A miscarriage refers to the death of a fetus within the first 20 weeks of pregnancy. The exact cause of miscarriage often remains unclear, but it is known to be influenced by factors such as genetic abnormalities in the fetus, underlying health conditions in the mother, lifestyle habits, and stress.
Professor Pyeon Seung Yeon of the Department of Obstetrics and Gynecology at Kyunghee University Hospital at Gangdong advised on June 27, “Since the exact cause of a miscarriage is still unknown, there is no clear method to prevent it. However, post-miscarriage care and prenatal care for subsequent pregnancies are crucial for a healthy pregnancy and delivery.”
Pyeon advised, “It’s important to get enough sleep and maintain a regular lifestyle, and to avoid smoking, drinking, and excessive caffeine intake. If you’re taking medication for diabetes or hypertension, you should consult with a specialist for hormone treatment and blood sugar and pressure control.”
She further warned against purchasing and taking unidentified miscarriage or abortion drugs through illegal distribution channels, stating, “There are cases of fake medications being distributed, and incorrect usage can lead to abdominal pain and significant vaginal bleeding.”
If someone has already experienced a miscarriage, it’s crucial to receive appropriate treatment and care. Not only does this affect their health, but it can also impact future pregnancies and childbirth.
The most common symptom of a miscarriage is vaginal bleeding accompanied by abdominal pain. Lower back pain may also occur. As the miscarriage progresses, early pregnancy symptoms such as nausea, fatigue, and breast tenderness may decrease or disappear, and in some cases, there may be no symptoms at all.
A threatened miscarriage refers to cases where there is vaginal bleeding in the first trimester of a confirmed pregnancy. Not all cases of vaginal bleeding lead to miscarriage, and less than 50% of these cases result in an actual miscarriage. There may be light abdominal pain and bleeding, and an ultrasound may reveal a hematoma surrounding the gestational sac. If the mother rests and receives appropriate treatment, such as progesterone supplementation, she can continue the pregnancy and reduce her risks of having a miscarriage.
A complete miscarriage occurs when the fetus and placenta are entirely expelled from the uterus following fetal death. Conversely, a state where part of the fetus or its tissues remains in the uterus is called an incomplete miscarriage. Most of the time, there are no special symptoms, and it can take several weeks for the woman to realize that she has had a miscarriage. This is called a missed miscarriage, which can be diagnosed by ultrasound when the gestational sac is visible in the uterus, but the yolk sac and fetus are not seen, or the fetal heartbeat is not detected.
In cases of missed or incomplete miscarriage, treatment is necessary due to the risk of bleeding and infection. If bleeding is severe, a procedure called a dilation and curettage (D&C) is needed to safely remove the remaining tissues. After a D&C, there may be a small amount of vaginal bleeding and lower abdominal pain for a certain period. However, if the pain persists and worsens, if the prescribed painkillers do not work, if bleeding soaks a large pad within an hour for more than two hours, or if there is a fever of 100.4°F or higher, it’s advised to visit a hospital.
Recurrent miscarriage is diagnosed when three or more consecutive miscarriages occur. This includes chemical pregnancies, where the pregnancy hormone level rises and then falls without a gestational sac being seen in the uterus. It can be helpful to test for recurrent miscarriage even if there have been two consecutive miscarriages where a gestational sac was seen.
While there can be various causes of recurrent miscarriage, there are two main causes that need careful treatment. The first is Antiphospholipid Syndrome, an immunological problem in the mother, and the second is a genetic predisposition in the mother to form blood clots, known as Thrombophilia. Other possible causes include genetic factors from the parents, anatomical factors, endocrine factors, and infectious factors.
After a miscarriage, the pregnancy hormone level usually returns to normal between 7 and 60 days, depending on the hormone level at the time of miscarriage.
Pyeon said, “It’s possible to get pregnant as soon as two weeks after a miscarriage, but we do not recommend immediate pregnancy after a miscarriage. For second trimester miscarriages, there is a risk of a repeat miscarriage or preterm birth if you get pregnant right after, so it’s better to use contraception for a while.” She emphasized the need for rest.
She added, “For early miscarriages, there’s no need for a special rest period, but emotional support is necessary as mood swings or depression can occur after a miscarriage.”
