Of course, when the pregnancy test is positive after a few IVF treatments, you can be happy for a while. But for some, the happiness is quickly over. Miscarriage can happen to anyone, but that doesn't make it any less painful. Often, you feel completely overwhelmed in such a situation, and then the clinic staff throw around technical terms that you don't understand. This article explains the most important terms.

General Epidemiology

Statistically, 50-70% of pregnancies are terminated prematurely. However, in the majority of cases (60%), this happens before or immediately after implantation, before the pregnancy is even detected. These miscarriages often go unnoticed and just look like a slightly delayed period. The remaining 10% of miscarriages occur after the pregnancy has been confirmed.

The risk of miscarriage also increases significantly with the mother's age. For example, the rate is 25% for mothers under 35 and 50% for mothers over 45.

Miscarriage

We always speak of a miscarriage when the birth is premature and, above all, involuntary. There are many ways to describe a miscarriage. The simplest is based on the time of the miscarriage. It can be divided into early and late miscarriages, with early miscarriages occurring before the 16th week of pregnancy and late miscarriages (stillbirth) occurring after that.

In addition, by definition, the child in an miscarriage weighs less than 500 grams. According to the law, no certificate (death certificate) has to be issued if these criteria are met, or even if the child is born before the 24th week of pregnancy.

Types of miscarriage

In addition to time, other criteria can be used to classify types of miscarriage. These are based on the course or stage of the miscarriage. The bleeding, the opening of the cervix and the ultrasound image are assessed.

The first stage is called imminent miscarriage (abortus imminens). This is usually indicated by vaginal bleeding. However, the cervix is still closed and the ultrasound shows that the pregnancy is still intact. Abortus imminens is the only type of abortion that can be stopped in a clinic. If you go to the clinic in time, the pregnancy can continue normally without any harm to the mother or baby.

The next stage is abortus incipiens. This is when the bleeding is already too heavy and the cervix begins to open. This is followed by an incomplete abortion (abortus incomletus). This is when the cervix is open and the embryo is not fully visible on the scan. Finally, there is a complete miscarriage (abortus completus), where there is no sign of the pregnancy on the scan.

Special forms of termination of pregnancy

Some forms of abortion do not fall into any of these categories. One such example is the so-called aborted egg. This is a developmental disorder of the placenta. As a result, the embryo cannot be adequately nourished and abortion occurs.

In addition, the term 'habitual miscarriage' is often used in IVF. This is when a woman has had at least three miscarriages in a row, all before the 20th week of pregnancy. This is often due to a disorder of the immune system. It may also be the reason why IVF was needed in the first place. This is why miscarriage is so common. However, the cause can often be treated.

Stillbirth

A stillbirth is when the baby weighs more than 500 grams or is born after the 24th week of pregnancy. The baby shows no signs of life after birth. Unlike an abortion, a death certificate must be issued by a doctor. There must also be a funeral.

Death is usually preceded by intrauterine amniotic death. Uterus means womb, so the baby dies in the womb. The point at which this diagnosis is made is not uniformly clarified in the literature. However, the period from the beginning of pregnancy to the 24th week of pregnancy can be used as a guide. If the baby has already died, it will be rejected by the body and there will be an abortion or stillbirth.

Live birth

This category includes all newborns who show signs of life at birth, regardless of how their health develops afterwards. If the newborn dies immediately, the same rules apply as after a stillbirth. In both cases, emergency christening is possible in hospital if you wish.

What causes a miscarriage?

The causes of miscarriage are many and varied. The problem may be with the mother, the baby or the placenta. Contractions can also be triggered by external trauma, such as a fall.

If the cause is foetal, it is usually due to poor development and/or a genetic defect. If the child is not viable because of abnormal development, it will be rejected by the body. The same applies to foetal infections. These are also a common cause of premature birth.

However, most causes of miscarriage can be traced back to the mother. The range of possible causes is very wide. Miscarriages are often caused by hormonal or immune system disorders. Chronic illnesses, adjustment problems, infectious diseases and diabetes can also play a role. There are also anatomical variations and all kinds of placental disorders.

Miscarriages, especially in the later stages of pregnancy, are often very dangerous for the mother. If you feel unwell, you should go to a clinic or see your gynaecologist immediately. If you have already had a miscarriage, it is important to find out what caused it. Many of the maternal factors can be treated if they are known. You may not have to give up trying to have children in the future. But first it is important that you get well and take time to heal and grieve. If you need support, don't be afraid to ask, because even an angel baby wants a healthy mum.