Imminent Miscarriage

Description:

Imminent or inevitable miscarriage, it is a threatened miscarriage that had bleeding, uterine contractions and cervical
dilations occurs. This usually happens before 20 weeks, typically on first 1 st trimester.

Signs and symptoms:

 heavy spotting - a light or trace amount of pink, red, or dark brown (rust-colored) blood. You may notice spotting
when you use the restroom or see a few drops of blood on your underwear. It will be lighter than your
menstrual period. 
 vaginal bleeding -
 discharge of tissue or fluid from your vagina
 severe abdominal pain or cramping
 mild to severe back pain

must do: Call your doctor right away if you experience any of these symptoms during your pregnancy. It’s also possible
to have these symptoms without experiencing a miscarriage. But your doctor will want to conduct tests to make sure
that everything is fine.

 Pelvic exam. Your health care provider might check to see if your cervix has begun to dilate.

 Ultrasound. During an ultrasound, your health care provider will check for a fetal heartbeat and determine if the
embryo is developing normally. If a diagnosis can't be made, you might need to have another ultrasound in about
a week.

 Blood tests. Your health care provider might check the level of the pregnancy hormone, human chorionic
gonadotropin (HCG), in your blood and compare it to previous measurements. If the pattern of changes in
your HCG level is abnormal, it could indicate a problem. Your health care provider might check to see if you're
anemic — which could happen if you've experienced significant bleeding — and may also check your blood type.

 Tissue tests. If you have passed tissue, it can be sent to a lab to confirm that a miscarriage has occurred — and
that your symptoms aren't related to another cause.

 Chromosomal tests. If you've had two or more previous miscarriages, your health care provider may order
blood tests for both you and your partner to determine if your chromosomes are a factor.

TREATMENT:

There are 3 kinds of treatment:

 Expectant
 Medical
 Surgical
Most suitable treatment :
SURGICAL and Medical

After no fetal heart sound detected and ultrasound reveals an empty gestational sac or nonviable fetus: healthcare
provider will offer medication to help the pregnancy pass or perform dilatation and curettage (D&C) or dilatation and
evacuation (D&E) to ensure all the products of conception are removed to prevent further complications such as
infections,
What causes miscarriage?

Most first trimester miscarriages happen because the fetus doesn’t develop normally. There are different factors that
can cause this.

- Genetic or chromosome issues

o Intrauterine fetal demise. The embryo forms but stops developing before you see or feel symptoms of
pregnancy loss
o Blighted ovum. No embryo forms at all
o Molar Pregnancy. Both sets of chromosomes come from the father, no fetal development occurs.
o Partial molar pregnancy. The mother’s chromosomes remain, but the father has also provided 2 sets of
chromosomes

- Underlying condition and lifestyle habits

o Poor diet or malnutrition
o Drug and alcohol use
o Advanced maternal age
o Untreated thyroid disease
o Issues with hormones
o Uncontrolled diabetes
o Infections
o Trauma
o Obesity
o Problems with the cervix
o Abnormally shaped uterus
o Severe HB Pressure
o Food poisoning
o Certain medications

What are the effects of miscarriage on the woman?

With miscarriage, the woman’s body will go through some changes. She will experience some bleeding and tummy
cramps.

The amount of bleeding will usually depend on how many weeks the woman is pregnant and what was recently seen in
her scan. If it is an early miscarriage, it may be like a heavy period for the first day or so, and go on for a week or 2
afterwards.

When a pregnancy is lost, the womb contracts to expel the pregnancy tissue. She will probably have some cramps ( like
strong period pains) in her lower stomach on the day of her miscarriage and then milder cramps or aches for a day or so
afterwards.

Following miscarriage, women experience a range of emotions. There is no right or wrong way to feel. The loss of a
pregnancy can cause significant grief. Sometimes these reactions are strong and long-lasting. A woman should let her
health care provider know if she is feeling profound sadness or depression following pregnancy loss, especially if it
continues for greater than several weeks.

These are some possible suggestions that the nurse can provide to the mother:

After discharge, the woman should assess the amount of vaginal bleeding she is having. By recording the
number of pads she uses.
 The woman can return to work and her daily routines whenever she feel ready. This might be right away or she
may want to wait for a few days.

Take showers instead of tub baths. This helps prevent infection. She can ask the healthcare provider when she
can take baths again.

Don’t do any strenuous exercise right away, such as aerobics and running. Wait until the bleeding slows to the
rate of a normal period.

Don’t have sex or use tampons or douches until her provider says it’s OK.

Get emotional support by asking her provider about support groups in her area. Many women find it helpful to
talk with other women who have had a miscarriage.