Miscarriages During Pregnancy

A miscarriage is a pregnancy loss that occurs in the early stages of pregnancy. Ending a pregnancy on request within legal limits is called legal termination, while ending a pregnancy due to reasons such as the expectant mother's health, fetal anomalies incompatible with life, or fetal death is called medical termination. This article will focus on spontaneous miscarriages.

One of the most common causes of miscarriage is the embryo's inability to develop in a genetically healthy way. More than 50% of miscarriages that occur in early pregnancy result from random chromosomal abnormalities. These abnormalities arise from errors in the genetic material of the fertilized egg cell (oocyte). Nature tends to preserve the most optimal genetic combinations through natural selection by reducing the survival chances of faulty genetic structures.

After fertilization, the embryo needs to implant in the uterus and continue developing there. However, problems during the implantation process can increase the risk of miscarriage. In addition, hormonal imbalances, the mother's chronic illnesses, abnormalities in the structure of the uterus, and other medical conditions can also increase the risk of miscarriage.

3. Factors That Increase the Risk of Miscarriage

There are many factors that increase the risk of miscarriage. The most common of these factors are:

Advanced Maternal Age: As the age of the expectant mother increases, the risk of miscarriage also increases. While the risk of miscarriage is around 10% in women younger than 20, this rate rises to 30% in women over 40. This increase is associated with the rise in genetic abnormalities that comes with age.

Paternal Age: The age of the expectant father can also affect the risk of miscarriage. In fathers over the age of 40, the risk of miscarriage doubles.

Hormonal and Chronic Illnesses: Hormonal disorders such as polycystic ovary syndrome (PCOS) and hypothyroidism, as well as chronic illnesses such as heart, liver, and kidney disease, can increase the risk of miscarriage. In addition, serious health problems such as autoimmune diseases, severe anemia, and cancer can also raise the risk of miscarriage.

Gynecological Problems: Gynecological problems such as uterine shape abnormalities, fibroids, and intrauterine adhesions can prevent the embryo from implanting properly in the uterus and can increase the risk of miscarriage.

Lifestyle Factors: Smoking and alcohol use, as well as certain occupational exposures (such as chemicals), are important factors that increase the risk of miscarriage. In addition, excessive stress and inadequate nutrition can also lead to pregnancy loss.

Previous Miscarriages: In women who have had a miscarriage before, the risk of miscarriage in subsequent pregnancies increases slightly. This risk rises further in women who have had two or more miscarriages. However, despite the number of previous miscarriages, the chance of having a healthy baby is still quite high, ranging between 55% and 75%.

4. Diagnosis and Treatment of Miscarriage

Miscarriage is diagnosed with ultrasonography and blood tests. Ultrasound is used to monitor the development of the embryo and its heartbeat, while blood tests are performed to assess beta hCG levels and other hormone levels.

Treatment for miscarriage varies depending on the underlying cause. For example, progesterone support or thyroid hormone treatment may be applied in miscarriages caused by hormonal imbalances. Uterine abnormalities can be corrected with surgical intervention. In addition, blood-thinning treatments may be used in miscarriages caused by blood clotting disorders.

5. What Should Be Done After a Miscarriage?

After a miscarriage, it is important to have an evaluation with your doctor. This evaluation can help identify risk factors for future pregnancies. In addition, receiving emotional support after a miscarriage can also help you get through this process in a healthier way.

Most miscarriages are not recurrent, and the chance of the next pregnancy continuing in a healthy way is high. However, if consecutive miscarriages occur, a comprehensive medical evaluation is needed to investigate the underlying causes.

Miscarriage during pregnancy can occur due to many causes, ranging from genetic factors to hormonal imbalances. However, this condition is usually not recurrent, and the chance of achieving a healthy pregnancy is high. Knowing the risk factors for miscarriage can help you make more informed decisions during this process.

What Tests Are Done After a Miscarriage?

Miscarriage is one of the most difficult experiences a woman can go through in the early stages of pregnancy. For women who have had recurrent miscarriages or more than one miscarriage, a series of tests and analyses may need to be performed to identify the underlying causes. These analyses provide important information that can help future pregnancies continue in a healthy way. Below is information about the tests commonly performed after a miscarriage and the purpose of each test.

7. Infection Tests

Some infections can negatively affect fetal development and increase the risk of miscarriage. Blood tests for infections such as rubella (German measles), cytomegalovirus (CMV), toxoplasma, and listeria can determine whether the mother has been exposed to these infections.

8. Genetic Counseling

For couples experiencing recurrent miscarriages, genetic counseling is a recommended approach to help future pregnancies continue in a healthy way. Genetic counseling provides couples with information about genetic risk factors and, if necessary, arranges for genetic testing to be carried out.

Threatened Miscarriage: Symptoms, Causes, and Treatment Methods

1. What Is a Threatened Miscarriage?

A threatened miscarriage presents with vaginal bleeding or spotting in the first half of pregnancy and is generally a worrying condition. A threatened miscarriage occurs in approximately 20-25% of pregnancies, and 40-50% of early miscarriages of this kind can end in miscarriage.

A threatened miscarriage is defined by vaginal bleeding occurring in the first 20 weeks of pregnancy. This means the pregnancy may end in miscarriage, but not every case of bleeding results in miscarriage. A threatened miscarriage is diagnosed through gynecological examination and ultrasonography. A diagnosis of threatened miscarriage can be made when the cervix is closed and the baby's heartbeat is observed on ultrasound. In very early weeks of pregnancy, when the baby's heartbeat cannot yet be detected, the gestational sac within the uterus is checked to see whether its normal structure has been preserved.

2. Symptoms of Threatened Miscarriage

The most common symptom of a threatened miscarriage is vaginal bleeding. This bleeding usually starts out light but can last for days or even weeks. As bleeding increases, the risk of the situation ending in miscarriage also increases. In addition, abdominal and pelvic pain can also be a symptom of threatened miscarriage. This pain may be mild to moderate in intensity and may resemble menstrual cramps.

3. Causes of Threatened Miscarriage

A threatened miscarriage can result from many factors. These factors include:

Hormonal Imbalances: Insufficient levels of hormones such as progesterone can lead to a threatened miscarriage in the early stages of pregnancy.

Genetic Abnormalities: Abnormalities in the genetic makeup of the embryo can prevent the pregnancy from continuing.

Uterine Abnormalities: Structural abnormalities in the uterus, fibroids, or polyps can lead to a threatened miscarriage.

Infections: Uterine or urinary tract infections can cause a threatened miscarriage to occur.

Trauma: Blows to the abdominal area or severe falls can lead to a threatened miscarriage.

Other Health Problems: Chronic health problems such as uncontrolled diabetes, hypertension, and thyroid disorders can also cause a threatened miscarriage.

4. Diagnosis of Threatened Miscarriage

Gynecological examination and ultrasonography are the most commonly used methods for diagnosing a threatened miscarriage. During the examination, it is checked whether the cervix is closed. Ultrasonography is used to evaluate the baby's heartbeat and the structures within the uterus. In early weeks of pregnancy, ultrasound is used to monitor whether the embryo is developing normally. In cases of bleeding, ectopic pregnancy, molar pregnancy, or other pathological conditions should also be evaluated.