Signs of miscarriage in early pregnancy

Miscarriage (spontaneous abortion) is the spontaneous termination of pregnancy before 22 weeks. Accordingly, they are divided into early and late. According to the dynamics of what is happening, they distinguish:

Threatened abortion
Abortion in progress
Complete (or incomplete) abortion
Non-developing pregnancy

The division into these types is very arbitrary; they can flow into each other. For example, a threatened abortion turns into a complete one, and a frozen pregnancy still ends with the release of the fertilized egg.

How often is pregnancy terminated?

It is believed that at least 20% of all conceptions end in spontaneous abortion. It is possible that this figure is underestimated. After all, many women do not even suspect a miscarriage when this happens at 4 weeks, mistaking it for a late period. The percentage of such events increases with a woman's age.

Some statistics:

80% of all sudden abortions are losses in the 1st trimester
90% of losses in the first trimester and about 30% in the second are the result of random chromosomal abnormalities that most likely will not recur.
more than half of all women at risk of miscarriage successfully carry their pregnancies to 40 weeks
At age 40, a woman has a 50% risk of spontaneous abortion.

Cleaning after spontaneous miscarriage

If the woman’s condition is not at risk and she feels relatively well, the doctor gives the body the opportunity to independently evacuate all the components of the interrupted pregnancy.
But if this does not happen and the membranes of the fertilized egg or embryo remain in the uterine cavity, the doctor is obliged to prescribe cleaning of the uterine cavity after a miscarriage
Drug therapy is prescribed using curettage and vacuum removal of the contents of the uterus. Then treatment includes the elimination of inflammatory processes, determining the woman’s ovulation cycle and the necessary hormone therapy

Possible causes of abortion

Violation of embryo development (chromosomal and genetic damage, deformities)
Read also: Osteoma of the frontal bone: symptoms, diagnosis, treatment, rehabilitation
Immune failures
Anomalies of the uterus and its tumors
Cervical insufficiency
Hormonal reasons
Maternal infections
Systemic diseases of the mother
Poisoning, injuries
Other

Unfortunately, it is not always possible to establish the exact cause of such an event. This is where most of the worries arise for parents planning a new pregnancy after failure.

Embryonic development disorders

Almost 90% of pregnancies that were terminated before 8 weeks were associated with the mutation. Chromosomal abnormalities are, as it were, “weeded out” by nature in order to prevent the birth of non-viable children. Therefore, abroad they do not even try to treat threatened abortion at such an early stage.

Immune failures

In recent years, the phrase “antiphospholipid syndrome” has brought fear to all women who have at least once lost their pregnancy. It is this diagnosis that people try in vain to find in cases of spontaneous abortion before 12 weeks, taking unnecessary tests.

APS is a syndrome in which the body produces antibodies to its own proteins. As a result, thrombosis and thromboembolism occur in the absence of visible causes of miscarriage in the early stages of 10 weeks. In addition, there is an increased risk of fetal growth restriction and severe preeclampsia. True APS requires treatment throughout all subsequent pregnancies.

To diagnose the syndrome, in addition to the detection of antiphospholipid antibodies, certain symptoms are needed (unexplained miscarriage, thrombosis). Therefore, there is no point in being tested for APS during the first pregnancy or after a single loss in the early stages.

Uterine abnormalities

Congenital defects of the genital organs, for example, an incomplete uterine septum, increases the risk of spontaneous abortion by almost 2 times. Surprisingly, more serious disorders (bicornuate and bicervical uterus) are less likely to lead to termination of pregnancy.

Cervical (isthmic-cervical) insufficiency

In the second trimester, the role of cervical insufficiency increases in the structure of spontaneous miscarriages. In this case, the cervix softens and shortens prematurely, which leads to the rupture of amniotic fluid and the onset of labor. The cause of this condition may be trauma during gynecological manipulations, anatomical features, or frequent induced abortions. Most often, this process occurs asymptomatically, only occasionally discharge or pain may appear. Therefore, absolutely all women at 19-21 weeks need to undergo cervicometry - measuring the length of the cervix using an intravaginal ultrasound sensor.

Hormonal reasons

There is some evidence that low progesterone levels may be a cause of miscarriage. Luteal phase deficiency is a manifestation of progesterone deficiency. In reality, this condition occurs less frequently than the diagnosis sounds. Sometimes NLF is combined with changes in the ovaries, pituitary gland and other endocrine organs. Very often, low progesterone is successfully combined with a normal pregnancy.

Infections

High temperature and severe intoxication of the maternal body can stimulate uterine contractions and cause termination of pregnancy. Therefore, any infection is potentially dangerous. However, some diseases especially often threaten miscarriage. These are rubella, toxoplasmosis, listeriosis, brucellosis (see causes of intrauterine infection in newborns). Other infections are not associated with increased abortion rates. It is important to note that if abortions are repeated, the role of infection is sharply reduced.

Systemic diseases of the mother

There are diseases that not only complicate the course of pregnancy, but can increase the frequency of spontaneous abortions. These include:

Diabetes mellitus (with poor glucose control)
Thyroid diseases
Blood clotting disorder
Autoimmune diseases

Poisoning and injury

A clear connection between toxic substances and abortion has not been established. It is believed that working with organic solvents and narcotic gases can cause abortion. Smoking, large doses of alcohol and drugs have the same effect.

Accidents that damage the abdomen, as well as surgery on the ovaries and intestines, can be dangerous during pregnancy. But the embryo in the uterus has good protection, so most of these interventions end successfully.

Signs in the early stages

The following symptoms indicate a threat of miscarriage:

pain in the lower abdomen;
vaginal bleeding (scarlet or brown discharge, spotting or heavy);
convulsions.

In the early stages, it is not always known about pregnancy, so the symptoms of a miscarriage can easily be mistaken for the beginning of a new menstruation. It is worth noting that there are secondary signs of spontaneous abortion that distinguish it from menstrual periods, in particular:

vomiting and frequent loose stools;
pain in the form of spasms;
weight loss;
bleeding alternating with mucus;
aching pain in the lumbar region.

If you know you are pregnant and even minor bleeding begins, you should urgently seek medical help.

There is such a thing as a frozen pregnancy, or a failed miscarriage. This is the cessation of fetal development and its death for up to 28 weeks. Signs of this condition:

absence of toxicosis;
decrease in basal temperature;
weakness.

In addition, the symptoms of a miscarriage may vary depending on the stage of its progress.

Stages of early miscarriage

Symptoms depending on the stage of miscarriage (table)

Stage	Clinical picture
State of threatened miscarriage	This stage is accompanied by aching pain in the lower abdomen and lumbar region. In some cases, spotting and spotting appears.
Beginning of spontaneous abortion	During the second stage of miscarriage, the pain becomes cramping, there is general weakness and dizziness. With every movement, the bleeding increases, and there are clots in the discharge.
Miscarriage in progress (or in progress)	Symptoms of miscarriage are a sharp pain that spreads throughout the abdomen and lower back, significant blood loss and the release of the fertilized egg from the uterus. In some cases, a woman may see a small gray bubble in the discharge; most often this happens if the fetus died a few days before the development of the main symptoms.
Completed miscarriage (completed abortion)	The bleeding gradually becomes less intense, but spotting may continue for several days.

Timely diagnosis of the threat of miscarriage and the onset of spontaneous abortion (first and second stages) with adequate treatment leave a chance of saving the child. The next stages are irreversible and lead to termination of pregnancy.

Stages of spontaneous miscarriage (gallery)

Bleeding after spontaneous abortion can last from 4 to 10 days

Some time later, the fertilized egg and placenta are expelled from the uterus

Clinical picture of a miscarriage: bleeding, accompanied by spasm and pain in the lower abdomen, pain in the lumbar region

Myths about the causes of early pregnancy loss

Before the 13th week, termination of pregnancy is almost never associated with the following factors:

Flying an airplane
Mild blunt trauma to the abdomen
Sports activities (adequate)
One previous miscarriage before 12 weeks
Sexual activity
Stress

Read our article about what you can and cannot do during pregnancy.

Diagnostics

What to do if a woman, while at home, suspects that she has started or has already had a miscarriage? The most important thing is not to panic, but to immediately seek medical help.

It is quite difficult to assess a woman’s health at home, so it will be better if she undergoes an examination in a medical facility. The main diagnostic methods for a threatened miscarriage are ultrasound and a blood test for hCG.

Each woman reacts differently to the manifestation of certain symptoms, so based only on visible signs it is impossible to accurately understand whether she has started a miscarriage and, if so, at what stage it is.

Ultrasound allows you to assess the condition of not only the female body, but also the fetus. Based on its results, conclusions can be drawn about the possibility of maintaining the pregnancy.

Another method for diagnosing early pregnancy is to measure the level of hCG in the blood. Human chorionic gonadotropin is a hormone produced in the body of a pregnant woman. In the absence of pregnancy, the level of this hormone ranges from 0 to 5 mIU/ml. During a normal pregnancy, it gradually increases depending on the duration of pregnancy.

How to recognize an abortion?

There are several main symptoms of miscarriage:

Bleeding of varying intensity

The discharge of blood is explained by partial or complete detachment of the chorion (future placenta). If this detachment occurs in the upper parts of the uterus, then the blood may not come out, but form a retrochorial hematoma. With a threatened abortion, there may be slight bleeding that goes away on its own and without consequences, but with an abortion in progress, the bleeding can be quite profuse.

Pain

Pain sensations are usually localized above the pubis, can radiate to the groin, lower back and have varying intensity. They can be constant or cramping in nature. It is important that most pregnant women may experience various unpleasant and unusual sensations in the abdominal area throughout the entire 9 months, which do not threaten the baby in any way. All doubts about the nature of the pain can be dispelled by the antenatal clinic doctor.

Exit of parts of the embryo from the genital tract

Most abortions end spontaneously after all parts of the embryo are released. This sign is an undoubted confirmation of the diagnosis, but sometimes a woman confuses blood clots with an embryo.

Rush of amniotic fluid

In the second trimester, the rupture of amniotic fluid always indicates an imminent abortion. Rupture of the membranes is followed by contractions and delivery of the fetus. Sometimes during pregnancy you may experience urinary incontinence or excessive vaginal discharge. If you have doubts about the nature of the liquid, it is better to immediately consult a doctor for special tests. Amniotic fluid test pads available in pharmacies may give a false positive result.

Prevention of miscarriage

The best prevention of miscarriage is a complete examination of both partners at the stage of pregnancy planning and the elimination of possible pathogenic factors. So, before the immediate onset of pregnancy, it is advisable to undergo tests to determine the chromosome and gene set, to exclude autoimmune pathologies, for sexually transmitted infections; it is also necessary to carefully examine the thyroid gland, reproductive organs to identify various defects in their work, etc.

Already pregnant, the expectant mother must also adhere to simple rules:

eliminate bad habits;
avoid excessive physical activity;
refrain from frequent drinking of strong tea and coffee;
visit your doctor regularly and follow all his recommendations;
maintain emotional calm;
Monitor closely for new symptoms and sensations.

What can spontaneous abortion be confused with?

Many symptoms of early miscarriage can also occur with other conditions and diseases. Therefore, it is important to consult a doctor to rule them out. Similar symptoms occur with:

ectopic pregnancy
cervical cancer
torsion of an ovarian cyst (without bleeding)
cervical trauma

Features in the early stages

In most cases, complete or incomplete miscarriages occur in the early stages of pregnancy.

With a complete miscarriage, the uterus rejects the fetus completely, along with the waters and amniotic sac.
In the case of an incomplete miscarriage, most often only the embryo is rejected, and the amniotic membranes remain in the uterine cavity. The embryo can come out either completely or partially.

To avoid the serious consequences of an incomplete miscarriage, the woman is cleaned and also prescribed hemostatic, hormonal, antibacterial medications that cause uterine contractions.

After cleaning, it is imperative to perform an ultrasound to make sure that there are no blood clots or fetal tissue left, and that the uterine lining is being restored.

Diagnosis for symptoms of miscarriage

Ultrasound

Using an ultrasound sensor, you can detect the fertilized egg as early as 3-4 weeks of pregnancy, and at a later date it becomes possible to find the heartbeat of the embryo. It is believed that if, with minor bleeding and a closed cervix, the doctor detects a fetal heartbeat, then the probability of carrying this pregnancy to term is 97%. If blood from the genital tract is combined with a severely deformed fertilized egg, an embryo that is too small or a lack of heartbeat, then abortion is considered inevitable.

Often, with bleeding or severe pain in the lower abdomen, a retrochorial hematoma can be detected on ultrasound. When small in size, it is not dangerous and requires only observation. With significant detachment and a large hematoma, there is a high risk of miscarriage and severe bleeding.

hCG

It is advisable to determine human chorionic gonadotropin only in very early stages, when ultrasound cannot yet determine the viability of the embryo. With a high-quality ultrasound examination, this is no longer necessary. If the pregnancy is 3-4 weeks, and the fertilized egg is not found, then it makes sense to determine hCG twice, with an interval of 48 hours. Depending on the results, the ultrasound is repeated or a miscarriage is confirmed.

PAP test

Oddly enough, sometimes during bleeding they do a smear for oncocytology. This is necessary if there is a living embryo on ultrasound, a hematoma in the chorion area is not visible, and bleeding continues. In this case, a smear helps rule out cervical cancer.

Ultrasound and other methods for diagnosing threatened miscarriage

At the first symptoms of spontaneous miscarriage, a woman should not stay at home; she needs to see her doctor as soon as possible. The gynecologist, first of all, should direct her to do a laboratory blood test to determine the concentration of pregnancy hormones and an ultrasound to determine the heartbeat and visualize the location of the embryo.

After receiving the results of laboratory tests and ultrasound, the obstetrician conducts an examination during which:

compares the size of the uterus to the week of pregnancy;
determines uterine tone;
assesses the condition of the cervix;
analyzes the nature and abundance of discharge and other symptoms of recurrent miscarriage.

Treatment

Treatment of threatened abortion

depends on its suspected cause. It is almost impossible to directly influence the course of events in the early stages (up to 12 weeks). Usually prescribed are Tranexam (to stop bleeding) and Utrozhestan (for unsuccessful previous pregnancies). In the second trimester, it is possible to slow down the shortening of the cervix with ICI (by applying sutures and a pessary). This is where the treatment methods end. In many countries, early miscarriages are not even treated due to the high incidence of chromosomal abnormalities. Recently, studies have appeared that Utrozhestan in suppositories does not prevent the release of an abnormal embryo, therefore it can be used for short periods.

What NOT to do when bleeding in early pregnancy (threatened abortion):
No-shpa
Candles with papaverine
Baralgin
Magne B6
Vitamin E
Bed rest

All of the above remedies and measures are ineffective and therefore are not recommended by leading Russian and foreign associations of obstetricians and gynecologists. Some old treatments, such as bed rest, can even harm a pregnant woman. When mobility is limited, the risk of constipation, thrombosis, and stress increases, which leads to various complications.

Accomplished complete abortion

This condition usually does not require treatment or even observation. Doctors usually recommend taking an hCG test 3 weeks after termination of pregnancy. If it returns to normal, then you can move on with your life. If the hCG does not decrease or decreases insufficiently, then hydatidiform mole may be suspected - a dangerous condition that requires treatment.

Abortion in progress

If, upon examination by a doctor, bleeding is still ongoing, and the fertilized egg or dead embryo has not yet left the uterus, then three approaches are used:

expectant (wait for the situation to resolve itself within 7 days)
medicinal completion (taking misoprostol to contract the uterus and expel the fertilized egg)
vacuum aspiration or curettage (cleaning) of the uterine cavity (in case of severe bleeding or other methods are ineffective)

The question of how to complete the abortion is decided by the doctor. Therefore, it is extremely important to contact a specialist and be observed by him until the end of the process. In case of life-threatening bleeding, hemostatic drugs are prescribed, and sometimes blood components have to be transfused in a hospital setting.

What can cause spontaneous abortion?

The reasons for early miscarriage can be different.

According to statistics, approximately 73% of miscarriages occur due to abnormalities in the development of the fetus. All systems in the fetal body are formed in the early stages of pregnancy. A woman’s immune system, having detected genetic abnormalities in a developing organism, can itself reject the fetus.

In most cases, these anomalies are not hereditary, but occur as a result of mutations that occurred in the cells of the parents due to the influence of mutagenic factors. These include viruses, radiation, poor ecology, hazardous production, etc.
As a rule, it is almost impossible to prevent a miscarriage in such cases. But by reducing the influence of negative factors and undergoing a course of treatment, the chances of another successful pregnancy and the birth of a healthy baby increase significantly.

For example, in many cases, the cause of spontaneous abortion was determined to be a violation of the woman’s endocrine system. This is due to the fact that hormones have a great influence on the intrauterine development of the child, and if a pregnant woman experiences any hormonal imbalance, then the body is unable to cope with pregnancy.

To diagnose the disorder, the doctor prescribes a series of tests, after which a course of treatment is prescribed. You can plan a new pregnancy after a miscarriage after restoring the balance of hormones in the body. But if you identify the problem in a timely manner and seek medical help, a miscarriage can be avoided.

One of the reasons for miscarriages at the initial stage of pregnancy is also abortions performed in the past (medical, vacuum, surgical). The fact is that abortion is not just a gross intervention, but also a strong shock and stress for the whole organism.
The consequences of abortion can be disruptions of the menstrual cycle, adhesions and scars on the uterus, dysfunction of the ovaries, adrenal glands, inflammation of internal organs, endocrine diseases, ectopic pregnancy, repeated miscarriages and infertility.
Doctors do not recommend planning your next pregnancy earlier than six months after the abortion. To reduce the risk of future complications, it is necessary to undergo appropriate treatment and recovery.

Spontaneous abortion is often caused by STIs: herpesvirus infection, cytomegalovirus, syphilis, trichomoniasis, chlamydia and others. Viruses and bacteria infect the membranes and infect the fetus, which increases the risk of miscarriage. To prevent this from happening, you should be tested for STIs before pregnancy and receive the necessary treatment.

The risk of early miscarriage increases with the so-called Rh conflict, when the blood of the expectant mother has a negative Rh factor. Then the woman’s immune system perceives the fetus as a foreign body and tries to get rid of it. Experts recommend paying attention to this even before pregnancy, getting tested and following the doctor’s orders. If a woman finds out about the Rh conflict already during pregnancy, it is necessary to consult a doctor and take special medications.

An unhealthy lifestyle has a negative impact on pregnancy and fetal growth. Therefore, you should get rid of bad habits (alcohol, smoking, etc.) at the stage of planning conception.

Severe stress, fear, unexpected grief, and nervous tension are dangerous both for the pregnant woman and for the child growing inside due to the release of large amounts of hormones into the blood. Try to keep your worries to a minimum and discuss this issue with your doctor. You may have to take a course of sedatives.

Taking certain medications, decoctions or herbal infusions can cause spontaneous abortion or provoke the development of certain defects in the fetus. The intake of some herbs, such as parsley, St. John's wort, nettle, tansy, cornflower, should be limited in the early stages of pregnancy.

Intense physical activity, heavy lifting, falls or strong impacts also pose a certain risk. Often such factors act only as a “push” for miscarriage if a woman has any of the above problems.

When is progesterone prescribed?

Hormonal support (Utrozhestan in suppositories intravaginally) is prescribed in the following cases:

two or more spontaneous abortions at less than 20 weeks
one miscarriage at 20 weeks in women over 35 years of age or with a history of infertility
proven insufficiency of the luteal phase of the cycle
threat of miscarriage due to cervical insufficiency (voluntary shortening of the cervix less than 25 mm)

In the first two cases, Utrozhestan (micronized progesterone) is used for prevention, starting from preparation for pregnancy and up to 10-12 weeks. If there is a threat of abortion before week 20, the drug is prescribed until the symptoms disappear.

How is threatened miscarriage diagnosed?

Ideally, a possible threat of miscarriage is diagnosed before its onset, at the planning stage. Thus, a woman planning to conceive undergoes thorough examinations and tests to identify any pathologies that could interfere with the healthy bearing of the baby. If pregnancy occurs spontaneously, then this is not a problem, because with a timely visit to a gynecologist, factors indicating a possible termination of pregnancy can also be identified. This happens with:

comparison of the size of the uterus and the duration of pregnancy;
determining the density of cervical closure;
identifying possible uterine tone;
analysis of the presence and nature of vaginal discharge;
taking tests (for example, a blood test for hormone levels, a blood test for intrauterine infections, a smear for ureaplasma, mycoplasma, chlamydia, etc.).

A fairly informative method for diagnosing such a threat in the first trimester is transvaginal ultrasound, which makes it possible to examine the condition of the cervix, its length, etc.

How to recover after a miscarriage?

The loss of a desired pregnancy is always stressful for a woman. Added to this is concern about the success of future pregnancies. Therefore, it is extremely important to rehabilitate your health and mood before planning offspring (see also the consequences of abortion and rehabilitation).

For a genital tract infection (if the bleeding is prolonged, for example), the doctor prescribes antibiotics. There is no point in taking them only for preventive purposes during self-abortion. If its completion was stimulated by misoprostol, then the fever on the first day will be due to the medicine and not to infection, so there is no need to worry. During surgery, a single prophylactic dose of an antibacterial drug is usually prescribed.
If pregnancy loss is accompanied by significant bleeding, you may need to take iron supplements to treat anemia.
Under certain circumstances, a gynecologist may recommend taking contraceptives. But with an uncomplicated spontaneous abortion at different stages, you can start planning a pregnancy as soon as you are in a psychological mood.
In case of recurrent miscarriage (3 or more spontaneous abortions in a row), it is necessary to undergo additional procedures and tests.

How is your period after a spontaneous miscarriage?

Restoration of the menstrual cycle, with adequate therapy, should occur within the next month after the miscarriage has occurred. If the menstrual cycle fails, you need to consult a gynecologist
Often the first period after a self-abortion occurs several weeks later than expected. If the bleeding does not stop, this is an immediate signal that you need to contact a specialist.
There are cases when the abortion did not occur completely and then hospitalization of the woman and instrumental cleaning of the uterine cavity are necessary to eliminate all residual parts of the pregnancy

Examination for recurrent miscarriage

If spontaneous termination of pregnancy is repeated 2 or more times (and by some standards - 3), then this condition is called recurrent miscarriage. It requires a thorough examination and identification of the causes. Approximate plan for examining and solving the problem:

Survey	Treatment when a problem is identified
Analysis of environmental, social conditions and habits	Elimination of bad habits, normalization of body weight, living and psychological conditions
Karyotyping of the abortion and parents (determination of chromosome set)	In case of chromosomal damage, a thorough genetic examination of the embryo is necessary in subsequent pregnancies.
Ultrasound of the pelvic organs, hysteroscopy	Removal of fibroids, polyps, uterine septum and other anatomical defects
Tests for APS	If the syndrome is confirmed in the next pregnancy, take low molecular weight heparin and aspirin to thin the blood
Tests for thrombophilia (only if there is a history of thrombosis in the woman and her immediate family)	Appropriate treatment
Checking the functioning of the thyroid gland (levels of TSH and other hormones)	Treatment (usually with L-thyroxine)
Test for hyperprolactinemia (high levels of the hormone prolactin)	Treatment with dopamine agonists
Determination of glycated hemoglobin (for diabetes mellitus)	Treatment with insulin
Tests for STIs (CMV, herpes, chlamydia, gardnerellosis, etc.), as well as toxoplasmosis.	If necessary, eliminate the infection

Causes

Various circumstances can provoke fetal loss, ranging from medical factors to social ones. It is often difficult to identify what caused the termination of pregnancy, since this phenomenon is based not on one factor, but several at once. Some women experienced spontaneous interruption several times, which negatively affected their health and psycho-emotional level.

Let us list the main causes of miscarriage in the first trimester . This may be the independent rejection of a non-viable fetus, which already at the initial stage of development has genetic problems or developmental abnormalities. For example, a congenital disease includes a mutation caused by poor environment, radiation or a virus living in the mother’s body.

Unfortunately, this phenomenon is beyond the control of medicine, since it cannot prevent or change it.

That is why many married couples need to prepare their body before conception, namely: cure diseases, start eating right, take vitamins, move and walk more, and also not “abuse” certain medications.

Then the question of what a miscarriage is will no longer worry the lady.

Unsatisfactory functioning of a woman’s hormonal and immune systems will not allow her to fully bear the baby. It is important for a woman to treat such health problems when planning a pregnancy. Before conception you should

undergo an examination to get rid of problems in the functioning of the adrenal glands and thyroid glands, as well as restore the balance of androgens and progesterone.

What else could cause an abortion? Often this phenomenon is observed as a result of Rh conflict between mother and baby. In this case, the pregnant woman’s body will react to the embryo as if it were a foreign body, trying with all its might to get rid of it. To avoid repeated abortion, the fair sex will need to undergo immunomodulatory therapy in order to be able to bear a child the next time.

Infections are rightfully considered the worst enemy of the normal course of pregnancy. The most dangerous for the fetus are trichomoniasis , cytomegalovirus, syphilis, herpes, chlamydia, and so on. Such bacteria penetrate the membrane of the embryo, which causes its infection, after which the death of the sick and non-viable embryo occurs.

What can cause the growth of a baby in the womb to be interrupted? Viral pathologies often lead to fetal death. These include severe sore throat, influenza, rubella, hepatitis, and inflammation of the respiratory system.

The unstable psycho-emotional state of a woman can cause embryo rejection at the initial stage of its formation. Often the interruption occurs due to the fact that the expectant mother is constantly nervous and angry. Stress has an adverse effect on conception. Therefore, it is important to try to keep yourself under control and not get wound up at the drop of a hat.

After all, if an interruption occurs, there is a subsequent risk of complete infertility.

Sometimes the cause is congenital diseases of the mother, which have anomalies or malignant tumors. In this case, unfortunately, full gestation is impossible.

It became clear how a miscarriage occurs. But how to distinguish menstruation from miscarriage, and what are the symptoms of this condition.

FAQ

Two years ago, the pregnancy miscarried at 7 weeks. Now I’m pregnant again, 5 weeks pregnant, the doctor prescribed Utrozhestan in suppositories. Are there any indications for this? Will the drug harm the child?

A frozen pregnancy alone is not an indication for the use of Utrozhestan. Perhaps there are other reasons for taking it that you did not indicate. In such a situation, Utrozhestan does not pose a danger to the child.

The gestational age is 16 weeks. Starting from the 14th week, heavy bleeding continues. According to ultrasound, the fetus is alive, there is a large hematoma. I'm worried that my hemoglobin level is dropping quickly, so the doctors are planning to stop it. Is there a chance to continue pregnancy if there is heavy bleeding?

Considering that the fetus is alive, there is a chance to continue the pregnancy. But if the hemoglobin level continues to fall, then in the interests of the mother's health, interruption is possible.

Could a cold at 7 weeks have caused a miscarriage?

Theoretically, high temperature can promote abortion. But in such a short period of time, a spontaneous genetic breakdown is most likely.

How long after an unsuccessful pregnancy (ended at 6 weeks) can I plan a new one?

If there are no complications, you can start planning immediately. But it’s better to wait 1-2 menstrual cycles for psychological preparation and taking folic acid.

What are the symptoms at 2 weeks of miscarriage?

If we consider the obstetric method of determining the gestational age based on the last menstruation, then at 2 weeks conception has not even occurred. If we mean the age of the embryo, then it corresponds to a period of 4 weeks. Such an interrupted pregnancy is called biochemical, since nothing can be seen on an ultrasound. Therefore, the symptom will be bleeding, coinciding with menstruation or with a delay of several days.

Author:

Evtushenko Anna Aleksandrovna obstetrician-gynecologist

Consequences of miscarriage

If the miscarriage occurs early, for example, within 2 weeks, then there should be no complications.
But if a spontaneous abortion occurs at a later date, for example, at 8-9 weeks, the woman will need curettage. This procedure is already fraught with complications. They can occur due to the inflammatory process that occurs after curettage. Inflammation is treated with antibiotics (injections), physiotherapy, and then a follow-up ultrasound is required. But it is not always possible to overcome inflammation; it becomes chronic. As a consequence of this process, adhesions are formed. All this leads to infertility.

In the early stages

If curettage is not required, spontaneous abortion occurs without complications. Of course, not counting the moral and psychological state of the woman. During this period, she especially needs the support of loved ones.

In the later stages

Here the threat of spontaneous abortion applies to the baby. Despite the fact that doctors currently know how to care for premature babies, no one excludes the risk of their mortality.

How to find out if a miscarriage has occurred

It is almost impossible to distinguish spontaneous abortion from menstruation based on external symptoms, especially if it occurs at a very early stage. Ultrasound examination in this case is also uninformative - for the device these processes look the same. The size of the fertilized egg at this period is still too small and does not allow it to be seen.

Determining whether a miscarriage or menstruation is the cause of bleeding is available thanks to the development of laboratory diagnostics.

There is a sign that allows you to find out with a high degree of certainty whether there was a pregnancy. It is indicated by the presence of a special hormone in the woman’s blood and urine – human chorionic gonadotropin (hCG).

It is on its detection that the action of all tests is based - the second strip appears if there is a sufficient concentration of this substance in the urine.

The hCG hormone begins to be produced approximately a week after implantation of a fertilized egg into the endometrium, its content in the blood rapidly increases until 11-12 weeks, and then begins to decrease. A high concentration of human chorionic gonadotropin in a woman’s blood and urine persists for several days after a miscarriage. This is what makes it possible to distinguish it from menstruation.

Therefore, the most accessible way to recognize an early miscarriage is to take a pregnancy test. When the bleeding is just menstruation, only one line will appear. And if it is caused by spontaneous abortion, the second one will be clearly or faintly visible.

A more reliable method is to determine hCG using a special blood test. A reliable result can be obtained within about a week after the start of bleeding. After a miscarriage, the level of the hormone decreases, and after a few days it is already difficult to detect.

If your period is late, it makes sense to take a test right away. Modern means detect an “interesting situation” on the very first day of delay. If the result is positive, if bleeding begins, it will be clear that the cause is not due to menstruation. Knowing this, you can promptly seek medical help.

In addition, one of the ways to recognize conception is to determine basal temperature and keep a graph of indicators . In the case of fertilization of the egg, the value increases noticeably, which also makes it possible with some degree of confidence to distinguish an interrupted pregnancy from menstruation in the event of bleeding.

What to do if you suspect a miscarriage

If you notice bleeding with clots, place a sanitary pad on your underwear. If more than two pads are needed per hour or you experience severe cramping, contact your doctor or emergency room immediately. The doctor will look at your cervix to see if it is open. Your blood will be taken to test your hCG levels to find out how far along you are in your pregnancy, and then tested again to see if your levels are rising or falling. If it increases, your pregnancy is most likely progressing, but if it decreases, a miscarriage occurs. You will likely have an ultrasound to check your heartbeat and make sure it is not an ectopic pregnancy. If you are at risk of miscarriage, your doctor may prescribe certain treatments if they feel it makes sense. You will most likely be sent home and asked to rest, although the benefits of bed rest have not been proven. If the bleeding stops and you have symptoms of pregnancy, in many cases it will progress further. If your pregnancy symptoms suddenly disappear and severe cramping and clots begin, your doctor will allow you to have a miscarriage at home. The doctor may suggest that you bring in clots and tissue for examination if this is not your first miscarriage. 2

Symptoms of the onset of a miscarriage

If symptoms of spontaneous abortion are detected, a woman should immediately seek medical help. The following may indicate a spontaneous abortion:

unexplained and sudden weight loss;
disappearance of pregnancy symptoms (breast swelling, toxicosis, drowsiness);
false contractions;
real contractions, accompanied by severe pain and frequency;
disorders of the gastrointestinal tract;
red, brownish or dark brown discharge;
increased bleeding with clots, cramps and pain in the lower abdomen or lumbar region;
any unusual vaginal discharge.

The most basic signs that help determine an incipient miscarriage are pain and bleeding. When there is a threat, discharge may not be red, but brown. But this factor should not confuse the expectant mother and force her to seek help from a doctor.

An increase in uterine tone is also a sign of an imminent abortion, but only in cases where it is accompanied by severe pain in the lower abdomen. You can avoid such a combination of circumstances by refusing to lift weights and exercise.

With a frozen or ectopic pregnancy, a complete miscarriage does not always occur, so contacting a doctor with the described symptoms is mandatory.

Experiences of other women

Taken from a foreign women's forum about pregnancy 3:

I'm 10 weeks pregnant and 2 days ago I went for an ultrasound because there was some blood coming out. They said my baby died at 8 weeks and 5 days. I decided not to have surgery to remove the baby, but to wait for a natural miscarriage. It scares me to think about what I might see, but will I actually be able to tell that a baby has come out? I had a miscarriage 7 years ago and I was 6 weeks pregnant when it came out it looked like a blood clot. I'm so upset that I had another miscarriage and it makes me feel worse with panic every time I go to the bathroom when I see something.

“After eight weeks, my pregnancy symptoms just disappeared overnight. Then I started bleeding, so I called the doctor. He told me to rest, but I started having really bad cramps and was coming out with some pretty big clots. Then the bleeding suddenly stopped. I knew I had miscarried and my period returned after about 6 weeks. I was able to conceive again and my next pregnancy was successful.”

“At about 7 weeks I started bleeding and then I saw two pieces of white rubber-like tissue, about a centimeter in size. They reminded me of a small piece of raw chicken. Then a clot about five centimeters long came out and nothing more.”

How does a miscarriage occur?

Due to lack of awareness, many women sometimes do not even suspect that something terrible has happened to them - the loss of a child. They have no idea how quickly miscarriage occurs and what follows after it. In order to be fully armed, you need to remember the following:

1. Spontaneous abortion, fetal death and rejection by the body usually do not occur at once, but last several hours or even days. The process occurs in several stages: threatened miscarriage, imminent (incipient) miscarriage, incomplete abortion and, finally, complete abortion.

2. The threat of miscarriage is characterized by the onset of placental abruption and the appearance of the first signs of miscarriage (pain in the lower abdomen and slight bleeding from the vagina). At this stage, the uterus is closed and the pregnancy can still be maintained.

3. Imminent (started) abortion is characterized by placental abruption and, accordingly, further death of the fetus. Imminent abortion cannot be stopped.

4. With an incomplete abortion, the placenta separates, the fetus dies, and the process of its rejection by the body begins.

5. During a complete abortion, the fetus and place are eliminated from the uterus, as well as from the female genital tract.

Causes of early miscarriages

Although the exact cause of miscarriage may not be determined in all cases, there are some common causes and risk factors that can lead to spontaneous abortions. These include:

Chromosomal and gene pathologies
Germ cell mutations
Immunological factors
Anomalies of the structure of the uterus and genitals
Tumor processes, infectious lesions of the uterus, ovaries
Hormonal imbalances, deficiency of sex hormones
Pathologies of endocrine organs (adrenal glands, thyroid gland, pituitary gland)
Infectious diseases (both acute and exacerbations of chronic ones), hidden infections
Severe somatic pathologies of the mother (heart defects, hepatitis, diabetes)
Traumatic impacts, accidents
Taking medications and plants, poisoning with poisons, toxins
Unidentified factors.

Thus, in the first place are severe chromosomal or genetic “breakages” in the germ cells of the father or mother, leading to the formation of a defective embryo. This group also includes mutations in germ cells that lead to the formation of gross developmental defects in the embryo that are incompatible with life. Typically, such pregnancies are terminated before 8 weeks of gestation, and often even earlier, and the woman perceives them as a delay in menstruation. Although this sounds cruel, this is how nature, through natural selection, weeds out initially non-viable or sick children. However, this selection mechanism does not always work.

Among the immunological factors, antiphospholipid syndrome may become the leading one in the formation of habitual early miscarriages. This is an immune aggression against the body’s own proteins, which becomes more active during pregnancy and leads to poor circulation in the uterus and fetus. With it, miscarriages are typical up to 12 weeks, and it is this type that is excluded first when examining women after early termination of pregnancy.

The abnormal structure of the uterus can disrupt the normal process of implantation of the embryo; it is located in a place inconvenient for the development of pregnancy, which is why it dies and is rejected by the body. This is most likely to happen with a bicornuate, saddle-shaped or unicornuate uterus, if there are septa inside it. Endometriosis of the uterus or fibroids can have an equally strong effect; they lead to deformation of the organ and problems with high-quality implantation of the embryo.

Hormonal influences, infections, diseases

According to research, ovarian failure and reduced progesterone levels can lead to miscarriage. This is due to the second phase of the cycle, the formation of the corpus luteum of the ovary at the site of release of the egg and the production of progesterone by this organ. This is usually combined with problems in the functioning of the pituitary gland, changes in the ovaries of an organic nature (polycystic disease, sclerosis) or the negative influence of pathologies of the thyroid gland or adrenal glands. Many experts say that there is no clear relationship between reduced progesterone levels and the threat of miscarriage.

Sexual infections and infection with viruses, microbes or fungal flora can threaten pregnancy . At high temperatures and intoxication syndrome, the embryo suffers, which can lead to contraction of the uterine walls and rejection of the fetus.

Important

Any infectious disease in the first trimester can be potentially dangerous. But among them there are those who threaten deformities and miscarriages more than others. These include influenza, rubella, brucellosis, toxoplasmosis, listeriosis and some others. They are able to penetrate the placenta into the body of the embryo, leading to its death. Sometimes the fetus survives, but may be born with severe birth defects in its development.

Some severe pathologies of the mother's body can cause termination of pregnancy due to the fact that it will be an excessive burden in conditions of illness or provoke exacerbations. Thus, the most dangerous are diabetes, hyperthyroidism and myxedema, autoimmune pathologies and coagulation problems .

Taking some medications leads to the formation of embryotoxic or teratogenic effects (death or deformity of the fetus), which triggers the mechanism of rejection of the fertilized egg and miscarriage. The situation is similar in case of poisoning, toxicosis and bad habits (drinking alcohol or smoking, including electronic cigarettes).

The rarest causes of termination of pregnancy are injuries, abdominal surgeries and psychogenic causes (stress, neurosis, depression).

Facts about the psychological consequences of spontaneous abortion

Preparing to become a mother, a woman collects a lot of information from various sources - conversations, books, TV shows and the Internet - about bearing, giving birth and caring for a baby. Of course, no one prepares for an unsuccessful pregnancy outcome, and there is virtually no literature or guidance on how to survive the period of loss, how to cope with the situation and what to expect from yourself, your feelings, emotions, and often from bodily changes in the body.

Practical advice and possible steps to overcome loss are based on shared experience. What often comes as a surprise to women who have lost a child during pregnancy or are in a situation where pregnancy is at risk?

Miscarriage or spontaneous abortion: different types

There are many reasons why a pregnancy fails, fails in the early stages, is terminated in the second trimester, or requires termination for medical reasons. Special terms describe different situations, but the essence is the same: fetal loss can occur in different ways. A miscarriage may begin suddenly, accompanied by bleeding, or information about a frozen pregnancy is received only at a doctor’s appointment without external signs. The threat may last for quite a long time or may not appear at all during the entire period.

The types of spontaneous abortion are physically different from each other, and the emotional state of the mother is also different.

Miscarriage can be a long process

It is impossible to say what has a stronger impact: a sudden loss or a long term with the threat of termination of pregnancy, ending in miscarriage. But the very fact that the process of miscarriage can last up to two months often affects women, and the fruitless existence in a protective mode, full of worries and hopes, greatly suppresses the psyche.

Inability to see the child

If the pregnancy ends unsuccessfully, the opportunity to see, “say goodbye” to the child, and visually confirm the fact of separation is very important and helps to recover faster. In some cases, a family burial ritual is also carried out, often purely symbolic. However, most do not have the opportunity to see the fetus or embryo - about half of registered miscarriages in the first trimester are caused by disorders that do not allow the embryo to develop. Surgical intervention in case of a developed threat also does not allow the woman to see the fetus. In this regard, a woman often feels that she “has no right to suffer” in the same way as other mothers who have “really” lost a child, and experiences the rehabilitation period more difficult. This wrong feeling, the prohibition on fully experiencing suffering, prevents us from living through the necessary cycle of perception of loss.

False shame

Although society encourages a woman to “be strong” and think about the next baby, without fully experiencing the loss it is impossible to restore psycho-emotional balance and enjoy life again, as before. However, the opinions of others often impose their own limitations, and women are ashamed of “moments of weakness”: tears, sadness, experiences, especially long-term ones.

Everyone deals with loss differently. However, there is nothing shameful in tears after parting with a loved one, which means there is no need to be ashamed after a failed meeting with the baby. Moreover, the general opinion often does not coincide with the private one: if you talk openly about the reason for your tears, you can find out that many people have faced a similar experience, and receive unexpected support from practically strangers.

Long rehabilitation process

The first weeks of acute grief are over, and it seems that the experience has passed? The acute stage can last up to three months, but is not limited to this. Suddenly finding tears in her eyes at the sight of a pregnant woman or not wanting to go to visit friends with a newborn, a woman is faced with the past and does not always control her reaction.

Perhaps you should take care of yourself and avoid meeting with friends who remind you of the loss, children's birthday parties, and visiting baby departments in stores, especially on dates close to the planned birth.

This reaction will pass. In the meantime, such sudden tears are evidence of how much love awaited the baby. And this is not a reason to be ashamed at all.

Physiological changes

At the physiological level, the process occurs at this stage of pregnancy, both in the mother’s and in the child’s body.

What happens in a woman's body?

During this period, more and more changes occur in the woman’s body, of course. First of all, the uterus is growing. This, in turn, puts a certain additional pressure on the bladder. Therefore, frequent urination occurs. But this process, with the normal development of pregnancy, occurs completely painlessly.

Problems with the intestines can also occur in the form of constipation.

The growing uterus sometimes provokes pinching of the sciatic nerve, as it begins to put pressure on it. From here, a sharp, seemingly tugging pain appears in the woman’s lower back. Such pain may also be present in the buttocks and thighs. If such symptoms appear, you should simply lie down on the side opposite to the pain.

At the 8th week of (obstetric) pregnancy, some women experience increased discharge. This process should not be accompanied by itching. If this fact is present, you should see a doctor. Minor brownish discharge, if there is no nagging pain in the abdomen, poor health and back pain, is also considered acceptable during this period. But the doctor should still be notified.

Breast volume continues to increase. At the physiological level, this is evidence that processes are gradually replacing adipose tissue with glandular tissue.

This stage of pregnancy assumes a certain body temperature of the expectant mother. It should be about 37 or a little higher. A temperature of 38 or more requires immediate medical consultation and treatment.

Insomnia may be a companion during this period. This negativity can be eliminated by walking in the fresh air, regularly and, of course, before bed.

The skin of the expectant mother at 8 weeks of pregnancy becomes especially smooth. But under the influence of certain physical factors, peeling sometimes appears.

Changes in the child's body. How does the baby develop?

At the current stage of pregnancy, the unborn baby is assigned the status of a fetus. From now on, the word “embryo” is no longer about it. The placenta is actively developing, which means the protective barrier from external factors is becoming stronger and more reliable every day. Uteroplacental blood circulation is significantly improved. And the main achievement of this period is that now the baby will be fed through the mother’s umbilical cord. Despite its tiny size, the fetus already has the appearance of a person, and on an ultrasound it is even possible to distinguish facial features.

During this week of pregnancy, all internal organs continue to improve. The baby’s heart is now four-chambered, bronchial branches are already visible in the lungs, and kidneys have appeared.

In boys, the testicles continue to develop, in girls - the ovaries, which are already beginning to produce eggs. True, even with ultrasound examination it is not yet possible to distinguish the sex of the child.

The development of the nervous system is also taking giant strides. The baby actively clenches and unclenches his fists on his arms and “tumbles.” On an ultrasound, all these movements are clearly visible. But due to the too tiny size of the fetus, the mother cannot yet feel these movements.

The 8th week of pregnancy is characterized by the appearance and formation of all organs. There will be no new appearances throughout the subsequent pregnancy. Everything that exists will simply develop and improve.

Weight gain

In the first trimester of pregnancy, normal weight gain for a woman is considered to be 400-500 g per week. But if you haven’t been able to gain half a kilo of new weight this week, it’s not a big deal. The alarm should be sounded when the mother begins to rapidly gain a kilogram per week. Excess weight can negatively affect fetal development.

Passing clots and tissue during miscarriage by week of pregnancy

Pregnancy can be terminated at any stage, but more often this happens in the first weeks. At earlier stages, during a miscarriage, you can only see blood and clots, but if the miscarriage occurs after 8 weeks, then there is a chance of detecting painful dense tissue, a sac with an embryo, and even a formed fetus.

Please keep in mind that these photos are just an example, intended to give you an idea and help you prepare. They do not mean that the embryo or fetus will be released in such a preserved form.

If you're less than 8 weeks pregnant, clots, cramping, and bleeding usually won't even be that different from a heavy period. At a more difficult period, in addition to clots, you may notice parts of denser tissue, which is placental or other products of conception. You may or may not see tissue that looks like an embryo or fetus. 1

4 – 5 weeks

During a miscarriage at 4 weeks of pregnancy, if there is bleeding with blood clots, you may notice some white or gray tissue among them. At this stage of pregnancy, you will not see the embryo itself at all during the miscarriage, as it is less than ½ cm long or the size of a grain of rice.

6 weeks

You may have bleeding, clots, and sometimes a small sac of fluid, a very small pea-sized embryo, and an attached placenta. Some women have even discovered the umbilical cord, but at six weeks it is still very difficult to see anything.

7 - 8 weeks

When experiencing a miscarriage around eight weeks' gestation, many women describe the tissue as resembling a "liver." The clots and placenta are dark red and very shiny. You may find the sac and the embryo in the baby will look almost like a "bean". You can even understand that his eyes are closed, and see the beginnings of arms and legs.

10 weeks

In spontaneous abortion, which occurs at ten weeks, the clots are dark red and jelly-like. Among them, you may notice tissue that looks like a film, which will be part of the placenta. If you separate the clots, you will likely find the yolk sac and see the formed fruit inside the liquid. He now looks more like a child with fully formed arms, legs, and fingers.

12 weeks

The baby may be delivered in a sac of fluid (the sac), but often at this time the sac is damaged and the sac comes out on its own. You may notice that after blood clots, the baby with the umbilical cord has not yet come out and is inside you. The placenta is then expelled. At this stage of pregnancy, you can even tell whether your baby was a girl or a boy.

16 – 20 weeks

Between the sixteenth and twentieth weeks, very large clots can be observed that look like “raw liver.” They may also be around the child. In addition, you can observe pieces of fabric that resemble film. During this time, you may notice water leaking from your vagina. At about twenty weeks the baby is fully formed, about the size of your hand.

Recommendations for threatened miscarriage

In order to stop signs of threatened miscarriage as quickly as possible, you must follow the following recommendations:

Do not drink carbonated drinks, strong coffee and tea, chocolate, fast food, and unheated foods;
Temporarily stop intimate life;
Do not follow a diet to lose weight, eat high-quality and nutritious food;
It is prohibited to visit baths, saunas, or take a hot bath;
Avoid physical activity and stress;
It is not recommended to travel, especially air travel;
Do not consume alcohol and tobacco products.

When can you plan a pregnancy after a miscarriage?

If this was the first miscarriage, and it had no complications or consequences, then you can start planning a pregnancy after 3-4 months or when the woman is ready for it psychologically and physically. If the miscarriage is repeated or there is a diagnosis of recurrent miscarriage, with three or more miscarriages in a row, a detailed examination is necessary to determine the reasons for this.

Alena Paretskaya, pediatrician, medical columnist

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Bleeding during pregnancy

Before looking at some photos, it is important to discuss bleeding during pregnancy. Every fourth woman notices bleeding early in pregnancy. But bleeding is common in the first 12 weeks and is usually not something to worry about. If the bleeding decreases and goes away within 1-2 days, then it does not indicate a miscarriage. Most often, pregnancy continues and a healthy baby is born.

However, some types of bleeding may be a sign of something more serious, especially if it is heavy or accompanied by cramping. Find out what bleeding looks like and how long it lasts during a miscarriage.

The bleeding may be red, like during menstruation, or light brown. Bloody discharge in the early stages is usually normal and is often a sign that an egg is implanted in the uterus (implantation bleeding). It usually occurs around the time your period is due and then stops after a few days.

What causes miscarriage?

Miscarriage occurs in 1 in 6 pregnant women, and most often in the early stages. Experts identify the following most common causes of spontaneous abortion:

Anomalies of fetal development.
Diseases of the mother's immune, cardiovascular, endocrine, and excretory systems.
Bad habits.
Rough sexual intercourse.
Wrong lifestyle.
Viral or bacterial infection. It penetrates the membrane and affects the fetus.
Nervous disorders and quarrels;
Overweight or underweight mother.
Excessive exercise and too active sports.
Hormonal disorder.
Abortion. Previous abortions can lead to both miscarriage and infertility.
Polycystic ovary syndrome.
Toxic effects on the body (harmful production, poor ecology);
Rh conflict, as a result of a discrepancy between the Rh factor of the child and the mother.
An accident in which the body primarily fights for the life of a woman.
Age over 35 years (the optimal age for bearing a child is considered to be 20-35 years old) or a recent IVF procedure.
Eating herbs with abortifacient properties (tansy, thyme, parsley).
Uterine abnormalities.
Some medications.

Most spontaneous abortions occur in the early stages, when the woman is not even aware that pregnancy has begun. In this case, the fertilized egg is excreted from the body along with menstruation.

Future parents must take a responsible approach to the process of preparing for childbirth, change their lifestyle and treat all existing diseases.