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bleeding in pregnancy

Bleeding can be a sign of miscarriage, but does not mean that miscarriage is imminent. Studies show that anywhere from 20-30% of women experience some degree of bleeding in early pregnancy. Approximately half of pregnant women who bleed do not have miscarriages. Approximately 15-20% of all pregnancies result in a miscarriage, and the majority occur during the first 12 weeks.
Signs of Miscarriage include:
• Vaginal bleeding
• Cramping pain felt low in the stomach (stronger than menstrual cramps)
• Tissue passing through the vagina
Most miscarriages cannot be prevented. They are often the body’s way of dealing with an unhealthy pregnancy that was not developing. A miscarriage does not mean that you cannot have a future healthy pregnancy or that you yourself are not healthy.

What exactly is a miscarriage?

Miscarriage means the spontaneous loss of embryo or foetus before 20 weeks of gestation or when the foetus is less than 500 g weight.

What signs and tests can help me?

Your doctor is the best judge of that. An ultrasound is the best tool to know the status of your pregnancy. A transvaginal ultrasound (meaning an internal ultrasound) can detect fetal heart rate as early as 5.5 weeks (about 12 days after a missed period). It may be noted that a gentle internal sonography is not harmful to the pregnancy. On the contrary, it is a valuable source of information, especially to rule out a tubal (ectopic) pregnancy.
Serial blood testing of the hormone Beta HCG can tell you whether your pregnancy is growing at a normal rate or not.
Your doctor may recommend many more tests to rule out infections, autoantibodies and certain hormonal deficiencies including diabetes and thyroid condition.

When it occurs, what is the treatment for it?

In most cases of bleeding, supporting the pregnancy with the hormone ‘progesterone’ helps to a certain degree.
In specific medical conditions where the woman is at risk (such as PCOS or previous miscarriages), the doctor would prescribe certain medications (such as hormones or blood thinners) and these decisions are best left to the obstetrician.
Most obstetricians and family members prescribe “bed rest”, but the benefit of bed rest in preventing miscarriage is as yet unproven and at best remains a ‘placebo’ therapy.
Since a majority of miscarriages are unexplained or due to a genetic cause, there are no guarantees of a successful pregnancy outcome. This is a perfect example of one of those medical conditions where “Man proposes, God disposes.”

Can complications occur? What are they?

A miscarriage can occasionally cause heavy bleeding which may threaten the life of the patient and may require immediate hospitalisation and D&C (surgical evacuation or ‘cleaning’ of the uterus). In neglected cases, the womb may get infected. These cases are fortunately relatively rare.
A miscarriage can leave you scarred for a long time, so please do not hesitate to ask for family and medical support and guidance.

How can I prevent a future miscarriage from occurring?

Unfortunately, there is no definite way to prevent an abortion before or during the pregnancy.
However, certain precautions may help:
• Visit a gynaecologist for pre-pregnancy counselling to prepare you mentally and physically for pregnancy
• Ingest folic acid daily, starting before pregnancy
• Eat healthy, wholesome, home food
• Avoid emotional and physical stress
• Do not delay pregnancy till a very late age
If you have had a miscarriage before, please visit your doctor before planning the next pregnancy so that he/she may initiate treatment before the pregnancy.