Signs and symptoms of a miscarriage can appear in pregnant women at up to 20 weeks of pregnancy. Pregnancies that do not make it to term after 20 weeks are usually referred to as second trimester or third trimester loss.
The main symptoms of a miscarriage are:
- Fever and chills;
- Vaginal discharge with foul odor;
- Vaginal bleeding, which may start with a brownish color;
- Severe abdominal pain, like severe period cramps;
- Loss of fluid from the vagina, with or without pain;
- Loss of blood clots from the vagina;
- Severe or constant headache;
- Absence of fetal movements either through felt or confirmed via ultrasound.
Miscarriages can occur suddenly without a specific trigger, but there are situations that can provoke a miscarriage. These include fetal malformation, excessive intake of alcohol or drugs, trauma to the abdomen, certain infections and a history of diseases that are not well-controlled (e.g. diabetes and hypertension).
What to do if you suspect you have had a miscarriage
If you have any of the above symptoms and suspect you are experiencing a miscarriage, proceed to the nearest emergency room immediately. The doctor will assess your symptoms as well as the baby's well-being. what you should do is go to the hospital as soon as possible and explain your symptoms to the doctor. The doctor will order testing and indicate treatment as appropriate, which may involve medication and bed rest.
How to prevent a miscarriage
The risk for miscarriage may be reduced by taking some factors into consideration, like avoiding all alcohol consumption and avoiding any medication use that is not directed by your doctor.
Also, pregnant women should only participate in exercise that is light to moderate, and should try to choose physical activities that are pregnancy safe. All prenatal care, including appointments and testing should be completed as directed by the doctor or obstetrician.
Women who have a higher risk for miscarriage or who have had complications that may prevent them carrying to term will require more frequent monitoring.
Types of miscarriages
Miscarriages can be classified as early (when there is fetal loss prior to week 12) or late (when there is fetal loss between weeks 12 and 20). In some cases, the termination of a pregnancy can be induced by a doctor, and it is usually done for therapeutic reasons.
When a miscarriage occurs, pregnancy tissue may be completely or partially eliminated, or not be eliminated at all. These miscarriages are classified as:
- Incomplete miscarriage - when the membranes rupture but only part of the pregnancy tissue is expelled
- Complete miscarriage - when all pregnancy tissue has been expelled
- Retained products of conception - when the fetus is retained in the uterus for 4 weeks or more.
In some parts of the world, abortion (a conscious decision to terminate the pregnancy) are not legal, and will only be completed if the baby's life or mother's life are at risk. In some countries, the law will allow abortion for a pregnancy that is a result of sexual abuse.
What happens after a miscarriage
After a miscarriage, you must be assessed by a doctor, who will evaluate whether there are any traces of pregnancy tissue inside the uterus. If any tissue is retained, a dilation and curettage (or D&C) is performed. The doctor might also consider prescribing a medication that will help with expulsion of any remaining pregnancy tissue, or perform surgery to remove the fetus immediately.
The doctor may recommend medication that causes the expulsion of embryonic remains or may perform surgery to remove the fetus immediately.