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Miscarriage (Abortion) occurs when a pregnancy ends before the baby is viable. Most miscarriages happen before the pregnancy is discovered. The cause of miscarriage cannot always be found. Here’s everything you need to know about the causes and risks of miscarriage
Also known as medical or chemical abortion, this treatment is considered the first choice method for terminating a pregnancy within the first few weeks of conception.
To be performed, pharmacological abortion requires the administration of an abortive drug—responsible for detachment of the embryo sac—and a prostaglandin analog, which induces contractions of the uterus favoring the expulsion of the embryo, sac, and amniotic. essential for. fluid, as well as the formation of the early placenta.
Throughout the article, the main features of medicinal abortion and the cases in which it can be used, possible side effects and contraindications for the implementation of this particular treatment will be analyzed.
Did you know that…
Medicinal abortion is also often referred to as “paradoxical”.
what is that
What is Medicinal Abortion?
Medicinal abortion is the termination of a pregnancy performed through the administration of a specific abortion drug, followed by the administration of a drug capable of inducing contraction of the uterus to favor expulsion of the fetus.
In Italy, medicinal abortion is a medical treatment that must be performed in authorized hospitals or clinics. As a result, the drugs used to carry it out are for hospital use only and must be prescribed and administered only by specialized medical personnel in the area.
Hints on the legislative aspects of abortion
Voluntary termination of pregnancy – by resorting to medicinal and non-medicinal abortion – in our country is permitted and regulated by Law 194. However, doctors opposing this type of practice can appeal for conscientious objection, refusing to prescribe and administer essential drugs. For interruption of pregnancy.
Despite this, the Court of Cassation has ruled out the possibility of raising a conscientious objection at the stage of embryo expulsion, during which the doctor – even if a conscientious objector – is required to provide assistance to the patient as it is a case of abortion surgery. Medical assistance provided after
Simplification, if a woman has already taken the necessary medicines for a medicamentous abortion or has already had a surgical abortion, the medical staff present at the time that the fetus and the material contained in the uterus is removed and the fetus is present In the later stages of removing the pouch, it is imperative to provide health care, even if it is a conscientious objection.
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Miscarriage (Abortion) occurs when a pregnancy ends before the baby is viable. Most miscarriages happen before the pregnancy is discovered. The cause of miscarriage cannot always be found. Here’s everything you need to know about the causes and risks of miscarriage.
Causes and Risks: Disorders in previous pregnancies (eg miscarriage, preeclampsia), maternal diseases, obesity, drug and alcohol abuse, smoking, stress, chromosomal disorders, infections, pollutants, immune response, hormonal disorders, physical causes
Symptoms: Vaginal bleeding, abdominal pain, pregnancy symptoms may subside
Diagnosis: ultrasound examination, gynecological examination, measurement of -hCG value
Treatment: bed rest if there is a risk of miscarriage, anti-constriction medication, treatment (suction or curettage) of the uterus if there is evidence of miscarriage, medication to induce labor if the abortion is late
Prognosis and course: depends on the cause, concomitant diseases and timing of treatment. After a miscarriage, there is usually a possibility of getting pregnant again.
Prevention: There is no general preventive measure. A healthy lifestyle, preventive medical screening and adequate treatment of concomitant diseases contribute to a healthy course of pregnancy.
What is Miscarriage?
In the event of a miscarriage, the pregnancy ends before the child is viable. A baby is considered clinically viable after the 23rd week of pregnancy and weighing 400 g at birth. If the pregnancy ends after this time, the baby speaks of premature birth if it is born alive.
In such a situation, special measures are taken to keep the child alive. This includes drugs for lung maturation and intensive care treatment. However, if the baby has already died in the womb, it is called a stillbirth.
Miscarriages also split at times. Early miscarriage is abortion before the 13th week of pregnancy. A miscarriage that occurs after the 16th week of pregnancy is called a late miscarriage.
If the miscarriage is due to natural causes, then the doctor speaks of spontaneous abortion. On the other hand, there are so-called artificial abortions, that is, artificially induced abortions through pharmacological or chemical measures. An example of this is abortion.
Some women have recurrent miscarriages. Doctors then talk about habitual abortion.
According to the guidelines of the European expert societies, it is a habitual abortion if a woman has had three or more consecutive miscarriages before reaching the 22nd week of pregnancy. The American Society for Reproductive Medicine recommends habitual abortion after two consecutive miscarriages.
About 10 to 15 percent of medically diagnosed pregnancies end in miscarriage. There are also pregnancies that can only be detected in the laboratory. It shows an increase to a certain value (ß-hCG), but there are still no clinical signs. If you include these pregnancies, the miscarriage rate is around 50 to 70 percent.
It has also been observed that the risk of miscarriage increases with every loss. The age of the mother also plays a role. The chances of miscarriage increase with age. A 40-year-old woman has a 40 percent chance of miscarriage.
Missed abortion: at which week of pregnancy is it most common?
The so-called missed abortion (also missed abortion or missed miscarriage) occurs mainly by the twelfth week of pregnancy. Typical symptoms of miscarriage such as bleeding is absent and the dead fetus remains in the uterus.
Father’s risk factors
Not only the mother, but the father also provides risk factors for miscarriage. Poor sperm count increases the risk of miscarriage. In case of increased miscarriage, a spermiogram can provide information. The presence, number and motility of sperm are assessed. Studies have shown that the likelihood of changes in spermatozoa increases with age.
Risk factors immune system
There are disorders in the mother’s immune system that favor abortion. In the most critical case, the body’s defenses attack the fertilized egg cell. Transplantation usually doesn’t happen at all. If it does, it is defective and ends in early miscarriage.
A blood group factor, the so-called Rhesus factor, sometimes plays a role in miscarriage. If the pregnant woman is rhesus negative and the unborn child is rhesus positive, the mother’s immune system produces antibodies. In the next pregnancy, these antibodies lead to a defense response against the unborn baby and trigger a miscarriage.
To prevent this type of miscarriage, gynecologists test pregnant women for related antibodies. To prevent the formation of antibodies, affected pregnant women receive an injection (so-called anti-D prophylaxis).
fetal risk factors
The most common cause of miscarriage is genetic changes in the fetus. The genetic information is located on the chromosomes in the cell nucleus. Half of the chromosomes come from the mother and half from the father. If there is a deviation in the number or size of these chromosomes, it leads to malformation in the fetus.
As a result, viability is limited or non-existent. The embryo dies and a miscarriage occurs.
Risk factors doctor
In some cases, medical interventions also lead to miscarriage. radiation, such as that is used in computed tomography, damages the genetic material of the fetus, up to and including miscarriage. In addition, certain drugs or certain vaccinations (so-called live vaccines) increase the chances of miscarriage.
The operation should also be avoided during pregnancy, as the operation and any anesthesia that may be needed increases the risk of miscarriage. Methods to detect malformations in the baby, such as examination of amniotic fluid (amniocentesis) or placenta (chorionic villus biopsy), also increase the risk of miscarriage.
Risk factors Smoking, alcohol and drugs
Studies show that if the mother smokes, drinks alcohol or takes drugs during pregnancy, it can lead to serious developmental disorders or malformations in the fetus or fetus. Excessive alcohol consumption is the most common cause of early miscarriage.
Risk factor stress
Mental stress increases the risk of miscarriage. An imbalance in the immune system and hormone balance disrupts pregnancy. On the one hand, low levels of hormones (especially progesterone) are observed, which maintain pregnancy. On the other hand, there is an increase in immune cells, which can lead to miscarriage.
In the early 1990s, an association between anxiety and increased rates of miscarriage was discovered. Above all, fears during pregnancy and childbirth affect the chances of miscarriage.
Accidents or similar serious traumatic events are also considered potential triggers of miscarriage.
Examination and diagnosis
As soon as a pregnant woman notices typical symptoms of miscarriage, she should see her gynecologist as soon as possible. The doctor will first examine the abdomen thoroughly to determine whether there is contraction or pain in the abdomen. For example, in an infected abortion, the uterus is tender.
The doctor examines the vagina and cervix. His special focus is on the cervix. The doctor evaluates whether it is closed or painful. In case of vaginal bleeding, he looks for the cause.
It is also important to locate the bleeding site. In an incomplete miscarriage, parts of the abortion tissue are still present in the uterus or cervix.
However, miscarriage cannot be diagnosed by examining the cervix alone. Bleeding or labor pain does not always accompany a miscarriage (eg with a “missed miscarriage” or a missed miscarriage). And the cervix often remains closed even when there is a risk of premature birth.
Therefore an ultrasound examination is necessary if a miscarriage is suspected. From this it can be found out whether the child remains in the mother’s womb or not. The unborn baby’s heartbeat can be seen in an ultrasound scan from about the sixth to seventh week of pregnancy.
If, for example, a bruise behind the placenta is the cause of an impending miscarriage, this can be shown with the help of ultrasound.
If the ultrasound examination does not give any obvious signs, the pregnancy hormone -hCG (human chorionic gonadotropin) is prescribed at regular intervals. Normally, this value continues to increase, especially at the beginning of pregnancy. In case of miscarriage, there is no increase in -hCG or the value is already low.
In addition, laboratory controls provide indications of an increased risk of miscarriage. A blood count, for example, shows not only typical signs of infection but also anemia.
A woman’s treatment after a miscarriage essentially depends on the type of miscarriage. Therapy depends on how far the miscarriage has progressed or whether it is still possible to get pregnant.
If there is a risk of miscarriage, the pregnant woman is advised to take bed rest. Vaginal examination should be avoided. The doctor usually monitors the condition of the unborn child to treat a miscarriage
If the doctor has definitely prescribed a miscarriage, then in many cases a cure is performed. In the case of an incomplete miscarriage, the parts of the pregnancy that remain in the uterus (such as the placenta) are removed. If this is not done, there is a risk of continued bleeding or serious infection, including blood poisoning (sepsis).
Abortion without treatment is possible from 24th week of pregnancy followed by complete abortion. This is only necessary if it is suspected that all parts of the pregnancy have indeed been terminated. Even if the bleeding does not stop after a miscarriage or the uterus does not contract afterwards, an intervention is still necessary. This is to avoid complications after a miscarriage.
Abortion instead of medicat cure
In the case of the so-called wind egg, that is, a pregnancy in which no child develops, and in the case of a delay in early abortion until the twelfth week of pregnancy, a scraping is necessary. At a later date, drugs are administered earlier. These aim to loosen and widen the cervix and stimulate the muscles of the uterus. Thus the dead embryo is thrown out.
Doctors also give the same medicine before surgical removal. This reduces the risk of injury to maternal organs from surgical instruments.
Read more about treatments
Read more about treatments that can help here:
Curriculum and Forecast
If a pregnant woman through abortion If I lose my baby, it is important that the doctor act very carefully and consistently. She should stop bleeding quickly, but at the same time ensure that the condition for subsequent pregnancies is maintained.
There is a risk of damage to the lining of the uterus due to careless scraping. This can affect the chances of getting pregnant again.
It is especially important to find out the cause of the miscarriage. This lowers the risk of similar complications if you become pregnant again. In principle, another pregnancy is possible after a miscarriage.
Pregnant after miscarriage
After experiencing a miscarriage, many women worry about a second pregnancy. Read everything you need to know about getting pregnant after a miscarriage here.
If germs enter the uterus after a miscarriage, infection occurs. Affected women develop fever between 38 and 39 Celsius. In some cases there is bleeding and pain. Infection mainly occurs after improper evacuation of the abortion.
In the case of this so-called infected abortion, transmission in the blood must be prevented at all costs, otherwise there is a risk of life-threatening blood poisoning and coagulation disorders. So the affected women are given antibiotics. The uterus is not examined until the patient is free from fever.
In addition to the medical aspects of abortion, it is also important to consider the mental state of those affected. After experiencing a miscarriage, affected women often fear that if they get pregnant again, they will still have a miscarriage.
For this reason, it is important that a doctor explains the possible causes and risks of miscarriage. After a spontaneous miscarriage, there is an 85 percent chance that another pregnancy will be normal.
Can abortion be prevented?
There is no general way to prevent miscarriage. However, some factors contribute to a healthy pregnancy, including:
Healthy lifestyle with balanced diet.
a healthy body weight
Avoid harmful substances such as alcohol, nicotine or drugs
Treat existing diseases such as diabetes mellitus, thyroid dysfunction or high blood pressure
Regular preventive check-ups at the gynecologist – this way, possible infections can be detected and treated at an early stage
It is better to avoid sports with high risk of injury during pregnancy.
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