Citizen's Comfort

Wherefrom Miscarriage

There is always something very beautiful and exciting about being pregnant, especially the first timers; the attention, care, pampering, and love from the husband and the people around the pregnant woman are good experiences that radiate a feeling of fulfillment. But when the source of the joy, the fetus, is spontaneously expelled before viability, different kinds of negative emotions like anger, bitterness, fear, worry, sadness bereavement, etc. take center stage in the mood and feeling of the woman and the spouse.

Miscarriage is not only very devastating for the woman, it is equally a frustrating and heart-wrenching experience for the couple. One moment they cling glasses in celebration of a positive pregnancy report, few weeks after they watch the report’s result going down the drain.

Despite all the anguish, bitterness, frustration, grief, and general feeling of bereavement, there is light at the end of the tunnel. Medical experts and medical reports say women who experience miscarriage still have a very high chance of carrying another pregnancy to term.

WEB MD medical reference says you can get pregnant after a miscarriage. According to the journal, at least 85% of women who have one miscarriage go on to have normal pregnancies and births. Adding that having a miscarriage doesn’t translate to a fertility problem.

Miscarriage

Whatever name or type a miscarriage is called- complete; incomplete; missed; septic; and or threatened, it is the spontaneous or unplanned expulsion of a fetus from the womb before it can survive independently outside the womb. If it’s planned or deliberate then it becomes abortion. Miscarriage brings a feeling of joy turned sour to the expectant couple.

Miscarriage happens when pregnancy or fetus usually less than 500g, unintentionally got expelled before viability age. According to medical experts, though miscarriages occur naturally without any human intervention, but there are risk factors that can predispose a pregnancy to miscarriage.

Prevalence

Odetayo T.O, an Obstetrics &Gynecology expert at LASUTH (Lagos State University Teaching Hospital Nigeria) said 50% of all pregnancies end in miscarriage, most often before a woman misses a menstrual period or even knows she is pregnant. However, he said, about 15-25% of recognized or confirmed pregnancy will end in a miscarriage. This assertion was corroborated by other medical experts.

Abiola AO et al, in a study Knowledge, Prevalence and Psychological Effect of Miscarriage among women of reproductive age group attending Obstetrics and Gynecology Clinics of Lagos University Teaching Hospital, Nigeria say “determining the prevalence of miscarriage is difficult and it is not possible to be precise about the frequency of spontaneous miscarriage”.  According to the scholars, this is due to difficulties in identifying the start of a pregnancy; many miscarriages occur very early in the pregnancy and are not being diagnosed but are regarded as a delayed or abnormal menstrual period. Adding that treatment of women with miscarriage at home do not go into miscarriage medical statistics. However, in spite of these difficulties, according to the study report, the prevalence values of miscarriage are still amazingly high and quite alarming. The report states that one in five pregnancies (or 20%) end in natural miscarriage.  This number can go as high as 50% because so many early miscarriages happen before a woman even realizes she is pregnant.

Except in the rare cases of late miscarriages, medical experts say 80% of miscarriages happen within the first trimester (3 months) of the pregnancy and less likely to happen after 24 weeks.

The mean age of the women involved in miscarriage, according to experts and medical journals, is 28.4 ± 6.4 years.

Symptoms

Symptoms for miscarriages that happen later than 12 weeks according to Odetayo include spontaneous discharge of fluid known as drainage of liquor. The liquor is the fluid in the sac surrounding the fetus. Once the sac breaks, the liquor is let out in form of intermittent leakage or a gush of fluid per vagina. According to the O&G expert, the leakage may be followed by painful uterine contractions till the products of conception are expelled in parts or whole.

– Spontaneous vaginal bleeding which may be preceded or followed by pain that may be crampy and radiates to the back and thigh.

-Bleeding may appear initially as spotting and there may be passage of tissues medically known as products of conception per vagina.

-Passage of fetal or placental tissue that may appear whitish and covered with blood.

-Passage of blood clots.

Bleeding may range from mild to severe.

Causes/ Risk Factors

So, what are the Causes & Risk Factors of miscarriages?

Chromosomes

Medical experts and medical journals seem to agree that most miscarriages happen when the unborn baby has fatal genetic problems or chromosomal issue. These problems according to Dr Odetayo of LASUTH, are neither related to the pregnant mother nor the way she carries the pregnancy, but commonly cause miscarriage in the first trimester.

WEB MD reference report on miscarriage confirms Odetayo’s assertions on the causes of miscarriage. According to the report, the majority of miscarriages are believed to be caused by genetic problems within the embryo that would prevent a baby from developing normally and survive after birth. These fatal genetic errors are not usually related to genetic problems in the mother. They are chromosomal issues relating to the development of the baby in the womb.

Miscarriages are nature’s response to abnormalities in the development of the cells of the baby in the womb.

A human body cell usually contains 46 chromosomes arranged in 23 pairs (23 from the mother and 23 from the father). A chromosomal abnormality happens if a baby carries too many or not enough chromosomes. This means it won’t be able to develop properly. Rather than allow the fetus to continue to develop abnormally, nature expels the fetus. Thus, miscarriage happens.

chromosomes

RISK FACTORS

-Infection: Infections that spread to the placenta including some viral infections.

-Medical conditions in the mother, such as hypertension

diabetes or thyroid disease

– Immune system responses hypertension

-Physical problems in the mother

-Uterine abnormalities

-Pregnant mother lifestyle: Smoking; drinking alcohol; hard drugs and marijuana

-Exposure to radiation or toxic substances

-Weight (obesity or underweight)

-Age: A woman has a higher risk of miscarriage if they are over age 35

-Prior miscarriages (three or more).

– Use of nonsteroidal anti-inflammatory drugs (NSAIDs) around the time of conception

Prevention

Not all miscarriages are caused by genetic abnormalities, medical experts say that the cause of prior miscarriage should be established before another pregnancy. Apart from establishing the cause of prior miscarriages, all risk factors must be avoided.

Dr Odetayo says healthy lifestyle before and during pregnancy may help prevent miscarriages. Healthy lifestyle includes:

-400 mcg of folic acid every day, beginning at least one to two months before conception

-Regular Exercise

-Eat healthy, well-balanced meals

– Avoid stress

-Maintain healthy weight

-No smoking

-No Alcohol

-No Illicit Drugs

-Pre-conception care and counselling for those with diseases such as hypertension, diabetes mellitus or thyroid disorder

-Avoid sports that carry a higher risk of injury- contact sports.

-No self-medication/ over the counter drugs during pregnancy

-Avoid environmental hazards and infectious diseases

-Book pregnancy early for antenatal care.

Source: Dare Agbeluyi, Chief Publisher.

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