Pregnancy Loss in Early Stages: Understanding Causes and Symptoms
In pregnancy, miscarriage is a heartbreaking experience for many women. It is estimated that 10-20 percent of all positive pregnancy tests end up in a miscarriage [1]. Early miscarriage, which occurs during the first trimester of pregnancy, typically between the first 12 weeks of confirmed pregnancy, is a common occurrence.
The most common causes of early miscarriage in women include chromosomal abnormalities, accounting for about 50-85% of cases, especially in the first trimester [1][3][5]. These abnormalities result from errors during cell division, leading to embryos that cannot develop properly.
Other significant causes include hormonal imbalances, structural issues in the uterus, lifestyle and environmental factors, medical conditions, and age-related factors.
Hormonal imbalances, such as those seen in conditions like polycystic ovary syndrome (PCOS) or deficient progesterone secretion, impair the uterine lining’s ability to support pregnancy [1][3]. Structural issues in the uterus, including septate uterus, fibroids, scarring, or other uterine abnormalities that interfere with fetal development, also contribute to miscarriage risks [1][2].
Lifestyle and environmental factors, such as smoking, alcohol use, drug abuse, high stress levels, and exposure to environmental toxins, increase the risk of miscarriage [1][3]. Medical conditions including uncontrolled diabetes, thyroid problems, lupus, blood clotting disorders, and certain infections like listeria or rubella, can damage fetal development or pregnancy maintenance [1][2][3].
Women over 35 experience a higher risk of miscarriage compared to younger women [3]. Additionally, chemical pregnancies—very early miscarriages occurring before the pregnancy is visible on ultrasound—are predominantly caused by chromosomal abnormalities but can also result from blood clotting disorders, hormonal imbalances, infections, thyroid issues, or uterine abnormalities [2].
A healthy lifestyle, including avoiding alcohol, drugs, caffeine, and unapproved medication, can help minimize the risk of miscarriage. It is crucial to talk about feelings after a miscarriage with a partner and consider future plans for pregnancy. Any trauma to the abdomen may potentially lead to miscarriage, so pregnant women should avoid contact sports or activities that risk the fetus.
After a miscarriage, rest and avoid activities like swimming and sexual activity until bleeding subsides. Adequate care after a miscarriage and taking time for the body to recover strength can pave the way for a successful future pregnancy. If tissue has not passed during an early miscarriage, a doctor may administer medication or perform a suction curettage to remove it.
A quantitative HCG blood test is used to measure human chorionic gonadotropin (hCG) hormone levels to confirm pregnancy and diagnose potential miscarriage. A transvaginal ultrasound is preferred for detecting early miscarriage, as it provides clear images of the uterus and fetus.
References:
[1] American College of Obstetricians and Gynecologists. (2015). Early Pregnancy Loss. Retrieved from https://www.acog.org/womens-health/faqs/early-pregnancy-loss
[2] Mayo Clinic. (2020). Miscarriage. Retrieved from https://www.mayoclinic.org/diseases-conditions/miscarriage/symptoms-causes/syc-20355487
[3] Royal College of Obstetricians and Gynaecologists. (2019). Early Miscarriage. Retrieved from https://www.rcog.org.uk/en/patients/patient-leaflets/early-miscarriage/
[5] American Pregnancy Association. (2020). Chromosomal Abnormalities. Retrieved from https://americanpregnancy.org/pregnancy-complications/chromosomal-abnormalities/
