อาการแท้งลูก สาเหตุที่แท้งลูก ปัจจัยเสี่ยงที่ทำให้แท้ง - Miscarriage: Symptoms, Causes, Risk factors and Preventions

Miscarriage

A miscarriage, also known as a spontaneous abortion, refers to the unforeseen termination of a pregnancy within the first 20 weeks of gestation. This condition can happen from various causes. Around 80% of pregnancy loss occurs during

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What is miscarriage?

A miscarriage, also known as a spontaneous abortion, refers to the unforeseen termination of a pregnancy within the first 20 weeks of gestation. This condition can happen from various causes. Around 80% of pregnancy loss occurs during the first trimester or 14 weeks of pregnancy. Miscarriages are beyond your control.

How many types of miscarriage?

  1. Threatened miscarriage: This occurs when your cervix is closed despite the vaginal bleeding and while the fetal heartbeats are still detectable. The pregnancy typically continues with no further issues. Your doctor will closely monitor you for the rest of the pregnancy.
  2. Inevitable miscarriage: Your cervix dilates, and the amniotic fluid may leak, which tends to lead to eventual miscarriage. 
  3. Complete miscarriage: You experience vaginal bleeding and pass fetal tissue. 
  4. Missed miscarriage: You are unaware of the pregnancy loss as you experience no symptoms. The missed miscarriage can be confirmed with a prenatal ultrasound when there is no fetal heartbeat. 
  5. Recurrent miscarriage: You have three or more consecutive miscarriages. 1% of pregnant women experience this type of pregnancy loss.

อาการแท้งลูก ปวดท้องรุนแรง มีเลือกออกตอนท้อง - Miscarriage: vaginal spotting or bleeding, which can be painful in some individuals.

What causes miscarriage?

Miscarriages can be due to a range of factors, including -- infection, exposure to TORCH diseases, hormonal imbalances, improper implantation of the fertilized egg in the uterine lining, maternal age, uterine abnormalities, incompetent cervix, severe malnutrition, smoking, alcohol consumption, or substance use, immune system disorders like lupus, severe kidney disease, congenital heart disease, uncontrolled diabetes, thyroid disease, radiation exposure, and certain medications, such as isotretinoin, an acne drug.

However, chromosomal abnormalities account for approximately 50% of miscarriages during the first trimester of pregnancy. If an egg or sperm possesses an abnormal number of chromosomes, the developing fetus will also have an irregular count, leading to miscarriage.

Some people believe that stress, exercise, sexual activity, or prolonged use of birth control pills can cause miscarriage; however, there is no scientific evidence supporting the idea.

What are the symptoms of miscarriage?

The symptoms of miscarriage can vary from person to person. For some, it may involve painful cramping and bleeding, like a heavy menstrual period. Others might experience cramps resembling those during menstruation. Interestingly, some individuals may not be aware of a pregnancy loss until they undergo a prenatal ultrasound, as symptoms may not be externally apparent.

Common signs and symptoms are as follows:

  • Vaginal spotting or bleeding, which can be painful in some individuals. 
  • Pelvic cramps or lower back pain -- the degree of pain depends on the type of miscarriage. 
  • Passage of large blood clots or tissue through the vagina. You should retrieve the tissue in a clean container and bring it to your doctor for an examination.

What are the risk factors for a miscarriage?

  • Age: For women who are in their 20s, the risk of miscarriage is around 12% - 15%. The risk of miscarriage rises to around 25% in women who are 40 years old. A chromosomal abnormality is the most common cause of age-related miscarriages.
  • History of miscarriage: Women who have a previous miscarriage have a 10-25% chance of another miscarriage.
  • Preexisting health conditions: Women with unmanaged diabetes, infections, or problems with the cervix or uterus have a higher risk of miscarriage.

ทำไมแท้งลูก แท้งลูกเกิดจากอะไร - Risk factors for a miscarriage

How is a miscarriage diagnosed?

  • An ultrasound can check the presence of the fetus and fetal heartbeat. 
  • A blood test can ascertain the human chorionic gonadotropin (hCG) hormone levels. Low hCG levels are signs of miscarriage.  
  • The doctor may perform a pelvic exam to check the opening of your cervix
    If you have recurrent miscarriages, your doctor may recommend additional procedures as follows: 
  • Genetic tests: The fetal tissue from the pregnancy loss is testable for genetic abnormalities, or you and your partner can have karyotyping to check for chromosome irregularities.
  • Blood tests: They can help detect if you have hormonal or autoimmune disorders which cause miscarriages.
  • Hysteroscopy 
  • Laparoscopy 

How is miscarriage treated?

If you experience a miscarriage, your doctor can perform an ultrasound to check if the uterus has expelled all the fetal tissues. If the miscarriage is complete, no further treatment is required. However, if some fetal tissue remains, you need to have it removed to prevent infection, heavy bleeding, and other complications.

  • Nonsurgical treatment
    If a miscarriage occurs before the tenth week of pregnancy, especially a missed miscarriage, you should wait to allow your body to pass the fetal tissue and products of conception. However, if waiting poses a risk, the doctor may prescribe medication to stimulate your uterus to expel the products of pregnancy. 

    If you experience miscarriage symptoms like bleeding, your doctor will ask you to bed rest for 2-3 days. Once the bleeding subsides, you can continue your daily activities as usual. In some cases, hospital admission for observation may be necessary. If you have a dilated cervix, you may be diagnosed with an incompetent cervix, which requires cervical cerclage to close the cervix. 
  • Surgical treatment
    If the miscarriage occurs after the 10th week of pregnancy with retained fetal tissue, or you have heavy bleeding, a dilation and curettage (D&C) or dilation and evacuation (D&E) will be performed. 
    After a miscarriage, you can have mild discomfort or spotting. Refrain from having sexual intercourse. Avoid inserting anything, such as a tampon, in your vagina for at least two weeks. Seek immediate medical care if you develop heavy bleeding, fever, chills, and intense pain, as these are signs of infection.

ป้องกันการแท้งบุตร แท้งลูก - What are the preventions of miscarriage?

What are the preventions of miscarriage?

Though most instances of miscarriage are not preventable, you can focus on your health to enhance the health of your baby.

  • Always consult your doctor for preconception care and attend your prenatal appointments. 
  • Avoid alcohol consumption, smoking, and substance use. 
  • Take vitamin supplements as prescribed by the doctor.
  • Limit your caffeine consumption to 200 milligrams daily (a 12-ounce cup). Check your food for caffeine. High doses of caffeine may lead to miscarriage and preterm birth. 
  • Inform your doctor if you have a preexisting health condition.

FAQ

  • Is it possible to get pregnant after a miscarriage?
    Yes, it is. Around 87% of the women who experience miscarriage can still become pregnant. 
  • When can I attempt pregnancy following a miscarriage?
    You can consider trying again after experiencing one normal menstruation. It is crucial to allocate time for both physical and emotional healing after a miscarriage. If you have had three consecutive miscarriages, discuss with your doctor the possibility of undergoing tests to identify any underlying causes. It is advisable to use birth control until the test results are available.
  • How do I manage the emotional impact of my miscarriage?
    Experiencing the loss of a pregnancy can be deeply distressing. Recovering emotionally from a miscarriage often proves to be more challenging and prolonged than the physical healing process. Talk and share your feelings with your partner, friends, and family, surround yourself with supportive individuals, or consider professional counseling to cope with this loss.

A note from MedPark’s doctor

Experiencing a miscarriage is an emotionally fraught moment for soon-to-be parents. It is crucial to understand that a miscarriage can happen to anyone and is not necessarily an indication of infertility. It is essential to avoid self-blame for the miscarriage and allow yourself the necessary time to heal both physically and emotionally. Take the time needed to grieve, seek support, and when you are ready, consider preparing for a future pregnancy. Remember that the journey to parenthood can be complex, and compassionate self-care is essential during this difficult time.

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Published: 11 Feb 2024

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