General Practice 2022

Spontaneous abortionâneo: what é, symptoms, causes and treatment

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Spontaneous abortionâneo: what é, symptoms, causes and treatment
Spontaneous abortionâneo: what é, symptoms, causes and treatment

Spontaneous abortion is the involuntary termination of pregnancy before 20 weeks of gestation, which usually happens due to malformation of the fetus, but which can also occur due to infections by viruses or bacteria.

Symptoms of miscarriage include severe abdominal pain, vaginal discharge, and blood loss from the vagina. It is more common in the first 12 weeks of pregnancy, and often, it may not even be noticed by the woman, especially if it occurs in the first 6 weeks, as it can be confused with menstruation. Learn how to identify if it's a miscarriage or menstruation.

Spontaneous abortion treatment should be done as soon as possible, and the nearest emergency room should be sought as soon as symptoms appear, so that the diagnosis can be made, avoiding complications such as sepsis due to products of conception retained in the uterus.

Symptoms of Miscarriage

The main symptoms of miscarriage are:

  • Vaginal bleeding;
  • Severe abdominal pain, similar to severe menstrual cramps, which may radiate to the back;
  • Fever or chills;
  • Smelly vaginal discharge;
  • Loss of blood clots or tissue from the vagina;
  • Absence of the natural signs of pregnancy, such as breast tenderness or feeling sick;
  • Absence of fetal movement for more than 5 hours.

Furthermore, these symptoms may be accompanied by heart palpitations or a drop in blood pressure. See other symptoms of miscarriage.

It is important to seek immediate medical attention or the nearest emergency room, in case of spontaneous abortion symptoms, so that the diagnosis and treatment can be initiated.

What to do if you suspect a miscarriage

In case the woman presents signs and symptoms such as severe abdominal pain and blood loss through the vagina, especially after intimate contact, it is recommended to go to the doctor to perform tests such as ultrasound to check if the baby and the placenta are well.

The doctor may recommend that the woman rest and avoid intimate contact for 15 days, but it may also be necessary to take painkillers and antispasmodics to relax the uterus and prevent the contractions that lead to miscarriage.

How to confirm the diagnosis

The diagnosis of miscarriage is made by the obstetrician through the analysis of symptoms, pelvic gynecological examination, blood test measuring the levels of beta-HCG, hemoglobin and hematocrit, and through pelvic or transvaginal ultrasound. Thus, it is possible for the doctor to diagnose the type of abortion.

Also, in the case of women who do not yet know their blood type, the doctor may order a blood test to determine maternal blood type and Rh factor, in case a blood transfusion or immunoglobulin administration is recommended anti-DFind out how the Rh factor can influence pregnancy.

Other tests that the doctor may order to determine the cause of miscarriage, such as gonorrhea or chlamydia infections, for example, are urinalysis and analysis of vaginal secretions and products of conception.

Types of miscarriage

Abortion can be classified into some types according to the characteristics of the cervix and expulsion of uterine contents, which may occur completely, incompletely or not at all.

The main types of miscarriage include:

  • Threat of abortion: occurs when a woman has vaginal bleeding, but her cervix is ​​not dilated. Generally, in this type, the pregnancy continues without major risks;
  • Complete abortion: when all uterine contents are expelled, without the need for surgical intervention, being more common in the first 12 weeks of pregnancy;
  • Incomplete abortion: when only part of the uterine contents is expelled, and parts of the fetus, placenta or membranes may still be retained in the uterus;
  • Retained abortion: when fetal death occurs, and the woman has no uterine activity to expel the fetus, which is retained in the uterus for 4 weeks or more;
  • Inevitable miscarriage: occurs when the cervix has dilated, but the products of conception have not been expelled.

Also, another type of miscarriage is septic abortion, which develops when uterine infection occurs.

Possible causes

The main causes of miscarriage are:

  • Fetal malformation;
  • Hormonal changes such as lack of progesterone;
  • Problems in the uterus, such as bicornuate, septate, arched uterus, or endometrial deformation;
  • Problems in the cervix, such as cervical insufficiency;
  • Polycystic ovary syndrome;
  • Thyroid disorders such as hypo or hyperthyroidism;
  • Infections caused by viruses or bacteria, such as gonorrhea, chlamydia, syphilis, mycoplasma, or toxoplasmosis;
  • Uncontrolled diabetes;
  • Thrombophilia;
  • Celiac disease;
  • Autoimmune diseases, especially antiphospholipid antibody syndrome;
  • History of two or more miscarriages;
  • Pregnancy after age 35;
  • Conception within three to six months after delivery;
  • Use of intrauterine device (IUD);
  • Excessive consumption of alcoholic beverages or beverages containing caffeine;
  • Use of drugs of abuse;
  • Exposure to cigarette smoke;
  • Low weight or obesity;
  • Invasive prenatal testing, such as amniocentesis or chorionic villus sampling.

In addition, taking medicine or teas without medical advice can also cause miscarriage. Know some remedies that can cause abortion.

How the treatment is done

The treatment of spontaneous abortion must be guided by the obstetrician-gynecologist and depends on the type of abortion that the woman has suffered. In the case of incomplete abortion, the doctor may recommend the use of drugs such as Cytotec for complete elimination and then perform a curettage or manual or vacuum aspiration to remove tissue remains and clean the woman's uterus, preventing infections. Learn how curettage is performed.

When there are signs of a uterine infection such as foul odor, vaginal discharge, severe abdominal pain, rapid heartbeat, and fever, the doctor may prescribe antibiotics in the form of an injection and uterine scraping.In more severe cases, it may be necessary to remove the woman's uterus.

When pregnant again

After having an abortion, the woman should receive professional psychological support, from family and friends to emotionally recover from the trauma caused by the loss of the baby.

A woman can try to get pregnant again after 3 months of abortion, waiting for menstruation to return to normal, having at least 2 menstrual cycles or after this period when she feels safe again to try a new pregnancy.

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