It is not easy to talk about abortions in a baby blog, but it is a reality that affects many couples who want to be parents. Therefore, we have prepared a series of special posts about abortion, starting with this one in which we will focus on the definition, causes and types of abortion.
Abortion is the termination of pregnancy of less than 20 weeks gestation, whether natural or provoked. The development of the fetus stops before it has the capacity to live outside the mother's womb. In the case of intentional loss it is called induced abortion, while the involuntary loss of pregnancy is called natural or spontaneous abortion.
We will stop to explain the causes (why they can occur) and different types of natural abortions or spontaneous abortions.
Most of the natural abortions They occur in the first trimester of pregnancy. When it occurs before 10 weeks it is called early abortion, between week 11 and 20, late abortion, and after 20 weeks it is considered premature birth.
It is believed that one in five pregnancies ends in abortion, although in most cases the mother does not find out. Sometimes the gestation is so short that it occurs before knowing that there has been pregnancy and the loss is confused with menstruation or with a delay thereof.
Fetal causes and maternal causes of abortion
It is very difficult to identify why pregnancy termination occurs. The causes can be multifactorial, and most of the time they are not known, but we will talk about the most frequent ones.
More than half of abortions are due to fetal causes, due to congenital anomalies of the fetus, often chromosomal failures in the early stages of pregnancy. But also due to non-chromosomal genetic abnormalities, trophoblast abnormalities (a layer of cells formed around the egg between the fifth and seventh day after fertilization) or other anomalies.
Abortion can also occur due to maternal causes, whether due to uterine alterations (myomas, synechia, cervical insufficiency, congenital anomalies, etc.), infections, endocrinopathies (thyroid pathology, progesterone deficiency, etc.), external aggressions (radiation, drug addiction, environmental factors, trauma), immunological (antiphospholipid syndrome, etc.), malnutrition states, systemic or infectious diseases (diabetes, nephritis, toxoplasmosis, brucellosis, syphilis, listeriosis, hepatitis B, etc.)
Threatened abortion
A threatened abortion The risk is to suffer a loss of pregnancy.
A metrorrhagia (vaginal bleeding not coming from the menstrual cycle) in the first trimester of pregnancy is a threat of abortion until proven otherwise.
The pregnancy test is positive. There is slight or moderate bleeding, uterine contractions, more or less painful or both symptoms at the same time.
In case of vaginal bleeding in pregnancy you have to see a doctor immediately who will perform an ultrasound to check the vitality of the fetus, the state of the cervix (if it is open or closed) and if it is the first ultrasound, verify the location and development of the fetus in the uterus to rule out abnormalities such as an ectopic pregnancy, a pregnancy molar, etc.
Before a threat of abortion, the doctor usually recommends absolute rest to try to retain the embryo, although its effectiveness is not fully proven, and not to have sex.
Types of abortion
Depending on the moment in which pregnancy pregnancy occurs and its characteristics, spontaneous abortion is classified as:
- Abortion: When the cervix is ajar it is a sign that the abortion is beginning.
- Illegal or imminent ongoing abortion: when the cervix is open and the passage of the fetus has begun. Either of these two cases is vaginal bleeding and the pain of uterine contractions is accentuated, indicating that the cervix is dilating.
- Complete or consummate abortion: When, after fetal death, all products of conception have been expelled from the uterus, there is no pain, bleeding is scarce and the cervix has been closed again. It does not usually require any treatment.
- Incomplete Abortion: when the contents of the uterus are not completely expelled after fetal death. It requires medical treatment to eliminate the remains that may have remained and thus avoid hemorrhages or infections, which pose a real risk to the mother. An incomplete abortion could lead to a septic abortion if the fetal or placental tissue that remain in the uterus is infected.
- Deferred or Retained Abortion: when the embryo dies but the woman fails to remove the gestational sac for several weeks or even months. It usually occurs between weeks 8 and 12, pregnancy symptoms gradually disappear, the uterus stops growing and pregnancy tests become negative approximately 10 days after fetal death. It requires treatment (curettage) to remove the contents of the uterus.
- Abortion due to detained ovule: when the abortion is so early that the ovum has been fertilized but the defined fetal tissue failed to form. It does not need any treatment and is eliminated with menstruation, most of the time going unnoticed.
Repeat abortions
The repeat abortions or recurrent abortions they are those that occur consecutively three times or more. Up to that point it is not considered that there may be any problem to conceive. In that case, it would be advisable to resort to a genetic study to rule out chromosomal abnormalities.
Anyway, most abortions they are not recurring, so the prognosis for the next pregnancy is good. Having an abortion does not mean that this will happen again.
To be continue
This post, for being the first of the abortion series, it is a more "technical" post, but in the following we will talk about prevention, alarm signals and emotional aspects in women and in the couple who have suffered an abortion. Stay tuned.
