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At least one in six couples may find the joy of passing a pregnancy test prematurely. Sometimes it results from health problems, and often – paradoxically – from the wisdom of nature.
According to estimates, about 50 miscarriages occur in Poland each year. This number of pregnancies are terminated before the end of the 20th week. In fact, it is difficult to count all cases accurately, as much as 50-70 percent. of all miscarriages are those where the pregnancy has not yet been confirmed. Many women think that an early miscarriage is a delayed period, which may be a little more painful than usual. They do not even suspect that conception took place several or several dozen days earlier. We have little influence on whether a miscarriage will occur. However, we know the factors that can lead to pregnancy loss. It is worth looking for the causes of miscarriage, if only because the factors responsible for causing the first one may be the causes of the next, and each time it is a painful experience for both partners.
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Nature knows better
Most of the cases, even 80%, are so-called early miscarriages, up to the 12th week of pregnancy, and resulting from biological selection of the woman’s body itself. It’s a bit like “correcting nature’s mistakes”. The fertilized egg reaches the uterine cavity, nestles in its wall, but the resulting embryo stops growing. It happens that the egg or sperm has the wrong number of chromosomes or other defects. The weak embryo is expelled because it would have no chance of survival in the future. A number of characteristic symptoms may appear, such as fatigue, breast pain, nausea, and a positive pregnancy test. This is because the onset of the placenta has already started producing the pregnancy hormone hCG. After a miscarriage, all of these symptoms suddenly disappear. In many countries, eg in the Netherlands, Belgium, France, at-risk pregnancies are not treated until the 15th week, recognizing that this is the time when this natural “screening” of defective embryos can take place.
Am I at risk?
Losing pregnancy can happen to any woman, regardless of age or health. However, as with any abnormality or disease, we also know the factors that contribute to miscarriages.
What can increase the risk of miscarriage?
Age. The older the woman gets, the more likely the fertilized egg will be abnormal. The incidence of early pregnancy loss increases significantly after the age of 35. While in women under the age of 29 it is less than 10%, and in the range of 30-34 – 11,7%, in women over 40 it is already around 50%. In mature women, the number of abnormal eggs is greater, and hormonal disorders and chronic diseases such as diabetes and hypertension are more frequent. The research also confirmed that the father’s age is not without significance. Poor sperm quality, as well as sperm damage, e.g. due to the action of toxic substances, may contribute to a miscarriage;
Some chronic diseases. Diabetes, blood diseases, and hormonal disorders (e.g. polycystic ovary syndrome) may not only make it difficult to get pregnant, but also to report it;
Changes in the reproductive organ. The most common are uterine hypoplasia, its abnormal structure and the presence of polyps, tumors, fibroids, cervical defects, erosions, and inflammations;
Genetic problems. If a woman or her partner’s family has had cases of genetic disease, or the woman has already given birth to a child with the disease, the risk of miscarriage is greater.
Anxieties. Some of them, even those previously used and well tolerated, may be dangerous to the fetus. That is why you should tell every doctor you visit about pregnancy.
Viruses and bacteria. Studies have shown that the risk of miscarriage increases with mumps, rubella, measles, cytomegaly, and HIV. The risk increases with STDs, infections and infections with a high fever. The problem is also poorly treated diabetes, thyroid diseases, hormonal disorders, mechanical injuries;
Contact with toxins. Substances (including vapors) such as lead, arsenic or chemicals, e.g. ethylene oxide, formaldehyde, benzene, can disrupt the development of a new life. One must also be careful with radiation and anesthetics;
Unhealthy lifestyle, i.e. alcohol, smoking and other stimulants, especially the so-called boosters, as well as overexertion, lifting, caring for older children, not getting enough sleep, etc., can lead to miscarriage. A balanced diet is also important. Deficiencies, even of iron or folic acid, are a great threat to women and children. The mental condition of the future mother is not without significance. Fear of pregnancy, anxiety, depression, or constant excessive stress can be harmful;
The risk of miscarriage is greater in women treated for infertility, and also in the case of multiple pregnancies. It may happen that the stoppage of embryo development is caused, for example, by a defect of the umbilical cord or chorion, underdevelopment of the placenta (the so-called acinar moles). There may also be a premature detachment of the placenta, which begins to function after the 12th week of pregnancy.
Another pregnancy in a short time. If 3 months have not passed since the previous birth, there is a high risk that the body will not be able to cope with the next, so much effort.
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When the body is wrong
The diseases that can cause miscarriage include, among others, some autoimmune diseases. It is a group of diseases in which the body misunderstands threats and begins to fight not only viruses or bacteria, but also normal cells. Including the developing embryo. These diseases are difficult to diagnose before pregnancy, because their symptoms often show up only after they are already underway. – It is estimated that the immune factor may be responsible for about 60 percent. all cases of recurrent miscarriages – says Michał Kunicki, MD, PhD, obstetrician-gynecologist from the INVICTA Infertility Treatment Clinic in Warsaw. – Antiphospholipid antibodies and antinuclear antibodies play the most important role. A serious opponent of future parents is, among others antiphospholipid syndrome (APS). These antibodies bind to phospholipids in cell membranes or proteins in the coagulation system, causing changes in various organs, causing thrombosis and making it difficult to conceive or report pregnancy. The condition can be treated. So, if there have been several miscarriages and the cause has not been found, it is worthwhile to test for the presence of antiphospholipid antibodies when planning another pregnancy, start treatment and avoid further failures.
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More stress, risk – not necessarily
One miscarriage does not mean that the risk of losing it will be higher in the next pregnancy. It also does not indicate any disturbances in the functioning of the body, neither of the woman nor her partner. – If you have two consecutive miscarriages, the probability of another one increases from 20 to 30 percent. – says Michał Kunicki, MD, PhD – The course of another pregnancy after several miscarriages is, among others, addicted to the cause that causes them. If it can be established (and all tests are correct in half of the cases) and it is the presence of eg antiphospholipid antibodies, the pregnancy is treated as a high-risk pregnancy. If, on the other hand, the cause lies in an improper hormonal balance, after treating the disorders, the pregnancy can be treated as normal – explains the specialist from Invicty.
Also read: Unnecessary tragedies
Another approach
It is possible to return to efforts for a descendant not earlier than after six weeks. This is how long the uterus needs to regenerate. Of course, a lot depends on individual circumstances, and the most important thing is the mental readiness of both parents. However, taking only medical considerations into account, doctors recommend waiting three consecutive cycles, observing whether they are regular, what is the intensity of the bleeding, whether there are spotting, pain, etc. in the middle of the cycle. This time can also be used to replace deficiencies, e.g. iron, careful testing and – sometimes – treatment. It is sometimes necessary when complications, such as infections, have occurred after the miscarriage. Obviously, it is necessary to be monitored by a gynecologist who will assess whether there has been any intra-uterine adhesions or post-inflammatory closure of the fallopian tube. When a hormonal imbalance was the cause of a miscarriage, this time is needed to rebalance. You should only worry about 2, 3 or more miscarriages.
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When the problem comes back
Dr. Michał Kunicki, MD, obstetrician-gynecologist from the INVICTA Infertility Treatment Clinic in Warsaw:
If there have been at least three miscarriages in the same partner relationship, it is a recurrent miscarriage. This applies to 1-2 percent. couples of childbearing age. It’s about 5 percent. all spontaneous miscarriages. In order to find the causes, a number of tests should be performed, including both partners should have a genetic test, i.e. a specific so-called karyotype. If any abnormalities are detected, it is necessary to consult a geneticist who will propose appropriate treatment. It is important to assess the structure of the reproductive organ in a woman. The basic examination is also ultrasound. If a uterine defect is suspected, the diagnosis is extended to include hysterosalpigography (HSG) and hysteroscopy, which allows the inside of the uterus to be visualized and any abnormalities (e.g. septum in the uterus) to be removed. You should also have immunological tests and tests for congenital thrombophilia (a disease where blood clots are increased). Hormonal tests are also necessary, e.g. to detect disorders of the thyroid gland or polycystic ovary syndrome.
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