Early miscarriage is the spontaneous end of a pregnancy during the first trimester (before 13 weeks), affecting 10-20% of all pregnancies. Most cases occur before 10 weeks of gestation. Approximately 65-70% of early miscarriages are due to chromosomal abnormalities. Less common causes include uterine abnormalities (submucosal fibroids or uterine septum), immune diseases (antiphospholipid syndrome), or harmful substances such as tobacco, alcohol, or illicit drugs. Risk factors that can increase the likelihood of early miscarriage include maternal age over 40 and a history of recurrent miscarriages.

Medical management of miscarriage is one of the treatment options that minimally impacts the uterus, thereby avoiding increased risk of intrauterine damage for future pregnancies. This method stimulates uterine contractions to expel fetal tissue. Patients may experience bleeding similar to a prolonged menstrual period (7-21 days), typically starting as fresh red blood before turning brown or dark. They may also have dull or cramping abdominal pain, similar to menstrual cramps, and might notice blood clots or fetal tissue passing.

After a miscarriage, you should not use tampons or menstrual cups. Instead, use regular sanitary pads to monitor the amount of bleeding and prevent bacteria from entering the uterus. Gently clean the external area with clean water or a mild feminine wash, and avoid vaginal douching. Abstain from sexual intercourse for at least two weeks or until bleeding stops to reduce the risk of uterine infection, as the cervix remains open during this time. For the first one to two weeks, avoid heavy lifting, strenuous work, and high-intensity exercise.

You must go to the hospital immediately if you experience heavy bleeding (soaking more than two thick sanitary pads within one hour for two consecutive hours), a fever above 38 degrees Celsius accompanied by chills, severe abdominal pain, or foul-smelling vaginal discharge. If an ultrasound two weeks after taking medication reveals retained placental tissue or a partial embryo, and the uterus cannot contract on its own to expel the remaining tissue, your doctor may prescribe additional medication or perform a suction aspiration to prevent infection and hemorrhage.

Dr. Thao provides genetic counseling to a couple at Tam Anh General Clinic, District 7. Illustration: Ngoc Chau

Regarding nutrition, you should consume meat, fish, eggs, legumes, and dark green leafy vegetables to replenish iron. You may also take iron supplements as prescribed by your doctor. Fruits such as oranges, tangerines, and guavas are rich in vitamin C, which aids wound healing and boosts immunity. Drinking plenty of water helps cleanse the body and reduces fatigue. Avoid cold foods and limit alcohol, coffee, and overly sour dishes.

Genetic testing after a miscarriage can help identify the underlying cause of early miscarriage, especially in cases of two or more consecutive miscarriages. Depending on your specific situation, your doctor may order tests such as karyotyping, gene carrier screening, immune disorder tests, and hypercoagulability factor tests. The goal is to determine the cause of the early miscarriage and develop an appropriate treatment plan to prevent future miscarriages.

Dr. Nguyen Phuong Thao

Fetal Medicine Unit

Tam Anh General Clinic, District 7