Early Pregnancy Loss: Miscarriage and Molar pregnancy
The spontaneous loss of pregnancy before the completion of 20 weeks is called early pregnancy loss. Most early pregnancy losses occur as the foetus or placenta fails to develop normally.
What is Miscarriage?
Miscarriage is the natural death of a baby in its mother's womb before 20 weeks and may happen even without a woman being aware that she is pregnant. This usually occurs in the first trimester (13 weeks) of pregnancy. Symptoms include vaginal spotting or bleeding, abdominal pain or cramping, and fluid or tissue passing from the vagina. If you have any of these symptoms, you should call your health care provider immediately, who may do an ultrasound exam and a pelvic exam to confirm miscarriage.
Most miscarriages are caused due to genetic abnormalities that occur by chance and are not related to the mother's or father's health. Other causes include infection, certain medications, hormonal effects, structural abnormality of the uterus, and disease conditions such as severe kidney disease, congenital heart disease and uncontrolled diabetes.
What is Molar pregnancy?
A molar pregnancy occurs when the tissue that normally becomes a foetus instead develops into a noncancerous tumour in the uterus. Early symptoms resemble a normal pregnancy and include missed period or morning sickness. Later symptoms become a cause of concern and include grape shaped tissue discharge from the vagina, dark brown to bright red bleeding from the vagina and severe nausea and vomiting. Your doctor may spot molar pregnancy during an ultrasound scan carried out between weeks 10-16 of pregnancy. As this condition is associated with serious complications, early treatment is recommended.
What is repeated miscarriage?
Repeated miscarriage is the occurrence of two or more consecutive miscarriages. About one woman in 100 experiences this condition; however, many of these women go on to have a successful pregnancy later. All the causes leading to this condition are not known. There are, however, a few known causes that include abnormal genetic makeup of the embryo (the developing organism from the time it implants itself in the uterus up to 8 completed weeks of pregnancy), conditions of the uterus such as a septate (divided into two) uterus, fibroids and polyps (non-cancerous growths) of the uterus and Asherman syndrome (adhesions and scarring in the uterus). Certain medical conditions such as auto immune diseases and diabetes mellitus may also lead to repeated miscarriages.
How can it be diagnosed?
To determine the causes, your doctor will ask questions about your medical history and past pregnancies. He or she may do a thorough physical examination accompanied with a pelvic examination, blood tests and imaging tests. If genetic causes are suspected, then a test called karyotype and microarray testing would be ordered.
What are the treatment options?
Treatment measures vary and are specific to the cause leading to the condition. It may involve medications or corrective surgery and where causes are unknown, there is still a reasonably good chance (65%) of a successful next pregnancy.