of therapy is carried out. If the control examination does not reveal pathology, the woman is allowed to become pregnant again.

The situation is completely different in patients who have had three or more spontaneous early miscarriages. This state classified as a variant of infertility ( habitual miscarriage) and always implies a full examination and therapy corresponding to its results.