You Ask , They Answer
Q
: How common are miscarriages and what are the main causes ?
A
: Pregnancy loss , also known as miscarriages or spontaneous abortion , is defined as a non-viable intrauterine pregnancy up to 20 weeks gestation . Early pregnancy loss , which occurs in the first trimester , is the most common type . In Malaysia , a foetus weighing less than 500 grams is considered a miscarriage as is one that is less than 22 weeks gestation . It is the most common complication of early pregnancy , with an incidence of 8-20 percent among known pregnant women .
The vast majority of miscarriages are caused by abnormalities in the chromosomes . Sometimes embryos will have too many or too few chromosomes ( e . g ., Down ’ s syndrome ). Other common causes of miscarriage include chronic conditions ( diabetes mellitus , thyroid disorders , obesity ), infections ( syphilis , zika virus , urinary tract infections ), and uterine abnormalities ( anatomic anomalies , such as fibroids polyps , may be associated with pregnancy loss based on their size and position ). Some medications , such as warfarin , some painkillers like NSAIDs , and certain antibiotics are dangerous to take during pregnancy because they can cause birth defects or increase the risk of miscarriages . Smoking , caffeine , recreational drugs , and alcohol also appear to increase the risk of pregnancy loss .
Q
: What can prospective parents do to prevent or reduce the risk of miscarriage ?
A
: While many miscarriages cannot be prevented , some can . There are many ways they can prepare for a healthy pregnancy and reduce the risk of miscarriage .
A healthy lifestyle before and during pregnancy definitely leads to a healthier pregnancy , therefore reducing the risk of a miscarriage . Other advice includes : stop smoking , reduce caffeine intake , eliminate alcohol , and evaluate your current medications .
Preparing for pregnancy by eating a healthy diet , exercising , reducing stress , optimising medical conditions , and taking prenatal vitamins is important before embarking on the pregnancy journey .
All women should consume 400 mcg of folic acid before pregnancy to prevent major birth defects , thereby reducing the risk of miscarriage .
Also , have a planned pre-conception visit with your gynaecologist for a medical checkup .
Q
: Can miscarriages lead to health complications ?
A
: A miscarriage is a traumatic and often shocking event which affects each woman differently . Some can experience grief , anxiety , depression , and even symptoms of post traumatic stress disorder ( PTSD ). Around 20 percent of women will experience some sort of depression or anxiety , impacting their quality of life and subsequent pregnancies .
Q
: Are women who ’ ve had a miscarriage at greater risk of future miscarriages ?
A
: Miscarriage is usually a one-time thing . As mentioned earlier , most women who miscarry go on to have healthy pregnancies after miscarriage . However , a small number of women ( one percent ) will have repeated miscarriages . Recurrent pregnancy loss is classically defined as the occurrence of three or more consecutive pregnancy losses . Recurrent miscarriages can be due to abnormalities in the uterus , such as a uterine septum or fibroids . Chromosomal abnormalities are very common .
Cervical insufficiency can cause losses late in pregnancy . The risk of miscarriage increases after each successive loss ( losses one after each other ). Women with three miscarriages in a row have a 4 in 10 chance of having another one .
Dr Somaskandar Sivasuntharam
Dr Somaskandar Sivasuntharam is a specialist in obstetrics and gynaecology at Gleneagles Hospital Penang .
8 ISSUE 5 | 2023 GlobalHealthAsiaPacific . com