Dear Dr Murage,
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A few months ago, I had a miscarriage that was treated with some tablets. I subsequently had an infection. Does this have implications on my long term health? And could it lead to infertility?
A miscarriage can be very traumatising. It leaves the victim distressed and unsure about her future reproductive potential. But most miscarriages occur by chance, and the risk of recurrence is usually very low. Majority of women who experience one or two miscarriages will subsequently end up with normal pregnancies.
Most miscarriages occur in the first three months of pregnancy, usually referred to as early pregnancy loss. An ultrasound scan is normally done to confirm the diagnosis. Some may require pregnancy hormone testing if the diagnosis is unclear. Most pregnancies lost that early are thought to have some genetic abnormalities, which is usually not salvageable. The likelihood of something being abnormal with either of the partners is usually very low, especially after a single miscarriage in young couples.
Once a miscarriage has been diagnosed, you can be left alone to allow for a spontaneous resolution. Other alternatives are the use of some tablets to enhance the process, or being taken to theatre for what is called a uterine evacuation. All the three options are pretty safe, with neither resulting to any long term health risks. Infections after a miscarriage are very rare. But gynaecologists tend to be very cautious, and you may sometimes be given antibiotics if there was even the slightest suspicion of an infection.
There is hardly any physical longterm health consequences following a miscarriage. The bleeding and cramping tend to settle down quickly. Uterine and ovarian functions go back to normal within weeks. And so does your reproductive potential. You are unlikely to have problems conceiving again just because you had a miscarriage, no matter how it was treated. A differentiation must be made between miscarriages and unsafe abortions. Plenty of unwanted reproductive health problems occur after unsafe abortions, which are best avoided.
You may experience some psychological trauma after a miscarriage, which can be as bad as losing an advanced pregnancy. It is common practice for you to be offered some psychological support after a miscarriage. Take this up especially if you find yourself struggling with your emotions. Talking things over with someone who relates helps. There some local support groups on social media and other forums that can help with your recovery. Get yourself a very early review in the next pregnancy, just in case some precautions would be deemed necessary.
— Dr Alfred Murage is a consultant obstetrician and gynaecologist
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