Contents
Early miscarriage: when the risk of miscarriage is greatest
Pregnancy can end spontaneously for up to 22 weeks of gestation. But it is in the first trimester that their incidence is most frequent. While miscarriages are unpredictable, doctors have identified some factors that can be taken to limit the risk. Almost 15% of diagnosed pregnancies end spontaneously during the first trimester. Many of these early miscarriages have no explanation, but some causes have been identified.
What is an early spontaneous miscarriage?
An early miscarriage is the spontaneous expulsion of an intrauterine pregnancy of less than 14 weeks of amenorrhea. It is most often manifested by blackish or bright red bleeding, possibly accompanied by severe pain in the lower abdomen. It may also not give any symptoms. The doctor then notes that the egg’s development has stopped during the first follow-up ultrasound.
In all cases, regular ultrasounds make it possible to ensure the complete expulsion of the gestational sac. If it does not take place spontaneously, expulsion can be caused by taking drugs that promote uterine contractions and therefore complete detachment of the embryo. This treatment can, if necessary, be supplemented by intrauterine aspiration (curettage). It is then advisable to wait two months before considering a new pregnancy.
Physiologically speaking, a miscarriage usually does not affect future pregnancies. But it should never be considered harmless by the medical, family or friendly entourage.
When there are more than 3 spontaneous early miscarriages, doctors speak of repeated early miscarriages and, from the second miscarriage, carry out various examinations to try to understand the origin.
Risk factors for early miscarriage
Chromosomal abnormalities, the primary risk of miscarriage
Chromosomal abnormalities are found in 50 to 70% of early miscarriages.
Uterine malformations
Repeated miscarriages can be explained by malformations of the uterus. The most common are septate uteri, that is to say, separated into two cavities. Women whose mothers took Distilbene during pregnancy are particularly at risk of uterine malformations.
When the immune system rejects the baby
Sometimes the mother’s immune system produces antibodies that reject the embryo, causing an early miscarriage.
The main diseases that can lead to miscarriage
Hypothyroidism
That is to say the insufficiency of thyroid hormones in the blood, increases the risks of early miscarriage. This is why it is recommended to do a TSH test before a baby project. Pregnant women with hypothyroidism benefit from increased monitoring and should continue to take their daily treatment.
Systemic lupus erythematosus
Systemic disease of autoimmune origin, increases the risk of pregnancy loss, especially if active. Future affected mothers therefore benefit from increased surveillance and, if necessary, preventive treatment.
Rubella
This childhood illness caused by a virus that circulates in the air can cause a miscarriage if it is contracted by the mother-to-be in the first trimester. This is why a blood serology for rubella is systematically done at the beginning of pregnancy. Pregnant women who are not immune (negative serology) can thus benefit from reinforced surveillance.
Prevent miscarriage
Flu vaccination
Current recommendations argue in favor of vaccination, regardless of the stage of their pregnancy. The fever caused by the flu can in particular increase the risk of miscarriage and then premature delivery. Influenza vaccination is 100% covered during pregnancy.
Rubella vaccination
Contracted during pregnancy, this childhood disease can cause miscarriages. This is why a blood serology for rubella is systematically done at the beginning of pregnancy. Pregnant women who are not immune (negative serology) can thus benefit from reinforced surveillance. This is also why vaccination is recommended for women of childbearing age who are not immune.
Monitor the thyroid
Hypothyroidism, which is a lack of thyroid hormones in the body, is not always easy to diagnose. However, it can explain some miscarriages. This is why it is now recommended for women planning to have a baby to have their TSH dosed.
Watch out for fever
Fever can be a symptom of an infectious disease (listeriosis, urinary tract infection, rubella) that can cause a miscarriage. It can also cause contractions which can also lead to pregnancy loss. It is therefore better to seek medical advice if a fever above 38 ° persists for more than 24 hours, even without other symptoms. Attention, to lower a slight fever, only paracetamol is authorized. Aspirin and ibuprofen are contraindicated during pregnancy.
Do sports, a risk of miscarriage?
Sports practice does not increase the risk of miscarriage. On the contrary, it is recommended throughout pregnancy, by adapting it of course: forgotten the notions of performance and competition, physical activity must be moderate and regular. It makes it possible to limit weight gain, reduce the risk of gestational diabetes, channel anxiety, treat insomnia, relieve lower back pain … Yes to walking, swimming, water aerobics, yoga, exercise bikes, soft gyms… On the other hand, combat sports, contact sports, sports with a risk of falling (horse riding, downhill skiing, windsurfing, cycling) are not recommended. As for diving, it is totally prohibited.