One in five pregnant women experiences a miscarriage... When should you go to the hospital?

 

Miscarriage refers to the death of a fetus within 20 weeks of pregnancy. It occurs when a fertilized egg implants in the uterus but the fetus, weighing less than 500 grams or less than 20 weeks of gestation, is unable to survive outside the uterus and is expelled.

 

Above all, experts emphasize the importance of active treatment and management during a miscarriage experience. This is because it can affect future pregnancies. Knowing the symptoms that require a hospital visit and responding quickly is crucial.

■Various causes such as underlying diseases and lifestyle habits of the mother

The cause of miscarriage is not clear, but it is known that fetal genetic defects, underlying maternal health conditions, lifestyle habits, and stress can have an impact. Specifically, underlying conditions such as acute infectious diseases in the mother, hypertension, diabetes, thyroid disorders, or unhealthy lifestyle habits like smoking, habitual drinking, and malnutrition are considered causes. Congenital uterine malformations or pelvic inflammatory disease can also be contributing factors.

Previous complications from artificial abortion, such as intrauterine adhesions or cervical abnormalities, can also be causes. Additionally, psychological shock or severe stress can also lead to this condition.

■Threatened miscarriage with vaginal bleeding, pregnancy can be maintained with treatment

More than 80% of miscarriages occur within the first three months of pregnancy, and the incidence sharply decreases afterward.

The most common symptoms are vaginal bleeding accompanied by abdominal pain or lower back pain. As miscarriage progresses, early pregnancy symptoms such as nausea, fatigue, and breast tenderness may decrease or disappear, and some women may have no symptoms at all.

Threatened miscarriage refers to cases where vaginal bleeding occurs in pregnant women confirmed to be pregnant during the first third of pregnancy. Less than 50% of those with vaginal bleeding actually progress to miscarriage. Symptoms include vaginal bleeding and mild abdominal pain, and ultrasound may reveal a hematoma surrounding the gestational sac. In cases of threatened miscarriage, if the mother rests and receives appropriate treatment such as progesterone supplementation, the pregnancy can be maintained and miscarriage can be prevented.

■Asymptomatic miscarriage, importance of treatment after miscarriage

Complete miscarriage refers to the condition where the fetus has died and the fetus, placenta, and other tissues have all been expelled from the uterus. Conversely, a condition where part of the fetus or its tissues remain inside the uterus is called incomplete miscarriage.

In many cases, there are no specific symptoms, and even after several weeks, the miscarriage may go unnoticed. This is called a missed miscarriage, and it can be diagnosed when an ultrasound shows a gestational sac in the uterus but no yolk sac or fetus is visible inside the sac, or when no fetal heartbeat is detected.

Incomplete or missed miscarriage requires treatment due to risks of bleeding and infection. If bleeding is severe, the remaining tissue must be safely removed through uterine curettage. After uterine curettage, small amounts of vaginal bleeding and lower abdominal pain may occur for a certain period. However, if the pain worsens progressively, prescribed painkillers become ineffective, bleeding saturates a large pad within an hour for more than two hours, or a fever exceeds 38°C, immediate hospital visit is necessary.

Causes of Thrombophilia, Habitual Miscarriage, and Antiphospholipid Syndrome

Habitual miscarriage is diagnosed when three or more consecutive miscarriages occur. In a state where the gestational sac is not visible within the uterus.

Chemical miscarriages, including cases where only the pregnancy hormone levels in the blood rise and then fall, are also included. It is also advisable to test for habitual miscarriage when the uterine pregnancy sac is confirmed and two consecutive miscarriages occur.

The causes are diverse, but the most important ones to treat carefully are antiphospholipid syndrome, which has immunological issues, and genetic thrombophilia, a hereditary condition in which the mother is genetically prone to blood clots. Additionally, it is necessary to identify other factors such as genetic factors inherited from parents, anatomical factors, endocrine factors, and infectious factors.

■Management needed for the next pregnancy…avoid illegal drugs

Depending on the pregnancy level at the time of miscarriage, there are differences, but usually the pregnancy level returns to normal between 7 and 60 days.

Professor Pyeon Seung-yeon of the Department of Obstetrics and Gynecology at Kangdong Kyunghee University Hospital said, "It is possible to conceive again as early as two weeks after a miscarriage, but because there is a risk of another miscarriage or preterm birth, immediate pregnancy after a miscarriage is not recommended," she explained. "Early pregnancy miscarriage does not require a special rest period, but emotional fluctuations or depression should be watched out for."

However, to prepare for the next pregnancy healthily, proper prenatal care is necessary. Adequate sleep and a regular lifestyle are important, and it is essential to practice smoking and alcohol abstinence and avoid excessive caffeine intake. If you are taking diabetes medication or blood pressure medication, consult a specialist to manage hormone therapy and control blood sugar and blood pressure.

Professor Pyeon Seung-yeon warned, "You should not take unidentified abortifacients or abortion pills obtained through illegal channels," and added, "Fake medications are commonly circulated, and improper use can cause abdominal pain and vaginal bleeding."