Introduction:
A miscarriage is the loss of your products of conception before the twentieth week of pregnancy. The loss of products of conception after 20 weeks is called a stillbirth. About 20-30% of women bleed or have cramping at some time during the first 20 weeks of pregnancy and half of these women have a spontaneous miscarriage. About 85% of spontaneous abortions occur in the first trimester and tend to have fetal causes; those occurring in the second trimester are more likely to have maternal causes.
Etiology:
- Abnormalities in embryo or foetus.
- Inadequate level of maternal hormones needed to assure fetal viability
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Maternal factors:
- Autoimmune disorders
- Systemic disease: e.g.Diabetes Mellitus, Thyroid disorders, Coeliac disease, Polycystic ovarian syndrome
- Blood Dyscrasias
- Nutritional, e.g. vitamin deficiencies (especially vitamin D)
- Maternal chromosomal anomalies, e. g. Translocations, deletions
- Incompetent, amputated or lacerated cervix
- Uterine Abnormalities
- acute infections
- Specific viral illnesses, e. g. Rubella, herpes, cytomegalovirus, toxoplasmosis
- Severe emotional shock
- Physical trauma.
Classification
- Early- Loss of fetus before 12 weeks of pregnancy.
- Late-Loss of the fetus between 12 and 20 weeks of preg.
- spontaneous- Loss of foetus without induction or instrumentation.
- Induced- termination of pregnancy for medical or elective reasons
- Therapeutic- Termination of pregnancy to preserve the woman life or health or because of foetal malformations incompatible with life.
- Threatened- Any vaginal bleeding or lower abdominal cramping in the first 20 weeks of pregnancy.
- Inevitable- Bleeding or rupture of the membranes accompanied by pain and dilation of the cervix.
- Incomplete- Expulsion of part of the products of conception.
- Complete- Expulsion of all the products of conception.
- Habitual- Three or more consecutive spontaneous abortions.
- Missed- Prolonged delay in the expulsion of a dead fetus.
- Septic- Infection of the contents of the uterus before, during or after a spontaneous abortion.
