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What is abortion?

Abortion or miscarriage is a term used for any pregnancy, which ends spontaneously, before the delivery of the child. Miscarriage is also called spontaneous abortion. It occurs due to a fetus or an embryo, which is in an unviable state, corresponding to a gestational age of approximately 20-22 weeks or less, being spontaneously expelled. The occurrence of abortion is as high as 15-29% in all pregnancies. Although most of the abortions occur before 13 weeks of pregnancy, there is also an increased risk of abortion in the second and third trimester.The causes of abortion are different depending upon the weeks of gestation of pregnancy. Once the embryo is implanted on the wall of the uterus, various changes occur in the body at the biological and hormonal level. Any imbalance in these hormonal levels, besides some other causes, can cause a developmental defect in the fetus, increasing the risk of abortion. The incidences of abortion at different sages of pregnancy is given below-

It can be observed from the chart that the highest incidences of abortion occur between the 9^th and 10^th week of pregnancy.

The causes of abortion at different stages of pregnancy are given below-

First trimester-

Defective germ plasm

Chromosomal abnormalities

Congenital malformations

Hormonal deficiency

Trauma

Infections

Uterine fibroid

A previous abortion

Chromosomal abnormalities are the commonest cause of abortion in the first trimester of pregnancy. Infections like syphilis can cause miscarriage, but if treated in time, the chances of conceiving in future are good. If the abortion occurs earlier in pregnancy, the fetus dies and is then expelled from the body, causing symptoms like pain in the abdomen and bleeding from the vagina.

Second trimester-

Technically, abortion in the second trimester occurs between 12-20 weeks. If the pregnancy is lost after 20 weeks, this loss of pregnancy is classified as stillbirth. There are several causes for an abortion in the second trimester. There is also a possibility that the death of the fetus occurred in the first trimester but it is detected only in the second trimester. This is referred to as a missed abortion. The causes of abortion in the second trimester are enumerated below-

Chromosomal abnormality

Infections

Congenital defects in the fetus

Congenital malformations of the uterus of the mother

Abnormal placenta

Cervical inefficiency

Abdominal trauma

Unknown causes

Women who have a history of abortion in the second trimester should consult a gynecologist before planning the next pregnancy.

Third trimester-

The incidences of abortion in third trimester are very low. However, great care is required in this period as the growing fetus can cause a change in the center of gravity of the mother. This can increase the chances of a fall and abdominal trauma leading to an abortion. Some other causes of abortion in the third trimester include infections, congenital defects, trauma or fall, cervical incompetence and hydramnios. However, these miscarriages are not termed as abortions in medical language. They are referred to as stillbirths.

It is important for females to know the early signs of abortion so that they can seek immediate help in case of an impending abortion. Immediate treatment and proper care can help the female in the continuation of the pregnancy, without loss of the fetus. These cases, in which there is an increased risk of abortion with eventual survival of the fetus is called, threatened abortion. Even in cases with complete abortion, proper care and treatment of the female is very necessary at both the physical and the emotional level. This can increase the chances of conceiving in the future and reduces the risk of repeated abortions.