Apart from the mental trauma suffered following a spontaneous abortion or miscarriage, there are certain other complications which may occur, depending upon the type of miscarriage. Early recognition of such dangers and prevention where possible, should be the focus.
What are the Dangers of a Miscarriage?
In any type of miscarriage, grief can lead to depression. Feelings of guilt are common where a woman may feel that the abortion may somehow be her fault. This can lead to anxiety and stress disorders, especially in case of recurrent abortions. Psychotherapy is important especially in women who are severely depressed. Identifying the cause of the miscarriage and reassuring the patient that a future pregnancy is possible is an important consideration for the partner, counselor and doctor.
A complete abortion does not usually cause any further problems. Bleeding is generally not severe and gradually diminishes once all the products of conception have been expelled. Infection is a rare possibility.
A threatened abortion in some women may lead to a complete abortion, even after adequate rest and other management. There is also an increased risk of preterm delivery.
Incomplete and Inevitable Abortion
- Some products of conception may be retained within the uterus following spontaneous abortion or after a suction D&C. This may lead to an infected or septic abortion.
- Asherman’s syndrome is a complication which may occur following a vigorous curetting or repeat curetting. Adhesions are formed within the uterus and in extreme cases, scar tissue fills up the uterus almost completely. Asherman’s syndrome could be the cause for infertility or miscarriage in the future and usually presents as amenorrhea or decreased flow during periods.
- Perforation of the uterus may occur following D&C since a pregnant uterus is softer than normal uterus (a surgeon may often feel it as a sudden loss of resistance while performing a D&C procedure). If the perforation is very small it may heal on its own.
- Excessive and uncontrolled bleeding may lead to hypovolemic shock or disseminated intravascular coagulopathy (DIC). These are serious conditions which need immediate medical attention.
- Wrong diagnosis could be dangerous. There may be an ectopic pregnancy where passage of a decidual cast may be mistaken for products of conception.
- Complications of anesthesia while performing a D&C procedure.
- Injury to cervix and vagina during the procedure.
- Bowel and bladder injury.
- Death may occur in extreme cases.
- Pelvic inflammatory disease (PID).
- Septic shock.
- Inferior vena cava thrombosis.