For expectant parents, the pregnancy period is a sacred and precious time. Individuals start to change their lives for their expected babies during this period and are filled with great excitement. However, avoiding such a bad situation could happen to an expectant mother as miscarriage may not always be possible, and sometimes miscarriage occurs due to the mother’s health problems, or sometimes due to the baby’s own developmental issues. When such a situation arises, the question of how miscarriage is recognised comes to the mind of the parents.

What is Miscarriage (Pregnancy Loss)?

Although not much information is known, bleeding and vaginal discharge are common signs of miscarriage. If pain accompanies the bleeding, miscarriage may be suspected, especially if bleeding is encountered frequently in the first month of pregnancy.

The most important point to be noted about this issue is that not every bleeding may be a sign of miscarriage. In medical literature, the situation of losing the baby before the 20th week is considered as a miscarriage, and after the 20th week, when the baby detaches from the uterus and comes out, it is called premature birth.

Unfortunately, a baby who has a chance of survival after the 20th week cannot survive if it comes out before the 20th week. Many miscarriage cases occur before the 15th week and therefore the baby is completely lost.

It is not always possible to predict the occurrence of miscarriage, but the bleeding, pains, nausea, and muscle cramps experienced during miscarriage indicate to mothers that a miscarriage has occurred.

If there is bleeding that turns brownish or bright red, and abdominal pain accompanies it, you as an expectant mother may be at risk of miscarriage. Especially, pains occurring regularly every 15-20 minutes in the back are a serious sign in this regard. In such cases, and if you experience one or several of these situations, you may need to visit your doctor and have your checks done.

What are the Symptoms of Miscarriage?

Symptoms of miscarriage range from light brownish vaginal spotting or bleeding to heavy bleeding. Other symptoms include:

• Loss of pregnancy symptoms such as nausea or vomiting
• Cramping and pain in the lower abdomen
• White-pink fluid coming from the vagina
• Passing tissue or clots from the vagina
• Feeling faint and light-headed
• Contractions
• Pain starting in a small part of the back and moving to the lower part of the abdomen
• Rapid weight loss
• Not experiencing what should be present in pregnancy

However, it is also important not to think that these symptoms will occur in every expectant mother. Because some expectant mothers may experience a miscarriage without showing any symptoms, and this situation generally manifests itself under a doctor’s control. Therefore, even if you do not experience miscarriage symptoms, you should not neglect your doctor checks regularly. Thus, the detection or treatment of unwanted situations that may occur during pregnancy will be possible.

What Causes Miscarriage During Pregnancy?

Miscarriage can sometimes be due to biological problems of the mother and baby, and sometimes it can be a condition affected by the mother’s lifestyle and environmental factors. Therefore, there can be many different reasons for miscarriage. The main reasons can be listed as follows:

• Smoking, alcohol, and drug use, exposure to environmental toxins, food poisoning, and pollution,
• Physiological disorders of the mother that make pregnancy unsuitable, physical disorders of the uterus,
• Mother being subjected to violence, experiencing psychological breakdown, and being under intense stress,
• Acute infections, febrile diseases,
• Hormonal problems,
• The embryo not descending correctly into the womb,
• Mother being over 35 years old,
• Folate and folic acid deficiency,
• Being excessively overweight or underweight,
• Having heart failure,
• Poor and inadequate eating habits.

Kidney problems, hyperthyroidism and hypothyroidism, hypertension and blood pressure problems, diabetes mellitus, and other disorders unfortunately increase the risk of miscarriage during pregnancy. It is known that genetic problems of the embryo also cause miscarriage. This situation is a natural mechanism of the body and prevents the birth of babies struggling with genetic problems by the body.

Ectopic pregnancy, which presents symptoms such as delayed menstruation, irregular vaginal bleeding, and abdominal pain, sometimes progresses very insidiously without any symptoms at all. Let’s take a look at what ectopic pregnancy is and how it is recognised.

What is an Ectopic Pregnancy?

Ectopic pregnancy is an abnormal pregnancy condition that occurs when the fertilised egg implants and develops outside the normal location of the uterus, most commonly within the fallopian tube. Ectopic pregnancy cases range from those with no complaints to those termed acute abdomen.

The pregnancy test (ß hCG) in the blood is positive. However, while in normal pregnancies this value increases by 66% within 48 hours, this increase is not observed in ectopic pregnancies. Such an increase in ß hCG only occurs after 7 days. If the ß hCG level is 2000 mIU/ml but the gestational sac cannot be detected inside the uterus by vaginal ultrasound, suspicions should be raised.

What are the Symptoms of Ectopic Pregnancy?

The symptoms of ectopic pregnancy can be listed as follows:

• Delayed menstruation
• Nausea
• Vomiting
• Breast tenderness
• Positive urine test
• Positive blood test

In addition to these symptoms, if one or more of the following complaints suddenly arise during pregnancy, immediate medical attention should be sought:

• Lower abdominal pain
• Pain or pressure in the shoulder, neck, or rectum
• Sharp cramps in one area of the abdomen
• Vaginal bleeding
• Fatigue followed by dizziness and fainting sensation

Why Does Ectopic Pregnancy Occur?

Ectopic pregnancy develops when the fertilised egg with delayed passage to the uterus develops in the form of an ectopic pregnancy. The causes of ectopic pregnancy are as follows:

• Mechanical Causes
• Functional Causes
• Infertility and Ovulation Treatments
• Failure of Contraception Methods
• Advanced Age

How is Ectopic Pregnancy Recognised?

Ectopic pregnancy can occur in various ways. The symptoms include delayed menstruation, irregular vaginal bleeding, and abdominal pain.

Sometimes it can progress very insidiously without any symptoms at all. The patient may menstruate close to her due date, and if there is damage and bleeding in the tube in the later period, a serious condition with sudden severe abdominal pain and widespread tenderness may develop due to intraperitoneal bleeding. In this case, while blood pressure drops, an increase in pulse is observed. The patient may experience fatigue, a feeling of faintness, and dimming of vision. Shock symptoms may be seen in 25% of patients.

How Long Does Ectopic Pregnancy Last?

Untreated ectopic pregnancy continues until the tissue ruptures and intraperitoneal bleeding occurs, leading to an acute condition, or until medical or surgical treatment is initiated if diagnosed. Rarely, it may regress spontaneously and be eliminated by the body.

Can Ectopic Pregnancy Recur?

The chance of recurrence of ectopic pregnancy is around 10%, regardless of whether the affected tube is repaired or removed.

What Should a Person Who Has Had Ectopic Pregnancy Pay Attention to in Their Next Pregnancy?

They should protect themselves from infections, avoid using birth control pills and emergency contraceptive pills containing only progestin, and should not use an intrauterine device (IUD) as a contraceptive method.

What is the Greatest Risk in Ectopic Pregnancy?

Ectopic pregnancy diagnosis is delayed, and if rupture occurs from where the ectopic pregnancy is located, intraperitoneal bleeding occurs. The patient may experience fatigue, a feeling of faintness, and dimming of vision. Shock symptoms may be seen in 25% of patients. This is a life-threatening condition.

What Should be the Treatment Method for Ectopic Pregnancy?

Ectopic pregnancy is a serious condition that needs to be terminated urgently. Unfortunately, the embryo attempting to develop outside the uterus cannot survive. Furthermore, there is no possibility for this embryo to be transported to the uterus. Therefore, the treatment method for ectopic pregnancy is mostly termination of pregnancy. This can be accomplished by:

• If the diagnosis of ectopic pregnancy can be made early, pregnancy can be terminated by administering one or more doses of appropriate injection therapy.
• If the pregnancy has progressed and has caused damage to the tubes, the egg in the tube is cleaned out through a surgical procedure, and if necessary, the damaged tube is removed.

The treatment of ectopic pregnancy and the ability to become pregnant again after treatment are possible. Even if one of the tubes is removed, women can easily become pregnant with their other healthy tubes.

There is no simple and definite answer to the question of how ectopic pregnancy is recognised. However, after some checks, a clear diagnosis can be made. However, if a sign outside the normal range is noticed by paying attention to the symptoms of ectopic pregnancy, it is necessary to consult a doctor without delay.

What is Abortion?

Abortion is the termination of pregnancy within the uterus of a woman who has become pregnant for any reason.

For What Reasons Is Abortion Done?

• Unplanned pregnancy
• Having a sufficient number of children and not wanting a new child
• Becoming pregnant as a result of an error while using any birth control method (such as forgetting to take the birth control pill, displacement of the intrauterine device, condom breakage, errors made while using the calendar method, failure to take protective measures during breastfeeding)
• Using drugs that may harm the unborn baby without knowing the pregnancy, exposure to X-ray and radiation
• Having diseases in the mother that can endanger her life if she gives birth, diseases where pregnancy is strictly prohibited
• Pregnancies resulting from rape or extramarital relationships
• Situations where the baby does not develop and dies or there is a severe genetic disorder.

What Kind of Procedure is Abortion?

When carried out by an experienced obstetrician-gynaecologist who specialises in abortion and in accordance with the rules, abortion is a very easy procedure with minimal complications. Whether performed with a large plastic syringe called a carmen device or with a vacuum device using modern methods today, it can easily be performed without scratching the uterus through the suction method without scraping the uterus.

Is Abortion Painful?

Generally, short-term superficial general anaesthesia is applied. The patient falls asleep shortly and wakes up smoothly after the procedure, not remembering the abortion and feeling no pain. They regain consciousness in 15 minutes and can walk home after resting for a short while. If the patient has previously had a normal delivery and does not want anaesthesia, the cervix can be anaesthetised with local anaesthesia. During this procedure, the patient is conscious and can chat with the doctor and the assisting staff. They may feel a few minutes of pain similar to menstrual cramps.

What are the Complications of Abortion?

In abortions performed by experts in the field and meticulously, the likelihood of any complication is extremely low.

• Development of infection: In abortions performed using sterile conditions and disposable materials, this possibility is extremely low.
• Retained tissue: In abortions performed by an experienced specialist, this is also a rare possibility. Sometimes, due to uterine fibroids or polyps, pieces in a certain area may not be completely cleaned, leading to unceasing bleeding, and a second cleaning may be required.
• Uterine perforation: Known as uterine perforation in colloquial terms, it is almost never seen in abortions performed within legal limits and gently.
• Continuation of pregnancy despite abortion: In abortions performed under ultrasound guidance, this possibility is quite rare. Delaying the abortion until the formation of the gestational sac prevents this risk.

Can Someone Who Has Had an Abortion Get Pregnant Again?

If no complications occur after an abortion performed with vacuum aspiration and by an experienced obstetrician-gynaecologist, you can get pregnant even the next month.

Is Abortion a Birth Control Method?

Abortion is not a method of birth control, it can be done only if necessary. Therefore, contraceptive rules should be followed as they should be, and efforts should be made to prevent unwanted pregnancies.

What Should Be Considered After Abortion?

Attention should be paid to points such as not having sexual intercourse for 15 days, avoiding swimming pools and the sea for 15 days, taking showers standing up for 15 days, regularly using antibiotics if recommended by your doctor, and going for a check-up to the doctor who performed your abortion after 15 days.

Should People with Blood Incompatibility Get Vaccinated After an Abortion?

Yes, if you have blood incompatibility, you should get an anti-D vaccine after every abortion you have undergone. This is a matter that should not be neglected for the health of your subsequent pregnancies.