Signs of Miscarriage in Pregnancy

By Dr. Okechukwu Amako, MBBS (Ibadan)
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The first 3 months of pregnancy are very crucial because more than 80% of all miscarriages occur during this time. We talked about some of the major risk factors (like getting pregnant at an older age, above 35 years; smoking and alcohol intake in pregnancy; and poorly treated diabetes mellitus in pregnancy) associated with miscarriage in one of our previous health tips.

On the other hand, it is very important every pregnant woman is aware of the possible signs of miscarriage especially in the first 3 months for two reasons:

1. The pregnancy can still be saved with prompt medical care in a hospital with good obstetric facilities

2. So the woman can receive emergency medical treatment thereby averting the development of any of the short or long-term complications of miscarriage

If a pregnant woman experiences any of these, especially in the first 3 months, it could be a miscarriage:

1. Any vaginal bleeding in the first trimester could be a miscarriage. If the bleeding is very minimal and painless, it is probably a type of miscarriage known as threatened abortion. It could also a sign of ectopic pregnancy.

Therefore, the woman should quickly see her obstetrician for a medical evaluation. This will entail, among other things, examination of her reproductive tract and an ultrasound scan to check for signs of life in the developing baby.

If the unborn baby is still intact, the woman will be placed on bed rest for close monitoring. It is also advisable she avoids sexual intercourse when discharged. The obstetrician will likely request her to come for another ultrasound scan after a week to assess the status of the developing baby.

2. In some cases, the woman bleeds with minimal or no pain, expelling things that look like chunks of blood clots and black tissues after which the bleeding stops, and her tummy gradually becomes smaller than it was before this incident happened. Such a woman will need immediate medical attention to help her body return to normal and to prevent her from developing any infection; she will also need to be counselled and followed up in her attempt to become pregnant again.

3. Some miscarriages may be preceded by lower abdominal pain and cramps which can radiate to the back. Bleeding with chunks of blood clots will likely occur simultaneously with this abdominal pain, and the bleeding can continue for days, getting worse in the process.

This continuous, worsening bleeding means some parts of the dead baby are still retained in the womb. So, the woman must be rushed to the hospital for evacuation of the remaining parts and proper follow-up medical management.

4. Some miscarriages can occur without any bleeding. In this case, the woman just notices that her big tummy is reducing in size and the symptoms of pregnancy are gradually disappearing. This type of miscarriage is deadly because the woman can develop a bleeding disorder and come down with a serious infection if she doesn't receive immediate medical care.

Early identification of these signs of miscarriage ensures the woman receives immediate and appropriate medical treatment and also get proper health education and counselling on how to plan for a subsequent pregnancy to avoid a repeat miscarriage.

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Published Wednesday, April 12th 2017

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