What causes miscarriage?

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Written by Victoria Awom

Clara Madu could not hide her joy after the test results showed that she was four weeks pregnant. She screamed, jumped up, hit the door out of excitement not minding who was watching or listening to her. She called her husband who travelled out of town to break the good news to him as well. Her joy is expected because this was her first pregnancy after three years of marriage.

However, Clara’s joy was cut short three week later, seven weeks into the pregnancy when she noticed a slight blood stain in her underwear. She thought it was a mild bleeding, but it lingered for two more days. Clara went to her doctor. After several test, the doctor confirmed that Clara had a threatened abortion. He gave her some tablets to manage the situation. But the next day, the situation grew worse and she was rushed back to the hospital. She lost the pregnancy and doctors did dilation and cureltage (&C) to evacuate the baby.

DR Chito Nwana, Consultant Gyneacologist and Obestrician at the Tabitha Health Centre, Maitama, Abuja says miscarriage which is medically called spontaneous abortion is caused by many factors depending on the gestation age of the pregnancy. “We attribute most of the miscarriages at this stage-the first trimester of pregnancy, which is 0-14 week to chromosomal problems. The baby came together and something in the baby went wrong and that was miscarried.”

In most cases, a baby lost to miscarriage has a problem in the chromosomes, such as extra chromosomes or missing genes that cause the baby to stop developing and eventually to be miscarried. Because chromosomal flaws are usually random, one-time events, most doctors do not initiate testing for miscarriage causes after the first miscarriage because most couples go on to have a normal pregnancy after one miscarriage.

Health experts say anyone can have a miscarriage due to chromosomal flaws, regardless of age, but the highest risk for this particular problem is in mothers over 35.

Nwana highlight one cause of miscarriage in the second trimester. “In the second trimester, we look at cervical incompetence. Some time the cervix is not strong enough to carry the baby. At those times, it opens up and the woman losses the pregnancy. From these miscarriages we determine what to do for their next pregnancy.”

Nwana explains further. “The cervix is composed of what we call collagens, some people have genetic tendencies that their collagen fibres are weak and we have people that have dilation character for removing pregnancies, these also make the cervix weak. In 2nd trimester when it may have to do with cervical incompetence, we put what we call a cerclage- we tie something like a knot there in the cervix, with a stitch and it will hold the cervix tight and will prevent the woman from losing her pregnancy in the second trimester.”

About half the time, doctors can find a cause for recurrent miscarriages and then the woman can be treated in her next pregnancy. The other half of the time, tests do not reveal a cause but even with two unexplained miscarriages, a woman can get pregnant again and still have greater statistical odds of a normal pregnancy than another loss.

Widely recognized causes of recurrent miscarriages include the following: Hormonal problems, infections or maternal health problems, lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances), Implantation of the egg into the uterine lining does not occur properly, maternal age and maternal trauma. However, factors that are not proven to cause miscarriage are sex, working outside the home (unless in a harmful environment) or moderate exercise.

According to health experts, there are a few warning signs that a woman is about to have a miscarriage. If you experience any or all of these symptoms, it is important to visit the hospital and see a gynaecologist. Mild to severe back pain (often worse than normal menstrual cramps), weight loss, white-pink mucus, true contractions (very painful happening every 5-20 minutes), brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies), tissue with clot like material passing from the vagina, sudden decrease in signs of pregnancy.

Since the cause of most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur. Eat healthy, manage stress, keep weight within healthy limits, take folic acid daily and do not smoke.

Once you find out that you are pregnant, again the goal is to be as healthy as possible, to provide a healthy environment for your baby to grow in.

Six months later, Clara became pregnant again and this time around she did not have a miscarriage. She did a scan which showed her baby boy was growing well.



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THANKS MY SIS NEEDS TO READ this she just had one, after staying childless for years sad! this is enlightening she asks questions everyday
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