Doctor’s Room: Miscarriage (1)

by Dr Olaomo Noah

Miscarriage is the loss of a pregnancy before the age of viability.

Age of viability is the age at which the baby has 50% chance of survival. In Nigeria and other developing countries, it is 28weeks. In the developed world, it ranges between 20-24weeks.

So, in our setting, miscarriage is the loss of pregnancy before 28weeks. Medically, miscarriage and abortion means the same thing. Though, the lay people like to categorize abortion as being an induced termination while a miscarriage is natural.

Miscarriage when spontaneous (natural) and pregnancy is desired could be traumatizing to the affected couple.

TYPES OF MISCARRIAGES
Miscarriages can be categorized based on the mode of occurrence or presentation;

A. Based on mode of occurrence;

  1. Spontaneous. This is if it occurs naturally.
  2. Induced: This is if the woman procures the abortion. This is popularly referred to D&C among the public

B. Based on mode of presentation.

  1. Threatened miscarriage: This presents with bleeding per vagina with or without pain. But the cervix (neck of the womb) is closed.
  2. Inevitable miscarriage:
    There is bleeding, abdominal pain and the cervix is open. So, the expulsion of the baby becomes unavoidable (inevitable).
  3. Incomplete miscarriage:
    Here some products of the pregnancy has been expelled leaving remnants in the womb. Further treatment will be needed.
  4. Complete miscarriage
    In this instance, all the products of conception (baby and placenta) would have been fully expelled spontaneously. Hence, the womb will be empty.
  5. Habitual (recurrent) miscarriage.
    This is when a woman has had 3 consecutive miscarriages. One of the commonest causes is cervical incompetence.
  6. Missed abortion.
    Here the baby has died but it is not expelled. The woman is still pregnant but the baby is no longer growing due to demise. This is usually diagnosed on ultrasound.
    7.Blighted ovum:
    In this pregnancy, there is no baby component from the outset, just placenta tissues predominantly.
  7. :Septic ( infected) miscarriage: In this instance, the product of conception becomes infected.

To be continued…

Dr Olaomo Noah Oluwafemi is a Consultant Obstetrician and Gynecologist with a love for writing. His desire is to enhance people’s lifestyle and effect positive change in their health through his writings

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