All Woman

Failed pregnancies: Causes and signs

BY DONNA HUSSEY-WHYTE All Woman writer husseyd@jamaicaobserver.com

Monday, January 02, 2012    

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More than at any other time of the year, January and February are months that traditionally bring news of conception for women, credited in large part to the celebrations associated with Christmas and New Year's holidays.

Unfortunately, the increase in the number of pregnancies recorded come with an associated increase in the number of failed pregnancies — from ectopic pregnancies to miscarriages.

But gynaecologist and obstetrician at the University of the West Indies, Professor Horace Fletcher has suggested that women need not be overly concerned by the number of failed pregnancies.

"Failed pregnancies are common after fertilisation," he told AW. "The high rate in January, February is in keeping with the high frequency of pregnancies that occur in December."

Importantly, Fletcher said that failed pregnancies is nature's way of taking care of what would perhaps otherwise have been an abnormal pregnancy.

"The egg is fertilised, but sometimes the foetus is abnormal and sometimes there is infection or low hormones," he noted.

At the same time, Fletcher said one miscarriage is very common and women should not be alarmed if this occurs.

"One miscarriage is very common," he said. "I would advise women that this might be a problem with that pregnancy and not with her, so she can get pregnant again," he told AW.

"If, however, you have had three miscarriages, then it needs to be further investigated, as something may be wrong with you."

The gynaecologist noted that if the patient loses the pregnancy within 18-20 weeks, many times it is because of a weakness of the cervix and they can, in fact, become pregnant again after benefiting from a cerclarge (the placement of stitches in the cervix to hold it closed) around the neck of the womb.

Fletcher said, too, that if persons have an ectopic pregnancy, they can become pregnant again.

"If the tube in which the pregnancy is formed is unruptured, it can be treated with chemotherapy to perish it without surgery," he said, adding that in some cases, the foetus can be taken out of the tube and it can heal.

In cases where the tube itself has to be removed because it was ruptured, the woman can get pregnant through the other tube, Fletcher said. If both tubes have been ruptured, then, he said, she can become pregnant through in vitro fertilisation.

"So in both the case of miscarriage or ectopic pregnancy a woman can get pregnant again," Fletcher said.

Meanwhile, there are some signs of failed pregnancy that women can look for. One important one is vaginal bleeding. Any vaginal bleeding during pregnancy is called a threatened miscarriage. However, it is believed that 25 per cent of women who go on to have a baby have experienced some vaginal bleeding. Therefore, it is best to consult your doctor should you experience any form of bleeding.

Another sign is pelvic or belly pain. This may be sharp pains on one side at first and then spread through a woman's belly; some women many experience period-like pain which worsens when she moves or if she strains herself. However, as with vaginal bleeding, pelvic or belly pain is not, on its own, an indicator of a problem, so consult your doctor.

ECTOPIC PREGNANCY

It is believed that in about two per cent of pregnancies, the embryo does not implant in the uterus, but in the fallopian tubes. This is known as ectopic pregnancy. It can be associated with life-threatening bleeding and usually needs to be removed surgically or by using medication.

An ectopic pregnancy is often caused by damage to the fallopian tubes. A fertilised egg may have trouble passing through a damaged tube, thus causing the egg to implant and grow in the tube.

The main causes of damage to the fallopian tube are:

* Smoking. The more you smoke, the higher your risk of an ectopic pregnancy.

* pelvic inflammatory disease (PID). This is is often the result of an infection, such as chlamydia or gonorrhoea.

* Endometriosis. This causes scarring of tissue in or around the fallopian tubes.

MISCARRIAGE

Miscarriages can occur for a number of reasons. The most common is a chance chromosomal or other genetic abnormality.

At conception, when the DNA from the father's sperm combines with the DNA from the mother's egg, a mistakes can occur when the DNA in the egg or sperm splits or copies itself, and this can result in an excess or deficit of chromosomes (or chromosome pieces) in the embryo.

If these embryos are not normal, miscarriage is nature's way of taking care of the problem.

Sometimes the pregnancy fails because there is no developing embryo in the pregnancy sac (blighted ovum). At other times, the embryo is there, but its heart has stopped beating (missed miscarriage).

Another cause is collagen vascular disease, such as lupus and diabetes, or other hormonal problems, including infection and congenital (present at birth) abnormalities of the uterus.

FALSE PREGNANCY

Also called, pseudocyesis, Fletcher said a a false pregnancy can occur at any time. It happens in women, he said, who are desperate to have a child but is unable to.

The signs include amenorrhoea (no periods), abdominal swelling from swallowing gas and foetal movements which is usually gas moving around.

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