Treatment of Miscarriage During Pregnancy

Miscarriage is the termination of pregnancy in the first 20 weeks of pregnancy. The incidence in pregnancy is 10%.

Types of Miscarriage:

- Early miscarriage: It is a miscarriage that occurs before the 12th week of pregnancy.

- Late Miscarriage: It is a miscarriage that occurs between the 12th and 20th weeks of pregnancy.

- Recurrent Miscarriage: Two or more consecutive pregnancies resulting in miscarriage.

- Early Pregnancy Loss: This is when the baby's heartbeat stops before the 12th week and the pregnancy ends spontaneously.

Symptoms of Miscarriage:

- Vaginal bleeding (can range from spotting vaginal bleeding to heavy vaginal bleeding)

- Abdominal pain (may be cramping or more sharp pain)

- Low back pain

- Tissue or fragments coming from the vagina

Causes of Miscarriage:

The exact cause of miscarriage cannot always be determined. However, some risk factors are as

follows:

- Chromosomal abnormalities: Abnormalities in the baby's chromosomes and genetic structure can cause miscarriage. It is the most common cause.

- Hormone imbalance: Hormone imbalances such as insufficient progesterone production can cause miscarriage.

- Intrauterine abnormalities: Masses inside the uterus, such as fibroids or polyps, which cause irregularities in the lining of the uterus, can affect the baby's attachment to the uterine wall and cause miscarriage.

- Infections: Some infections such as Toxoplasma, Cytomegalovirus can cause miscarriage.

- Trauma in the womb: Trauma such as a fall or accident can cause miscarriage.

- Chronic diseases: Chronic diseases such as diabetes, thyroid disease or immune system disorders can increase the risk.

- Age: The risk of miscarriage increases in pregnancies after the age of 35.

- Smoking and alcohol use: Smoking and alcohol use can cause miscarriage.

- Drug use: Drug use is also a risk factor for miscarriage.

Miscarriage Treatment:

The treatment of miscarriage depends on the type of miscarriage, the week of pregnancy and the general health of the patient. Methods applied in miscarriage treatment:

Rest: At rest, the blood flow to the uterus increases by 20%. This is especially important for pregnancies in the first weeks.

Progesterone treatment: If insufficient progesterone levels are detected, progesterone hormone supplements may be given. Progesterone treatment is administered orally, vaginally or as intramuscular injection into the muscle. The method of use varies from patient to patient and side effects.

Side effects seen in progesterone use:

Constipation,

Bloating

slow gastric and intestinal emptying,

loss of appetite

Change in taste in the mouth

Excessive sleepiness

Weakness, fatigue, inability to get out of bed

Surgical intervention If the pregnancy ends in miscarriage and there are fragments left in the uterus, the uterus can be removed by abortion. Or the baby's heartbeat may stop without any vaginal bleeding. In this case, an abortion is necessary to remove the pregnancy tissue from the uterus.

Sedation anesthesia is usually applied in our clinic in abortion procedures performed after miscarriage. Thanks to sedation anesthesia, the patient does not feel pain; the intervention is finished. The anesthesia applied here is not a deep anesthesia as we apply in operations. The intervention time takes an average of 10-15 minutes. The intervention is over until the patient falls asleep and wakes up. The miscarrying mother and her relatives are upset. The fact that the intervention is also painful creates stress on the mother and her relatives. Therefore, the fact that at least the intervention part of a pregnancy that ends negatively is painless relieves the mother and her relatives to some extent.

After Miscarriage:

Recommendations after miscarriage vary according to the week the pregnancy ended.

Sexual intercourse is prohibited for 1 week after the intervention.

Activities such as baths, pools, sea, sauna are not recommended for 1 week.

Active bleeding may last 7-10 days if the miscarriage occurred in the early week and up to 40 days if the miscarriage occurred in the 20th week.

The next period will be 4-6 weeks later.

It will be appropriate to wait 1-3 months for the next pregnancy planning.

Recurrent Miscarriages:

Families who experience recurrent miscarriages are anxious and have a lot of questions to answer. The negative outcome of every pregnancy that starts with hope causes an intense sense of anxiety in the expectant mother. Therefore, the causes of recurrent miscarriage should be thoroughly investigated and pregnancy should be planned by taking the necessary precautions to be taken in the next pregnancy.