Miscarriage, i.e. the loss of an unborn child, is a painful experience for a woman and difficult to rationalize. What could be causing a miscarriage and how to get back into balance after losing your pregnancy?

Worn for a dozen or so or even a few weeks, the baby was a source of dreams, hopes and plans, the whole future life, and suddenly - like a bolt from the blue - a job-related message fell on the woman: the fetus is dead. The whole world dies with him. It's hard to imagine any more pain than pregnancy loss. And for would-be mums it does not matter that the child lived only in her body, that she had not yet had time to pick him up, look him in the eyes or hug him. It was their child for them. Immersed in sadness and regret, and even in despair or depression, they ask themselves: why has this happened to me?

Common causes of miscarriage

Before we move on to listing the most common causes of miscarriages, let's emphasize one thing: this phenomenon is not that rare - miscarriage is an experience that must be faced by approx. 20 percent. par. And if you add a miscarriage so early that a woman does not even realize that she is pregnant, it turns out that the miscarriage rate is over 50%. all conceive. So only less than half of fertilization results in the birth of a child. The most common causes that lead to a miscarriage include :

  • Embryo disease - this is the most common cause of early miscarriage (up to the 12th week of pregnancy); the embryo dies because of serious chromosomal defects or other genetic abnormalities that prevent its proper development. Even if such a pregnancy was termed, the child would have severe birth defects. So nature corrects the error that arose at fertilization. It is estimated that this happens in the case of approx. 50 percent. early spontaneous miscarriages; such a natural selection takes place between the 6th and 7th week of pregnancy1 .
  • Viral infections - this is the second most frequent cause of embryo death. Sometimes a banal viral infection - a two-day runny nose, aching muscles, sometimes diarrhea - after a few or several days results in spotting, and then an ultrasound examination reveals the death of the embryo or fetus1 .
  • Hormonal disorders - both the deficiency of sex hormones, which support pregnancy, andother endocrine disorders related to diabetes or thyroid diseases can also result in miscarriage; such miscarriages usually occur up to the 12th week of pregnancy1 .
  • Changes in the reproductive organs - anatomical defects of the uterus (septal uterus, two horns), fibroids, cervical injuries, cervical insufficiency, damage to the endometrium, i.e. the lining of the uterus, are also among the most common causes of miscarriages; in such cases, the miscarriage usually takes place a bit later in pregnancy - in the second trimester1 .
  • Some infectious diseases - miscarriage may also result in infection of a pregnant woman with rubella, toxoplasmosis, chlamydiosis and other bacterial or fungal diseases, especially with high temperature1 .
  • Immune-related disorders - miscarriage can also cause some immune-related diseases, primarily the antiphospholipid syndrome (ASP), also known as lupus, in the course of which antibodies from the mother's blood prevent the formation of a normal placenta1 .
  • Complicated pregnancy - ectopic pregnancy, molar (degenerative change in the tissue forming the placenta), and in the 2nd and 3rd trimester - rupture of the fetal bladder, intrauterine infection, premature detachment of the placenta most often lead to miscarriage1.

In addition to the causes mentioned above, there are also external and environmental factors that greatly increase the risk of miscarriage. These include: poor nutrition, heavy physical work (e.g. lifting heavy objects), alcohol, nicotine, x-rays and ionizing radiation, certain medications, and severe psychological shock.

According to an expertprof. dr hab. Romuald Dębski, obstetrician gynecologist

Until his death in December 2022, prof. Dębski headed the gynecology department of the Bielański Hospital, previously - the Obstetrics and Gynecology Clinic at the prof. Orłowski. He was an outstanding specialist in the field of obstetrics and gynecology, perinatology, gynecological endocrinology and reproductive medicine. Academic lecturer and author of many publications related to obstetrics and gynecology, gynecological endocrinology and ultrasound diagnostics. An excellent lecturer and a respected doctor, specialist in "difficult and hopeless matters", devoted to the end of his patients.

Rescue from disability

Miscarriageis an extremely unpleasant experience. In most cases, it is the result of correcting mistakes made by nature when creating a new life. This is on the one handirreparable loss, but often the only way to save yourself from severe disability.

One common chromosomal cause of miscarriage is the trisomy of the 16 chromosome pair, or the triple set of all chromosomes, defects never found in newborn babies. Fortunately, these developmental abnormalities do not tend to repeat themselves.

There are 15-20% of pregnanciesabused. So about 1 percent. completely he althy women can miscarry three times! Therefore, while it may seem heartless, only then should you look for abnormalities that may cause recurring pregnancy losses.

Many women would like to undergo such diagnosis after two or even one miscarriage. This is unfounded, because by performing hundreds of unnecessary tests, lying down 24 hours a day and taking a lot of drugs, after getting pregnant again they have exactly the same risk of miscarriage: 15-20 percent. How better it is to think that the chance of having a he althy baby is very high, as it is 80-85 percent.

When there is a miscarriage

When a miscarriage occurs early (around the 6th-7th week of pregnancy) it is almost always the so-called complete miscarriage, i.e. the embryo is spontaneously expelled from the woman's body along with the entire fetal tissue. The uterus cleans itself. If the pregnancy was more advanced, the embryo is expelled from the uterus, and only a part of the placenta and fetal membranes. It is then necessary to perform curettage of the uterus, i.e. mechanical removal of the remains of fetal tissue from it. It is most often performed under general anesthesia. The material collected as a result of curettage is subjected to histopathological examination, but its result often does not indicate the cause of the miscarriage. It also happens that the pregnancy dies, but the uterus does not contract, the cervix remains closed and the fetus is not expelled. This state of affairs could last up to 3-4 weeks. Carrying a stillborn baby and waiting for a spontaneous birth is difficult for a woman to deal with. Therefore, according to psychologists, the miscarriage should occur within three days at the latest, so that the psychological costs incurred by the woman are as low as possible.

How to survive the loss of pregnancy?

  • You should allow yourself a period of mourning; not refraining from crying - a woman has the right to be sad and even despair. Mourning the loss is an important stage in recovering. Some women find it helpful to create a memorial site like a child's grave - symbolic or real. The current regulations allow for the burial of even a few weeks old fetus.
  • You should talk to your loved ones about your loss and your experiences with itrelated. In these difficult times, it is extremely important to support your husband or partner, but also other people, e.g. a friend, mother, doctor, maybe a priest.
  • Find contact with other women who have or are going through the same thing - support groups are available at some hospitals and psychology clinics, and the easiest way to find them is online.
  • Whenever possible, you should go away with your husband or the closest person for at least a few days. It will not be a carefree vacation, but the time spent in a beautiful, quiet place, talking and walking, will allow you to break away from the surroundings, where everything reminds you of a tragedy, and strengthen ties and a sense of closeness.
  • You should also try to find a specific activity, for example to tidy up the garden or balcony or to renovate it. It will not be possible right after the tragedy, but when a person has something to do for his hands (and head), the most difficult time necessary to reconcile with what has happened will pass faster. Because time is essential - it's a truism, but it's just the way it is. From the perspective of several months or years, the dimension of each tragedy decreases - otherwise we could not live on.

Survive the toughest moments after a miscarriage

It can be difficult because probably every woman will meet with unfortunate consolation like You haven't had time to meet this child or get used to him, you can still have many children. People who say this have no ill will, they only lack delicacy and understanding, because in fact no one who has not experienced such a tragedy himself is able to understand what a woman feels after a miscarriage. But what is worst to bear is the sight of pregnant women and young children. It hurts. Try not to show anger or regret, as no one is to blame for what happened, especially bystanders. You have to remember that in the immediate vicinity there are people who still need a wife, mother, daughter, sister, that there is someone to live for.

Planning your next pregnancy

Most doctors are of the opinion that after the first miscarriage, you do not even need to do special tests - you just need to give your body some time to regenerate, and above all, for the woman to regain her mental balance. Life shows that they are often right. It is to be believed that the vast majority of women who have a miscarriage become pregnant, sooner or later, and give birth to a he althy child. But how to regain this balance? It is difficult, but necessary. For many women, the best treatment for depression is to become pregnant again. Although you can start intercourse 4-6 weeks after the miscarriage, some doctors recommend itat least a 3-month break before the next pregnancy, which will allow the body to regenerate. Please consult your doctor and find out his position on this matter.

Post-miscarriage tests worth doing

During a medical visit (about 3 weeks after a miscarriage), the doctor may order basic tests, such as ultrasound (in the first trimester in women with recurrent miscarriages, and in the second trimester in all women with at least one pregnancy loss 1and blood hormone tests Many doctors stop there by supplementing the case report with a careful history and recommending that you take folic acid before the next conception. only after a woman miscarries three times. Many of these tests can be done on your own, but then they are payable. It is worth doing, for example, tests for progesterone and prolactin levels, tests for thyroid function (TSH), tests for rubella infections, toxoplasmosis, Chlamydia bacteria, possibly immunological tests for the presence of antiphospholipid antibodies. Detection of possible anatomical defects of the uterus is possible during ultrasound or hysterosalpingography (HSG)1 . It is an X-ray after the contrast is administered intra-uterinely. If the test results turn out to be bad - treatment can be started, and when the test results are good - they give the woman the feeling that she has done everything she needs to make her next pregnancy develop properly. If a woman has no anti-rubella antibodies in her blood, she should be vaccinated. After rubella vaccination, you should not become pregnant for three months. In addition, it is also worth getting a flu vaccine. Above all, however, you have to come to terms with the loss of pregnancy and start living again, thinking positively and believing that your dreams of motherhood will soon come true. You should rest, slow down, take care of yourself and your relationships with your loved ones, and there will be a very good chance that this will happen and soon the desired child will come to the world.

Read:

Fetal development: how the fetus develops week by week

Pregnancy at risk: causes. Where are the problems with termination of pregnancy?

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