2023-10-12 14:30:52
During pregnancy, positive feelings usually predominate for us mothers. We are really looking forward to our baby, choosing a name, shopping for cute outfits and furnishing the children’s room full of anticipation. But not all expectant mothers have such a carefree time during the ball – for example, because bleeding suddenly occurs during pregnancy or there is great concern regarding losing the child once more due to previous miscarriages.
Miscarriage: When the dream of having a baby is shattered
That’s how it was for me too. A few months before I was pregnant with my older son (5 years old), I had a miscarriage at 11 weeks gestation. I will never forget the moment when my gynecologist told me, looking at the monitor: “Unfortunately, I can no longer see a heartbeat.” I was devastated and incredibly sad.
I became pregnant once more relatively soon – but in a second pregnancy I was constantly worried that I would lose this child too. Many mothers are like me: the traumatic experience of losing a child can overshadow subsequent pregnancies.
What exactly is a miscarriage?
A miscarriage occurs when the pregnancy ends before the child is viable. Children are typically considered viable from the 24th week of pregnancy and from a weight of 500 grams. A very large proportion of miscarriages (50 to 70 percent) occur before the pregnancy is even detected. Sometimes even without the women noticing the miscarriage. Doctors speak of a miscarriage before the 13th week of pregnancy as an early abortion, and a miscarriage between the 14th and 23rd week of pregnancy as a late abortion.
Miscarriages are not uncommon: According to the WHO, one to three percent of all couples experience repeated pregnancy loss. Of course, that doesn’t make the loss any less painful – But sometimes it helps to know that others feel the same way. Exchanging ideas with other affected people can be very helpful in such a situation!
It is not talked regarding enough, but unfortunately many couples experience the painful experience of a miscarriage. Photo: Pexels
What are the reasons for miscarriage?
Unfortunately, we women tend to blame ourselves. The carousel of thoughts started straight away for me too: Was I not careful enough? Did I eat something wrong?! Doctors are conducting intensive research into the reasons and risk factors. But one thing is clear: most expectant mothers are not to blame if they lose their child. A miscarriage can happen to any woman!
In many cases, early abortions are caused by chromosomal disorders in the cell, i.e. a serious “error” in the DNA blueprint of the embryo. In this case, the body terminates the pregnancy. In most cases, we star moms don’t know the reasons why a miscarriage occurred – unless we specifically request a tissue examination.
Possible causes of miscarriage:
Genetic defects or Malformations des Embryos
Implantation disorders in early pregnancy
Malformations the uterus, Fibroids in the uterus
Cervical weakness (Service insufficiency)
Blood clotting disorders mother
Autoimmune diseases or antibodies once morest the placental tissue
Hormonal disorders (e.g. thyroid disorder)
Infections mother
Progesteronmangel (Lutealphaseninsuffizienz)
Endometriosis
Risk factors for miscarriage:
Previous miscarriages
Frequent pregnancies
Multiple pregnancies
High Alter dad’s, defective sperm
Medication, alcohol or cigarette consumption
Psychological stress
Risk factor Progesterone deficiency
Progesterone deficiency (luteal phase insufficiency) can be the cause of recurrent miscarriages in early pregnancy. The body does not produce enough of its own progesterone. The hormone is super important for a stable, healthy pregnancy. Progesterone increases blood flow to the uterine lining and thus ensures ideal conditions for the implantation of the fertilized egg.
“During pregnancy, progesterone causes the muscles of the uterus to relax and also stabilizes the cervix,” our expert knows Dr. Elena Maria Leineweber, specialist in gynecology and expert in hormones and fertility. “In addition, it immunologically causes the pregnancy to be accepted in the uterus.” In the first seven weeks of pregnancy, the so-called corpus luteum ensures the production of progesterone, following which the placenta takes over this important task step by step. During this sensitive transition phase (luteoplacental shift), miscarriages can occur more frequently.
Premature birth: When the baby comes (much) too early
Around 5 to 10 percent of all newborns are premature babies. Photo: Pexels
But miscarriages are not the only traumatic experience for expectant mothers. But also if the baby comes early. If a child is born before the 37th week of pregnancy, Doctors speak of a premature birth. The children often weigh less than 2500 g. Five to ten percent of all children are premature babies. The timing of a premature birth often determines the life and health of the child. Every day in mom’s protective belly counts!
Luckily come 70 percent of premature babies are born following the 34th week of pregnancy and therefore have a good chance of a healthy, happy life. In addition, intensive medical care has improved enormously, so that premature babies can now be better looked following and cared for. Nevertheless, doctors are of course very keen to know the causes and risks in order to be able to better prevent them.
Possible causes of premature birth
In 40 percent of cases the cause remains unclear. However, there are some factors that can often increase the risk of premature birth. If one of these factors is present, it is referred to as a high-risk pregnancy. As a high-risk pregnant woman, you need particularly intensive medical support and regular check-ups. Possible causes:
Pre-existing illnesses of the mother (z.B. Asthma, Diabetes)
Infections mother
Malformations the uterus / shortened cervix
Malformation, chromosome defects, malformations of the embryo
Pregnancy-related diseases
Premature contractions, rupture of membranes
Risk factors for premature birth:
Shortened cervix (Cervix)
Age of the pregnant woman (increased risk over 40 years)
Multiple pregnancies
Severely over or underweight mother
Previous premature births
Number previous pregnancies, pregnancy interval of less than 12 months
Unhealthy lifestyle (e.g. nicotine, alcohol consumption) High social or psychological stress
Artificial insemination risk factor
Women who use artificial insemination methods have a significantly increased risk of miscarriages and premature births. In addition, it is not uncommon for multiple pregnancies to occur, which are generally associated with a high risk of premature birth. 18% of singletons, 83% of twins and 100% of triplets are premature births (before the 37th week of pregnancy). In addition, the hormonal stimulation of fertility treatments is accompanied by a weakened corpus luteum. “Against this background, as part of fertility treatment, the luteal phase and early pregnancy are substituted with vaginal progesterone,” explains Dr. Linen weaver.
Am I at risk and how can I prevent a miscarriage or premature birth?
The bad news first: Unfortunately, miscarriages and premature births cannot be completely prevented. There are factors that expectant mothers simply cannot influence. The good news: You can at least reduce the risk of a miscarriage or premature birth with targeted measures.
First of all, it is important to determine your individual risk. According to the guidelines, diagnostics are recommended following three miscarriages and are covered by health insurance. An assessment is possible through gynecological examinations, blood tests, smears or ultrasound examinations by your gynecologist. A shortened cervix can also be detected through an ultrasound examination and treated with therapies (such as targeted progesterone administration). Dr. Leineweber: “The diagnosis of a true progesterone deficiency cannot actually be made with a single blood sample, seebut it depends, among other things, on certain symptoms, so if you suspect something, you should talk to your gynecologist regarding it. to make an individual assessment.”
This is how you can stabilize your early pregnancy
The risk of another miscarriage can be reduced, especially at the beginning of pregnancy. Photo: Pexels
As previously mentioned, progesterone is important for a healthy, stable pregnancy. It’s not for nothing that my own gynecologist prescribed progesterone for me during my second pregnancy. In the 1st trimester, the use of vaginal progesterone, i.e. in the luteoplacental shift phase, supports pregnancy. Studies have shown that giving natural progesterone reduced the risk of recurrent miscarriage by up to 7 percent!
Dr. Leineweber: “One reason for the temporary, preventative vaginal use of progesterone during pregnancy may be recurrent miscarriages.“
Progesterone during artificial insemination and late pregnancy
If you became pregnant through artificial insemination, the issue of progesterone is particularly relevant, as the treatment often leads to a weakened corpus luteum. As a rule, gynecologists therefore prescribe a vaginal progesterone preparation approved for this area of application as part of fertility treatment, e.g. B. as a progesterone capsule up to the 12th week of pregnancy.
In later pregnancy (from the 2nd trimester onwards), taking natural progesterone is also useful if there is an existing risk and corresponding symptoms. Prevention with progesterone can reduce preterm birth in risk groups by up to 30 percent. Especially in women with cervical shortening, previous miscarriages or premature births or proven progesterone deficiency.
How is progesterone used and does health insurance cover the costs?
Vaginal progesterone is administered, for example, as a capsule or gel. Experts recommend vaginal use, for example Soft capsule so that progesterone can work exactly where it is supposed to: in the uterus. Dr. Leineweber: “As a rule, progesterone is very well tolerated.” It’s best to follow your gynecologist’s instructions exactly. It is also important that the progesterone is used continuously.
Health insurance companies only reimburse the costs for Progesterone preparations that are approved for use as part of fertility treatment. Depending on the preparation, up to a maximum of the 12th week of pregnancy. In the case of spontaneous pregnancies, progesterone is a self-pay service. However, it may be worthwhile to submit an application to the health insurance company for reimbursement of costs.
In good hands: Prevent miscarriages and premature births through regular checks
In general, it is very important that you always keep appointments in your gynecological practice and if you have any irregularities in your pregnancy, contact your gynecologist immediately. Through regular check-ups, you can discover possible risk factors early and thus better prevent miscarriages and premature births. Pregnant women at high risk of premature birth should seek advice from a perinatal center. The clinics specialize in the care of high-risk pregnant women and the care of premature babies.
Don’t be afraid to get competent help and support on board. After all, during pregnancy we carry the most valuable thing we have under our hearts – our baby. Every miscarriage or premature birth that can be prevented counts.
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