What is miscarriage ?
Miscarriage is a spontaneous termination of pregnancy up to 20 weeks. The medical term for this is "spontaneous abortion" but because "abortion" is used colloquially for a voluntary termination of pregnancy (officially: abortion), that word is often used with some caution parents who involuntarily lose a pregnancy.
A stillborn baby is a baby after the first 20 (or other number, definitions vary) weeks of pregnancy are born, but already deceased before birth (intrauterine fetal death) or dies at birth. The Burial and Cremation Act defines a stillbirth as a gestational age of at least 24 weeks stillborn come human fruit. See also perinatal mortality.
Frequency
Miscarriages are more common than most people think. About 25% of all women will have to deal with in their lives. Is counted from the moment of fertilization, it is even possible to 90% of all fertilized eggs shed prematurely; usually, however, the very early pregnancies that end in miscarriage not even noticed, because a normal menstrual period follows, whether it is only one or two days later. So half of all pregnancies end even before the woman knows she is pregnant. All the 'established' pregnancies running average of 15% of miscarriage.
The age of the mother is the most important risk factor: the risk of miscarriage is about 9% for women between 20 and 24 years, more than 50% for women aged 42 years and up to 75% for 45 year old women.
Course
The course of a miscarriage can be very different:
-Sometimes a woman does not know that the fruit of her womb is deceased. Often they will find out at the first ultrasound, which from 2007 between the 8th and 11th week of pregnancy is made by the obstetrician or gynecologist. The heart of the fetus is correct or not, and sometimes the fetus is not even perceive and they just see an empty gestational sac. Often in these cases the fetus already several weeks dead. One speaks of a missed abortion. There are several possibilities: wait for the miscarriage naturally gaining momentum; using drugs induce the expulsion of the deceased embryo; curettage have it done by a gynecologist in the hospital.
-Sometimes a miscarriage spontaneously. The possible signs of a spontaneous miscarriage are conducting pregnancy symptoms (such as nausea and breast tenderness), bleeding or menstrual-like cramps. One speaks of an "abortion imminens (threatened abortion). Only blood loss is not always the harbinger of a spontaneous abortion, 50% of these pregnancies will be still successfully propagated. However, if the cervix opens and / or the fetus at ultrasonography already deceased turns out, it is called an 'abortion incipiens (inevitable abortion) and the incidence of abortion has become certain. The blood loss and cramps will persist until the fruit is expelled from the uterus. Up to 13 weeks of pregnancy the fruit leaves usually simultaneously with the membranes and placenta uterus.
-After the first trimester (after 16 weeks) of pregnancy is actually a question of birth, if the fetus has reached that limit. May occur for labor. Also, the waters break and the woman gets violent contractions. The fetus and placenta usually leave after each uterus. If the fetus was still alive, which usually dies during childbirth. If a fetus is already deceased and spontaneous miscarriage does not start, then the delivery must be initiated. If the placenta does not come, it is still required curettage.
After a week or two the woman is usually physically fully recovered from a miscarriage. Three to eight weeks is a normal period within which to follow the first menstruation again. It is also possible that a woman is pregnant again immediately. A pregnancy is at such a moment unreliable because the hormone hCG even from the previous pregnancy in the blood can sit.
Miscarriage causes
Sometimes it can be through research later determined the cause of miscarriage. Usually that research is done only when there are two consecutive miscarriages. In that case, the probability of a next miscarriage greater than after a single miscarriage. One speaks with repeated miscarriages of habitual abortion.
There can be several causes:
-A construction defect in the fetus (embryonic factor). This is by far the leading cause of miscarriage. To this is often a genetic defect underlying. This is rarely an inherited DNA error, mostly error occurred during fertilization.
-Coagulation disorder in the mother (such as the antiphospholipid syndrome).
-Hormonal abnormalities in the mother (such as diabetes mellitus, hyperhomocysteinemia).
-Anatomical abnormalities of the uterus. These may include: a deformed uterus (whether or not because of the DES-hormone), fibroids or a partition in the uterus.
-Infections in the uterus (very rare).
-Infection with fifth disease.
-Lifestyle habits: smoking, excessive coffee and / or alcohol use and obesity are all associated with a slightly increased risk of miscarriage.
Miscarriage treatment
A treatment in order to avoid a miscarriage is not yet there. There were (and are) tried many different treatments, which in the past the most famous use of Diethylstilbestrol (DES) is. This synthetic hormone, in some countries, in the Netherlands between 1947 and 1976, is widely prescribed to pregnant women. It did not work, but it increased the risk of abnormalities in fetuses or children of the second or third generation.
Continues to search for possible treatments for miscarriage. Hormones like progesterone example, HCG, LHRH analog ones with gonadotrifinen, and thyroid hormones are sometimes prescribed, but so far none of these therapies in scientific research is clearly useful.
Psychological aspects
Although a woman physically recovers quickly from a miscarriage, the psychological recovery can be long in coming. This can vary greatly: one woman is after a few months 'over', the other takes years. There is no directive to give. Even if a woman ten years after several miscarriages, still brings a healthy child, the fear of a cot death of this child may still haunt her. The time the sharp edges must eventually wear off. Forget some women may never however.
What do all women have in common is that they are going through a grieving process. How short the fetus has lived, it makes for the sense of loss nothing. From the moment a woman knows she is pregnant, she starts by building a bond with her unborn child. If it appears that the child is not viable, dreams, fantasies and future shattered. Almost all women also wonder whether things that they have done for the miscarriage, miscarriage have not called or cause:. Made a strenuous effort, once a bit too much to drink, etc. There are no indications for and the importance of the woman reassure this point. The mourning is often deeper as they had expected more like a baby in mind and there all kinds of expectations had developed about.
Besides the feeling of loss plays incomprehension in the area often an issue. Someone who has not experienced a miscarriage personally, can not know what it is and how far-reaching it is. People in the area think after a few weeks or perhaps months that the woman there will be over. Pregnancy and miscarriage are barely mentioned in a conversation, often because the subject is too painful. This can give the woman a great sense of isolation.
In addition to dealing with pregnant women and newborn children is often painful. This complicates dealing with friends, acquaintances and relatives sometimes strong. Just after a miscarriage women sometimes do not want the street at all, for fear of encounters with acquaintances or pregnant women.
A woman after a miscarriage can do some things to process what happened better (support and understanding of the partner is essential):
-Give the child a name
-Photographing the child
-Bury the child
-Read books on the subject
-Talk about
-Contact with people looking for: Internet are numerous forums where fellow sufferers meet
-Sometimes it helps to seek professional help: even though it is often a natural process that often naturally finds its way, it can sometimes be very long. In such cases, it may help to talk with for example a psychologist or a bereavement counselor