Spontaneous abortion symptoms vary depending on the cause of the miscarriage. Early spontaneous abortion may result from chromosomal abnormalities, fetal growth retardation, or other conditions that interfere with implantation of the embryo into the uterus. Other causes include maternal reproductive tract abnormalities (eg, bicornuate uterus, fibroids, adhesions), and major trauma to the uterus. In rare cases, women may have an autoimmune condition that results in the failure of a healthy pregnancy to develop and implant.
In a woman with early spontaneous abortion, she will usually bleed, cramp, and feel abdominal pain. The cervix will dilate and the membranes will rupture. Uterine bleeding will eventually stop, and the tissue will be expelled. The gush of fluid is rarely large enough to cause internal bleeding, but it is an important warning sign that the pregnancy is ending.
Some early spontaneous abortions are accompanied by fetal cardiac activity, which is present on ultrasound or blood tests performed at the time of the miscarriage. This explains why some women with early spontaneous abortion experience bleeding after their miscarriage has started and before they can see a doctor.
Other patients with early spontaneous abortion do not have fetal cardiac activity on ultrasound and are not at risk for bleeding or complications. This is why this type of miscarriage is sometimes called a “missed” miscarriage. This can occur because the fetus has not developed and does not have a heartbeat, and because the uterus is not enlarging.
There are several types of miscarriages and a diagnosis is made after evaluating the patient’s history and physical examination. The doctor determines the type of miscarriage by ruling out other possible causes and examining the fetus on ultrasound.
If the doctor is unable to find any evidence of a fetus on ultrasound, a blood test is used to confirm an early miscarriage. The doctor can tell if the fetus is present in the blood or not by checking the levels of beta-hCG.
The doctor can then decide on the best management for the woman. Options include expectant management, medical management, and surgical management. These methods are all safe and effective and can be administered in the office or in the operating room depending on the patient’s preference.
Surgical management has the highest success rate for complete abortion. It also has the lowest bleeding rate. It is typically performed in the office or in the operating room with anesthesia if necessary, depending on the woman’s preferences after counseling.
Other treatments for late spontaneous abortion are acetaminophen and ibuprofen. These medications can be taken to reduce the amount of bleeding and are not contraindicated in pregnancy.
It is also recommended that women with late spontaneous abortion be counseled and given grief support if the miscarriage leads to a pregnancy loss. The resulting depression can be serious and lead to problems in re-conception.
In this study, the authors found that the incidence of spontaneous abortion was higher in women with lower socioeconomic status. Moreover, rural women were found to be more likely to have SA than urban women. The results of this study suggest that the socioeconomic status of rural women should be increased and their access to reproductive health services should be improved.
