Her gynaecologist said she was unable to pinpoint any particular reason and that Swati's was an unexplained cause. Swati isn't alone. Thousands of women go through miscarriages. However, it just doesn't end there. After a miscarriage, a woman can suffer many health complications too.
Why does it happen? "There are several reasons for a miscarriage. It is believed that 75% of all pregnancies result in miscarriage, though most go unrecognised since they happen so early that it feels like a normal period, though slightly delayed. About 15-20% of women will experience a miscarriage, which is clinically recognised. It can happen due to genetic, infective, immunological, endocrine or environmental causes or structural defects," explains gynaecologist Dr Suman Bijlani.
Reasons
Genetic: Genetic causes account for about 50% of early miscarriages. The foetus is genetically or chromosomally defective and unable to survive. This occurs as a random event and a majority of such women will have a normal pregnancy the next time.
Immunological causes: Some women carry antibodies in their blood, which may attack their own cells. Some of these antibodies may attack the placenta or promote formation of clots in the blood supply to the foetus, leading to slower foetal growth and eventual demise.
Anatomic causes: Some women may have a septum (wall) within the uterus, a 'double' or 'half' uterine cavity, or a similar defect. Miscarriage may result from that. Huge fibroids, especially those which encroach upon the uterine cavity, may also interfere with a successful pregnancy outcome.
Infectious causes: Infections can interfere with early pregnancy development and many types of bacteria, viruses or parasites have been implicated in causing pregnancy loss, though that is not common.
Endocrine causes: Early pregnancy is an interplay of multiple maternal hormones, which work in balance to provide an ideal environment to the developing embryo. Hence, some women with menstrual disturbances and PCOS may have a higher risk of early pregnancy loss.
Environmental causes: Harmful substances such as drugs, alcohol, smoking or excessive caffeine intake and stress may harm the foetus and cause miscarriage.
Health risks that arise later The first symptom of a miscarriage is bleeding, which may range from spotting to heavy bleeding (haemorrhage). "A miscarriage may result in haemorrhage, which may rarely be life-threatening if good medical help is at hand. In the long run, a woman may become anaemic due to blood loss, unless she is given adequate iron supplements. Occasionally, infection of the uterus and pelvic organs can result from an unattended miscarriage. Hence, a woman should be under the supervision of a gynaecologist. Some women experience extreme pain and a sense of loss or failure. Many blame themselves or feel responsible. This may lead to anxiety and depression," says Dr Bijlani.
Treatment
Gynaecologist Dr Mugdha Raut says, "If possible, a woman must take a few days off work and get adequate rest. Bleeding will taper off after a week — it will get lighter and stop. If it persists or is heavier than a normal period, visit your doctor. Sexual intercourse should be avoided as it can increase the chance of infection. Even though the cervix will be closed again, sperm can travel up and introduce infection into the uterus, which is still healing. Contraception is highly recommended to prevent getting pregnant immediately."
Adds Dr Bijlani, "Many women abort naturally without any medical aid while some need to take pills to complete the process and others may opt for D&C (surgical evacuation of the uterus). An iron and vitamin-rich diet and supplements take care of nutritional deficit. Infection may occur at any point since the mouth of the uterus is open — from a few hours to days — during a miscarriage and that makes it open to attack by invading bacteria. Antibiotic cover with good hygienic practices (avoidance of douching, intercourse and tampons, frequent change of sanitary napkins) and adequate rest prevent infection in most cases. The symptoms of infection are pelvic pain, fever, foul-smelling discharge, burning and/or pain while passing urine, which may be accompanied by vomiting and bodyache or lethargy. She may need a counsellor if she is unable to cope."
Precautions to take
Experts say it takes about six weeks for a woman's body to come back to normal after a miscarriage. "A couple can plan their next pregnancy from the third month after the miscarriage, but before doing that, they must be thoroughly investigated to rule out any possible causes of repeated miscarriages. In case of repeated miscarriages, certain treatments like Active Immunotherapy can be taken before planning the next pregnancy," says Dr Raut.
Explains Dr Bijlani, "One should attempt to identify the cause of the present miscarriage so as to avoid a future mishap. If a cause is found, it should be treated before attempting another pregnancy. After a first miscarriage, basic testing is done to rule out obvious infection or endocrine causes. However, after a second miscarriage, more detailed testing needs to be done. A late miscarriage warrants immunological testing to look for harmful antibodies in the blood. After a third loss, detailed counselling, including genetic counselling and a search for any possible cause should be performed.
A woman should also undergo pre-pregnancy counselling and start on folic acid supplements. Her basic nutritional and mental health should be corrected. In the next pregnancy, she needs to be under close observation with hormonal supplements to support the pregnancy and adequate mental and physical rest. Options such as immuno-therapy or pre-implantation genetic diagnosis with embryo selection may be explored in select patients under the guidance of specialists."
http://timesofindia.indiatimes.com/followceleb.cms?alias=treatment,Miscarriages,Causes
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