The term abortion refers to the expulsion of the foetus from the
uterus before the complete
formation of the placenta. It is also commonly known as miscarriage. This may occur any time
before 28 weeks of gestation but is most common during the first 12 weeks of pregnancy. Once
in five to ten pregnancies terminates in this way.
When miscarriage occurs repeatedly at a certain period of pregnancy, it is termed " habitual
abortion ". It is one of the most perplexing problems of gyanaecology and a major cause of
maternal mortality. A woman who has suffered two or more terminations of this sort
consecutively is said to be a case of
habitual abortion.
Symptoms
Pains of the same character as labour pains and bleedings are the two main
symptoms of
possible abortion. Bleeding may lead to the detachment of the ovum from the
uterus. It now acts
as a foreign body in the
uterus which stimulates uterine contraction. This generates a lot of pain
and the foetus is thrown out of the body. In later weeks when the foetus is well developed, if it
dies in the
uterus, it leads to maceration of the body. The abdomen is filled with blood and the
skin colour appears red. Sometime after a few more days, the foetus gets dehydrated and the
fluid surrounding the foetus gets dried away.
Causes
One of the most important cause of
habitual abortion is a congenital malformation of the
uterus.
A hysterogram, before the woman becomes pregnant, will be useful in detecting any abormality,
so that she is made aware of her case. Deficient functioning of the
thyroid is another important
cause of
habitual abortion.
Most cases of
habitual abortion, however, result from an inadequate secretion of the female
hormone
progesterone. This hormone is responsible for the development of the placenta. In the
early stage of pregnancy, the gonadotrophin secreted by the cytotrophoblast of the chorion, one
of the foetal membranes, stimulates the corpus lotemum to produce more oestrogen and
progesterone, both essential female hormones. At a later stage, by about the 12th week of
pregnancy, the placenta takes over the production and secretion of the hormones. Any
deficiency of these hormones at this stage is detrimental to the growth of the foetus. It is,
therefore, during this critical period,when
habitual abortion mostly occurs. Lack of
progesterone
is especially instrumental in expelling the fertilised ovum and it results in an abortion.
Another important cause of
habitual abortion may be chronic
constipation which leads to
putrefaction of morbid matter and wastes in the large intestines. This in turn causes
auto-intoxication and inflammation of the reproductive organs, which can lead to a miscarriage.
Abortion may result from the excessive use of certain drugs. Drugs enter the foetus through the
placenta. They may act quite differently on the foetus from the mother. Drugs which have
adverse effects on the foetus are called " tera-togenestic drugs " and may include painkillers,
antibiotics, tranquillisers and hormones. A high dosage of such drugs may produce contraction
in the
uterus and induce abortion.
Other cause of
habitual abortion are excessive physical exercise, mental excitement, sexual
intercourse,
syphilis infections fibroid tumours, blood incompatibly of husband and wife, systemic
disorders in the mother like hypertension, chronic nephritis,
diabetes and even her mental
condition.
Thorough examination of the pregnant woman's blood, urine, blood pressure and their related
parameters help in detecting maternal disorders. Serological tests, for example, prove the
presence or absence of
syphilis infection. Pelvic examinations help to diagnose uterine
displacements , fibroids or ovarian tumours. A hysterogram also helps to detect uterine
malfunctions. The exact cause must be ascertained for prescribing correct treatment.
Treatment
Conditions such as hormonal imbalance, infections of the
uterus and chronic
constipation can be
remedied by natural methods of treatment . For congenital uterine malformation, however,
recourse may have to be taken to surgery.
On appearance of the first
symptoms of possible abortion, the patient should be put to bedimmediately and the bottom end of the bed raised. Cold compresses at 60 o F temperature
should be applied continuously to the inner portion of the thighs, the perinium, the vagina and
the
lumbar region. Compresses should be changed every 15 to 20 minutes. When the compress
is removed for renewing, the surface should be rubbed with a warm dry flannel for half a minute
or until reddened, before applying the compress again. Simultaneously, a hot application should
be made to the feet.
A neutral or warm water enema is an effective remedy for a constipated colon which is a major
cause for the toxaemic condition of the
uterus. This will relieve the bowels and thus reduce any
excessive pressure on the
uterus and other pelvic organs. A regular cold hip bath for a duration
of 10 minutes twice every day is very helpful in relieving congestion and inflammation of the
uterus. Wet girdle packs, twice every day, on an empty stomach, also relieve congestion's and
infections in the
uterus and other pelvic organs. It is advisable that women with a history of
repeated abortions should adopt these techniques before conception and continue them during
the first two months of pregnancy.
Hormonal imbalances can be set right by practicing yogic exercise. Yogic asanas such as
sarvangasana, vajrasana, bhujan-gasana, shalabhsana, dhanurasana, paschimottashana, and
trikonasana are especially useful in improving
thyroid, pituitary, adrenal and gonaidal endocrine
functions and should be practised regularly by women who suffer from imbalances of this sort,
upto the first two months of pregnancy.
Dietary
control is of utmost importance in the prevention of
habitual abortion. Pregnant women
should avoid refined carbo- hydrates, sugars, non-vegetarian food, coffee and tea. They should
also avoid oily and fried foods as such foods lead to
constipation, which is very detrimental to
pregnancy. Smoking or chewing tobacco and drinking
alcohol must be strictly avoided.
The pregnant woman's diet chart should be on the following lines :
Breakfast : Fresh fruits and a glass of milk mixed with a teaspoonful of honey.
Lunch : Steamed vegetables, boiled rice or whole wheat chappatis and soup or buttermilk.
Midafternoon : A glass of fruit juice or a whole fruit.
Dinner : Cooked diet similar to the afternoon meal may be taken till the seventh month. After
that, fruits, nuts, germinated seeds and sprouts, milk, buttermilk and soups must form her diet
because they reduce the workload on the digestive system and thus help avoid
indigestion,
constipation and related disorders.
Indian gooseberry, known as amla in the vernancular, is considered useful in preventing
abortion. A teaspoonful of fresh amla juice and honey mixed together should be taken every
morning during the period of pregnancy. It will also prevent infections and help in the absorption
of iron. A brew made from safflower foliage is also said to prevent abortion.
Pregnant women with a history of repeated abortions should take all other precautions
necessary to prevent miscarriage. They should avoid sexual intercourse, during early
pregnancy. They should go to bed early and rise early and take regular exercise, but avoid
fatigue. They should sleep on a hard mattress with their heads low, and remain calm and cool.
All these measures will greatly help in correcting the phenomenon of
habitual abortion.