Early Miscarriage – An Early Loss of Pregnancy

Globally, about 26 million miscarriages happen every year, and early miscarriage accounts for 80% of all these cases. Thus, it's crucial for everyone planning to have a baby to learn about this problem. In this article, you will find a comprehensive analysis of the symptoms and causes of early miscarriage. Also, some actionable steps will be discussed so you can minimise your risk of miscarriage within the first twelve weeks of pregnancy. 

Understanding Early Miscarriages – Pregnancy Loss in the First Trimester

Early miscarriage or early pregnancy failure occurs when you lose your embryo during the first trimester. Miscarriages often happen on their own, primarily due to the baby not developing properly, which may result from various factors. Globally, approximately 10 to 20 out of 100 pregnancies end in miscarriage. The loss of pregnancy can be a painful and devastating experience. Fortunately there are some therapies and medications that can help reduce your risk of miscarriage.

Early Miscarriage Symptoms

Many miscarriages happen before you realise that you are pregnant. Thus, it can be challenging to recognize that you have had a loss of a pregnancy. Therefore, a thorough assessment of the signs and indications of an early miscarriage can help you understand and enable you to take prompt action.

Although a miscarriage is irreversible, seeking early intervention is crucial to ensure your uterus returns to normal, as well as preventing future recurrences. Please consult your fertility healthcare provider immediately for proper evaluation, support, and treatment if you notice any of the following symptoms during the first weeks of pregnancy.

Vaginal Bleeding

Vaginal bleeding is the most noticeable symptom of miscarriage. Your experience may vary from spotting to heavy bleeding. But light vaginal bleeding is a common occurrence in the early stages of pregnancy, and regular check-ups with your obstetric gynaecologist can help detect anything unusual.   

Abdominal Pain

Pregnant women commonly experience mild abdominal pain or cramping during the first trimester. This pain results from the changes your body is undergoing, including the expansion of the womb, constipation, and stretching of ligaments. However, intensive or persistent abdominal pain could be a sign of a miscarriage.   

Passing Tissue

If you have a miscarriage, you may pass pregnancy tissue or an unusual vaginal fluid discharge from a burst baby sac. It may be difficult to tell if you have passed your baby because the tissue can take the appearance of a blood clot, which may not be consistent. If you pass any unusual tissue during the first trimester of pregnancy, wrap it and take it to the hospital for examination.

Back Pain

Another common symptom of pregnancy loss is mild to severe lower back pain. Just like regular period cramps, uterine contractions that result from a miscarriage can induce lower back pain. Pain medications can help relieve the pain, but you should consult your doctor for further assistance.

Decreased or Loss of Pregnancy Symptoms

If you suddenly cease to experience pregnancy symptoms such as breast tenderness, cravings, and morning sickness, it could be a sign of a miscarriage. However, some women do not exhibit some of these symptoms, and it may not necessarily mean you have lost your baby. Therefore, it is best to visit your doctor for a proper diagnosis as soon as you notice any changes.

Pelvic Discomfort 

Another worrisome sign of miscarriage is pelvic discomfort. The cramping pain in the pelvis could result from the body trying to expel the pregnancy tissue or contractions from the uterus returning to the pre-pregnancy shape and size. Seeking early medical assistance can help prevent long-term impact and improve your chances of having a baby.

What Causes a Miscarriage?

Presently, it may not be possible to tell why a woman has a miscarriage. However, research shows that certain health conditions may lead to a miscarriage. Understanding these causes is crucial in taking actions that help reduce your risk of early miscarriage. The most common potential causes of miscarriage include the following:

Chromosomal Abnormalities

Sometimes, errors occur during chromosomal duplication and division, leading to abnormal chromosome numbers (aneuploidy). Such errors are sporadic because they happen by chance and are not inheritable. The abnormal chromosomes are less compatible with life and can lead to miscarriage. 

Hormonal Imbalances 

The endometrium may fail to develop in preparation for implantation due to hormonal Imbalances such as elevated prolactin levels. As a result, the uterus won't be able to support and nourish the embryo, leading to miscarriage. 

Uterine Abnormalities 

Research shows that about 15% of women with uterine abnormalities experience miscarriage. You can have uterine abnormalities from birth, or you may acquire them later in life. Most of these abnormalities cause a deficiency in nutritional support for your baby, increasing the risk of miscarriage. 

The most common uterine abnormalities include:

• The shape of the uterus: a normal uterus has a triangular cavity and an inverted pear-like shape. In some cases, one can be born with an abnormally shaped uterus with an abnormal or smaller cavity, reducing its capacity to support pregnancy.
  
  
• Uterine fibroids: submucosal fibroids can damage the endometrium or distort the uterine cavity, affecting implantation and growth of the embryo.
  
  
• Uterine polyps are non-cancerous uterine growths or scars that appear like skin tags. These scars result from surgical treatments and can obliterate your uterus, causing miscarriage. Luckily, uterine polyps are manageable.
  
  

Maternal Age

Women who are older than 35 have higher rates of chromosomal abnormalities in their ova. Therefore, your risk of stillbirth and miscarriage increases with age. If you plan to get pregnant and have children later, you can reduce this risk by freezing your eggs in your early 20s. 

Lifestyle Factors 

Some lifestyle habits increase your risk of miscarriage; 

• Smoking exposes the foetus to carbon and limits oxygen, thus increasing the risk of losing your baby.
  
  
• Heavy alcohol intake and the use of illegal drugs like cocaine can be harmful to your unborn baby.
  
  
• Weight problems: research shows that miscarriages are common in women who are overweight or underweight.
  
  

Others 

Other factors that can cause miscarriages include; 

• Physical trauma.
  
  
• Blood clotting disorders (thrombophilia).
  
  
• Diseases that compromise the endocrine system, like diabetes, polycystic ovary syndrome (PCOS), and thyroid disorders.
  
  
• Some autoimmune diseases, such as celiac disease, systemic lupus, and rheumatoid arthritis.

Preventing an Early Pregnancy Loss 

Most miscarriages happen by chance and are not preventable. However, having a miscarriage does not necessarily mean you cannot have a baby. You can help reduce the risk of pregnancy loss by taking actions such as: 

Seeking Early Antenatal Care

A recent study established that early antenatal care (ANC) visits can help reduce early pregnancy loss by about 43%. Therefore, seeking early ANC is one of the best ways to reduce your likelihood of having a miscarriage.

Maintaining a Healthy Body Weight 

Being obese (having a BMI of above 30) increases your risk of losing your pregnancy. The best approach to a healthy weight during pregnancy is losing the extra weight before getting pregnant. Your doctor can help recommend a weight loss specialist or clinic. 

Adopting a Healthy Diet During Pregnancy 

Although a healthy diet is a crucial aspect of living a healthy life all the time, it is more critical during pregnancy or when planning to conceive. You must eat various food categories to give your body the proper nutrients for the baby's growth and development.

Taking Care of Your Emotional Health

Studies reveal that exposure to psychological stress can increase the chances of early miscarriage. Therefore, you should prioritise your emotional well-being during pregnancy to minimise this risk. Ensuring you get quality sleep, practising mindfulness, strengthening social connections, reducing stress, and building resilience can help improve your emotional health.

Avoiding Alcohol and Illegal Drugs 

Research shows that alcohol can pass from your bloodstream to your baby through the placenta. Thus, drinking during pregnancy can have a severe impact on the baby's growth and development and may result in miscarriage or premature birth. 

Avoid or Quit Smoking During Pregnancy 

As mentioned earlier, cigarette smoking denies your unborn baby sufficient oxygen besides exposing it to harmful chemicals. It would be best if you considered quitting or avoiding smoking during pregnancy to increase your chances of a safe pregnancy. 

Treating or Managing Underlying Conditions 

Sometimes, early pregnancy loss may be due to identifiable underlying medical conditions. In this case, treating these conditions can help prevent further miscarriages. Such conditions include weakened cervix or cervical incompetence, antiphospholipid syndrome (APS), PCOS, uterine fibroids, and diabetes. 

Scheduling Regular Check-Ups

Most importantly, scheduling periodic check-ups is crucial during pregnancy. Regular medical exams and ultrasounds help determine the progress of your baby. Moreover, during these examinations, the doctor can detect any underlying condition that could impact the foetus and take timely action.

Conclusion

Losing a pregnancy can be a painful and devastating experience. Sometimes, you may lose your baby before realising you are pregnant. Some warning signs of an early miscarriage include vagina bleeding, abdominal pain, passing tissue, back pain, pelvic discomfort, and decreased pregnancy symptoms.  

The common factors that can cause early miscarriage are chromosomal abnormalities, hormonal imbalance, uterine abnormalities, advanced maternal age, lifestyle factors, and endocrine disorders.

While miscarriage is not preventable, you can reduce the risk of losing your baby during early pregnancy by seeking early antenatal care, maintaining a healthy body weight and diet, and making healthy choices by avoiding smoking alcohol and illegal drugs. Moreover, scheduling regular check-ups, including ultrasound, is crucial to ensuring a safe pregnancy.

References

• van den Berg, M. M., van Maarle, M. C., van Wely, M., & Goddijn, M. (2012). Genetics of early miscarriage. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease, 1822(12), 1951-1959. Retrieved from https://www.sciencedirect.com/science/article/pii/S0925443912001494

• Arck, P. C., Rücke, M., Rose, M., Szekeres-Bartho, J., Douglas, A. J., Pritsch, M., & Klapp, B. F. (2008). Early risk factors for miscarriage: a prospective cohort study in pregnant women. Reproductive biomedicine online, 17(1), 101-113. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1472648310603008

• Larsen, E. C., Christiansen, O. B., Kolte, A. M., & Macklon, N. (2013). New insights into mechanisms behind miscarriage. BMC medicine, 11(1), 1-10. Retrieved from https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-154

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