Let's start with the obvious: What are common telltale signs of a miscarriage?
“Things like obvious bleeding, spotting, severe abdominal or menstrual cramps, pain associated with bleeding. Anything like that are signs that a woman may be miscarrying,” says Dr Roshan. If you experience any of these symptoms, it’s important to see your doctor right away.
What are the less obvious signs of a miscarriage?
“It’s when something’s wrong with the baby but the patient doesn’t experience any pain,” says Dr Roshan. “Early on you don’t know, and some pregnancies end up with spontaneous miscarriage where the baby’s heartbeat stops but the patient doesn’t experience anything in terms of bleeding or cramping or spotting. So they usually don’t know until they go to the doctor for a checkup and then the doctor says there’s no longer a heartbeat.”
“When a woman is pregnant, they face things like vomiting, morning sickness, breast tenderness, a different taste in the mouth, hormonal changes,” he explains further. “Then when the miscarriage happens, the pregnancy doesn’t go forward and the patient suddenly doesn’t feel nauseous anymore, the morning sickness or breast tenderness goes away. Those are signs that they’re no longer pregnant and not producing hormones that causes all those changes in the first place
What are the common causes of a miscarriage?
“The most common cause is usually a genetic problem, where something’s wrong with the number of chromosomes in the baby,” says Dr Roshan. “When the chromosomes are dividing in the mother, sometimes they divide unevenly so some eggs have extra pieces of chromosome, some eggs have missing pieces, and therefore the pregnancy won’t be normal.”
Other than that, Dr Roshan explains that a miscarriage could also be due to structural defects in the baby.
What increases a woman's risk of miscarrying?
There are a variety of risk factors that that could cause a miscarriage. “Issues like thyroid problems (low thyroid, high thyroid), systemic diseases like lupus, rheumatoid arthritis or some autoimmune disease can all increase someone’s risk of miscarriage,” reveals Dr Roshan. “Sometimes, for women with autoimmune disease, the body rejects the pregnancy and sees it as a foreign material.”
Other risk factors include an abnormally-shaped uterus, hormonal problems like low progestrons or polycystic ovary, or disorders like endometriosis, whereby tissue that usually lines the inside of your uterus grows outside it instead.
Dr Roshan goes on to say that even diabetes that isn’t under control can also lead to a miscarriage “due to malformations of the baby.”
Does increased age increase the risk of miscarriage?
“As one’s age goes up, the chances of miscarriage goes up,” Dr Roshan says. However, he reveals that there “no real danger zone”. “You can’t go up to a woman and say ‘you’re too old to get pregnant'”, he continues. However, women need to know the risk of conceiving past a certain age.
“As age goes up, the chance of chromosome problem goes up. By age 35, the chance of chromosomal problems may be something like one percent; by age 40, it’s 1 in 40 (or 2.5 per cent). By age 44-45, the risk could be 20-30 per cent. “
What are some preventive measures?
“Obviously if you have any hormonal problems, endocrinology problem, thyroid problems, diabetes, to manage those things before you conceive and make sure everything’s within normal range,” says Dr Roshan.
“If there is history of low progesterone, get progesterone therapy to maintain the pregnancy. Taking supplements like folic acid pre-conceptionally may decrease the chance of chromosomal problems. Taking prenatal vitamins three months before conception might help too. Basically having a healthy lifestyle, healthy body, taking care of any medical problems before conception might all help reduce your chance of a miscarriage.”
Text: Elizabeth Liew / Additional reporting: Bauer