Miscarriage at 12 weeks symptoms. Spontaneous miscarriage - symptoms and causes

Pregnancy is wonderful. But sometimes it happens that the body itself decides to get rid of the emerging new life, and then a miscarriage occurs. In most cases, this happens in the early stages of pregnancy, in the first 12 weeks.

Statistics say that every fifth woman loses a child before even knowing that she is pregnant. From a gynecological point of view, a miscarriage is considered to be a spontaneous termination of pregnancy before 22 weeks, since children born prematurely - after 22 weeks and weighing 500 grams - can be saved by today's medicine. But, if the weight is below 500 grams, then the possibilities are zero.

As we have already said, in most cases it happens that the woman does not even suspect that she is pregnant and nothing bothers her. While waiting for her period to come, she simply registers that she is late, and a few days later her period begins, but comes more heavily than usual and with pain.

Sometimes, miscarriage early characterized only by moderate pain in the lower abdomen and heavy bleeding, then the woman does not even go to the doctor if the bleeding stops soon. If bleeding occurs profusely for several days, then a visit to the doctor cannot be avoided.

In some cases, such delayed periods are very painful, and one day a blood clot comes out. Then we can definitely say about spontaneous miscarriage at an early stage. Usually this clot resembles a burst blood blister. This phenomenon always frightens those who encounter it for the first time. After the release of a blood clot, you must definitely consult a doctor: firstly, to undergo an examination and determine exactly what it was; secondly, to check if cleaning is needed.

Miscarriage is a phenomenon that makes both the body and the soul suffer. Many people know that there is such a danger as spontaneous abortion, but not everyone knows about its causes and how it can be prevented.

If we talk about early miscarriage up to 12 weeks, then basically it is a test and warning for parents. A miscarriage at this stage of development indicates that either the mother’s body is not yet ready for the normal development of the baby inside it, or something is wrong with the health of both parents, and it needs to be strengthened so that the baby develops healthy in the future, and the body from unhealthy and in the future it will get rid of itself.

Early miscarriage: causes

The reasons for miscarriage in the early stages of pregnancy can be very different - from hormonal imbalance to an emotional state. To avoid consequences, it is important to establish why spontaneous abortion occurred.

Genetic disorder in the fetus

In the first weeks of pregnancy Special attention is devoted to the healthy formation of all organs of the future person, which requires equal 23 chromosomes from mom and dad. And if one of them suddenly contains a mutating element, then it is recognized as incompetent, and a miscarriage occurs in the early stages.

The presence of such elements is influenced by the environment, viruses, and occupational hazards. It is very difficult to avoid these factors; you can only reduce the risk of their influence on the body by going on vacation: to fresh air and for a long time. By carrying out a miscarriage, the body thus produces natural selection, characteristic of all life on earth.

Hormonal disorders

It is known that hormones are responsible for the good functioning of a woman’s body, so their incorrect balance in the body can lead to early miscarriage. Also, a lack of the hormone progesterone or an excess of the male hormone causes this phenomenon. If such a problem is diagnosed in a woman in advance, then before planning a pregnancy she is prescribed hormonal therapy, which helps avoid miscarriage.

Rhesus conflict

It is not for nothing that when planning a pregnancy, they are required to take a blood test to determine the group of both the mother and the father (if the mother turns out to have a negative Rh factor). In this case, the father’s Rh is important, since its opposite indicator can lead to the development of an Rh conflict, when the embryo inherits the father’s positive Rh, and the mother’s body identifies its tissues as foreign and rejects them, saving itself, as it seems.

If the father also has a negative Rh factor, then such a problem does not arise. With timely diagnosis of such a pathology, the hormone progesterone is used, which plays a protective role for the embryo and eliminates this cause of spontaneous miscarriage in the early stages.

Infections

Infection is bad in any case. If you know that you or your partner have a sexually transmitted infection, you need to get rid of it before conception. When a pregnancy occurs with this diagnosis, the fetus becomes infected and, again, the body gets rid of the embryo at an early stage.

Diseases of internal organs

Any increase in temperature up to 38 degrees caused by illness internal organs, can cause early miscarriage. Typically, such a temperature is accompanied by intoxication of the entire body, and therefore it is unable to hold the embryo. This is why it is so important to undergo a complete examination when planning a pregnancy in order to detect and treat all chronic diseases and get vaccinated if necessary.

Abortion

As is known, this is an intervention in ordinary life female body. If an abortion has ever taken place, it can lead either to habitual spontaneous miscarriages in the early stages or to infertility.

Medicines

In the first trimester, the use of any medications is not recommended at all, as this can lead to defects in fetal development. There are also herbs that are contraindicated in early pregnancy: parsley, nettle, cornflower, St. John's wort, tansy. Their use can cause early miscarriage.

Bad mood

Severe stress, grief, and prolonged mental stress can negatively affect the birth of a new life and lead to miscarriage in the early stages of pregnancy. In this case, with the recommendation of a doctor, it is possible to take some sedatives.

Lifestyle

You need to change your lifestyle when planning a pregnancy. Getting rid of bad habits, balanced and nutritious nutrition are the first conditions for development healthy child, the opposite can lead to early miscarriage.

Physical impact

Unsuccessful falls and heavy lifting can cause early miscarriage. If the woman is healthy, then this effect must be very strong to cause termination of pregnancy.

Early miscarriage: symptoms

The most common signs of early miscarriage are pain in the lower abdomen and bleeding. Also, unpleasant sensations from the lower abdomen can spread to the lower back. This pain is periodic. Vaginal discharge indicates a threat of early miscarriage. If they have a reddish or even brownish tint, you should consult a doctor to avoid miscarriage.

Often the cause of miscarriage is the tone of the uterus, but only in cases where it is accompanied by discomfort for the mother and pain. If it is not accompanied by anything, then doctors’ recommendations stop at reducing physical activity and reducing stressful situations.

In some cases, even after the above symptoms, pregnancy proceeds normally, only under more careful medical supervision, then they talk about the threat of miscarriage.

The symptoms of spontaneous miscarriage at any stage of pregnancy are relatively similar. They may only be accompanied by stronger pain and copious discharge.

Symptoms of miscarriage in the second trimester:

about bag damage amniotic fluid says liquid that drips from the vagina, in this case, contacting a doctor should be immediate;
vaginal bleeding is a sign of miscarriage in any trimester of pregnancy;
blood clots appear during urination, accompanied by pain;
internal bleeding, which can be indicated by very severe pain in the shoulder or in the stomach area.

How is threatened miscarriage diagnosed?

If your pregnancy is planned, and you have gone through all the necessary preparation procedures that the doctor told you about, taken all the tests and treated all the detected diseases, then the possibility of a miscarriage is reduced to a minimum. If any contraindications were discovered in advance, then attention is paid to them already when the baby is conceived. In this case, the diagnosis of the threat of miscarriage takes place at the planning stage, and treatment is prescribed in advance.

If pregnancy occurs spontaneously, without preliminary treatment and examination, then any gynecologist can diagnose a miscarriage or its threat during a routine examination. When examining a woman who comes in with a delay problem, the doctor determines the expected duration of pregnancy.

checks the size of the uterus for the given period;
checks for uterine tone;
determines whether the cervix is closed;
pays attention to the nature of the discharge (bloody or mucous).

The most reliable way to diagnose a miscarriage or premature birth already for more later– transvaginal ultrasound performed by an experienced doctor. Using this method, the length of the cervix and the condition of the internal os are checked.

Treatment of threatened miscarriage in the early stages

The most basic and first thing that the doctor advises if there is a threat of miscarriage at any stage of pregnancy is to adhere to bed rest. In some cases, in order to maintain the pregnancy, the woman is even forbidden to get out of bed.

It is also recommended to reduce the level of anxiety, bad news and thoughts. Already from the first weeks of existence, the nascent life feels you from the inside; any of your excitement can negatively affect its condition. And disturbances in the condition can lead to its rejection by your body. To avoid these nervous tensions, your doctor may prescribe valerian or motherwort.

You yourself can use relaxation therapy: sit comfortably on a sofa or chair and think about something good. The most appropriate in this case may be dreams about the future baby, choosing a name, mentally drawing his portrait. But all this is after consultation with a doctor.

If the threat of miscarriage is more serious and just good thoughts are not enough, then the first thing the doctor does is determine the cause. After determining the cause of the threat of miscarriage, hormonal medications are prescribed in the first weeks of pregnancy, which are designed to maintain a good pregnancy.

You may be prescribed progesterone (it is part of Utrozhestan, Duphaston), you may be prescribed drugs for hyperandrogenism (if large quantities male hormones), as well as medications if there is a threat of Rh conflict.

If the doctor deems it necessary, they may conduct an additional intrauterine ultrasound examination. If insufficiency is detected with this diagnostic method, then sutures are placed on the cervix, which stop the fertilized egg inside the uterus. This operation is performed in a hospital and under anesthesia, while relaxing drugs are injected into the uterus.

Most cases of threatened miscarriage in early pregnancy are treated in a hospital; sometimes women have to remain under the supervision of doctors until the very end of pregnancy, that is, until childbirth. In some cases, treatment begins in a hospital, and then proceeds to home conditions while observing bed rest. Sometimes, having undergone treatment for a threatened miscarriage in the early stages, a woman does not return to it until the birth.

Prevention

To avoid early miscarriage in most cases it is possible. If a couple approaches their decision carefully and responsibly, then they will be examined by a doctor in time, which will reveal all sorts of deviations and inconsistencies in the bodies of the man and woman. A preliminary examination will allow you to cure all kinds of infectious and hormonal diseases that can cause a miscarriage later.

One in five pregnancies ends in miscarriage; More than 80% of miscarriages occur in the first 3 months of pregnancy. However, their actual number may be underestimated, since most occur in the early stages, when pregnancy has not yet been diagnosed. No matter when your miscarriage occurs, you may feel shock, despair and anger. A sharp decrease in estrogen can cause a decline in mood, although most women become depressed without it. Best friends or even family members sometimes refer to what happened as a “bad period” or “a pregnancy that wasn’t meant to be,” which only adds to your grief. Many women feel guilty, thinking that something wrong was the cause of their miscarriage. What if it's because of the weights you've been lifting at the gym? Because of the computer at work? Or over a glass of wine with lunch? No. Remember that the vast majority of miscarriages are due to chromosomal abnormalities. Only a small proportion of women (4%) with a history of more than one miscarriage suffer from some kind of disease that requires diagnosis and treatment. It is important to find moral support after the incident. Give yourself time to go through all 4 stages of grief—denial, anger, depression, and acceptance—before you try to get pregnant again. Understand that this is an illness and share your pain with someone you trust. Your partner is grieving the loss just as you are, now is the time to support each other. Finally, remember that in most cases, even women who have miscarriages go on to have healthy children in the future.

Classification of miscarriage

Spontaneous miscarriages can be classified according to many criteria.

Of practical interest are classifications based on differences in gestational age, degree of miscarriage development (pathogenetic sign) and clinical course.

Spontaneous - miscarriages are distinguished:

By gestational age: a) early - in the first 12-16 weeks of pregnancy, b) late - in 16-28 weeks of pregnancy.
According to the degree of development: a) threatening, b) beginning, c) in progress, d) incomplete, e) complete, f) failed. If spontaneous miscarriages recur during successive pregnancies, they speak of a habitual miscarriage.
According to the clinical course: a) uninfected (not febrile), b) infected (feverish).

At the core pathogenesis Spontaneous miscarriage may be due to the primary death of the fetal egg due to toxicosis of pregnancy, acute and chronic infections, hydatidiform mole, etc. In such cases, reactive changes usually occur in the pregnant woman’s body, entailing contractions of the uterus with the subsequent expulsion of the dead fertilized egg. In other cases, reflex contractions of the uterus occur primarily and precede the death of the fetal egg (secondary death of the fetal egg), which occurs from a disruption in the connection of the fetal egg with the maternal body due to detachment of the placenta from its bed. Finally, both of these factors, i.e., contractions of the uterus and death of the egg, can be observed simultaneously.

Until 4 weeks of pregnancy, the fertilized egg is still so small that it takes up an insignificant place in the total mass of the falling membrane. Contractions of the uterus can completely or partially remove the falling membrane from its cavity. If the part of the membrane in which the egg is implanted is removed from the uterine cavity, a spontaneous miscarriage occurs, which the pregnant woman either does not notice at all or mistakes for heavy menstrual bleeding. By removing part of the falling membrane that does not contain the fertilized egg, the egg can continue to develop after the contractions have stopped. In such cases, slight bleeding from the pregnant uterus may even be mistaken for menstruation, especially since a small amount of menstruation-like discharge sometimes occurs in the first month of pregnancy. Further observation of the pregnant woman reveals the true picture.

If contractions of the uterus precede the death of the fertilized egg and cause its detachment from the bed in the area of the decidua basalis, where a rich vascular system is developed, a short but severe bleeding occurs, quickly bleeding the patient, especially if half or a region is detached.

The closer to the internal os of the uterus the egg is implanted, the more severe the bleeding. This is explained by the lower contractility of the uterine isthmus compared to its body.
Sometimes the fertilized egg of early pregnancy exfoliates entirely and, having overcome the obstacle from the internal uterine os, descends into the cervical canal. If at the same time the external pharynx turns out to be impassable for the egg, it seems to get stuck in the canal of the cervix and stretches its walls, and the cervix takes on a barrel-shaped appearance. This form of miscarriage is called cervical abortion (abortus cervicalis).

A miscarriage in late pregnancy (after 16 weeks) proceeds in the same way as premature birth: first, the uterine os opens with wedging of the amniotic sac, then the amniotic sac opens, the fetus is born, and finally, detachment and the birth of the placenta occur. In multiparous women, the membranes often remain intact, and after the opening of the uterine pharynx, the entire fertilized egg is born entirely at once.

Types of miscarriage

Depending on what was discovered during the examination, your doctor may name the type of miscarriage you experienced:

Risk of miscarriage. If you are bleeding, but the cervix has not begun to dilate, then this is only a threat of miscarriage. After rest, such pregnancies often continue without further problems.
Inevitable miscarriage (abortion in progress). If you are bleeding, your uterus is contracting and your cervix is dilated, a miscarriage is inevitable.
Incomplete miscarriage. If some of the tissue from the fetus or placenta is expelled, but some remains in the uterus, this is an incomplete miscarriage.
Failed miscarriage. The tissues of the placenta and embryo remain in the uterus, but the fetus died or did not form at all.
Complete miscarriage. If all the tissue associated with the pregnancy comes out, it is a complete miscarriage. This is common for miscarriages occurring before 12 weeks.
Septic miscarriage. If you develop a uterine infection, it is a septic miscarriage. Urgent treatment may be required.

Causes of miscarriage

Most miscarriages occur because the fetus does not develop normally. Abnormalities in a child's genes and chromosomes are usually the result of random errors during the division and growth of the embryo - not inherited from the parents.

Some examples of anomalies:

Dead egg (anembryony). This is a fairly common occurrence and is the cause of almost half of miscarriages in the first 12 weeks of pregnancy. Occurs when only the placenta and membranes develop from a fertilized egg, but no embryo.
Intrauterine fetal death (frozen pregnancy). In this situation, the embryo is present, but it dies before any symptoms of miscarriage appear. This also occurs due to genetic abnormalities of the fetus.
Bubble drift. Hydatidiform mole, also called trophoblastic disease of pregnancy, is uncommon. This is an abnormality of the placenta associated with disturbances at the time of fertilization. In this case, the placenta develops into a rapidly growing cystic mass in the uterus, which may or may not contain an embryo. If the embryo does exist, it will not reach maturity.

In some cases, the woman's health status may play a role. Untreated diabetes, thyroid disease, infections, and hormonal imbalances can sometimes lead to miscarriage. Other factors that increase the risk of miscarriage include:

Age. Women over 35 have a higher risk of miscarriage than younger women. At 35 years of age the risk is about 20%. At 40 years old, about 40%. At 45 - about 80%. The age of the father may also play a role.

Here are the possible causes of miscarriages:

Chromosomal abnormalities. During fertilization, the sperm and egg each contribute 23 chromosomes to the future zygote and create a set of 23 carefully selected pairs of chromosomes. This is a complex process, and the slightest disruption can lead to a genetic abnormality, which will stop the growth of the embryo. Research has shown that most miscarriages have a genetic basis. How older woman, the more likely such anomalies are.

Hormonal imbalance. About 15% of miscarriages are caused by hormonal imbalances. For example, insufficient progesterone levels can prevent the embryo from implanting into the uterine wall. Your doctor can diagnose the imbalance through an endometrial biopsy, a procedure usually performed at the end of the menstrual cycle to assess ovulation and the development of the lining of the uterus. Treatment uses hormonal drugs that stimulate the development of the embryo.

Uterine diseases. Fibrous tumor of the uterus can cause miscarriage; Such tumors often grow on the outer wall of the uterus and are harmless. If they are located inside the uterus, they can interfere with implantation of the embryo or blood flow to the fetus. Some women are born with a uterine septum, a rare defect that can cause miscarriage. The septum is a tissue wall that divides the uterus in two. Another reason may be scarring on the surface of the uterus, as a result of surgery or abortion. This excess tissue can interfere with embryo implantation and also impede blood flow to the placenta. A doctor can detect these scars using x-rays, and most are treatable.

Chronic diseases. Autoimmune diseases, heart, kidney or liver disease, and diabetes are examples of disorders that lead to approximately 6% of miscarriages. If you have a chronic health condition, find an obstetrician/gynecologist who specializes in pregnancies for these women.

Heat. It doesn't matter how healthy a woman is normally if you have heat(above 39 °C) in the early stages, this pregnancy may end in miscarriage. Fever is especially dangerous for an embryo up to 6 weeks.

Miscarriage in the 1st trimester

During this period, miscarriages occur very often, in approximately 15-20% of cases. In most cases, they are caused by a fertilization anomaly, which causes abnormalities in the chromosomes of the fetus, making it non-viable. We are talking about a mechanism of natural selection, which does not imply anomalies on either the mother's or the father's side.

Physical activity has nothing to do with it. Therefore, you don’t have to blame yourself for the fact that you, for example, didn’t get enough rest, nor feel responsible for it. A miscarriage that occurs in the first trimester of pregnancy does not require further special examination, except in cases of two or three consecutive spontaneous abortions.

Miscarriage in the 2nd trimester

From the 13th to the 24th week of amenorrhea, miscarriages occur much less frequently - approximately 0.5%) and, as a rule, are provoked by infection or abnormal opening (gaping) of the cervix. For preventive purposes, you can do a cerclage of the neck, and in case of infection, take antibiotics.

What does not cause miscarriage?

These daily activities do not cause miscarriage:

Physical exercise.
Lifting or physical exertion.
Having sex.
Work that excludes contact with harmful substances. Some studies show that the risk of miscarriage increases if the partner is over 35 years old, and the older the father, the greater.
More than two previous miscarriages. The risk of miscarriage is higher if a woman has already had two or more miscarriages. After one miscarriage, the risk is the same as if you have never had a miscarriage.
Smoking, alcohol, drugs. Women who smoke and drink alcohol during pregnancy have a greater risk of miscarriage than women who do not smoke or drink alcohol. Drugs also increase the risk of miscarriage.
Invasive prenatal examinations. Some prenatal genetic tests, such as human chorionic villus or amniotic fluid testing, may increase the risk of miscarriage.

Symptoms and signs of spontaneous miscarriage

Often the first sign of a miscarriage is metrorrhagia (vaginal bleeding that occurs outside of menstruation) or palpable contractions of the pelvic muscles. However, bleeding is not always a symptom of a miscarriage: we are often talking about a disorder in the 1st trimester (it affects one woman in four); in most cases, pregnancy continues unimpeded.

A threatened miscarriage (abortus imminens) begins either with the destruction of the falling membrane, followed by cramping contractions of the uterus, or with the occurrence of contractions, followed by blood discharge from the uterus - a sign of the beginning detachment of the fertilized egg from its bed. The initial symptom of a threatened miscarriage is, in the first of these options, slight bleeding, in the second, cramping contractions of the uterus. If the process that has begun does not stop, it moves to the next stage - the state of an incipient miscarriage.

Thus, the diagnosis of threatened miscarriage is made if there is a sign in pregnancy based on one of the mentioned symptoms - minor cramping pain in the lower abdomen and sacrum and slight bleeding from the uterus (or both symptoms together), provided that there is no shortening of the cervix and opening of the uterine pharynx. With a two-handed examination performed during contractions, the uterus is compacted, and the compaction remains for some time after the patient has stopped feeling pain from contractions.

Incipient miscarriage (abortus incipiens).. At this stage of miscarriage, cramping pain in the abdomen and sacrum and blood discharge from the uterus are simultaneously observed; both of these symptoms are more pronounced than in the stage of threatened miscarriage. As with a threatened miscarriage, the cervix is preserved, the external os is closed. The compaction of the uterus during contractions is more pronounced than during a threatened miscarriage. If the connection with the uterus is broken only on a small surface of the fertilized egg, for example, less than one third, its development can continue and the pregnancy is sometimes carried to term.

As the process progresses, contractions intensify and become painful, as during childbirth; bleeding also increases. The cervix shortens, the pharynx gradually opens, up to the size necessary for the passage of the fertilized egg. During a vaginal examination, due to the opening of the cervical canal, an examining finger can be inserted into it, which palpates parts of the exfoliated ovum here. This stage of the development of a miscarriage is called abortion in progress (abortus progrediens). In such cases, the fertilized egg is born partially or entirely.

When only parts of the fertilized egg are expelled from the uterine cavity, they speak of an incomplete miscarriage (abortus incom-pletus). In such cases, the main symptoms are: heavy bleeding with large clots, which can lead to acute and severe bleeding of the patient, and painful contractions. A two-manual gynecological examination reveals blood clots, often covering the entire vagina, a shortened and softened cervix, patency of the cervical canal along its entire length for one or two fingers; the presence in the vagina, in the cervical canal and in the lower part of the uterine cavity of parts of the exfoliated fertilized egg, if it was not expelled from the uterus before the examination, an increase in the body of the uterus, some softening (uneven), roundness and pain, short-term contraction of the uterus under the influence of the examination and etc.

A complete miscarriage (abortus completus) is said to occur when the entire fertilized egg is expelled from the uterus. A vaginal examination reveals that the uterus has decreased in volume and is dense, although the cervical canal is open, the bleeding has stopped, only scanty bleeding is observed; After 1-2 days, the cervix is restored and the cervical canal closes. However, although the fertilized egg is expelled from the uterus as if entirely, in the cavity of the latter there are usually still fragments of the falling membrane and villi that have not lost contact with the uterus, etc. When the uterus has expelled the fertilized egg entirely, it can only be decided after clinical observation of the patient and repeated two-manual gynecological examination. In all other cases, it is more correct to clinically consider each miscarriage as incomplete.

A failed miscarriage is recognized after clinical observation on the basis of cessation of growth of the uterus, which had previously increased in accordance with the duration of pregnancy, and then its reduction, the appearance of milk in the mammary glands instead of colostrum, a negative Ashheim-Tsondeka reaction (appears no earlier than 1-2 weeks after death of the fertilized egg), slight bleeding from the uterus, and sometimes even its absence.

One or another stage of development of a miscarriage is established (which is of great practical importance) based on the mentioned signs of each of them.

The following pathological processes can be complications of miscarriage.

Acute anemia, which often requires immediate intervention. If a woman who has a miscarriage is healthy in all other respects, especially if the body’s compensatory ability is full, then with timely and appropriate measures taken to combat acute anemia, death from the latter is very rarely observed.
Infection. During a miscarriage, a number of conditions are created that favor the development of the septic process. These include: an open uterine pharynx, which makes it possible for microorganisms from the cervical canal and vagina to penetrate into the uterine cavity; blood clots and remnants of the fertilized egg located in the uterine cavity, which serve as a good breeding ground for microorganisms; exposed placental area, which is an entrance gate easily permeable to microorganisms; the patient's exsanguinated state, which reduces the body's resistance to infection. In each case, it is necessary to determine whether there is an infected (febrile) or uninfected (non-febrile) miscarriage. An infected miscarriage will be indicated by the presence of at least one of the following signs: high temperature, palpation or percussion pain in the abdomen, pain in the uterus not associated with its contractions, as well as pain in its appendages and fornix, admixture of pus in the blood flowing from the uterus, general intoxication phenomena. body ( rapid pulse, depressed or excited state of the patient, etc.), if they are not caused by other reasons, etc.
Placental polyp. The formation of such a polyp is usually observed in cases where a small part of the placental tissue is retained in the uterine cavity. Blood oozing from the uterine vessels due to insufficient contraction of the uterus gradually permeates the remaining placental tissue, then layers on it, organizes and takes on the appearance of a polyp. The lower pole of the polyp can reach the internal pharynx, which does not contract completely due to the presence of a placental polyp (like a foreign body) in the uterus. This process is accompanied by slight bleeding from the uterus, which can last up to several weeks or even months, periodically intensifying. The entire uterus contracts poorly. When the polyp reaches a size that causes uterine irritation, contractions begin and bleeding intensifies.
Malignant degeneration of the epithelium of chorionic villi retained in the uterus - chorionepithelioma.

Treatment of spontaneous miscarriage

The main issue that should be resolved at the first examination of a pregnant woman with signs of miscarriage is the possibility of maintaining the pregnancy. At proper care and treatment of a patient with a threatened miscarriage and, somewhat less frequently, with an incipient miscarriage, pregnancy can be saved; Once a miscarriage has developed, it is impossible to maintain the pregnancy. From this follows the doctor’s tactics when treating a patient with spontaneous miscarriage.

Having established the presence of a threatening and incipient miscarriage, the pregnant woman is immediately placed in a maternity hospital, where a medical and protective regime must be organized. Its necessary elements are bed rest, physical and mental rest, strengthening faith in maintaining pregnancy (psychotherapy, hypnosis), normal or, if necessary, extended sleep, etc.

Drug treatment is carried out taking into account the identified etiological factors that caused the miscarriage. But since this is difficult to establish in most cases, medication measures are aimed at increasing the viability of the fertilized egg and eliminating the increased excitability of the uterus. Prescribe sodium bromide (1-2% solution orally, 1 tablespoon 3 times a day), glucose (20 ml of a 40% solution intravenously once a day), the patient’s stay in the open air (in winter time frequent inhalation of oxygen); for infectious etiologies, injections of penicillin (50,000 units every 3 hours) and other drugs are used; if there are contractions - opium preparations (opium tincture 5-10 drops 2-3 times a day orally or opium extract 0.015 g in suppositories - 2-3 suppositories per day); Progesterone injections are effective (5-10 mg daily for 10 days). After this, take a break and, if necessary, repeat the course after 5-10 days. Continuous injections of large doses of progesterone over a long period of time sometimes have an adverse effect on the course of pregnancy, in particular on the viability of the fetus.

Vitamins A, B2, C, D, E are also useful. They are prescribed in their pure form or products containing these vitamins are recommended: fish oil, brewer’s yeast, etc.

The administration of ergot, ergotine, quinine, pituitrin and other similar hemostatic agents is strictly contraindicated and is a gross medical error, since they increase uterine contractions, and at the same time contribute to further detachment of the ovum.

If these measures do not give the desired effect, bleeding and contractions intensify and the miscarriage moves to the next stage - abortion is in progress, it is not possible to maintain the pregnancy. In such cases, in the first 3 months of pregnancy, if there are no contraindications (infected miscarriage), they resort to instrumental emptying of the uterine cavity - removal of the fertilized egg or its remains from the uterine cavity, followed by curettage.

After 3 months of pregnancy, the patient is prescribed conservative treatment: cold on the lower abdomen, quinine (0.15 g orally every 30-40 minutes, 4-6 times in total) and alternated with injections of pituitrin 0.25 ml every 30-45 minutes, 4-6 times in total. After the birth of the fetus, the placenta, if it is not born on its own, is removed with a finger inserted into the uterine cavity, and its remains are removed using curettes.

In the postoperative period, bed rest, application of cold to the suprapubic area, uterine contractions are prescribed: liquid ergot extract - 25 drops 2 times a day, ergotine 1 ml intramuscularly 2 times a day, etc. With a fever-free course of the postoperative period and good general condition and the patient’s well-being can be discharged 3-5 days after surgery. Before discharge, a thorough general and necessarily special gynecological (two-handed) examination must be performed.

Treatment of patients with infected, febrile miscarriage is carried out either strictly conservatively ( medications), either actively (surgery) or actively expectantly (elimination of infection followed by instrumental removal of the remaining fetal egg). When choosing a method of managing a patient, you should be guided by her general condition and the severity of the infectious process.

In this case, they distinguish:

uncomplicated infected miscarriage, when only the fetal egg or the fetal egg along with the uterus is infected, but the infection has not spread beyond the uterus;
complicated infected miscarriage, when the infection has spread beyond the uterus, but the process has not yet been generalized;
septic miscarriage, when the infection is generalized.

Complicated infected and septic miscarriage is usually observed with criminal intervention for the purpose of expulsion.

When treating patients with an infected uncomplicated miscarriage, some obstetricians prefer immediate instrumental evacuation of the uterine cavity. Another, large part of obstetricians adheres to the active expectant method: for 3-4 days the patient is prescribed bed rest and drugs that tonic the muscles of the uterus (cold on the lower abdomen, orally quinine, pituitrin, ergot preparations, etc.) and aimed at eliminating the infection ( sulfa drugs, antibiotics). After the signs of infection disappear, the uterine cavity is carefully emptied surgically.

Finally, a number of obstetricians prefer strictly conservative management of patients, without any intrauterine intervention. For this purpose, the above remedies are supplemented with injections of estrogen hormone, pituitrin or thymophysin, given orally castor oil etc., in order to stimulate uterine contractions and promote spontaneous expulsion of the remaining fertilized egg from the uterus. Instrumental emptying of the uterus is resorted to only in case of severe bleeding that threatens the patient’s life.

With any of the listed methods of managing patients with an infected uncomplicated miscarriage, measures are taken to increase the patient’s body’s defenses and tone. This is achieved by good care, a rational diet, easily digestible, high in calories, containing a sufficient amount of vitamins, and other measures.

Having tested for many years each of the listed methods of treating patients with uncomplicated infected miscarriage - incomplete and complete, we were convinced of the advantages of the active expectant method. We resort to urgent instrumental evacuation of the uterus only in exceptional cases, when severe bleeding from the uterus threatens the patient’s life and must be stopped immediately.

Treatment of patients with a complicated infected miscarriage, i.e. when the infection has spread beyond the uterus, should only be conservative, since surgical intervention in such cases usually leads to the occurrence of peritonitis or sepsis. Surgical intervention may be necessary only in those exceptional cases when sudden bleeding of the patient and incessant bleeding from the uterus create an immediate threat to the patient’s life.

When treating patients with missed miscarriage, competing methods are expectant-observational and active - one-stage instrumental evacuation of the uterine cavity.

Considering the danger that threatens a pregnant woman when a dead fertilized egg is retained in the uterus, caused by infection, intoxication, malignant degeneration of villi, etc., one should strive to empty the uterine cavity as soon as the diagnosis of the disease is definitely established. In case of a failed miscarriage, treatment begins with the prescription of drugs that stimulate uterine contractions and thereby provoke the onset of a miscarriage: injections of estrogen hormone 10,000 units are made daily for 2-3 days. After this, 60 g of castor oil is given orally, and after half an hour, hydrochloride quinine is given 6 times, 0.2 every 30 minutes; after taking the fourth quinine powder, make 4 injections of pituitrin, 0.25 ml every 15 minutes. Then a hot vaginal douche is prescribed, and the temperature of the liquid should not exceed 38° for the first time; in the future it is gradually increased within the limits of the patient’s endurance. Often, the fetus lingering in the uterus is expelled completely or partially without instrumental intervention, which is subsequently resorted to to remove the remnants of the fetal egg.

Even in cases where this method of treatment does not lead to the goal, i.e., the expulsion of the fertilized egg retained in the uterus, it is useful, as it increases the tone of the uterine muscles. This creates favorable conditions for subsequent surgical removal of the fertilized egg: with a well-contracted uterus, bleeding rarely occurs during and after the operation and there is no perforation of the uterus during the operation.

Treatment for placental polyp consists of instrumental removal (curettage).

Prevention of spontaneous miscarriage

Prevention of spontaneous miscarriage should precede or begin with the appearance of its first symptoms. IN antenatal clinic At the first visit to a pregnant woman, those women who have a history of spontaneous miscarriages or premature births, especially when there were several of them (“habitual miscarriage”, “habitual premature birth”), and women with various pathological conditions, which can cause spontaneous miscarriage. Preventive measures consist of prescribing anti-inflammatory treatment, correcting the abnormal position of the uterus, combating toxicosis of pregnancy, hypovitaminosis, eliminating and preventing mental and physical trauma; in appropriate cases - prohibition of sexual intercourse during pregnancy, transfer to a lighter type of work, etc.

Pregnant women with a “habitual miscarriage,” as well as those with threatened and incipient miscarriage, should be placed in a maternity hospital, in a pregnant ward. Of great importance is strengthening the patient’s faith in the possibility of maintaining pregnancy, as well as carrying out therapeutic measures: maintaining rest, extended sleep, prescribing progesterone, painkillers, drugs that reduce uterine excitability, multivitamins, especially vitamin E, etc.

If deep ruptures of the cervix occur during childbirth, its integrity must be restored immediately after childbirth. If this has not been done, then in order to prevent further spontaneous miscarriage, plastic surgery on the cervix should be performed before the next pregnancy to restore its integrity.

Pregnancy is a period of joyful anticipation, which, unfortunately, is often cut short by such a terrible phenomenon as a miscarriage. According to statistics, approximately 1/5 of all pregnancies end in miscarriage. Although we note that most of them happen in very early stages, that is, at a time when many still do not even know about their pregnancy.

Note! If a miscarriage occurs before two weeks, then no symptoms are often observed.

But sometimes tragedy happens to those who have already sincerely fallen in love with the baby, and the only ray of light for them is the realization that they can soon try to get pregnant again. But to ensure that a miscarriage never happens again, you need to know about the main factors that provoke it. So, today we will talk about early miscarriage (no later than the 12th week).

It is worth noting that in later stages this happens extremely rarely.

The most common symptoms are aching pain in the lower abdomen and bleeding (of any intensity). The pain (it has a wave-like character) is sometimes transmitted to the lower back. Discharge may also indicate a threat of miscarriage, and if it is brown or red, you should definitely go to the hospital.

Note! With severe bleeding, the chances of saving the child are much less than with minor bleeding. But if the discharge contains pieces of flesh, then a miscarriage has already occurred.

A less common symptom is uterine tone, accompanied by pain and discomfort. And if the tone is not accompanied by anything, then in such cases doctors advise reducing the number of stressful situations and reducing physical exercise. Sometimes, even in the presence of all the above signs, pregnancy proceeds normally, but, of course, exclusively under medical supervision.

If at least one of the symptoms is noticed, you should immediately go to the hospital.

Main reasons

Genetic abnormalities cause miscarriage in ¾ of cases. But there is no need to panic, because these disturbances are usually random and occur due to radiation, various kinds viral infections, etc. Such miscarriages can be considered one of the forms of natural selection, when nature gets rid of sick or non-viable offspring.
Hormonal imbalances can also cause interruption. This is often caused by progesterone deficiency, although with timely diagnosis and treatment the child can be saved (a course of hormonal medications is prescribed). Another disorder is an increased concentration of the male hormone, which prevents the production of estrogen and progesterone.
Sometimes a Rh conflict occurs, that is, when the mother and the fetus have different Rh factors. As a result, the mother’s body sees something foreign in the embryo and, therefore, rejects it.
Infectious diseases that are sexually transmitted also cause abortion. These include chlamydia, gonorrhea, syphilis, etc. In addition, there is also cytomegalovirus and herpes, which provoke miscarriage in about 1/5 of cases. It must be remembered that most infections occur without any symptoms, so it is recommended to be tested for STIs before conception and, if necessary, undergo treatment, otherwise the pathogenic virus will infect the fetus and cause a miscarriage.
Previous abortions. If a woman has already had an abortion, this can lead to miscarriage or, in the worst case, infertility.
Wrong lifestyle. Even at the planning stage, you should give up bad habits.
In the early stages, taking any medications is undesirable, otherwise defects in the development of the embryo may occur.
Severe stress, tension, grief - all this can have an impact Negative influence to develop a new life. In such cases, it is permissible to use some sedatives, but only as prescribed by a doctor.
Spontaneous miscarriages are rarely caused by too frequent hot baths. Of course, no one forbids pregnant women to swim, but they should not forget about safety. Thus, the water temperature should not be too high, and the duration of the procedure should not exceed 15 minutes.
Excessive exercise or accidental falls can lead to miscarriage, but only if one of the above reasons is present.

Note! Usually the fetus dies before hatching begins.

Classification of miscarriages

Note! The most effective way Diagnosis of miscarriage is an ultrasound examination performed by an experienced doctor.

If the embryo is completely released (in which case it looks like a round bubble gray), and the uterus has independently cleared itself of fetal fragments, then the woman does not need further therapy. Usually the cleansing lasts for 2-3 weeks after the miscarriage and is manifested by bloody discharge (sometimes with white particles). But if the fetus comes out in parts or a frozen pregnancy occurs and it continues to be in the uterus, then gynecological cleaning of the uterine cavity will be required (the procedure is also called curettage or curettage).

Note! Many people consider cleaning to be an excessive precaution. If a miscarriage occurs at home, then after the embryo is rejected, women often do not resort to medical care, believing that they no longer need her. But in reality this is not the case.

Not in all cases the fetus completely leaves the body. If cleaning is not done, the residues will begin to decompose, which will lead to the spread of pathogenic microorganisms and, as a result, inflammation. Therefore, if the termination of pregnancy occurred outside the hospital, you must immediately consult a doctor, because only a qualified specialist will be able to assess the condition of the body and determine whether cleaning is required. And if the doctor strongly recommends curettage, then there is no way to refuse the operation! Otherwise, the consequences will be the most dire.

How is cleaning carried out? Under normal conditions, this should be done two to three days before the start of menstruation (this will allow the uterus to recover faster), although after a miscarriage this, of course, is not always possible. Cleaning is carried out on a gynecological chair. First, an injection is given of a drug that puts the woman to sleep, then a special dilator is inserted into the vagina, which allows visual observation of the cervix. Next, a probe is inserted into the uterus to perform hysteroscopy - examination of the uterine cavity using a portable video camera. Such an examination allows for maximum safety of the operation, since the surgeon can see how the cleaning is carried out.

For the curettage itself, a curette is used - a surgical instrument that resembles a spoon. The doctor carefully scrapes off the surface layer of the walls of the uterus, and the extracted material is subsequently used in histological examination. Roughly speaking, the operation lasts about half an hour.

Curettage, like any other surgical operation, can lead to complications. The most common - uterine bleeding - occurs in women with hemophilia. In order to prevent bleeding, oxytocin injections are prescribed. If the discharge is too strong, the woman must immediately inform the attending physician.

Another possible consequence is the accumulation of blood clots in the uterine cavity (hematometra), which can cause inflammatory processes. This is a consequence of cervical spasms at the end of the procedure. To prevent hematomas, before the operation you need to take antispasmodics (for example, no-shpu), which help the uterus to relax.

Finally, after cleaning, the lining of the uterus may become inflamed, and therefore antibiotics are prescribed at the end of the procedure. It is extremely important that all doctor's recommendations are followed. The main symptoms of inflammation are abdominal pain and high fever.

Note! As you can see, it is very important to know about possible consequences curettage and notify the doctor in time if there is weakness, abdominal pain, fever, etc.

Serious problems arise quite rarely. Complications can occur if a miscarriage is provoked by folk remedies/medicines or, for example, if after this there are particles of the embryo left in the uterine cavity (although the latter usually happens at a later stage). And to prevent this, an ultrasound should be performed after a miscarriage.

In addition, you need to go to the hospital even when the next menstruation goes “wrong” (too much discharge, pain).

What conclusions can be drawn? Curettage after a miscarriage is not always required (the exception is a frozen pregnancy, in which it is required), but in any case you need to undergo an appropriate examination.

	Research
In time of miscarriage (if detected frozen pregnancy)	1) Ultrasound of the pelvis with a transvaginal sensor (for congenital anomalies of the genitals, myomatous nodes). 2) During curettage for frozen pregnancy and incomplete miscarriage, histological analysis of the contents of the uterine cavity. 3) Cytogenetic analysis of the fetus for genetic abnormalities.
After a miscarriage /ZB/ (immediately)	1) Testing for latent infections (TORCH complex), namely culture for ureaplasma, mycoplasma; antibodies to chlamydia, herpes virus, human papilloma virus, cytomegalovirus. 2) Genetic research For woman: ---Karyotype research and determination of the frequency of spontaneous chromosomal aberrations (and many other studies) For a man: ---Karyotype research and determination of the frequency of spontaneous chromosomal aberrations ---Study of microdeletions of the AZF locus on the Y chromosome ---Study of the most common mutations in the cystic fibrosis gene (and many other studies) 3) Spermogram
After a miscarriage /ZB/ (after 1-3 months)	1) Testing for latent infections (TORCH complex), namely culture for ureaplasma, mycoplasma; antibodies to chlamydia, herpes virus, human papilloma virus, cytomegalovirus 2) Vaginal smear for gonococcus and flora (vaginal cleanliness). Bacterial culture for group B streptococci 3) Determination of hormone levels /ethradiol, progesterone, FSH, LH, 17-OP, testosterone, dehydroepiandrosterone (DHEA), 17-ketosteroids, prolactin, thyroid hormones/ -at the beginning of the cycle 5-6 days -in the middle of the cycle -at the end of the cycle 21-25 days You can find out more about when to take which hormones HERE 4) Diagnostic tests antiphospholipid syndrome(AFS) ---Venous blood testing for lupus anticoagulant (LA) ---Blood test for antiphospholipid antibodies 5) Determination of the titer of autoantibodies to cardiolipin, DNA, thyroid gland, nerve growth factor 6) Immunogram 7) Coagulogram and hemostasiogram (control of blood clotting) 8) Typing for second class histocompatibility antigens (HLA) for both spouses 9) Determination of blood homocysteine level (indicates an increase in the frequency of genetic failures)
Before planned pregnancy (prevention repeated miscarriages and ST)	1) Thorough refurbishment infections; translation of chronic infections into remission phase. 2) Exclusion of men's sperm /fractionation of sperm into X and Y fractions followed by insemination with X fraction, which excludes the birth of a boy/, if a miscarriage (MS) is associated with fetal pathology linked to X chromosome /boys in a family in such a situation either die in utero or are born sick/. 3) Progesterone with its insufficient content in blood plasma. 4) Rh0-(aHTH-D)-Ig (anti-Rhesus immunoglobulin) immediately after curettage or miscarriage if the woman’s blood is Rh negative. 5) Drugs that reduce hypercoagulation of blood. Treatment antiphospholipid syndrome. 6) Treatment of isthmic cervical insufficiency by suturing the cervix with a circular suture at 14-18 weeks. Surgical treatment of anomalies and fibroids way.

Video – Miscarriage, 12 weeks

In this article:

Pregnancy is a wonderful period in a woman’s life. But it is not always destined to end with the birth of a child. Sometimes the body itself decides to expel the emerging life from the female womb. In most cases, miscarriage occurs at the very beginning of pregnancy - in the first trimester. But why and how does a miscarriage happen? There are many reasons - from bad habits of the mother to chromosomal pathologies in the fetus.

According to statistics, every fifth pregnancy ends spontaneous interruption. To avoid this, a woman should know the symptoms and signs of miscarriage, as well as what to do if she finds herself in a similar situation.

How does pathology develop?

How does a miscarriage occur is a question that worries every woman who is faced with the threat of miscarriage. The body rejects the fetus as a result of the influence of negative factors. It is excreted from the uterus either completely, which is typical in the first weeks of pregnancy, or partially. Often, women completely overlooked the symptoms of miscarriage, not noticing their condition.

Depending on the cause, for example, the presence of an acute infectious-inflammatory process in the body (flu, rubella, etc.), the immune system begins to show aggression towards developing pregnancy, which may result in a miscarriage. The formation of a connection between the mother and the unborn child is disrupted, it ceases to function, and the fetus is deprived of support and nutrition.

As a result, the fertilized egg is rejected from the lining of the uterus and comes out of it along with bleeding. Depending on the mechanism of development of a miscarriage, experts determine its causes.

Types of miscarriages

Let's look at the main ones:

Incomplete miscarriage , also called inevitable. In this case, the woman notes pain in the sacrum and lower abdomen, which is accompanied by bleeding and dilation of the cervix. If we are talking about an inevitable miscarriage, then in this case the membranes have ruptured. For an incomplete miscarriage, the symptoms of pain and bleeding are constant.
Complete miscarriage means that the fertilized egg or fetus is completely expelled from the uterine cavity. In such a situation, bleeding may stop on its own, like other symptoms.
Failed miscarriage . The embryo or fetus dies, but remains in the uterine cavity. Usually this condition is called frozen pregnancy, and it is discovered accidentally during a routine ultrasound examination or examination by a gynecologist.
Anembryony . Despite the fusion of the sex cells of a man and a woman, the fetus does not begin its development in the uterus. In this condition, signs of pregnancy may be observed and even the gestational sac and corpus luteum can be diagnosed using ultrasound, but the child is absent from it; curettage is necessary, as after a miscarriage.
Repeated miscarriage is diagnosed in a woman if she has had at least three spontaneous abortions one after another. This disorder occurs rarely, in no more than 1% of families. Usually it is included in the group of consequences after a miscarriage.
Chorioadenoma . This disorder is also preceded by fertilization, but during it a breakdown of chromosomal information occurs, and instead of an embryo, tissues develop in the uterus, which grow and increase in volume over time. The pathology may end spontaneously as a miscarriage, or it may require cleaning of the uterine cavity.

Causes

About 20% of pregnancies end in miscarriage. Most often, this happens at a time when the woman herself does not yet know about her situation. But this can also happen to those who were planning a pregnancy and managed to rejoice at its onset. Why is this happening?

The reasons for miscarriage in early pregnancy (mainly before the 12th week, since the first trimester is the decisive point in this matter) will be as follows:

Chromosomal problems in the fetus . Experts believe that in approximately 73% of cases, pregnancy is terminated solely due to genetic disorders. At the same time, chromosomal mutations are not always inherited at the genetic level; their occurrence can be influenced by negative factors environment, such as radiation, viruses and much more. It is believed that in this case the pregnancy is terminated according to the type of natural selection, that is, initially such an embryo is not viable. Therefore, we are talking about a condition such as micro-miscarriage, which occurs much earlier than at 12 weeks of pregnancy. Many women do not even know that they were pregnant, mistaking unexpectedly heavy periods for menstrual irregularities.
Hormonal disorders . Fluctuations in hormonal levels in the early stages of pregnancy often lead to its termination. Usually the culprit is progesterone, a hormone aimed at supporting pregnancy. If the problem is detected in time, the fetus can be saved. Spontaneous abortion can also be provoked by an excess of male hormones - androgens, which inhibit the synthesis of progesterone and estrogen. This usually leads to multiple, repeating miscarriages.
Immunological problems . Most often they occur in the blood of the mother and fetus. In this case, the child inherits the father’s Rh factor with a “+” sign, while the mother’s Rh factor is “-”. The woman’s immune system perceives the Rh-positive embryo as foreign bodies, beginning an active fight against them.
Infections . The causative agents of cytomegalovirus, herpes, chlamydia and other pathogenic bacteria and viruses infect the membranes and the fetus itself in the uterine cavity, causing miscarriage. To avoid this, you need to prepare for pregnancy and promptly treat any infectious and inflammatory processes in the body. Common infectious diseases are also fraught with a threat to the development of the fetus, these include influenza, rubella, etc. All these diseases occur with intoxication damage to the woman’s body and a strong increase in body temperature, which can cause spontaneous abortion.
Past abortions . This is not just a medical procedure aimed at removing the fetus and membranes from the uterus. This is also a serious stress for a woman’s body, which can lead to complications. For example, dysfunctional ovarian dysfunction, changes in adrenal function, inflammatory phenomena in the reproductive system. In the future, all this leads to infertility and problems with carrying subsequent pregnancies.
Taking medications and medicinal plants . Almost all pills and other medications are dangerous in the first trimester, as the fetus is actively developing. Most drugs provoke malformations of the fetus or disrupt the formation of the placenta, all of which can lead to spontaneous abortion. Tablets that can cause miscarriage, for example, at 12 weeks - hormonal drugs, narcotic analgesics, etc. Not only medicine can cause a miscarriage, but also some medicinal herbs that are quite harmless at first glance - mint, parsley, nettle, tansy and much more.
Stress . Any mental shock is dangerous for pregnancy. If you cannot avoid stress, it is important to seek help from a specialist to prevent the possibility of miscarriage.
Bad habits . Alcohol abuse, smoking, and drug addiction can cause early pregnancy termination. If a woman wants to give birth to a healthy and strong child, she must give up bad habits at the stage of planning conception and ask her partner about it.
Excessive exercise . Violent sexual intercourse, falling, lifting heavy objects sometimes become a trigger for miscarriage. Pregnancy is a time when you need to take the utmost care of your own health.

Symptoms

What symptoms occur during a miscarriage? The first sign is abdominal pain, which is soon followed by spotting. Painful sensations are not always localized in the lower abdomen; many women note that it radiates most intensely to the sacral area.

Discharge from the genital tract can be different, varying in color scheme and intensity. But their detection, in any case, requires consultation with a doctor. Light spotting may indicate a threat of miscarriage and the possibility of saving the pregnancy. Profuse uterine bleeding, especially with tissue particles and clots, speaks for itself - the fetus has died, and cleaning is needed after a miscarriage.

These signs are typical for any stage of pregnancy, so it doesn’t matter at what week they appeared. It is more important to know what symptoms are characteristic of the loss of a child, and what measures need to be taken in this situation.

There are 4 stages of miscarriage, let's look at them briefly:

Threatened miscarriage . A woman complains of pain in the lower back and lower abdomen. There may be slight bleeding from the vagina. In this case, the pregnancy can still be saved.
Incipient miscarriage . The pain increases and becomes like contractions. The discharge intensifies. Weakness and dizziness appear. The chances of saving the fetus are minimal.
Miscarriage in progress . The pain intensifies and the bleeding is significant. Fetal death at this stage is obvious. The fetus may leave the uterus completely with bloody discharge, or it may require cleaning after a miscarriage.
Completed miscarriage . The fetus and its membranes are expelled, and the uterus contracts after a miscarriage. The bleeding stops. It is necessary to conduct an ultrasound to determine the condition of the uterus and the presence of remnants of the fertilized egg.

When does a miscarriage occur?

Typically, pregnancy is terminated in the first trimester due to the fact that the fetus is not viable. More often this happens during the expected onset of menstruation, and then the woman may not even know that she was pregnant. If this happens later, the fertilized egg rarely comes out completely, it is necessary vacuum cleaning uterus after miscarriage.

It is much less common for a pregnancy to be terminated in the second trimester. This condition is called late miscarriage.

Diagnostics

Diagnosing a miscarriage is not difficult for a specialist. The doctor examines the patient on a gynecological chair, determining whether the size of the uterus corresponds to the period of pregnancy, the presence of tone, the condition of the cervix and the nature of the discharge. For a final assessment of the woman’s condition, an ultrasound is prescribed. With its help, the specialist sees the localization of the fertilized egg, the presence of detachment or its complete absence.

Based on the diagnostic examination, subsequent treatment tactics are decided. If the pregnancy can be saved, the woman is sent to the hospital. If we are talking about fetal death, the patient needs post-miscarriage cleaning and treatment.

Is it possible to independently determine that there was a miscarriage?

Determine for yourself that a miscarriage is occurring , it is difficult if the pregnancy is short and the woman knew nothing about it; it’s another matter if spontaneous abortion occurred later, for example, at 12 weeks. In this case, the woman simply cannot miss the symptoms associated with the death and expulsion of the fetus. This situation requires mandatory consultation with a doctor, as cleaning will be required after a miscarriage.

Therapy

Treatment measures depend entirely on the results of ultrasound and the clinical manifestations of the pathology. When a miscarriage threatens and has begun, the woman is prescribed treatment aimed at maintaining the pregnancy.

If the fertilized egg detaches and bleeding begins, then the pregnancy has already been terminated, and cleaning or curettage is necessary after a miscarriage.

For a miscarriage at a later stage, for example, at 28 weeks, drugs are needed to contract the uterus and artificially induce contractions (Oxytocin). After expulsion of the fetus, so that the uterus contracts better and bleeding decreases, an ice pack is placed on the woman’s stomach.

Treatment after a miscarriage does not end there. A woman must undergo an examination to determine the cause of spontaneous abortion: pelvic ultrasound, diagnosis of infections, hormones, cytogenetic examination of the ovum, etc. For a period of up to 6 months, the woman is prescribed oral contraceptives to restore the reproductive system and prevent unwanted pregnancy, since sex soon after a miscarriage can lead to a repeat situation. The body needs to be given time to get stronger.

Complications after miscarriage

Complications after a miscarriage are often associated with the fact that the situation may recur. Therefore, it is important to undergo rehabilitation and find out why the failure occurred and when you can get pregnant again.

If treatment after a miscarriage is ineffective, a woman may experience the following complications:

development of inflammation in the organs of the reproductive system with subsequent chronicization of the process into endometritis, salpingo-oophoritis, adhesions, etc.;
hormonal disorders;
problems with conception and secondary infertility.

In addition, frequent consequences after a miscarriage - extreme stress, depression, psychological experiences of a failed mother.

Prevention

It is impossible to prevent a miscarriage at 12 or any other week of pregnancy due to genetic factors - you cannot influence genetics. But every woman who wants to have children can adjust her lifestyle and take care of her health.

So, how to minimize the likelihood of miscarriage and complications after it:

plan your pregnancy in advance, while adjusting your diet, giving up bad habits, undergoing examinations and treatment;
after pregnancy occurs, direct all efforts to preserve it, for example, timely diagnosis if there is a threat of miscarriage;
avoid stress, physical and psycho-emotional fatigue, visit the gynecologist on time.

Since complications after a miscarriage can be serious, it is recommended to plan a new pregnancy six months after the miscarriage. At this time, doctors advise using hormonal contraceptives, which allow the body to recover faster.

According to statistics, sex after a miscarriage already on the twelfth day of the cycle can lead to a new pregnancy. Some women take advantage of this, wanting to quickly forget a failed pregnancy. Thus, they expose themselves to a new blow, because the weakened body can again reject the fetus. There is no need to rush, only time and effort will help set up the reproductive system to expect a child.

Useful video about early miscarriage

anonymously

Hello, I'm 23 years old. She was treated for ureaplasma-mycoplasma. 06/13-22/06 I took Unidox Solutab, 06/23-02/07 - ornidolzole and ofloxin, I also took baths and droppers (I don’t know with what). There was a delay, the doctor said that the cycle could have gone wrong due to the treatment. My inner instinct told me to buy a pregnancy test, on July 12 the test showed 2 stripes, I went to the doctor, they did hCG, the analysis showed variability of 6 weeks. I was sent for an ultrasound, it showed no abnormalities. But the doctor insisted on an abortion, the child was the first, I was against abortion and went to a geneticist. The geneticist said to continue the pregnancy. I found another gynecologist and registered. All tests were good, I wasn’t even bothered by nausea. But on July 5 I was on the beach and got badly burned, on July 6 heavy bleeding began, I was taken to the hospital, they did an ultrasound, it showed a detachment. They began to maintain the pregnancy. On August 15, I did a screening (12 weeks), everything developed according to the timing, donated blood for chromosomal abnormalities: Estradiol-11389 pmol/l, hCG-96775 mU/ml, PAPP-A 0.78 mU/ml - normal; ureaplasma-mycoplasma not detected, TSH-good. But on August 19, heavy bleeding began again (all this time I was in the hospital), I was urgently given a cleanse (12 weeks). Pathohistological conclusion: in tissue fragments with noncreticized embryonic chorionic villi (areas of placental infarction) in many chorionic villi there is sclerosis of the stroma. Conclusion: morphological picture of impaired intrauterine pregnancy in the first trimester (incomplete abortion). Langidase and Acipol suppositories were prescribed. OK are not prescribed for me until my period arrives (it’s been a month without it). They recommended taking tests: hemogram, progesterone in the 2nd phase of the cycle, prolactin. The questions are as follows: 1. Why did this happen, could ureaplasma-mycoplasma, treatment for STIs, my overheating in the sun have affected the miscarriage, 2. Are there really no abnormalities visible at screening, 3. Are these recommendations sufficient, 4. What are the chances? get pregnant and carry a child? With great gratitude in advance, Irina.

Hello! First of all, please accept my regrets about what happened. I very much doubt that ureaplasma and mycoplasma could affect the development. As for the sun, this is possible. Overheating of the body could impair blood circulation and reduce the nutrition of the fetus and the flow of blood to it. It is also possible that the development of the fetus was affected by the toxic effects of the antibiotics taken. As for screening, it determines genetic mutations and the risk of genetic disorders in a child. Pregnancy is not always disrupted due to problems with genetics; there are many factors. As for your chances of getting pregnant, I hope your chances are quite good. You just have to find out the reason for the termination of pregnancy and prepare for the next one and everything will be fine with you