Can cause great injury. But watching the miscarriage process itself can be even more difficult. A miscarriage or spontaneous abortion is defined as the loss of a child before 24 weeks, although sometimes this period is cut off to 20 weeks. About 50% of pregnancies end in miscarriage, but at very early times, women often don't even know they were already pregnant and didn't experience any symptoms. Among clinically confirmed pregnancies, this figure is about 15-20%.

Bleeding during pregnancy

Before looking at some of the pictures, it's important to discuss bleeding during pregnancy.
Every fourth woman notices bleeding at an early stage. But bleeding is common in the first 12 weeks and is usually nothing to worry about. If the bleeding decreases and disappears in 1-2 days, then it does not indicate a miscarriage. Most often, the pregnancy continues and a healthy baby is born.

Bleeding may be red, as during menstruation, or light brown. Early bleeding is usually normal and is often a sign that an egg has implanted in the uterus (implantation bleeding). This usually happens around the expected date of your period and then stops a few days later.

Outgoing clots and tissues during miscarriage by week of pregnancy

Pregnancy can be terminated at any stage, but more often it happens in the first weeks. At earlier times, during a miscarriage, only blood and clots can be seen, but if a miscarriage occurs after 8 weeks, then there is a chance to detect diseased dense tissues, a sac with an embryo, and even a formed fetus.

Please keep in mind that these photos are just an example, meant to give you a general idea and help you prepare. They do not mean that the embryo or fetus will come out in such a preserved form.

If you are less than 8 weeks pregnant, the clots, cramps, and bleeding will usually not even be different from a heavy period (period). At a more difficult time, in addition to clots, you may notice parts of a denser tissue, which is placental or other products of conception. You may or may not see tissue that looks like an embryo or fetus.

4 – 5 weeks

Experiences of other women

Taken from a foreign women's pregnancy forum:

I am 10 weeks pregnant and went for an ultrasound 2 days ago because there was some blood coming out. They said my baby died at 8 weeks and 5 days. I decided not to have an operation to remove the baby, but to wait for a natural miscarriage. I'm terrified at the thought of what I might see, but can I actually tell that a baby has come out? I had a miscarriage 7 years ago and I was 6 weeks pregnant when it came out it looked like a blood clot. I'm so upset that I had another miscarriage and I get worse with panic every time I go to the toilet when I see something.

“After eight weeks, my pregnancy symptoms just disappeared overnight. Then I started bleeding, so I called the doctor. He told me to rest, but I got really bad cramps and came out with pretty big clots. Then the bleeding suddenly stopped. I knew I had a miscarriage and my period came back after about 6 weeks. I was able to conceive again and the next pregnancy was successful.”

This week, the fetus is already 8 weeks old - at this time the embryonic stage of the development of the baby is completed. Already next week, from the "status" of the embryo, he will move into the "status" of the fetus, a new period of its development will begin - the fetal one. In the meantime, the sensations at the 10th week of pregnancy make themselves felt in the same way as a week ago, hormones continue to do their job, which means that toxicosis has not yet passed. The expectant mother can calm herself in this case by the fact that in the very near future, toxicosis will remain in the past: usually its symptoms disappear by week 12. Nausea and occasional vomiting are accompanied by other sensations, such as drowsiness, fatigue, absent-mindedness. There are also mood swings, emotional instability.

Belly at 10 weeks pregnant

Despite the fact that a lot of time has passed since conception and the fetus continues to actively grow and develop, the stomach at the 10th week of pregnancy has not yet begun to round. At the same time, at this stage, some pregnant women may find a dark strip on their stomach that runs from the navel to the bottom - this is the result of increased synthesis of the melanin substance in the body of the expectant mother. Although the stomach has not yet begun to grow, nevertheless, a certain increase in weight is noted - by about 2-3 kg. The woman is obliged by the “additional” mass to the increasing volume of blood, the engorgement of the mammary glands, and also to the growing uterus.

Uterus

The size of the uterus already reaches the size of a large apple or grapefruit, it slowly becomes “cramped” in the pelvic cavity. For this reason, the uterus at 10 weeks of pregnancy already begins to rise above the pubic joint, and very soon it will begin to be felt by hand.

Analyzes

Usually, for a period of 10 weeks, a woman is already aware that in a few months she will give life to a new little man. If for some reason up to this point the woman has not yet been registered, then now is the time to go to the antenatal clinic in order to do this. And - get a referral for tests at the 10th week of pregnancy, which without fail involve taking a sample for a general blood test, a urine test, and a blood test for sugar.

When conducting tests at the 10th week of pregnancy, specialists pay special attention to blood sugar levels, especially for women over 25 years old, those pregnant women who are overweight or whose relatives have diabetes. Also, by conducting a blood test, they analyze the level of testosterone in a woman's body, which can be slightly increased during pregnancy.

Among other things, the doctor often prescribes an analysis of hCG at the 10th week of pregnancy. Typically, such an analysis is performed if there is a suspicion of a possible miscarriage. The hormone chorionic gonadotropin is actively produced by the tissues of the fetus from the first days of conception, and its level constantly increases as the embryo develops. The dynamics of the increase in the level of hCG allows you to determine how favorably the pregnancy is proceeding, whether there is a threat of its termination.

At week 10, according to the indications, a biopsy of the fetal villi is also analyzed. It may be required for the timely prenatal detection of genetic abnormalities in the development of the fetus already in the early stages of pregnancy.

At the same time, an ultrasound examination at this time is usually not yet carried out, only a date is set for the corresponding examination: usually the first ultrasound is performed before the 14th week of pregnancy. However, at week 10, an ultrasound may be needed to confirm a progressing pregnancy and clarify the due date.

ultrasound

During an ultrasound scan at the 10th week of pregnancy, you can clearly see the fetus, which is already unusually similar to a person - however, very small. The size of the baby now resembles a small plum, but this “plum” already has miniature knees and ankles. And an ultrasound at the 10th week of pregnancy can display how the fetus bends its knees, how it waves its arms and bends them at the elbows, how it moves its legs.

Fetus

The fetus at the 10th week of pregnancy completes the fundamental laying of all major organs and systems. This means that with the next crisis stage of its development passing, many factors that posed a threat to the baby at the first stage of its development will no longer be so dangerous. From now on, the baby will only grow, gradually "gathering" all the new cells to the laid "foundation".

The size of the fetus at the 10th week of pregnancy reaches 30-40 mm, its weight is on average 5 g. And, at the same time, this tiny miracle already bears a direct resemblance to a human cub. Let the baby still be completely transparent, the hairs are not yet growing, and the fluff is just being laid, his heart is already working very powerfully, up to 150 beats per minute.

The fetus at the 10th week of pregnancy can “boast” of formed limbs, on which fingers are visible, knee and elbow joints. The auricles and oral cavity have also formed - the baby is already actively grimacing, closing and opening his mouth, bringing his hands to his face and putting his fingers in his mouth.

At the 10th week of pregnancy, the fetal brain develops with great speed: about 250 thousand neurons are created in 1 minute. At the same time, the nervous system is already completely divided into central and peripheral.

Already at such an early date, the laying of the rudiments of the milk teeth of the future baby begins, and therefore the presence of calcium-containing products in the diet of a pregnant woman becomes a necessity. The intestines, rectum, bile ducts have almost completed their development, while the liver is still actively developing. The formation of the lymphatic and immune systems also continues.

Despite the fact that the genitals are not yet visible, it is nevertheless possible to determine gender: if a boy grows in the womb of a woman, the testicles already produce the male hormone testosterone.

Pain at 10 weeks pregnant

In the early stages of pregnancy, many women are characterized by complaints of pain of one kind or another. A pulling and painful sensation in the inguinal regions, for example, experts explain by the tension of the ligaments of the uterus.

Unless the leading positions are occupied by complaints of pain at the 10th week of pregnancy in the abdomen. In this case, the nature of the pain must be carefully analyzed. If the pain is located in the upper abdomen, most likely, this makes the stomach aware of itself. To eliminate the pain, it may be enough to simply review the diet and reduce portion sizes, if it does not help, you should plan a trip to the gastroenterologist.

Much more dangerous pain at the 10th week of pregnancy in the lower abdomen, pulling or cramping, sharp. Such pain may indicate a high risk of premature and spontaneous abortion, especially if accompanied by bloody or brown discharge. Therefore, an appeal to a doctor should be made immediately, if necessary - even with a call to an ambulance at home.

You should also consult a doctor if the pain at the 10th week of pregnancy is accompanied by a still frequent urination. Rezi, itching, burning in the genital area when emptying the bladder indicates the presence of a urinary tract infection and also requires mandatory treatment.

Allocations

The same recommendations - about consulting a doctor - are also relevant if painful sensations accompany uncharacteristic discharge at the 10th week of pregnancy. Normally, the discharge at this time is light or milky in color, moderate, of a uniform consistency. If curdled, purulent or mucous discharges, flakes or vesicles, discharges with a pungent and unpleasant odor appear, a doctor's consultation is required, because such discharges indicate the development of an infection.

Most often, a woman during pregnancy is disturbed by candidiasis (thrush), colpitis, but the appearance of uncharacteristic discharge at the 10th week of pregnancy can also be associated with infection with chlamydia, gonococci, Trichomonas and other pathogens. Infection of the mother and untimely treatment is dangerous because the infection can infect the fetus in utero, which is fraught with a violation of its development and even the death of the baby.

Bloody or brown discharge at the 10th week of pregnancy most often indicates a miscarriage that has begun. Usually, the threat of interruption is also accompanied by pain in the lower abdomen, similar to painful or pulling sensations during menstruation. In this case, you need to act without delay, calling an ambulance team - timely qualified intervention in most cases allows you to save the pregnancy.

However, it should be borne in mind that spotting at the 10th week of pregnancy may occur after a gynecological examination or sexual intercourse. Such manifestations are characteristic in the presence of cervical erosion: loose tissues of the uterus are easily damaged and bleed, but pain in the abdomen is not observed.

Bleeding

Bleeding of various kinds in early pregnancy is not uncommon: according to statistics, approximately 30% of pregnancies are accompanied by recurrent bleeding. And if minor spotting may not pose a significant threat, then bleeding at the 10th week of pregnancy is already considered a pathology, indicating a threat of miscarriage. In this case, the blood can be bright red, pink or brownish, and the bleeding is accompanied by pulling pains in the abdomen and aching in the lower back.

Another reason why bleeding can occur at the 10th week of pregnancy is an ectopic pregnancy. An ectopic pregnancy is a complex and dangerous pathology that occurs when a fertilized egg is implanted not in the uterus, but outside it (most often in the fallopian tube). An ectopic pregnancy very skillfully “disguises” itself as a normal pregnancy, you can suspect something is wrong by aching and pulling pains in the lower abdomen and spotting. If an ectopic pregnancy is not detected in time, the risk of rupture of the fallopian tube from overstretching due to the growth of a fertilized egg is inevitable. And this often happens at the 10th week of pregnancy, accompanied by severe pain and heavy bleeding. With a rupture of the fallopian tube, the question of saving a woman goes on for seconds, hospitalization and surgical intervention become an absolute necessity.

Colds and fever at 10 weeks pregnant

In the early stages of pregnancy, a woman is most susceptible to all sorts of viral diseases. Weakened against the background of adaptation to new conditions of "work", the body is easily attacked by pathogens, and therefore a cold at the 10th week of pregnancy, and even more so - in the midst of a "violence" of viral diseases, spring and winter periods.

A cold at the 10th week of pregnancy, according to experts, no longer poses such a threat as at an earlier date - the most important critical period has already passed. And yet, this does not mean that with a cold, you can let the situation take its course and wait "when it goes away by itself." It is necessary to treat colds, definitely, after consulting a doctor. After all, most drugs are now banned, and the priority in the treatment of colds at the 10th week of pregnancy is for traditional medicine.

In the fight against nasal congestion, rinsing the nose with water with a salt solution will help, with a sore throat - rinsing with water with soda and salt. Inhalation can help to cope with a runny nose and sore throat - provided that there is no temperature. Do not forget about vitamins: it is advisable to fill the need for vitamins (especially vitamin C) with fresh vegetables and fruits, rosehip broth. For cough, you can also use traditional medicine recipes, for example, drink onion juice settled with honey.

With regard to temperature, the recommendations that apply to the previous weeks of pregnancy remain valid. The temperature at the 10th week of pregnancy, reaching or even exceeding 38 degrees, can and should be brought down. On the recommendation of a doctor, children's rectal suppositories can be used, but first you can try to cope with a high temperature through rubdowns and lotions. If the temperature at the 10th week of pregnancy fluctuates between 37-37.5 degrees, then this situation is often regarded by doctors as the norm and is explained by the "violence" of hormones.

If we talk about the basal temperature, then normally the temperature at the 10th week of pregnancy in this case should not exceed 37 degrees, and also decrease below 36.8 degrees.

Alcohol

Alcohol is known to be a highly toxic substance. And the most dangerous alcohol for the fetus, which is rapidly developing in the womb. Despite the fact that the 10th week of pregnancy is marked by the completion of the laying of all the main organs and systems of the unborn baby, the fetal brain continues to develop rapidly, as discussed above. And not a single physician can guarantee that alcohol at the 10th week of pregnancy will not “hit” just this one of the main organs of the baby and will not make him crippled even before birth.

Although many medical experts are of the opinion that alcohol in small quantities - for example, a glass of dry red wine - is safe for the fetus, yet most authoritative organizations in the form of the WHO, the institutes of pediatrics and gynecology insist on the complete rejection of alcoholic beverages during gestation baby. After all, the consequences that alcohol can provoke at the 10th week of pregnancy can be severe and very sad. If in one case alcohol may not harm the fetus, then in another it can become a catalyst for the development of all kinds of defects and anomalies in the baby, for which there is even a common name - fertile alcohol syndrome.

Sex

But you should not refuse carnal pleasures for a period of 10 weeks of pregnancy, of course, if there are no contraindications in the form of a threat of termination of pregnancy. Sex at the 10th week of pregnancy is not only possible, but also necessary - despite mood swings and not very good health. The husband often looks at his wife at this time with a “new look” - he is definitely attracted by the rounded forms of the woman and the smoothness that has appeared in her movements. And, unpleasant symptoms such as toxicosis, irritability and fatigue have not yet exhausted the woman completely, then sex at the 10th week of pregnancy can be a pleasant relaxation and a way of even closer rapprochement between future mothers and fathers. That's just to be zealous, as well as unnecessarily "active", practicing sex at the 10th week of pregnancy, after all, is not desirable.

Nutrition at 10 weeks pregnant

The issue of nutrition at the 10th week of pregnancy is also relevant for the expectant mother. Of course, nutrition at the 10th week of pregnancy must necessarily be healthy and balanced in order to provide the fetus with all the necessary nutrients and nutrients.

The diet of the expectant mother at this time must necessarily include a large amount of fresh vegetables and fruits (in addition, they also improve intestinal motility and help avoid constipation), meat and fish (protein), as well as dairy products (a source of calcium).

It would be time to give up coffee, as well as strong tea. The ban also includes spicy, fatty, salty foods, marinades that irritate the stomach, as well as sweets that increase blood sugar levels and contribute to the development of diabetes. Products made from white flour (bread, pasta) is the time to replace products made from wholemeal flour, white rice - brown rice.

It is necessary to take food fractionally, the best option is 5-6 times a day in small portions. Dishes are best steamed, baked, stewed or boiled. Late dinners should be abandoned - the last meal should be no later than 19 hours, with a strong feeling of hunger, it is permissible to eat a couple of apples (other fruits) or drink a glass of kefir.

Abortion is any termination of pregnancy that occurs up to 28 weeks, in 20% of cases the pregnancy ends due to spontaneous abortion - a miscarriage that occurs regardless of the woman's desire. After 28 weeks, termination of pregnancy is already considered an artificial birth, and the born fetus is already viable and it is possible to save the baby's life with the help of special medical equipment. In any case, an abortion at 10 weeks or later is not an easy test in the life of any woman.

Artificial abortion is the most controversial issue in modern society, someone believes that abortion at any stage of pregnancy is the murder of an unborn child, and someone zealously defends the right of a woman to decide when she becomes a mother.

The safest type of abortion is pharmacological or medical, it is carried out by taking special drugs that stimulate spontaneous abortion, it can be carried out for a period of 0 to 4 weeks, since later carrying out may not give any results, or the fetal egg will not come out completely and will be necessary uterine cleansing.

Vacuum abortion or mini-abortion is carried out for a period of 5 to 6 weeks by introducing a vacuum aspirator connected to special equipment into the uterine cavity. During the procedure, a vacuum is created in the uterus, due to which the fetal egg comes off the wall.

Surgical abortion for a period of 10 weeks is carried out under general anesthesia, and the course of curettage is controlled by ultrasonic sensors.

After the 12th week of pregnancy, an abortion is not carried out at the request of the woman; the only reason for it can be medical (fetal pathologies that threaten the life of the child or mother) or social indications (too late or early pregnancy, having at least 5 children).

In late pregnancy, abortion is performed through a complex operation that threatens with serious complications. If an abortion at the 10th week of pregnancy is still performed in a way that is more or less safe for the woman's health, then at a later date it is carried out through the introduction of saline into the fetal bladder, after which the already dead fetus is removed from the uterus.

In any case, abortion is a painful procedure not only on the physical level, but also morally.

Abortion at 10 weeks of gestation: complications

As with any other operation, various complications can occur due to abortion, which lead to irreversible consequences for the health of the failed mother. The most serious complication after surgical abortion at 10 weeks is perforation of the uterine wall, which leads to internal bleeding, trauma to internal organs and peritonitis. Such consequences of an abortion at the 10th week of pregnancy can lead to the removal of the uterus.

Abortion at 10 weeks: consequences

An abortion always leads to a hormonal breakdown, because, having tuned in to pregnancy, the woman's body produces specific hormones, which, if the pregnancy is disrupted at a later date, lead to an inevitable failure in the hormonal system. An abortion at week 10 will lead to more global consequences than at week 4, since at an earlier date hormonal changes in the body will have a less detrimental effect on a woman's health.

Provoking a spontaneous abortion at home using alternative medicine methods can have even more serious consequences, since the bleeding that has begun cannot be stopped on its own. Such extreme experiments often lead to the removal of the internal genital organs of a failed mother, and a fatal outcome is not ruled out.

Having decided to have an abortion procedure at week 10, a woman should know that a highly qualified specialist must have an abortion at an acceptable time and in a specialized medical institution. Also, abortion at week 10 leads to an imbalance in the blood pressure regulation system, the immune system, renal-hepatic function and circulating blood volume. Often, postponing an abortion at week 10 increases a woman's irritability, leads to a deterioration in her sleep and increased fatigue.

A woman's body becomes vulnerable to infectious and inflammatory diseases, and inflammation of the uterine appendages that often accompanies abortion, ultimately leads to obstruction of the fallopian tubes, which in turn can cause ectopic pregnancy or infertility. Dysfunction of the ovaries, which leads to infertility, is not excluded.

Due to blind scraping of the uterine mucosa, microtraumas, thinned areas, scars and other phenomena often occur, due to which there is a violation of the normal nutrition of the embryo during a subsequent pregnancy, which is fraught with miscarriages, fetal malformations or premature birth.

Video from YouTube on the topic of the article:

One in five pregnancies ends in miscarriage; more than 80% of miscarriages occur in the first 3 months of pregnancy. However, their actual number may be underestimated, since most occur in the early stages, when pregnancy has not yet been diagnosed. No matter when the miscarriage occurs, you may feel shock, despair, and anger. A sharp decrease in estrogen can cause a decline in mood, although most women become depressed without it. Best friends or even family members sometimes refer to what happened as a “bad period” or “pregnancy that was not meant to be,” which only deepens your grief. Many women experience guilt, thinking that something wrong was the cause of the miscarriage. What if it's because of the weights you lifted at the gym? Because of the computer at work? Or because of a glass of wine at dinner? No. Remember that the vast majority of miscarriages are due to chromosomal abnormalities. Only a small proportion of women (4%) with a history of more than one miscarriage suffer from some kind of disease that requires diagnosis and treatment. It is important to find moral support after what happened. Give yourself time to go through all 4 stages of grief—denial, anger, depression, and acceptance—before trying to conceive again. Understand that this is a disease and share your pain with someone you trust. Your partner is grieving the loss just like you, now is the time to support each other. Finally, remember that in most cases, even women who have had miscarriages have healthy children in the future.

Miscarriage classification

Spontaneous miscarriages can be classified in many ways.

Of practical interest are classifications based on differences in gestational age, degree of miscarriage (pathogenetic sign) and clinical course.

Spontaneous - miscarriages are distinguished:

1. By gestational age: a) early - in the first 12-16 weeks of pregnancy, b) late - at 16-28 weeks of pregnancy.
2. According to the degree of development: a) threatening, b) beginning, c) in progress, d) incomplete, e) complete, f) failed. If spontaneous miscarriages are repeated in successive pregnancies, they speak of a habitual miscarriage.
3. According to the clinical course: a) uninfected (non-febrile), b) infected (febrile).

At the core pathogenesis Spontaneous miscarriage may be the primary death of the fetal egg during toxicosis of pregnancy, acute and chronic infections, cystic drift, etc. In such cases, reactive changes usually occur in the body of a pregnant woman, entailing uterine contractions, followed by expulsion of the dead fetal egg. In other cases, reflex contractions of the uterus occur primarily and precede the death of the fetal egg (secondary death of the fetal egg), which occurs from a violation of the connection between the fetal egg and the mother's body due to detachment of the placenta from its bed. Finally, both of these factors, i.e., uterine contractions and egg death, can be observed at the same time.

Up to 4 weeks of pregnancy, the fetal egg is still so small that it occupies an insignificant place in the total mass of the falling off shell. Contractions of the uterus from its cavity can completely or partially remove the falling shell. If that part of the membrane in which the egg is implanted is removed from the uterine cavity, a spontaneous miscarriage occurs, which the pregnant woman either does not notice at all, or takes it for heavy menstrual bleeding. When removing a part of the falling off shell that does not contain a fetal egg, the egg, after the cessation of contractions, can continue its development. In such cases, a slight bleeding from the pregnant uterus can even be mistaken for menstruation, especially since a small amount of discharge, similar to menstruation, sometimes occurs in the first month of pregnancy. Further observation of the pregnant woman reveals the true picture.

If uterine contractions precede the death of the fetal egg and cause its detachment from the bed in the decidua basalis region, where a rich vascular system is developed, a short but severe bleeding occurs, quickly bleeding the patient, especially if half or rion exfoliated.

The closer to the internal os of the uterus the egg is implanted, the more bleeding. This is explained by the lower contractility of the isthmus of the uterus compared to its body.
Sometimes the fetal egg of early pregnancy exfoliates entirely and, having overcome the obstacle from the internal uterine os, descends into the cervical canal. If at the same time the external pharynx turns out to be impassable for the egg, it seems to get stuck in the cervical canal and stretches its walls, and the neck takes on a barrel-shaped appearance. This form of miscarriage is called cervical abortion (abortus cervicalis).

A miscarriage in late pregnancy (after 16 weeks) proceeds in the same way as preterm birth: first, the uterine os opens with the fetal bladder wedging into it, then the fetal bladder opens, the fetus is born, and finally, detachment and birth of the placenta. In multiparous women, the membranes often remain intact, and after the opening of the uterine os, the entire fetal egg is born entirely at once.

Varieties of miscarriage

Depending on what was found during the examination, your doctor may name the type of miscarriage that you have:

• Risk of miscarriage. If you are bleeding, but the cervix has not begun to open, then this is only a threat of miscarriage. After resting, such pregnancies often continue without further problems.
• Inevitable miscarriage (abortion in progress). If you are bleeding, your uterus is contracting and your cervix is ​​dilated, a miscarriage is inevitable.
• Incomplete miscarriage. If part of the tissue of the fetus or placenta came out, and some remained in the uterus, this is an incomplete miscarriage.
• Failed miscarriage. The tissues of the placenta and embryo remain in the uterus, but the fetus died or did not form at all.
• Complete miscarriage. If all the tissues associated with the pregnancy have come out, it is a complete miscarriage. This is usually for miscarriages that occur before 12 weeks.
• Septic miscarriage. If you have a uterine infection, it is a septic miscarriage. Urgent treatment may be required.

Causes of miscarriage

Most miscarriages occur because the fetus does not develop normally. Violations in the genes and chromosomes of the child are usually the result of random errors in the division and growth of the embryo - not inherited from parents.

Some examples of anomalies:

• A dead egg (anembryony). This is a fairly common occurrence, causing almost half of the miscarriages in the first 12 weeks of pregnancy. Occurs if only the placenta and membranes develop from a fertilized egg, but there is no embryo.
• Intrauterine fetal death (missed pregnancy). In this situation, there is an embryo, but it dies before any symptoms of a miscarriage appear. This is also due to genetic abnormalities of the fetus.
• Bubble drift. A mole, also called trophoblastic disease of pregnancy, is uncommon. This is an anomaly of the placenta associated with disorders at the time of fertilization. In this case, the placenta develops into a rapidly growing cystic mass in the uterus, which may or may not contain an embryo. If the embryo is still there, it will not reach maturity.

In some cases, a woman's health status may play a role. Untreated diabetes, thyroid disease, infections, and hormonal imbalances can sometimes lead to miscarriage. Other factors that increase the risk of miscarriage are:

Age. Women over 35 have a higher risk of miscarriage than younger women. At 35, the risk is about 20%. At 40, about 40%. At 45 - about 80%. Can play a role and the age of the father.

Here are the various causes of miscarriages:

Chromosomal abnormalities. During fertilization, the sperm and egg each contribute 23 chromosomes to the future zygote and create a set of 23 carefully selected pairs of chromosomes. This is a complex process, and the slightest failure can lead to a genetic anomaly that stops the growth of the embryo. Studies have shown that most miscarriages have a genetic basis. The older the woman, the more likely such anomalies.

Hormonal imbalance. About 15% of miscarriages are mediated by hormonal imbalances. For example, an insufficient level of progesterone can prevent the implantation of the embryo into the uterine wall. Your doctor can diagnose imbalances with an endometrial biopsy, a procedure usually performed at the end of your menstrual cycle to assess ovulation and the development of the lining of your uterus. As a treatment, hormonal drugs are used that stimulate the development of the embryo.

Diseases of the uterus. Fibrous tumor of the uterus can cause miscarriage; such tumors often grow on the outer wall of the uterus and are not dangerous. If they are located inside the uterus, they can interfere with implantation of the embryo or blood flow to the fetus. Some women are born with a uterine septum, a rare defect that causes miscarriage. The septum is a tissue wall that separates the uterus in two. Another cause may be scarring on the surface of the uterus, as a result of surgery or abortion. This excess tissue can disrupt the implantation of the fetus, as well as obstruct blood flow to the placenta. A doctor can detect these scars with an x-ray, and most of them can be treated.

chronic diseases. Autoimmune diseases, heart, kidney or liver disease, and diabetes are examples of disorders that cause about 6% of miscarriages. If you have any chronic medical condition, find an OB/GYN who specializes in pregnancy management for these women.

Heat. No matter how healthy a woman is in her normal state, if you have a high temperature (above 39 ° C) in the early stages, this pregnancy may end in a miscarriage. Elevated temperature is especially dangerous for an embryo up to 6 weeks.

Miscarriage in the 1st trimester

During this period, miscarriages are very common, in about 15-20% of cases. In most cases, they are caused by an anomaly of fertilization, which causes a deviation in the chromosomes of the fetus, making it unviable. We are talking about the mechanism of natural selection, which does not involve anomalies either on the part of the mother or on the part of the father.

Physical activity has nothing to do with it. Therefore, you should neither blame yourself for the fact that, for example, you did not have enough rest, nor feel responsible for this. A miscarriage that occurs in the first trimester of pregnancy does not require further special examination, except in cases of two or three consecutive spontaneous abortions.

Miscarriage in the 2nd trimester

From the 13th to the 24th week of amenorrhea, miscarriages occur much less frequently - about 0.5%) and are usually triggered by infection or abnormal opening (gaping) of the cervix. For prevention purposes, you can make a cervical cerclage, and in case of infection, drink antibiotics.

What doesn't cause a miscarriage

Such daily activities do not provoke a miscarriage:

• Physical exercise.
• Lifting loads or physical exertion.
• Having sex.
• Work that excludes contact with harmful substances. Some studies show that the risk of miscarriage increases if the partner is over 35 years old, and the older the father, the more.
• More than two previous miscarriages. The risk of miscarriage is higher if a woman has already had two or more miscarriages. After one miscarriage, the risk is the same as if there was no miscarriage yet.
• Smoking, alcohol, drugs. Women who smoke and drink alcohol during pregnancy have a higher risk of miscarriage than non-smokers and non-drinkers. Drugs also increase the risk of miscarriage.
• Invasive prenatal examinations. Some prenatal genetic testing, such as sampling of chorionic villi or amniotic fluid, may increase the risk of miscarriage.

Symptoms and signs of spontaneous miscarriage

Often the first sign of a miscarriage is metrorrhagia (vaginal bleeding that occurs outside of a period) or palpable contractions of the pelvic muscles. However, bleeding is not always a symptom of a miscarriage: it is often a 1st trimester disorder (affecting one in four women); in most cases, the pregnancy continues unhindered.

Threatened miscarriage (abortus imminens) begins either with the destruction of the falling off membrane, followed by cramping uterine contractions, or with the onset of contractions, followed by bleeding from the uterus - a sign of the beginning detachment of the fetal egg from its bed. The initial symptom of a threatened miscarriage is in the first of these options a slight hemorrhage, in the second - cramping uterine contractions. If the process that has begun does not stop, it goes to the next stage - to the state of an incipient miscarriage.

Thus, the diagnosis of threatened miscarriage is made if there is a symptom in pregnancy based on one of the symptoms mentioned - minor cramping pains in the lower abdomen and in the sacrum and minor bleeding from the uterus (or both symptoms together), provided that there is no shortening of the cervix uterus and opening of the cervix. In a two-handed study made during contractions, the uterus is sealed, and the seal is retained for some time after the subject has ceased to feel pain from contractions.

A miscarriage that has begun (abortus incipiens). In this stage of miscarriage, cramping pains in the abdomen and sacrum and blood discharge from the uterus are simultaneously observed; both of these symptoms are more pronounced than in the stage of threatened miscarriage. As with a threatened miscarriage, the cervix is ​​preserved, the external os is closed. Consolidation of the uterus during contractions is more pronounced than with a threatened miscarriage. If the connection with the uterus is broken only on a small surface of the fetal egg, for example, less than one third, its development can continue and the pregnancy is sometimes carried to the end.

With the progression of the process, the contractions intensify and become painful, as during childbirth; bleeding also increases. The cervix shortens, the pharynx gradually opens, up to the size necessary for the passage of the fetal egg. During vaginal examination, due to the opening of the cervical canal, an examining finger can be inserted into it, which gropes here for parts of the exfoliated fetal egg. This stage in the development of a miscarriage is called abortion in progress (abortus progrediens). The fetal egg in such cases is born partially or entirely.

When expelled from the uterine cavity, only parts of the fetal egg speak of an incomplete miscarriage (abortus incompletus). In such cases, the main symptoms are: profuse bleeding with large clots, which can lead to acute and severe bleeding of the patient, and painful contractions. With a two-handed gynecological examination, blood clots are found, often filling the entire vagina, a shortened and softened cervix, the patency of the cervical canal throughout its entire length for one or two fingers; the presence in the vagina, in the cervical canal and in the lower part of the uterine cavity of parts of an exfoliated fetal egg, if it was not expelled from the uterus before the study, an increase in the body of the uterus, some softening (uneven), roundness and soreness, a short contraction of the uterus under the influence of the study and others

A complete miscarriage (abortus completus) is said to occur when the entire fetal egg is expelled from the uterus. During vaginal examination, it turns out that the uterus has decreased in volume, is dense, although the cervical canal is open, the bleeding has stopped, only scanty spotting is observed; after 1-2 days, the cervix recovers and the cervical canal closes. However, although the fetal egg is expelled from the uterus as if entirely, fragments of the falling membrane and villi that have not lost contact with the uterus, etc., usually still remain in the cavity of the latter. repeated two-handed gynecological examination. In all other cases, it is more correct to clinically consider each miscarriage as incomplete.

A failed miscarriage is recognized after clinical observation on the basis of the cessation of growth of the uterus, which increased before in accordance with the gestational age, and then its decrease, the appearance of milk in the mammary glands instead of colostrum, a negative Ashheim-Zondek reaction (appears no earlier than 1-2 weeks after death of the fetal egg), slight bleeding from the uterus, and sometimes their absence.

One or another stage of the development of a miscarriage is established (which is of great practical importance) on the basis of the mentioned signs of each of them.

Complications of miscarriage can be the following pathological processes.

1. Acute anemia, which often requires urgent intervention. If a woman who has a miscarriage is healthy in all other respects, especially if the compensatory ability of the body is full, then with timely and appropriate measures taken to combat acute anemia, death from the latter is very rare.
2. Infection. With a miscarriage, a number of conditions are created that favor the development of a septic process. These include: an open uterine os, which makes it possible for microorganisms to enter the uterine cavity from the cervical canal and vagina; blood clots and remnants of the fetal egg located in the uterine cavity, which serve as a good breeding ground for microorganisms; exposed placental platform, which is an entrance gate easily permeable to microorganisms; bleeding state of the patient, reducing the body's resistance to infection. In each case, it must be established whether there is an infected (febrile) or uninfected (non-febrile) miscarriage. An infected miscarriage will be indicated by the presence of at least one of the following symptoms: high fever, palpation or percussion tenderness of the abdomen, tenderness of the uterus, not associated with its contractions, as well as tenderness of its appendages and vaults, admixture of pus to the blood flowing from the uterus, general intoxication phenomena body (frequent pulse, depressed or excited state of the patient, etc.), if they are not caused by other reasons, etc.
3. placental polyp. The formation of such a polyp is usually observed in cases where a small part of the placental tissue has lingered in the uterine cavity. Oozing from the uterine vessels due to insufficient contraction of the uterus, the blood gradually impregnates the remaining placental tissue, then layers on it, organizes and takes on the form of a polyp. The lower pole of the polyp can reach the internal os, which is not completely reduced due to the presence of a placental polyp in the uterus (like a foreign body). This process is accompanied by a slight bleeding from the uterus, which can last up to several weeks and even months, periodically intensifying. The entire uterus is poorly reduced. When the polyp reaches a size that causes irritation of the uterus, contractions begin and bleeding increases.
4. Malignant degeneration of the epithelium of chorionic villi retained in the uterus - chorionepithelioma.

Treatment of spontaneous miscarriage

The main issue that should be resolved at the first examination of a pregnant woman with signs of a miscarriage is the possibility of maintaining the pregnancy. With proper care and treatment of a patient with a threatened miscarriage, and somewhat less often with a miscarriage that has begun, pregnancy can be saved; with the developed picture of a miscarriage, pregnancy cannot be saved. From this follows the doctor's tactics in the treatment of a patient with spontaneous miscarriage.

Having established the presence of a threatening and incipient miscarriage, the pregnant woman is immediately placed in a maternity hospital, where a medical-protective regime should be organized. Its necessary elements are bed content, physical and mental rest, strengthening of faith in the preservation of pregnancy (psychotherapy, hypnosis), normal or, if necessary, extended sleep, etc.

Drug treatment is carried out taking into account the identified etiological factors that caused the miscarriage. But since this is in most cases difficult to establish, then medical measures are aimed at increasing the viability of the fetal egg and eliminating the increased excitability of the uterus. Sodium bromide is prescribed (1-2% solution inside, 1 tablespoon 3 times a day), glucose (20 ml of a 40% solution intravenously once a day), it is useful for the patient to stay outdoors (in winter, frequent inhalation of oxygen); with infectious etiology, injections of penicillin (50,000 IU every 3 hours) and other drugs are used; in the presence of contractions - opium preparations (opium tincture 5-10 drops 2-3 times a day orally or opium extract 0.015 g in suppositories - 2-3 suppositories per day); progesterone injections are effective (5-10 mg daily for 10 days). After that, they take a break and, if necessary, repeat the course after 5-10 days. Continuous injections of large doses of progesterone for a long time sometimes have an adverse effect on the course of pregnancy, in particular on the viability of the fetus.

Vitamins A, B 2, C, D, E are also useful. They are prescribed in their pure form or products containing these vitamins are recommended: fish oil, brewer's yeast, etc.

The appointment of ergot, ergotine, quinine, pituitrin and other similar hemostatic agents is strictly contraindicated and is a gross medical error, since they increase uterine contraction, and at the same time contribute to further detachment of the fetal egg.

If these measures do not give the desired effect, bleeding and contractions intensify and the miscarriage goes to the next stage - abortion in progress, it is not possible to maintain the pregnancy. In such cases, in the first 3 months of pregnancy, if there are no contraindications (infected miscarriage), they resort to instrumental emptying of the uterine cavity - removal of the fetal egg or its remains from the uterine cavity, followed by curettage.

After 3 months of pregnancy, the patient is prescribed conservative treatment: cold on the lower abdomen, quinine (0.15 g orally every 30-40 minutes, 4-6 times in total) and, in alternation with it, pituitrin injections of 0.25 ml every 30-45 minutes, total 4-6 times. After the birth of the fetus, the placenta, if it is not born by itself, is removed with a finger inserted into the uterine cavity, and its remains are removed with the help of curettes.

In the postoperative period, bed content is prescribed, application of cold to the suprapubic region, and means that reduce the uterus: ergot liquid extract - 25 drops 2 times a day, ergotine 1 ml intramuscularly 2 times a day, etc. With a fever-free course of the postoperative period and good general condition and feeling the patient can be discharged 3-5 days after the operation. Before discharge, a thorough general and necessarily special - gynecological (two-handed) - examination should be carried out.

Treatment of patients with synfected, febrile miscarriage is carried out either strictly conservatively (drugs), or actively (surgery), or actively and expectantly (elimination of the infection followed by instrumental removal of the remnants of the fetal egg). When choosing a method of conducting a patient, one should be guided by its general condition and the severity of the infectious process.

At the same time, they distinguish:

1. uncomplicated infected miscarriage, when only the fetal egg or the fetal egg along with the uterus is infected, but the infection has not gone beyond the uterus;
2. complicated infected miscarriage, when the infection has gone beyond the uterus, but the process has not yet been generalized;
3. septic miscarriage, when the infection is generalized.

Complicated infected and septic miscarriage is usually observed with criminal intervention for the purpose of fetal expulsion.

When treating patients with an infected uncomplicated miscarriage, some obstetricians prefer immediate instrumental emptying of the uterine cavity. Another, large, part of obstetricians adheres to the active-waiting method: for 3-4 days, the patient is prescribed bed rest and drugs that tone the muscles of the uterus (cold on the lower abdomen, inside quinine, pituitrin, ergot preparations, etc.) and aimed at eliminating the infection ( sulfa drugs, antibiotics). After the disappearance of signs of infection, the uterine cavity is carefully emptied by surgery.

Finally, a number of obstetricians prefer strictly conservative management of patients, without any intrauterine intervention. To this end, the above funds are supplemented with injections of estrogen hormone, pituitrin or thymophysin, giving castor oil inside, etc., in order to stimulate uterine contractions and promote spontaneous expulsion of the remnants of the fetal egg from the uterus. Instrumental emptying of the uterus is resorted to only with severe bleeding that threatens the life of the patient.

With any of the listed methods of managing patients with an infected uncomplicated miscarriage, measures are taken to raise the patient's body's defenses and tone. This is achieved by good care, a rational diet, easily digestible, high-calorie, containing a sufficient amount of vitamins, and other activities.

Having tested for many years each of the listed methods of treating patients with uncomplicated infected miscarriage - incomplete and complete, we were convinced of the advantages of the active-waiting method. We resort to urgent instrumental emptying of the uterus only in exceptional cases, when severe bleeding from the uterus threatens the life of the patient and it is necessary to stop it immediately.

Treatment of patients with a complicated infected miscarriage, that is, when the infection has gone beyond the uterus, should only be conservative, since surgery in such cases leads, almost as a rule, to peritonitis or sepsis. Surgical intervention may be necessary only in those exceptional cases when a sharp bleeding of the patient and incessant bleeding from the uterus pose a direct threat to the life of the patient.

In the treatment of patients with a failed miscarriage, the methods of expectant-observational and active methods are competing - one-stage instrumental emptying of the uterine cavity.

Considering the danger that threatens a pregnant woman when a dead fetal egg is retained in the uterus due to infection, intoxication, malignant degeneration of the villi, etc., one should strive to empty the uterine cavity as soon as the diagnosis of the disease is established with certainty. In case of a failed miscarriage, treatment begins with the appointment of drugs that stimulate uterine contractions and thereby provoke the onset of a miscarriage: for 2-3 days, estrogen hormone injections of 10,000 units are made daily. After that, 60 g of castor oil are given inside, and after half an hour, quinine hydrochloride is given 6 times, 0.2 every 30 minutes; after taking the fourth powder of quinine, 4 injections of pituitrin, 0.25 ml, are made every 15 minutes. Then a hot vaginal shower is prescribed, and the temperature of the liquid should not exceed 38 ° for the first time; in the future, it is gradually increased within the limits of the patient's endurance. Often, the fetus that is retained in the uterus is expelled completely or partially without instrumental intervention, which is later resorted to to remove the remnants of the fetal egg.

Even in those cases when this method of treatment does not lead to the goal, i.e., to the expulsion of the fetal egg that has lingered in the uterus, it is useful, as it increases the tone of the muscles of the uterus. This creates favorable conditions for the subsequent surgical removal of the fetal egg: with a well-contracted uterus, bleeding rarely occurs during and after the operation and there is no perforation of the uterus during the operation.

Treatment for a placental polyp consists in its instrumental removal (curettage).

Prevention of spontaneous miscarriage

Prevention of spontaneous miscarriage should precede or begin with the appearance of its first symptoms. In the antenatal clinic, at the first visit of a pregnant woman, a special account is taken of those women who have a history of spontaneous miscarriages or premature births, especially when there were several of them (“habitual miscarriage”, “habitual premature birth”), and women with various pathological conditions, which may be the cause of spontaneous miscarriage. Preventive measures include prescribing anti-inflammatory treatment, correcting the incorrect position of the uterus, combating pregnancy toxicosis, hypovitaminosis, eliminating and preventing mental and physical trauma; in appropriate cases - prohibition of sexual intercourse during pregnancy, transfer to a lighter type of work, etc.

Pregnant women with a "habitual miscarriage", as well as with a miscarriage threatening and begun, should be placed in the maternity hospital, in the ward of pregnant women. Of great importance is the strengthening of the patient's belief in the possibility of maintaining pregnancy, as well as the implementation of therapeutic measures: maintaining rest, prolonged sleep, prescribing progesterone, painkillers, drugs that reduce the excitability of the uterus, multivitamins, especially vitamin E, etc.

If during childbirth there were deep ruptures of the cervix, its integrity must be restored immediately after childbirth. If this has not been done, then in order to prevent further spontaneous miscarriage, plastic surgery on the neck should be performed before the onset of the next pregnancy - restoring its integrity.

Abortion is a difficult step for any woman. The procedure is carried out up to 28 weeks, but serious problems can be avoided only in the early stages. Termination of pregnancy affects both the physical and moral condition. Therefore, it is better to have an abortion before 10-12 weeks.

Methods

Each period has its own way of terminating a pregnancy. Some options have virtually no consequences, others are accompanied by complications.

• Medical.
• Surgical.
• Vacuum.

At week 10, abortion is done more often through surgery. Timely interrupted pregnancy in this way practically does not give complications. However, problems cannot be avoided.

Procedure

Experts use several methods. The method is chosen depending on the duration of pregnancy.

• Vacuum excochleation.
• Surgical intervention.

The first option is applied until the end of the 10th week. Specialists use a vacuum excochleator. It is a cylindrical instrument with an oval socket at the end. A hose is connected to the device, connected to the suction and the waste container.

With the help of a dilator, the channels of the neck are moved apart. After that, a cannula is inserted into the uterus, and the pressure pump is activated. The method requires caution and is carried out exclusively by professionals. By rotating the instrument, the doctor destroys the fetal egg, treating the walls of the uterus. The waste is pumped into the tank by a pump. This method is considered safer than surgery.

After the procedure, a bag of cold liquid is placed on the woman's stomach, and then drugs are injected that help the uterus contract. The recovery time after the procedure is different for every woman. The patient is discharged only after examination and permission of the doctor.

The second method is applied from 10 to 12 weeks. During the surgical termination of pregnancy, the patient is under anesthesia. With the help of a special tool, the cervix expands. The doctor, using curettes, removes the destroyed tissues of the fetal egg.

The specialist completely cleans the walls of the uterus. In this case, vacuum aspiration can be used. The doctor, with the help of ultrasound, must make sure that all the contents are removed. After the successful completion of the intervention, the doctor observes the patient for some time. A woman needs to observe bed rest, as well as take drugs that promote uterine contraction.

Complications

Like any operation, abortion has some consequences. This is especially true of the procedure carried out at week 10 and later. Sometimes termination of pregnancy leads to irreversible complications. What should be feared during an abortion at such a time?

Complications after the surgical method:

1. After the intervention, bleeding caused by the use of sharp instruments is possible. Damaged uterine walls sometimes even lead to death.
2. Bleeding accompanied by abdominal pain means that the curettage was not completed. The particles of the embryo remaining in the uterus lead to inflammation.
3. Other complications appear in the patient within a month after the abortion. Inflammatory processes occur due to an infection, parametritis, salpingo-oophoritis, endometritis. These diseases are accompanied by pain, discharge, high fever.
4. Termination of pregnancy makes itself felt even after years. In women, the hormonal background is disturbed, menstruation failures. There are problems such as miscarriage, problems with tubal patency.
5. It happens that as a result of an abortion, a woman becomes infertile.

Complications after the vacuum method:

• There may be pain in the genital area.
• Bleeding.
• Infection.
• Pain in the abdomen.
• The appearance of unpleasant secretions.
• Vomit.
• Heat.
• Absence of menstruation.
• Hormonal disruptions.

Each method of abortion at week 10 has complications. Therefore, after the procedure, it is important to monitor your well-being, and if problems arise, immediately contact a specialist.

Consequences

Termination of pregnancy is accompanied by a hormonal breakdown. Unfortunately, it is impossible to avoid it. An organism tuned in to motherhood produces certain hormones that cause a breakdown during an abortion. When interrupted at week 10, the consequences are much more serious than in the early stages.

You need to consult a professional about abortion. If it is easy to terminate a pregnancy in the early stages, then unforeseen complications may occur at week 10. Only a highly qualified doctor is able to cope with problems. Although even a specialist will not save the patient from the consequences.

Abortion results in:

• Violation of blood pressure.
• Immune problems.
• Violation of blood circulation.
• Kidney and liver problems.
• Microtrauma.
• fatigue.
• Sleep disturbance.
• Irritability.
• Ovarian problems.

When scraping, only the latest equipment should be used. This will help to avoid damage to the walls of the uterus, the occurrence of scar tissue, and in the future, problems with the fetus.

Rehabilitation

There are some tips that a woman should follow after an abortion. The rules are the same for any abortion method.

1. No sex for at least 21 days.
2. Abstinence from stress. Do not lift weights or play sports.
3. After an abortion, you can not visit baths, saunas, swim in public reservoirs.
4. Pay special attention to hygiene.
5. It is necessary to abandon the diet.
6. It is important to constantly monitor your well-being.
7. Avoid alcohol for two weeks.

After an abortion, a woman should pay attention to her health. The right lifestyle will help speed up rehabilitation, as well as avoid most complications. A woman needs more rest, and if the pregnancy is terminated at 10 weeks or later, the services of a psychologist may be needed. In addition, until the recovery is over, a new pregnancy should be avoided.