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| Causes of Miscarriage or stillbirth |
When a child dies during pregnancy, during or after birth, it is usually a fateful event. As a rule, neither his parents nor the medical professionals could have prevented it with the greatest possible effort.
A healthy little human does not always develop from the fusion of an egg cell and a sperm cell. Most miscarriages are caused by a fundamental disorder in fertilization or implantation of the fertilized egg into the uterus. In the case of irregularities in the "blueprint" of the embryo , the development usually stops abruptly.
It is believed that about half of all premature pregnancies go unnoticed because the embryo was not viable. It then enters a bleeding that appears like the normal or somewhat delayed menstrual period. Of all diagnosed pregnancies, 11 to 15 percent end in miscarriage. About one percent of all couples who want to have children experience three or more abortions, which in technical language are called "habitual abortions".
In the first trimester of pregnancy, ie until about the ninth week after fertilization, the child's organs develop. Up to this time it is called embryo, then fetus or fetus. From the third month of pregnancy, the placenta takes over the supply of important hormones, which were previously produced mainly in the ovaries. Pregnancy is particularly susceptible to disturbances during this period. If the pregnant woman loses her child during this time, it is called a miscarriage in early pregnancy (early abortion).
Miscarriage in the first trimester of pregnancy is caused to 50 to 70 percent by abnormalities in the chromosome number of the embryo. The chromosomes may be present in pairs instead of single (monosomy) or triple (trisomy). These disorders often prevent the further development of the embryo.
Other causes of miscarriage include, for example, a weakness of the cervix (cervical insufficiency), infections, harmful substances and toxins (alcohol or other drugs), hormonal imbalances or antibody response. In rare cases, metabolic diseases of the mother, such as untreated diabetes mellitus, can lead to miscarriage.
Emotional stress can also cause a miscarriage. Thus, excessive stress can weaken the immune system and promote infections that endanger the pregnancy.
Sometimes the pregnancy ends in surprise, accompanied by bleeding and spasmodic pain. Or an ultrasound examination reveals that the baby's heart is not beating anymore. As long as there are no acute problems, you can usually take some time. Often, pregnant women need a few days to say goodbye to their child. The body usually empties the embryo and the mother cake by itself.
If the woman wants to accelerate the miscarriage, in case of heavy bleeding or if it is determined that after a miscarriage tissue remains in the uterus, they can be removed with a shaving (Abrasio, curettage). This is done under general anesthesia and can usually be done on an outpatient basis. Alternatively, this is often possible with the gentler suction method (suction curettage). Medication can also cause a miscarriage.
Miscarriage in the second trimester
If the child dies after the twelfth week of pregnancy and is less than 500 grams, this is referred to as late miscarriage or late abortion. The child is already too big for a scraping at this time. Instead, his birth is usually initiated by medication with the help of artificial hormones, so that the mother gives birth to her child in a natural way. If there is no medically speaking against it, one can wait in agreement with the supervising doctor, the doctor or the midwife for a while until the contractions begin without medication. Childbirth can also begin too early, even before the child is viable: if premature labor begins, the cervix opens prematurely due to a weakness, or a bubble break - for example, as a result of infection. Also in this case, after birth, a scar under anesthesia may be required so that no placental remains in the uterus.
For the most part, the causes of stillbirth mentioned below can also be the reason for the death of a child in the womb that is not yet viable.
Stillborn (stillborn)
If the child dies during pregnancy or childbirth and weighs at least 500 grams, it is a "stillborn" in the jargon. Out of 1,000 births, approximately two to three children are born dead in Germany. Boys are more likely to be affected than girls - 52 to 48 percent.
A stillbirth can have different causes:
Disorders of the placenta, which have led to the child no longer being adequately treated. There may be circulatory problems, or the placenta has prematurely detached from the uterine wall.
Infections that have damaged the child or the placenta. An infection can be transmitted, for example, via the amniotic fluid and the membranes , usually by premature vomiting of the flowers.
Diseases of the mother, such as diabetes or the HELLP syndrome.
Umbilical cord complications that have hindered the care of the child. Such complications include, for example, an umbilical cord or umbilical cord prolapse. It also happens (rarely) that the umbilical cord is too tight around the child's neck.
Lack of oxygen, which is not due to a placental disorder.
Malformations of the child, sometimes due to chromosomal abnormalities, such as trisomy 13 or 18, or genetic disorders.
Acts of violence caused by an accident or physical violence.
The cause of death is not always clear, even if the child is post- mortemed after birth .
Some children die during or shortly after birth. This can have the following causes:
- The lungs are still immature, causing severe respiratory problems.
- The child has malformations that can not be operated on and that do not allow them to live on.
- Cerebral haemorrhage has occurred as a result of hypoxia.
- Severe infections and sepsis have led to organ failure.
- The child was born too early and is too small and immature to survive.
- Due to lack of supply in the womb, the child has too low a birth weight.
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