21 September 2020

Understanding Miscarriage Causes and How to Avoid It

Pregnancy loss or commonly known as miscarriage is a devastating situation where a pregnant woman loses her baby before the twentieth week of pregnancy. In some cases, miscarriages happen very early in the pregnancy, even before a woman realises she is pregnant. Some women experienced miscarriages several times. 

A woman who suffers one or more miscarriages in the second trimester or three or more miscarriages in the first trimester is considered having recurrent miscarriages. Identifying the main causes of pregnancy loss help women take better precautions and get the medical attention they need to avoid miscarriages. This article guides you through what you need to know about miscarriages and how to prevent it.

How is a miscarriage diagnosed?

Pregnancy must be verified before a miscarriage can be diagnosed. Pregnancy can be confirmed with the use of ultrasound or a pregnancy hormone testing kit that tested for the presence of beta-human chorionic gonadotropin. 

Women can identify a miscarriage with the following signs and symptoms:

  • Abdominal pain or cramps
  • Brownish discharge or bleeding which progresses from light to heavy
  • Low backache which may be mild to severe
  • Sudden loss of pregnancy symptoms

Women who experienced these symptoms should contact their doctor for advice. After a miscarriage, some women may also experience mild discomfort and spotting. Women who experience fever, chills, pain or heavy bleeding should contact their doctor right away as these may be signs of infection.

What causes repeated miscarriages?

Many factors can lead to miscarriages. Women with a history of miscarriages are more likely to experience recurrent or repeated miscarriages. Other common risk factors are obesity, drinking caffeinated beverages, alcohol and maternal smoking. 

Nonetheless, recurrent miscarriages may be caused by the following factors:

i. Medical and gynaecological conditions, which include:

    1. Diabetes: Women with diabetes either cannot produce insulin or cannot use their insulin effectively. Since insulin is critical for controlling the level of blood sugar, diabetic women may experience several complications during pregnancy which may even affect their baby’s wellbeing.
    2. Polycystic ovary syndrome or PCOS: PCOS can negatively impact the quality of eggs that the ovaries produce. Also, it can impair the reproductive organs’ function after ovulation. Hence, women with PCOS have a higher risk of miscarriages.
    3. APS or antiphospholipid syndrome: APS, which is also called the sticky blood syndrome, is an autoimmune disorder that happens when a person’s body’s immune’s system attacks his or her normal proteins. APS increases the risk of blood clots created in the placenta, which may lead to miscarriages.
    4. Uterine abnormality: The embryo implants and grows in the uterine lining. Abnormality in the uterus can result in recurrent miscarriages because of poor blood supply to the uterus during pregnancy.

ii. Second-trimester foetal demise

Chromosomal abnormalities in one of the parents cause around two to five per cent of recurrent miscarriages. Foetus’ chromosomal abnormalities, on the other hand, cause about thirty to fifty miscarriages. Foetus’ chromosomal abnormalities risk rises with maternal age.

iii. Second-trimester foetal demise

Congenital birth deficiencies can result in foetal demise, especially in the second trimester. Umbilical cord complication or placenta dysfunction also causes foetal demise in the second trimester. Moreover, pregnant women with weakened cervix lead to premature dilation. Pregnancy cannot be held if this condition is not detected in time, leading to miscarriage.

How to identify the cause of repeated miscarriages?

Gynaecologists may perform the following tests to identify the cause of recurrent miscarriages:

  • Going through the pregnant woman’s medical history to detect any medical issues
  • Complete physical exam, including blood tests, to evaluate any underlying medical issues
  • X-ray or ultrasound of the womb
  • Assessing the pregnant woman’s or her partner’s chromosomes or DNA

What if the cause of miscarriage is unknown?

More than halves of pregnancy loss cases have no definite cause. While medical practitioners may offer many treatments, there is no universal treatment recommendation. Fortunately, the overall chances of pregnancy are over fifty per cent without the need for any intervention.

How to avoid the next miscarriage?

The best way to prevent the next miscarriage is to consult with a specialist or gynaecologist. The gynaecologist will manage the recurrent miscarriages by first identifying the cause of miscarriages.

Tips for choosing the right gynaecologist in Singapore

A good gynaecologist in Singapore helps women prevent the next miscarriage effectively. Nevertheless, looking for the right gynecologist can be daunting. To choose the right one, be sure to consider the gynaecologist’s credibility, reputation, years of experience, specialities, hospital affiliation and overall services fee.