What Causes a Miscarriage?
Depending upon the timing of the missed miscarriage, the causes could vary. Since most miscarriages occur during the first trimester (first 12 weeks), the cause is most frequently chromosomal abnormalities within the fetus.
More than half of first trimester miscarriages and nearly a quarter of second trimester miscarriages are due to chromosomal abnormalities within the fetus.
The abnormalities may be due to:
· Chromosomal abnormalities with the egg or sperm. Either one will form a fetus that is abnormal genetically and as a result the woman's body rejects the fetus and the pregnancy ends.
· Abnormal cell division of the fetus.
· Chromosomal abnormalities of either parent. To determine this, a genetic counselor evaluates the 23 pairs of chromosomes from each parent and does an assessment for the risk of recurrent miscarriage. High levels of homocysteine, or the present of MTHFR
· gene mutations are possible causes.
Other causes for miscarriage include:
· Infections, such as sexually transmitted diseases, rubella, and toxoplasmosis can all be implicated in miscarriage
· Immune disorders like antiphospholipid antibodies
· Anatomical abnormalities of the uterus, such as septate uterus
· Uterine fibroids
· Incompetent cervix
· Systemic illness such as thyroid disease, PCOS, diabetes
· Hormonal abnormalities - low progesterone
· Luteal phase defect
· Substance abuse
Treatment for Miscarriage
A missed miscarriage usually requires medical intervention. There are three methods that are available for treatment:
· Observation - without question the most difficult option of treating a missed miscarriage. The woman is diagnosed and told she is having a miscarriage and then she is sent home to allow nature to take its course.
She is to rest, put nothing in the vagina, examine vaginal discharge for white or grey matter (products of conception), and if pain or bleeding is excessive or severe or if she develops a fever, then she should seek medical attention. This process can last for hours, days or in some cases, weeks.
· Medication - In the case of ectopic pregnancy that is caught early, a chemotherapy drug, methotrexate, is administered by injection. The drug stops the embryo cells from dividing and causes a miscarriage - which occurs between two and six weeks after the injection.
The other medical option is the use of prostaglandins to cause the cervix to ripen. Then pitocin is administered, usually by drip, and contractions start. The woman delivers her miscarriage, an incredibly difficult and emotionally stressful procedure for a couple.
· Surgical - D&C, dilatation and curettage is the surgical method of treating a miscarriage. Under anesthesia, the woman has her uterus dilated and either suctioned or scraped clean of the products of conception.
It is a treatment that is determined by the woman and her practitioner. The positive side to this treatment is that the products of conception can be sent to a pathologist to determine if the miscarriage was due to chromosomal abnormalities, which is good information to have when the couple tries to conceive again.
Regardless how it happens and what method of treatment is determined, a missed miscarriage is a painful and difficult experience. It is hoped the woman and the couple have a strong support system to help them through.