Whence Cometh Miscarriage

Monday 21 May, 2021

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Last week, we looked at miscarriage under “Life After Miscarriage”. We noted that Miscarriage is the spontaneous or unplanned expulsion of a foetus, usually less than 500g, from the womb before reaching viability age, which in Nigeria and other developing climes is categorized by world Health Organization (WHO) as 28 weeks of gestation.

We brought to you views from medical reports and O & G experts. Dr Odetayo T.O, Senior Registrar, Obstetrics & Gynecology, Lagos state University Teaching Hospital (LASUTH) discussed miscarriage related issues like global fetal viability ages, miscarriage prevalence, miscarriage types and miscarriage myths. While discussing miscarriage prevalence, Odetayo revealed that about 15-25% of recognized pregnancy and 50% of all pregnancy will end up in miscarriage.

Miscarriage, we noted, is the most common complication of human pregnancy; and is one of the most common clinical problems encountered by gynecologists in clinical practice.

Our report also attempted to look at the causes of miscarriages. Though medical experts tend to suggest miscarriages as a natural phenomenon, but some speculative, non-scientific factors were also given as likely causes. Such speculations were categorized as myths and stereotypes.

To catch-up click https://www.citizencomfort.com/2021/06/16/life-after-miscarriage/

So, what are the Causes & Risk Factors of miscarriages?

Medical experts and medical journals seem to agree that most miscarriages happen when the unborn baby has fatal genetic problems. These problems according to Dr Odetayo of LASUTH, are chromosomal issues that are not related to the mother but commonly cause miscarriage in the first trimester.

WEB MD reference report on miscarriage confirms Odetayo’s assertions on the causes of miscarriage. According to the report, the majority of miscarriages are believed to be caused by genetic problems within the embryo that would prevent a baby from developing normally and surviving after birth. These fatal genetic errors are not usually related to genetic problems in the mother. They are chromosomal issues relating to the development of the baby in the womb.

Chromosomal Issues

Miscarriages are nature’s response to abnormalities in the development of the cells of the baby in the womb.

Chromosomes are the building blocks in a baby’s development. They are in rod-shaped structures (usually found in pairs in a cell nucleus) that carry the genes. These genes decide the sex of the baby and the characteristics a baby inherits from its parents. A human body cell usually contains 46 chromosomes arranged in 23 pairs (23 from the mother and 23 from the father).

A chromosomal abnormality happens if a baby carries too many or not enough chromosomes. This means it won’t be able to develop properly. Rather than allow the fetus to continue to develop abnormally, nature expels the fetus. Thus, miscarriage happens.

Credit: Getty Image/I Stock

RISK FACTORS

But there are risk factors that can threaten the survival of a pregnancy or make pregnancy vulnerable to miscarriage. Dr Odetayo of LASUTH, and many other experts listed the following as problems that can increase the risk of miscarriage:

-Infection: Infections that spread to the placenta including some viral infections.

-Medical conditions in the mother, such as diabetes or thyroid disease

– Immune system responses

-Physical problems in the mother

-Uterine abnormalities

-Pregnant mother lifestyle: Smoking; Drinking alcohol; hard drugs and marijuana

-Exposure to radiation or toxic substances

-Weight (obesity or underweight)

-Age: A woman has a higher risk of miscarriage if they are over age 35

-Prior miscarriages (three or more).

– Use of nonsteroidal anti-inflammatory drugs (NSAIDs) around the time of conception

Cervical incompetence, according to Odetayo is a major risk factor to miscarriage. A miscarriage may happen when the mother has a weakness of the cervix. Doctors call this a cervical insufficiency. It means the cervix can’t hold the pregnancy. This type of miscarriage is common in the second trimester and may warrant stitching up the cervix to prevent a miscarriage in subsequent pregnancy.

Treatment

Now you know that miscarriage is not a fertility problem. In fact, WEB MD reports say that at least 85% of women who have miscarriages have subsequent normal pregnancies and births. Pregnant woman that suffers miscarriage needs to consult physicians immediately, particularly O&G experts for evaluation and treatment when necessary.

Treatment of miscarriage, once it starts, depends on the symptoms. The main goal of treatment during and after miscarriage, according to Odetayo, is to prevent heavy bleeding and infection. If the miscarriage is complete and the uterus is empty, there won’t be need for further treatment.

Sometimes all the pregnancy tissue doesn’t come out. If that happens, there will be need for treatment to stop bleeding and infection. The patient may undergo what experts call manual vacuum aspiration;  dilation and curettage (D&C) procedure to remove any remaining tissue. There is also the option of medication (misoprostol) that will cause any tissue left in the uterus to leave.

Always allow medical experts to make the right choice for the particular miscarriage. DO NOT PATRONIZE UNSKILLED HEALTH WORKER; DO NOT SELF MEDICATE

Bleeding and mild discomfort experts say are common symptoms after a miscarriage. If you have heavy bleeding with fever, chills, or pain, contact your doctor right away. These may be signs of an infection.

Individuals with Rhesus negative blood that have miscarriage may need a shot of Rhesus immune globulin vaccine to prevent problems in the future—Odetayo

Psychological/emotional challenges & management

Prior miscarriage or even just perception of miscarriage can have profound and tremendous psychologic and emotional effects on mothers before or during subsequent gestations.

A study titled Miscarriage & Maternal Health by John and Rosemary cited by Intechopen.com 2019, have shown that compared to women without prior miscarriage, women with previous history of miscarriage had greater state anxiety in the second and third trimesters. To help women with prior miscarriage, the study suggested that attention must be paid to patterns of distress with a view to deliver appropriate support resources that may help reduce risk for stress related outcome.

The effects of miscarriage, according to the study, can be a tragic, and life-altering experience. Women who experience miscarriage worry about future pregnancies. Pregnancy after miscarriage can be experienced as emotionally and psychologically distressing. According to a descriptive study of pregnancy following miscarriage in PortHacourt, Nigeria, subsequent pregnancy after miscarriage was perceived as threatening. Pregnancy-specific anxiety is higher in those with prior loss.

The feeling of being responsible for the loss coupled with the premium placed on childbirth leads to profound anxiety, sadness and depression. Understanding and empathy from healthcare providers and family members aided the recovery process from Pregnancy- specific anxiety

Prevention

Not all miscarriages are caused by genetic abnormalities, medical experts say that the cause of prior miscarriage should be established before another pregnancy. Apart from establishing the cause of prior miscarriages, all risk factors must be avoided.

Dr Odetayo says healthy lifestyle before and during pregnancy may help prevent miscarriages. Healthy lifestyle includes:

-400 mcg of folic acid every day, beginning at least one to two months before conception

-Regular Exercise

-Healthy well-balanced meals

-Managing and avoiding stress

-Healthy Weight

-No smoking

-No Alcohol

-No Illicit Drugs

-Pre-conception care and counselling for those with chronic diseases such as hypertension, diabetes mellitus or thyroid disorder

-Avoiding sports that carry a higher risk of injury, such as contact sports and skiing, and always wear your seat belt during pregnancy

-No over the counter drugs during pregnancy

-Avoid environmental hazards such as X-rays and infectious diseases

-Book pregnancy early for antenatal care.

10 FOODS THAT CAN CAUSE MISCARRIAGE IN EARLY PREGNANCY (Courtesy Firstcry Parenting)

Foods with high cholesterol including crabs, smoked Seafoods, raw egg, unpasteurized milk etc. High cholesterol may cause uterus to shrink and this may cause miscarriage.

Moringa- contains alpha- sitosterol, with estrogen-like structure that can cause miscarriage.

Animal Liver: Although animal liver is nutritious, but it can be toxic and harm pregnant women if the liver is taken from an infected or a sick animal. Liver also contains high amounts of vitamin A and cholesterol. Consumption of these in excess can adversely affect the foetus and cause miscarriage.

Aloe Vera-Pregnant women should not eat or drink anything that includes aloe vera because this can lead to pelvic haemorrhage which can further cause a miscarriage. It is best to avoid all kinds of aloe vera products during first trimester of pregnancy.

Sprouted Potatoe: This food is not only dangerous for pregnant women but for everyone. Potato when sprouted contains various toxins, harmful to the health of the mother and her baby. There is solanin in potato with green sprout and this can be harmful for foetal growth.

Pineapple: Pineapple juice is commonly used at the time of delivery to make the process fast and easy. Pineapple contains bromelain, which can make uterine muscle smooth and thus lead to miscarriage. If you consume this during the first three months of your pregnancy, this may cause miscarriage.

Caffeine: Too much of it is dangerous for early pregnancy.

Unripe / Green Pawpaw: They have component that act as laxatives and bring on premature labour causing contraction of the uterus resulting to miscarriage.

Herbs: They contain steroids that adversely affect the baby’s growth. Consult a doctor before taking any herb during pregnancy.

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SOURCEDare Agbeluyi - Chief Publisher Citizen's Comfort
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Dare Agbeluyi is a 1985 graduate of Mass Communication, University of Lagos. And Master of Arts, Communication and Language Arts, University of Ibadan, 1988. A very experienced media practitioner since 1986. He has worked in both print and broadcast media. A prolific writer; He became a columnist with The Punch where he pioneered the automobile column known as Automart, now metamorphosed to Transport column published every Wednesday, while still working officially as senior Advertorial Coordinator, in charge of supplements. He is an all-around media practitioner. In 1996, Dare started media brokerage, interfacing between agencies and media, leveraging on his media experience to bulk and sell cheaper. A versatile media man, who has a knack for creative writing. He is also a prolific scriptwriter. Dare is an independent media content provider for radio, print and digital. Dare Agbeluyi is in the full membership category of the Advertising Regulation Council of Nigeria (ARCON).

2 COMMENTS

  1. I’ve never read such an insightful article about miscarriage. This is a must read for everyone, particularly those that attribute miscarriages to evil spirit.

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