Kenya News

Miscarriage

While most pregnancies result in the birth of a healthy baby, every parent knows that some don’t.

Understanding miscarriage

The most common time for something to go wrong with a pregnancy is in the first days and weeks after conception. Many different conditions can lead to miscarriage at this time.

It’s thought many early miscarriages go undetected. If your period arrives as normal you may never even suspect you were pregnant.
About one in six confirmed pregnancies (when a pregnancy test has proved positive) miscarries, usually before 12 weeks. Most women who have one miscarriage go on to have a normal, healthy pregnancy next time.

If you miscarry at home, you’ll need to see your doctor and may also have to go to hospital. In some situations, you may need an operation called a dilatation and curettage (D&C) to be sure your uterus is clear.

Reasons for miscarriage

Miscarriage isn’t fully understood. Some miscarriages just happen with no explanation other than nature ‘taking a hand’ and expelling an embryo that’s less than perfect.

Other possibilities include:

• Blighted ovum – when a fertilised egg doesn’t develop as it should.
• Illness in the mother – for example, high fever due to a viral illness in early pregnancy.
• Problems with the cervix – the cervix starts to open and the uterus contracts, pushing the baby out too soon, often before 20 weeks.
• Ectopic pregnancy – the embryo develops in one of the fallopian tubes.
• Hydatidiform mole – this rare problem isn’t a real pregnancy, as there’s no fertilised egg. Instead, the body responds with pregnancy hormones to the development of a collection of fluid-filled sacs growing from tissue that would have become the placenta if the pregnancy had been successful. An operation may be needed to remove the mole, but hormonal treatment is also available.

Later miscarriage and stillbirth

Miscarriage is defined as the spontaneous loss of a foetus before 24 weeks. Stillbirth is when a baby dies in the uterus after this date.
Reasons for late miscarriages and stillbirths include:

• Poor nourishment by the placenta, which means the baby lacks oxygen and doesn’t survive.
• An abnormality in the baby’s development.

Sometimes babies die suddenly inside the womb without any apparent reason. In such cases, the mother often realises the baby has stopped moving – although you shouldn’t assume this is the only reason for lack of movement if it happens to you. Babies vary in their activity levels, and may even sleep for long periods.

If you think your baby has stopped moving, call the hospital. If there’s any concern, it may be suggested that you come to the antenatal clinic so they can listen to the baby’s heart.

You and your baby

Miscarriage is always a sad event, and both you and your partner will need understanding, sympathy and support. You may want to talk over the possible reasons for the miscarriage with a doctor and ask about becoming pregnant again.

In most cases, there’s no reason why you shouldn’t go on and become pregnant again fairly soon. However, you may want to wait for your next period so you can tell when you’ll be able to conceive.

With a late miscarriage, you might find it helpful to see and hold your baby, if that is possible. If your baby has grown enough and your loss has happened in hospital, you may be helped to dress them. A midwife or doctor may also take a photograph for you to keep. Many parents are glad to have had this opportunity to express their love and sadness.

You may be asked permission for a post-mortem examination. It may help to find out why your baby died. A post-mortem is done carefully and won’t affect how your baby looks.

Could I have prevented my miscarriage?

Miscarriage is almost always something that’s outside your control. Your doctor may be able to reassure you about this. Don’t blame yourself for something you couldn’t prevent.

Research into miscarriage

These are some of the latest theories why some women miscarry:

• Some women may have a ‘rogue gene’ that makes them more likely to miscarry repeatedly.
• Some painkillers used in early pregnancy appear to be linked with a higher risk of miscarriage.
• A malfunction in the mother’s immune system may lead it to identify the foetus as a foreign invader and destroy it.
• Women with recurrent miscarriage may have antiphospholipid syndrome. In this disorder, antibodies are produced against cell membrane phospholipids, increasing the risk of thrombosis and miscarriage.