Miscarriage is defined as the loss of an embryo before the 20th week of pregnancy as it is incapable of surviving independently. In
medical terminology, miscarriage is a type of abortion, as it refers to
the pregnancy ends with the death and removal or expulsion of the
fetus, regardless of whether it is spontaneous or medically induced
abortion. In US alone, over 15% of pregnancy ends in miscarriage.
Symptoms
1. Bleeding
Most common symptoms of miscarriage. 50% of bleeding during 20 weeks of pregnancy ends in miscarriage
2. Abdominal cramps and pain
Generally, it is the first sign of the incidence
3. Etc.
Causes and risk factors
1. Chorionic hematomaIt
is the most common cause 0f vaginal bleeding presented in the live
embryo in the first trimester, known as sonographic abnormality. It is
the pooling of blood between the chorion, a membrane surrounding the
embryo, and the uterine wall. The risk of miscarriage increase depending
to the size of of hematoma.
2. Chromosomal abnormalities
Genetic
defects such as Down Syndrome can increase the risk of miscarriage as a
result of abnormal chromosomes forming of when fertilization occurs.
In
a study of "The effect of recurrent miscarriage and infertility on the
risk of pre-eclampsia." by Trogstad L, Magnus P, Moffett A, Stoltenberg
C. researchers found that women with a history of recurrent miscarriages
are at risk of developing preeclampsia.
4. Collagen vascular diseases
Increased
risk of miscarriage for a woman with collagen vascular diseases such as
antiphospholipid syndrome and systemic lupus erythematosus as a result
of autoimmune disorders, that causes the immune system to attack its own
tissue.
5. Diabetes
Risk of miscarriage for women with uncontrolled diabetes during pregnancy.
6. Hormonal factors
In
a study presented at European Society for Human Reproduction and
Embryology conference in Stockholm, researchers found that levels of
progesterone and of the pregnancy hormone human chorionic gonadotrophin
(hCG), are 2 of 6 hormonal factors which have greatest impact on
miscarriage risk.
7. Reproductive tract infections
Sexually
transmitted infections, Chlamydia, Cytomegalovirus (CMV), etc. are the
greastest risk of reproductive tract infection and can lead to
miscarriage.
8. Abnormal structural anatomy
Abnormal anatomy
of the uterus, such as bicornuate uterus, septate uterus, and
unicornuate uterus, Uterine fibroids, etc. can also increase the risk of
miscarriages.
9. Prenatal Diagnosis
Medical procedure in used
to test the chromosomal abnormalities and fetal infections such as
amniotic fluid test or AFT, can increase the risk of miscarriage but
rarely. Others such as chorionic villus sampling (CVS) use to test the chromosomal or genetic disorders in the fetus also increase the risk as well.
10. Tissue rejection
Antiphospholipid
antibodies can interfere with the formation of the normal placenta
involves the fusion of small cells called cytotrophoblasts into giant
cells known as syncytiotrophoblasts, causing tissue rejection.
11. Smoking
In
the article of "Effect of Maternal Cigarette Smoking on Pregnancy
Complications and Sudden Infant Death Syndrome" by Joseph DeFranza and
Robert Lew, published in the Journal of Family Practice on 4/1/95, the
authors indicated that smoking causes 18,925 miscarriages a year.
14. Nonsteroidal anti-inflammatory drugs
In
a study of Exposure to non-steroidal anti-inflammatory drugs during
pregnancy and risk of miscarriage: population based cohort study by
De-Kun Li, epidemiologist (dkl@dor.kaiser.org), Liyan Liu, programmer
analyst, Roxana Odouli, research associate, researchers found that 53
women (5%) reported prenatal NSAID use around conception or during
pregnancy. After adjustment for potential confounders, prenatal NSAID
use was associated with an 80% increased risk of miscarriage (adjusted
hazard ratio 1.8 (95% confidence interval 1.0 to 3.2)). The association
was stronger if the initial NSAID use was around the time of conception
or if NSAID use lasted more than a week. Prenatal aspirin use was
similarly associated with an increased risk of miscarriage. However,
prenatal use of paracetamol, pharmacologically different from NSAIDs and
aspirin, was not associated with increased risk of miscarriage
regardless of timing and duration of use.
15. Caffeine
In a report of Caffeine doubles miscarriage risk, study finds by CTV.ca News Staff, Dated
Tue. Jan. 22 2008 10:30 AM ET, indicated that women who drink even
moderate amounts of caffeine during pregnancy -- whether from coffee,
tea, caffeinated soft drinks or hot chocolate -- have almost double the
risk of miscarriage compared to women who stay away from such drinks.
16. Alcohol
In
article of New Link Between Alcohol and Miscarriage Found By Colette
Bouchez HealthScoutNews Reporter, the author indicated that alcohol has
toxic effects on the baby, especially at the earliest stages of
development.....""Any toxin, anything that can affect [egg] quality,
will increase the risk of miscarriage--and alcohol is one of those
toxins," says Lockwood, the director of obstetrics and gynecology at
Bellevue Medical Center in New York City.
17. Polycystic ovary syndrome
Increased risk of miscarriage by over 30% if a woman is diagnosis with PCO's. In a study of "Effects of metformin on early pregnancy loss in the polycystic ovary syndrome" by Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Roberts KA, Nestler JE in 2002, researchers found that the
drug metformin significantly lower the rate of miscarriage in women
with PCOS in one-third of the miscarriage rates of the control groups.
18. High blood pressure during pregnancy
High
blood pressure during pregnancy also known as Pre-eclampsia can cause
endothelial dysfunction, leading to abnormal immune respond to the
developing fetus.
19. Etc.
9. Etc.
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