A miscarriage, also known as “spontaneous abortion,” is medically defined as the loss of the baby before the 20th week of pregnancy. (On the 20th week onwards, the loss of the fetus is termed “still birth.”)
A miscarriage is a profoundly distressing experience, and yet 1 in 3 Filipinas will experience it in their lifetimes. The actual figure is likely to be higher because miscarriages often occur very early in the pregnancy, even before a woman realizes she’s pregnant.
The signs of a miscarriage
Vaginal bleeding or spotting
The discharge ranges from brownish in color to bright red. Spotting does not necessarily mean that a miscarriage has taken place. But it could signal that something untoward is afoot, so a visit to the doctor might be considered.
The larger the volume of the discharge, the greater the danger the baby has been lost. When there is a release of fetal tissue (white mass), this is a serious indication of miscarriage.
Painful cramps in the abdomen, back and pelvis
These are not the usual aches and pains that pregnant mothers commonly endure. The most severe ones are comparable to pain during actual labor.
A miscarriage can happen very rapidly, or over a period of several days or even weeks --with the pain coming and going during the whole process.
Loss of the signs of pregnancy
Pregnancy, especially in the first trimester, comes with symptoms like morning sickness, lightheadedness, nausea and breast tenderness. A cessation of these may signal that pregnancy has been unexpectedly terminated.
What Are The Causes Of Miscarriage?
The loss of a child is a deeply traumatic experience. There’s an unnecessary stigma attached to it and mothers often blame themselves for the loss. The causes of miscarriage are plenty, and there are also many risk factors that increase the chance of it happening:
Researchers from the UK and China have found that psychological stress before and during pregnancy can increase the risk of miscarriage by 42%. They reported that stressors like financial, marital and work problems can have a negative impact on pregnancy.
Certain drugs and antibiotics
A study published in the Canadian Medical Association Journal has found that macrolides, quinolones, tetracyclines, sulfonamides and metronidazole have been linked to higher risk of miscarriage.
Age of conception
A research published in the British Medical Journal saw a steep rise in age-related miscarriage—from 9% for mothers who are in their 20s, to 75% for mothers aged 45 and above.
A normal fertilized ovum has a total of 46 chromosomes—23 chromosomes from the mother and 23 from the father. This, however, is not always the case. Sometimes, a zygote gets too many or too little. This affects the long term viability of the fertilized ovum and often ends up with the termination of the pregnancy.
The medical term for a woman’s womb is the “uterus.” The womb is the home of the fetus for 9 months. Abnormalities arising from it can pose a serious threat to the baby. A miscarriage can result from the abnormal shape, size or position of the uterus.
The womb should also be hospitable enough for the fetus to grow in. Otherwise, a fertilized ovum may not even be successfully implanted in the uterus. In some cases, the womb may not provide enough blood flow and nutrients to the fetus. When this happens, there is a serious threat to the life of the fetus.
Diseases and disorders
Pregnancy puts a tremendous strain on a woman’s body. Metabolic processes become erratic and hormone levels drastically change. A healthy woman can adequately deal with such irregularities. But a mother’s preexisting conditions might not only be her problem -- they may also adversely affect her baby.
For example, diabetes has been linked to pregnancy complications and miscarriage. Recurrent miscarriages might signal that a mother has medical conditions that prevent a full and healthy 9-month gestation.
Autoimmune disorders are a special set of conditions that can cause recurrent miscarriages.
In an autoimmune disease, the body’s defenses (instead of stopping harmful antigens like bacteria, viruses and toxins) are attacking healthy cells and tissues. It is mistakenly attacking itself, instead of harmful foreign entities.
With a woman with an autoimmune condition, the fertilized ovum (with the father’s DNA) may be mistakenly identified as a foreign body by her immune system. It then works to eradicate the threat as soon as possible, resulting to an early miscarriage.
The silver lining with autoimmune causes of repeated miscarriages is that it is mostly treatable. Historical evidence shows that up to 80% of treatments of autoimmune-caused miscarriages can lead to successful pregnancies.
Autoimmune diseases and recurrent miscarriages
The American Society of Reproductive Medicine defines “recurrent miscarriage” as two or more clinical miscarriages.
There are many types of autoimmune diseases and they can affect fertility in various ways and in different stages of gestation. For example, a mother with Antiphospholipid Antibody Syndrome (also known as APAS, an autoimmune disease) can cause blood clots in the placental region or the umbilical cord and cause insufficient blood supply to the fetus.This, in turn, leads to inadequate supply of critical nutrients to the baby and could ultimately result in miscarriage.
Antinuclear Antibodies and the ANA Test
Aside from APAS, your reproductive immunologist might prescribe tests to determine other autoimmune disorders, such as Antinuclear Antibodies (ANA).
ANA are proteins that specifically attack the nucleus of the cell and affect cellular activities and metabolic functions.
Having a positive ANA test doesn’t necessarily mean the presence of an autoimmune condition. Many patients who test positive for ANA live normal healthy lives. Some traces of it in the blood is normal. Your doctor will not diagnose on lab test results alone. He will also look into your medical history and your symptoms for more data points.
The ANA Test is a general tool used to by doctors to determine if the patient has an autoimmune disease. But it cannot determine which particular one it is. There are many autoimmune diseases and additional blood tests would be necessary to properly identify one.
Consult with a reproductive immunologist about possible autoimmune diseases and ANA testing.
BloodWorks Lab specializes in repro-immunological screening. We perform ANA titer and screens that assist you and your doctor with fertility discussions.
We are proud to be the first laboratory in the Philippines to also offer neurological tests like the Anti-NMDA Receptor Antibody Test and the Anti Acetylcholine Receptor (lgG) Antibody Test.