Who had a late miscarriage? Causes of miscarriage in women in late pregnancy

The loss of a child causes deep shock for parents. And rarely the grief is reduced due to the fact that the baby was still tiny and in the womb. Almost always, a woman and a man go through this period very hard, but it is worth continuing to live for the sake of their future children, who will definitely appear.

For many women, the information we have prepared below can cause unpleasant memories and a bitter aftertaste. However, there are others who would be comfortable knowing more about their loss.

Our society still does not understand girls who are upset by the loss of a child in the early stages. Because of this, many women hide their grief or believe that their feelings are abnormal. Although this is not at all true, because with this baby, hopes for his future are lost and worries about unfulfilled motherhood are completely justified. In the comments, you can share your bitter experience with other women and this will allow them to feel that they are not alone in their grief.

Causes of late miscarriage

As medical practice shows, there are many known reasons for miscarriage in the second trimester. In more than 70% of cases, it occurs due to genetic malfunctions in fetal development, which are associated not with heredity, but with environmental influences. Among the remaining reasons, the characteristics of the female body, as well as the lifestyle that a particular woman leads, prevail.

In order to reassure expectant mothers at least a little, we note that when a woman’s pregnancy exceeds 12 weeks, the likelihood of a miscarriage is significantly reduced. According to statistics, late miscarriage occurs in 25% of all miscarriages that occur annually in our country. If an unassisted termination of pregnancy occurs after the 22nd week, it is considered a premature birth. Children born during this period are considered premature and in most cases survive thanks to modern medical advances.

When it comes to miscarriage in the second trimester, possible disruptions in the development of the unborn baby are not even considered among its possible causes. Among the factors influencing miscarriage during this period are:

Inflammatory processes of the walls of the uterus or areas of the placenta.
Untimely separation of the placenta.
Various infections.
Operations that were previously performed on the uterus or blood vessels.
Quite common mental disorders, leading to severe depression and depression.

Why is pregnancy terminated?

There are many possible causes, such as infections, hormonal imbalances, problems with implantation or placenta. Most often, something goes wrong immediately or a short time after conception and the fetus does not develop properly.

For most women, it is impossible to determine why a miscarriage occurred. Even after thorough testing.

Here are some of the most common reasons:

Abdominal surgery.
A history of surgical intervention in the abdominal area (for example, a woman previously had surgery to remove an ovarian cyst) quite often leads to recurrent or single miscarriages
Empty fertilized egg
Sometimes the egg is fertilized but does not continue to divide. The pregnancy test and hCG analysis will be positive, the fetal sac is formed, but the baby itself is not. In this case, there is an interruption of 7 to 12 weeks.
Any severe or poorly controlled chronic disease
Diseases such as hypothyroidism and diabetes, if left unchecked by specialists, can cause miscarriage, although this is quite rare.
Isthmic-cervical insufficiency.
An insufficiency of the cervix is when the cervix is unable to hold the contents of the uterus and dilates too early without pain, usually occurring after the 14th week. According to the Congress of Obstetricians and Gynecologists of Russia: “When cervical insufficiency was detected between 12 and 26 weeks, surgical correction was performed using the McDonald method. The women were also examined for the presence of urogenital infections and their hormonal levels were studied. After the operation, tocolytic, hormonal and antibacterial therapy was prescribed, rectal suppositories with interferon and sanitation of the lower genital tract were carried out with an aqueous solution of povidone-iodine. Thus, timely diagnosis and such treatment in 95% of cases made it possible to obtain viable newborns, and in 79% of cases allowed to prolong pregnancy to full term.”
Chromosomal defects or abnormalities.
Most chromosomal abnormalities or defects occur randomly and in most cases their causes are unknown.
Direct injuries.
A strong direct blow to the lower abdomen can damage the uterus and placenta.
Immunological problems.
Sometimes (for example, with Rhesus conflict), the mother’s immune system begins to reject the fetus, identifying it as an aggressor for the woman’s body.
Infections or viruses
For example, listeriosis or toxoplasmosis are very dangerous for the fetus.
Abnormalities in the shape of the uterus
Some women are born with an unusual uterine shape, which can increase the chance of spontaneous abortion. Read more about the bicornuate shape of the uterus.
Excessive abuse of bad habits.
If the expectant mother smokes or consumes large doses of alcohol or drugs every day, then the likelihood of losing the child increases.

How to avoid losing a child?

The success of this event depends on the stage at which the interruption process is currently located. If a woman is at risk of miscarriage with aching pain in the lower abdomen and slight bleeding, then a medical institution can carry out preserving treatment and the child’s life will be saved.

If blood clots appear, the bleeding intensifies and the nagging pain does not stop, then in this case everything can end well, you just need to seek help from the hospital in time.

But when parts of the fertilized egg are already visible in the discharge, then nothing can be done.

Many studies have been conducted and still have not found a method that would 100% guarantee protection against miscarriage. Why? The reason is that in most cases, the pregnant woman loses the fetus, which is not viable. It has been established that bed rest, lack of heavy physical activity or poor nutrition have no effect on termination of pregnancy.

The materials of the Congress of Obstetricians and Gynecologists of Russia indicate:

In patients with alloimmune disorders, the treatment of choice is a combination of active and passive immunization in the first trimester of pregnancy. For autoimmune pathology (APS), the most effective treatment is continuous antithrombotic therapy until 16 weeks of pregnancy.

Don't lose hope after a miscarriage

Often, women who have experienced a late miscarriage despair and do not believe that they will ever be able to get pregnant and bear a full-fledged child. In fact, you can get pregnant, but you should know that after such a phenomenon, the cervix will become much weaker than before. This occurs due to the fact that the cervical tissue is too hard, as a result of which it is possible to temporarily close the canal while the fetus is successfully growing and increasing the volume of the uterus. After 8 weeks of pregnancy, in expectant mothers with a weak cervix, the canal gradually expands, which should not happen during a normal pregnancy.

An unwanted late miscarriage very often entails rupture of the membranes (due to weakness of the cervical canal) and, as a result, leakage of amniotic fluid. To prevent this, the obstetrician-gynecologist is obliged to bandage the cervix in a special way in a timely manner. After 33 weeks of pregnancy, this sling is removed. It is thanks to such surgical intervention that a large proportion of women ultimately give birth to full-fledged and healthy children. There are also other (milder) consequences of late miscarriage that do not require the help of surgeons and are limited to short-term therapy.

The main causes of late miscarriage

There are many factors that can cause miscarriage during late pregnancy:

Violation of the blood hemostasis system.

Maintaining balance and proper regulation of physiological antagonists (coagulation and anticoagulation systems) of the blood is very important for the normal development of pregnancy. Changes with the predominance of one or another system can cause irreversible consequences for the fetus and cause its death.

Cervical insufficiency.

The cervix should normally be closed during pregnancy.

The length of the cervical canal must exceed 25 mm.

When the cervix opens and shortens, there is a risk of miscarriage. The further development of pregnancy becomes questionable.

With pronounced changes, prolapse (gaping) of the fetal bladder through the cervix is possible, with rupture of the membranes. This is the reason for termination of pregnancy.

Uterine fibroids.

Large size of myomatous nodes can interfere with the physiological development of the fetus. The rapid growth of nodes during pregnancy interferes with the stretching of the muscle cells of the uterus. In addition, uterine fibroids in the area of placenta attachment can cause circulatory disorders in the fetoplacental blood flow, which can lead to fetal death.

Infectious factor.

One of the leading causes of spontaneous miscarriage is infection of the fetus. The spread of infection can occur in various ways: through the placenta (transplacental route), ascending infection (the inflammatory process is transmitted from the vagina, cervix), canalicularly (through the fallopian tubes), transmuscularly (through the muscular wall of the uterus).

An infectious agent (pathogen) affects the tissue of the placenta, causing inflammation in it (placentitis). Subsequently, the inflammatory process moves to the fetal membranes with the development of amnionitis. The subsequent spread of infection in the fetus causes intrauterine infection. The resulting foci of infection can lead to fetal death.

Endocrine factor.

Recently, more attention has been paid to the hormonal causes of abortion. Many endocrine diseases cause profound metabolic disorders in the body, which can lead to fetal death.

The most common are: diabetes mellitus, hyperandrogenism syndrome, hyperprolactinemia, decreased endocrine function of the pituitary gland, ovarian failure, thyrotoxicosis, severe hypothyroidism.

The most common cause is a violation of hormonal interactions at the placenta level.

It is known that one of the functions of the placenta is the production of hormones. With placental insufficiency, there is a deficiency of the hormone progesterone, which makes a major contribution to the prolongation (development) of pregnancy.

This is why placental insufficiency can cause abortion.

Circulatory disorders in the fetoplacental system.

With insufficient blood flow in the uterine arteries, umbilical cord vessels, as well as pathology of the vascular network of the placental bed, irreversible changes can occur, including fetal death. Adequate blood circulation is an important condition for a normally developing pregnancy.

Genetic abnormalities.

Certain hereditary diseases can cause self-abortion.

The main part of the so-called “genetic reset” occurs in the early stages of pregnancy (the most severe malformations).

However, in the later stages, termination of pregnancy is also common due to the presence of congenital diseases in the fetus (heart defects, kidney defects, nervous system defects, and other vital organs).

Anomalies of uterine development.

Changes in the anatomical structure of the uterus can cause miscarriage.

For example, such a pathology as a bicornuate uterus often leads to similar situations.

In this situation, the uterine cavity is divided by a septum, which reduces the volume of each cavity.

If pregnancy begins to develop in one of the horns of the uterus, then at a certain point an obstacle arises to further stretching of the muscle fibers. A bicornuate uterus does not allow the fetus to fully develop.

In addition, with the normal structure of the uterus, there are anastomoses (connections) in the arterial system between the uterine arteries, which contributes to a complete blood supply to the placental system.

With a bicornuate uterus, the arterial system of the two uterine arteries does not anastomose with each other, which significantly reduces the potential blood flow in the fetoplacental system. This can also cause fetal death.

External factors.

These include harmful environmental influences (ionizing radiation, climatic, geographical factors). Toxic effects (poisoning with heavy metal salts, intoxication). Not only the type of influencing factor is very important, but also the duration. Mechanical factors (injuries, bruises, physical strain) can also adversely affect the course of pregnancy.

Psycho-emotional impact.

News of an extremely bad event, severe fear, and negative emotions can cause spontaneous abortion. The mechanism is associated with the activation of stress hormones (adrenal hormones, activation of the sympatho-adrenal system), which lead to an increase in the tone of the uterine muscles, as well as vasospasm of the fetoplacental system, which causes self-abortion.

Serious illnesses of the mother that prevent the development of pregnancy (severe heart defects, kidney defects, tuberculosis, chronic diseases in the stage of decompensation).

Breasts after miscarriage

Often, the breasts secrete milk after a miscarriage (most often this happens in late pregnancy). If a miscarriage occurs before the 14th week of pregnancy, milk will not be produced in the breast. Understanding the nature of this phenomenon is quite difficult, since not a single woman in the world can know in advance how the hormones responsible for filling the breasts with milk will behave. There are cases where expectant mothers released colostrum even when they were just thinking about a possible miscarriage.

Breasts may behave differently after a miscarriage. If you want to stop her milk production, don't pump and wear a tight bra all day long. In order to suppress discomfort in the chest, you can take a warm shower, apply cabbage leaves and cool compresses to the mammary glands. If the pain of suppressing your mother's milk production becomes unbearable, try expressing a little, each time reducing the volume of expressed milk.

You can also prevent the production of breast milk through special medications, which should be purchased only after prior consultation with your gynecologist. If your breasts are very sore, red, or large lumps are noticeable, consult a doctor immediately.

Diagnosis of threatened miscarriage

Any changes in health should be a reason to consult a doctor. You should especially be wary of uterine tension (hypertonicity), which is felt by the expectant mother as the belly grows, nagging pain in the lower back and lower abdomen, spotting on underwear or bleeding, and copious liquid discharge with a sweetish odor. If at least one of these manifestations is present, it is important to immediately call an ambulance and be hospitalized in a hospital. In the early stages, the threat of miscarriage is quite treatable. If the situation is critical, doctors will decide how to further manage the pregnancy - whether it can be saved and whether the timing allows for early delivery.

In any case, they coordinate all their actions with the expectant mother; they explain to her the meaning and necessity of each of the procedures, especially if it is necessary to apply sutures or install a pessary. If a woman does not agree to such measures, she writes a written refusal to manipulate, taking responsibility for the future of the pregnancy upon herself. In any case, doctors will do everything to save the baby using available methods.

Prevention of late miscarriage

Unfortunately, it is not always possible to avoid late miscarriage, since its cause lies in the improper development of the fetus itself. However, in order to bring your pregnancy to its last week and at the same time preserve your health and the life of your baby, you should follow some tips:

Try to be optimistic and drive away a bad mood, which most often entails stressful situations that have a detrimental effect on the gestation of the fetus;
Avoid unhealthy foods, remembering that only healthy food will enrich your child with all the beneficial vitamins and microelements;
Forget about cigarettes and alcohol;
Do not eat for two, so as not to gain too much weight in the last months of pregnancy;
Read also: Pain in the lower abdomen after ovulation as before menstruation
Do morning exercises, including exercises for expectant mothers.

Other reasons for threatened miscarriage

Some other reasons may also provoke the threat of miscarriage in the later stages. These include infectious and inflammatory pathologies in the area of the uterus, membranes or placenta, which provoke its detachment. Severe viral infections with severe fever, poisoning and toxic damage to the fetus can also provoke the threat of miscarriage. Also, a constant threat of miscarriage is likely in the presence of Rh conflict. In this case, it is necessary to constantly monitor the level of antibodies in the blood.

The threat of miscarriage is also possible with severe emotional stress, heavy physical exertion and abdominal injuries, and heavy lifting. Therefore, during pregnancy it is worth limiting exercise and avoiding harmful effects. If the threat of miscarriage worries doctors, then the woman is hospitalized for the entire period until the danger passes - for some this is a couple of weeks, and for some - right up to childbirth.

Recovery after a late miscarriage

Many parents who dream of a child will try to conceive again even after a miscarriage. However, in order to more easily survive the current stressful situation and achieve a positive development of events for the second time, follow a few tips and recommendations from experts:

Immediately after a late miscarriage, do not rush to conceive a child again, since the weakened female body will not be able to bear it until the 9th month;
If you have postponed your next conception for a while, skillfully approach the choice of contraceptives (for this it is best to ask a doctor for help);
To prevent another miscarriage, talk to your gynecologist about the possible causes of this phenomenon.

Having experienced a late miscarriage, do not lose hope and remember that many women, even after 4 such cases, manage to give birth to a healthy and long-awaited baby.

Main signs of miscarriage

Symptoms include:

Pain localized in the lower abdomen. It can be pulling or cramping, regular or irregular.
Blood from the genital tract is usually scarlet in color, and bleeding may be light or heavy.
Sometimes the temperature rises.
Vomiting is possible (cervical reflex: when the cervix dilates, nausea or vomiting appears).
The appearance of a feeling of fear, anxiety.
With heavy bleeding, dizziness and even loss of consciousness may occur.
Stages of spontaneous abortion.

Why do women strive to get rid of pregnancy on their own?

Most women who find themselves in a similar situation are in no hurry to go to a medical facility. Fear of publicity and a judgmental attitude forces you to look for ways to solve the problem yourself. However, not all of them are effective, and some can cause significant and irreparable harm to health.

Ingestion of decoctions that should cause a miscarriage:

Drinking milk with iodine. This should not be done under any circumstances. This potion can seriously harm the thyroid gland, the consequences can be irreversible.
Drink a decoction of bay leaves. This is a completely useless exercise, the results of which are unknown to medicine. You can only provoke an allergic reaction.
Drinking a decoction of tansy. This drink is truly poisonous; it can harm the fetus and cause significant developmental defects. It also promotes the opening of heavy bleeding. It is not known whether there will be a miscarriage, and it will be difficult to stop the bleeding. This method is fraught with the need for “cleaning”, which is equivalent to a surgical abortion. In addition, this herb can harm internal organs: liver, kidneys and heart.

Taking medications:

Emergency contraception. There are medications that can be taken immediately after unprotected intercourse. The main thing is to have time to drink them as soon as possible. Most of them immediately begin to block the body's release of progesterone, and act at the receptor level. With the help of the drug, the likelihood of ovulation is reduced. Fertilization of the egg, attachment to the endometrium and implantation do not occur. The main active ingredient of such drugs is mifepristone. It contributes to the death of the embryo as a result of cessation of development. But the concentration of the substance is so low that it will not be enough for a miscarriage. This fact is indicated in the annotation and you should not hope for a favorable effect.
Use of oxytocin. This drug is used to stimulate dilatation of the cervix. It is used during labor, when labor activity is low. The drug is administered after abortion or childbirth to contract the uterus and speed recovery. Therefore, such a remedy will not be effective for terminating a pregnancy. However, it can cause significant harm to the body. Side effects of the drug include the appearance of heavy uterine bleeding, severe nausea and vomiting, and pressure surges. Medical assistance not provided on time can lead to negative consequences.
Ascorbic acid. There is an opinion that if you take ascorbic acid in large quantities, a miscarriage will occur. This statement is absurd and is similar to if it were claimed that a similar effect would occur as a result of taking large portions of parsley or lemon. But you can deal a strong blow to the stomach.

Measures to terminate pregnancy without medication:

Hot baths. In such a condition, taking hot baths is strictly contraindicated. After sitting in hot water for even a few minutes, you can lose consciousness. This is due to a significant decrease in pressure, which occurs due to the dilation of blood vessels. As a result, the blood supply to the brain may be impaired.
Intense physical activity. In this way, you can provoke the onset of bleeding, but the miscarriage may not be complete, some parts may remain in the uterus, then you will have to do a “cleaning”. It is worth noting that “cleaning” is resorted to as a result of most home experiments. In addition to this threat, excessive stress on the heart may occur, which will provoke an attack, possibly with a fatal outcome.

Medical abortion

How can I get rid of pregnancy using medication? This question is relevant among those women whose menstrual delay does not exceed 14 days. Medical abortion is performed up to 42 days of amenorrhea.

Abortion is performed using two drugs: mifepristone and misoprostol. They can only be prescribed by medical institutions that are licensed to provide medical abortions. Mifepristone contributes to the death of the embryo. The second drug leads to spasm and dilatation of the cervix. Thus, mini-labor activity is activated and it is possible to get rid of pregnancy.

One of the drugs cannot be used; they should only be used together. It is worth noting that these medications cannot be purchased at a pharmacy; this is prohibited by law.

However, unscrupulous individuals offer to buy them on the Internet. First of all, this is contrary to the law, and secondly, these may be drugs of unknown quality. It is better not to buy goods of dubious manufacture from unverified persons. Complications may occur after taking them.

Abortions with the help of medications are carried out strictly under the supervision of a doctor. He will observe the body's reaction immediately after taking the pills. Throughout the entire period of miscarriage, she will be able to advise and, if necessary, provide assistance.

Causes and symptoms of miscarriage

For many women, the information we have prepared below can cause unpleasant memories and a bitter aftertaste. However, there are others who would be comfortable knowing more about their loss.

Late termination of pregnancy after the 22nd week

At this time it is already difficult to lose a child. If a miscarriage occurs after 28 weeks, it is considered premature birth. There are cases when at this time it was possible to save the baby’s life. The very first sign of a miscarriage is bleeding from the uterus, even the slightest.

Spontaneous miscarriage most often begins with small bleeding, which in an increasing sequence turns into heavy bleeding.

Along with this symptom, spasmodic pain in the lower abdomen may appear. Blood can have either a scarlet color or a brown tint. Bleeding is not always profuse, but it can last up to several days.

Pain in this case is not necessary. It may appear or go away for a while. A woman may suddenly feel unwell. In this case, bloody pieces may be released from the uterus. This means that a miscarriage has occurred. This condition is explained by the fact that the fetus could have died long before the first symptoms appeared and is therefore separated in parts.

Repeated miscarriages

In just one case of miscarriage, as a rule, there is no indication that there is an increased risk of re-terminating the next pregnancy. If you have had more than one spontaneous abortion, you will need your doctor to find the cause. There are certain conditions that can be treated early to reduce the likelihood of this problem occurring. Conditions such as thrombophilia (a bleeding disorder), autoimmune diseases, diabetes and thyroid problems increase the risk of miscarriage, but they are highly treatable. A defect in the shape of the uterus can also prevent embryo implantation. Talking to your doctor about pregnancy losses that keep reoccurring can help you get early treatment and increase your chances of carrying your baby to full term.

How does a miscarriage occur? Symptoms

When a pregnancy is threatened with miscarriage, little depends on the woman herself, her family, and even medical workers. This is an equally scary time, full of uncertainty and anxiety.

The pregnant woman is sent for an ultrasound, where a specialist will determine the fetal heartbeat and the opening of the cervix. It is unfortunate, but if the heart does not beat and the cervix is open, then a miscarriage has either already occurred or will inevitably occur in the near future.

A miscarriage may be threatened, but sometimes it can occur without any warning signs (it does not matter whether the warning signs did not appear in a primiparous or multiparous woman).

The very first signs of interruption:

Uterine bleeding, which may increase.
Painful cramps in the lower abdomen, similar to menstrual pain.

If a complete spontaneous abortion occurs, bleeding and pain stop. If incomplete, symptoms will be present until the uterine cavity is completely cleansed.