Miscarriage

Miscarriage or spontaneous abortion is pregnancy loss before the period of viability (that is baby’s ability to survive outside the mother’s womb). In most countries, this period is of 24 weeks but in India, it is 20 weeks.

Many times miscarriage might not have any symptom.

– After a confirmed pregnancy (just on a urine strip test even), bleeding is a very common symptom of miscarriage. It may vary from light spotting to something like normal menstruation. One must check with her midwife or gynecologist if you have this complaint in the first three months of pregnancy.

Mild to severe cramps especially if they progressively become stronger or are associated with bleeding, can be a sign of miscarriage.

– It is normal for pregnancy symptoms to fade away by the end of the first trimester.  But if you entirely loose pregnancy symptoms, such as nausea or vomiting before the end of the first trimester then you must mention it to your gynecologist, especially if it is alongside vaginal bleeding or spotting.

Discharge of white-pink/brown mucus or passing of tissue or clot-like material is another symptom of miscarriage which should not be ignored.

Maintaining a healthy diet and lifestyle, in general, helps in preventing miscarriage. Some specific suggestions are:

  • Start taking 400mcg of folic acid at least two to three months before conception and continue it for the first three months post-conception.
  • Keep a check on your weight and try to maintain it within the normal range in accordance with your height and age, before pregnancy preferably.
  • Do not smoke or drink alcohol. Also, stay away from passive or environmental smoke.
  • Exercise regularly and preferably under the supervision of a trained person.
  • Treat/optimize specific adverse condition (if known).

A silent miscarriage is when the fetus stops developing but the embryonic tissues still remain in the uterus. During a silent miscarriage, one does not experience the usual symptoms of a miscarriage. This makes it difficult to diagnose or suspect a lost pregnancy. The obstetrician can confirm the miscarriage after performing an ultrasound and seeing if the fetal heartbeat is present or not.  However, in most cases, another ultrasound (mostly a vaginal scan) is recommended to confirm the diagnosis as sometimes it might just be a delayed conception or wrong dates.

Ultrasound is the best method to confirm whether or not one is carrying a live baby. Transvaginal ultrasound (internal/ TVS) can be done to check the baby’s heartbeat at, as early as six weeks of gestation (14 days after your positive urine pregnancy strip test). On the abdominal scan, baby’s heartbeat is seen by seven weeks of gestation (two weeks after your missed period). In case of any doubtful findings on ultrasound, a blood test (S. βhCG) may be required.

Maintaining a healthy diet and lifestyle, in general, helps in preventing miscarriage. Some specific suggestions are:

  • Start taking 400mcg of folic acid at least two to three months before conception and continue it for the first three months post-conception.
  • Keep a check on your weight and try to maintain it within the normal range in accordance with your height and age, before pregnancy preferably.
  • Do not smoke or drink alcohol. Also, stay away from passive or environmental smoke.
  • Exercise regularly and preferably under the supervision of a trained person.
  • Treat/optimize specific adverse condition (if known).

In most cases, periods start four to six weeks after the termination procedure. If it doesn’t start even after six weeks, one should do a pregnancy test and consult a doctor. This could be due to a new conception or retained products after the miscarriage or sometimes a result of hormonal imbalance in response to your stress or emotions after the miscarriage. Also, the first period after a miscarriage is usually heavier and may last longer.

During pregnancy it is highly advisable to avoid the following foods:

– Pineapple and papaya

– Raw and undercooked eggs

– Undercooked and raw meat and poultry, such as pink or raw meat that is bloody

– High mercury-containing fish such as shark, swordfish, king mackerel, albacore and tuna

– Unpasteurized milk

Usually, intercourse is not recommended for at least two weeks after a miscarriage to avoid any sort of infection. Though it is possible to get pregnant again as early as by four weeks after a miscarriage; one should plan the next pregnancy at least six months after the termination of pregnancy. In case of any complications or special concerns, one should consult a health care provider for appropriate advice.