Spontaneous Abortion (Part One)

Abortion is the spontaneous (unprovoked) loss of pregnancy before the 20th week. About 10-20% of identified pregnancies end in spontaneous abortion, but the actual number of spontaneous losses is higher, as most pregnancies end before the woman realizes she is pregnant.

Most failures occur because the fetus has not developed normally, and it is often difficult to determine or find the true cause.

Symptoms

Most spontaneous abortions occur before the 12th week and present the following signs:

• Vaginal discharge in dark to red color (hemorrhage)
• Pain and cramps in the lower abdomen or lower back
• Flow of fluid or pieces of tissue through the vagina (which should be sent to the hospital for additional examinations).

However, often, the majority of women who experience vaginal bleeding during the first trimester manage to complete the pregnancy.

Causes

Chromosomal abnormalities, genetics. Most failures occur because the fetus has not developed normally, as a result of random chromosomal errors and not as a result of problems inherited from parents. Such cases may include:

• Blighted ovum: when the embryo fails to form.
• Developmental arrest of the embryo within the uterus: in this case, the embryo is present but its development is halted, or the heartbeats stop.
• Molar pregnancy: a non-cancerous tumor that develops in the uterus. It occurs when an extra set of chromosomes of paternal origin fertilizes an egg cell at conception.

Maternal health conditions:

• Uncontrolled maternal diabetes
• Maternal infections
• Hormonal problems
• Diseases of the uterus or cervix
• Thyroid gland diseases

What does not cause failure?

• Everyday activities
• Exercise
• Sexual intercourse
• Work, provided there is no exposure to chemical or radioactive substances

Risk Factors

• Age: Women over 35 have about a 20% risk, and at the age of 40, it increases to 40%, reaching 80% at 45. Advanced age also plays a significant role in the chances of achieving pregnancy.
• Previous failures: Women who have had 2 or more consecutive failures are at higher risk of spontaneous abortion in subsequent pregnancies.
• Chronic diseases: such as uncontrolled diabetes, chronic kidney or liver diseases.
• Uterine and cervical problems: such as congenital uterine anomalies, fibroids, synechiae, malformed or damaged cervix from previous abortions.
• Smoking, alcohol, drugs: Excessive and continuous use reduces the quality of carrier cells of genetic material and damages the environment where conception and embryo development take place.
• Weight: Very underweight or overweight women are prone to spontaneous abortions.
• Invasive prenatal tests: such as chorionic villus sampling or amniocentesis.