What happens in your body during a miscarriage? - Nassim Assefi and Emily M. Godfrey

Prevodilac: Jovana Babic Lektor: Milenka Okuka

Globally, around 23 million pregnancies end in miscarriage each year.

Globalno se oko 23 miliona trudnoća završi pobačajem svake godine.

Despite how common it is, miscarriage is still considered a taboo subject.

Uprkos tome koliko se često javlja, pobačaj se i dalje smatra tabu temom.

The experience can feel isolating, and for some, emotionally traumatizing.

Ovo iskustvo može dovesti do osećaja izolovanosti, a za neke je i traumatično.

And myths about miscarriage add to the stigma,

Mitovi o pobačajima samo doprinose stigmatizaciji,

leading many to blame themselves for the loss.

što navodi mnoge da sebe krive za gubitak.

However, most miscarriages are unpreventable

Međutim, većina pobačaja se ne može sprečiti

and caused by factors beyond a person’s control.

i uzrokovani su faktorima koji su van lične kontrole.

They happen because pregnancy is a complex process,

Oni se dešavaju jer je trudnoća složen proces,

which requires careful choreography between the fertilized egg and uterus.

koji zahteva pažljiv odnos između oplođene jajne ćelije i materice.

In fact, of every three eggs that are fertilized,

Zapravo, od svake tri oplođene jajne ćelije

only one progresses to a live birth.

samo jedna doživi rođenje.

So, let’s take a closer look at what happens in the body

Zato, hajde da pogledamo malo bliže šta se dešava u telu

during the first 12 weeks of pregnancy,

tokom prvih 12 nedelja trudnoće

when a majority of miscarriages occur.

kada se dogodi većina pobačaja.

Pregnancy is maintained by several hormones:

Trudnoća se održava pomoću nekoliko hormona:

progesterone and estrogen, produced within the ovaries,

progesterona i estrogena, koje stvaraju jajnici,

and human chorionic gonadotropin, or hCG, sent out by the fertilized egg.

i humanog horionskog gonadotropina ili hCG koga luči oplođena jajna ćelija.

During the first half of each menstrual cycle estrogen levels increase,

Tokom prve polovine svakog menstrualnog ciklusa nivo estrogena raste,

followed by an increase in progesterone.

nakon čega mu se pridružuje progesteron.

These hormones signal to the uterine lining to enhance its blood supply

Ovi hormoni šalju signale sluzokoži materice da poveća dotok krvi

and thicken its mucosa,

i zadeblja svoj zid

creating the conditions needed for an early pregnancy to grow.

stvarajući uslove za rast u ranoj trudnoći.

If an egg arrives at the uterus unfertilized,

Ako jajna ćelija dođe neoplođena do materice,

these hormone levels naturally drop,

nivoi ovih hormona prirodno padnu,

triggering contractions and the shedding of the uterine lining in menstruation.

izazivajući kontrakcije i ljušćenje sluzokože materice tokom menstruacije.

Yet, if the egg arrives fertilized, its outermost layer begins producing hCG.

Ipak, ako jajna ćelija dođe oplođena, njen spoljni sloj počinje da stvara hCG.

This hormone travels to the ovaries and stimulates the continued release

Ovaj hormon putuje do jajnika i stimuliše konstantno lučenje

of progesterone and estrogen,

progesterona i estrogena,

halting menstruation.

zaustavljajući menstruaciju.

hCG also binds to receptors on the uterine lining

hCG se takođe vezuje za receptore na sluzokoži materice

to prevent it from rejecting the fertilized cell mass as it embeds.

i sprečava odbacivanje implantiranja oplođene jajne ćelije.

This is a stage where things often go awry.

Ovo je faza u kojoj stvari često krenu naopako.

For reasons that are not fully understood,

Iz i dalje nepoznatih razloga,

as many as one third of fertilized eggs fail to properly attach,

čak trećina oplođenih jajnih ćelija ne uspeva da se implantira

passing undetected in a normal-seeming menstrual period.

i prolazi neprimećeno tokom naizgled normalne menstruacije.

And implantation is only the first hurdle for fertilized eggs

A implantacija je samo prva prepreka koju oplođena jajna ćelija

that do properly attach.

mora da prevaziđe.

Once burrowed in the uterine lining,

Nakon ukopavanja u zid materice,

the rapidly dividing fertilized egg’s own DNA guides its growth.

brza deoba oplođene jajne ćelije je vođena njenom DNK.

Chromosomal abnormalities can therefore cause irregular development,

Hromozomske nepravilnosti stoga mogu uzrokovati nepravilan razvoj

or stop embryo growth entirely.

ili ga u potpunosti zaustaviti.

While many mistakenly believe their miscarriage was caused by factors

Iako mnogi pogrešno smatraju da je njhov pobačaj rezultat faktora

like stress, exercise, vaccination, or past birth control use,

poput stresa, vežbanja, vakcinacije ili korišćenja kontraceptiva u prošlosti,

a vast majority are in fact caused by these genetic issues

velika većina je zapravo rezultat ovih genetskih problema

or other health factors beyond a person’s control.

ili drugih zdravstvenih faktora van lične kontrole.

Some pregnancy losses lead to few, if any, noticeable physical symptoms.

Neki pobačaji izazivaju retke ili gotovo neprimetne simptome.

In other cases, hCG levels drop, followed by a decrease in progesterone,

U drugim slučajima, nivoi hCG padnu, zajedno sa smanjenjem progesterona,

causing bleeding and cramping.

izazivajući krvarenje i grčeve.

In either situation, there are three treatment options—

U svakom slučaju, postoje tri terapijske opcije -

two of which are also used for induced abortion procedures,

dve koje se takođe koriste kao procedure za indukciju pobačaja

when patients choose to end a pregnancy.

kada pacijentkinje žele da prekinu trudnoću.

The first of the three options is what’s commonly known

Prva od tri je ono što je inače poznato

as the “watch-and-wait” method.

kao metoda ,,čekaj i posmatraj".

A person waits for pregnancy hormones to drop further,

Osoba čeka da joj nivoi hormona dodatno opadnu,

allowing the pregnancy tissue to be released with the shedding uterine wall.

omogućavajući tkivu trudnoće da se izbaci zajedno sa sluzokožom materice.

This approach works up to 90% of the time,

Ovaj pristup uspeva u oko 90% slučajeva,

but it can involve several weeks of unpredictable pain and bleeding.

ali takođe može izazvati nekoliko nedelja nepredvidivog bola i krvarenja.

Others may opt for option two,

Neki se mogu odlučiti za drugu opciju,

taking the pills mifepristone and misoprostol in sequence.

uzimanje pilula mifepristona i misoprostola jedne za drugom.

The first works hormonally, by blocking progesterone receptors,

Prva deluje hormonalno, blokirajući progesteronske receptore,

and the second mimics a molecule which induces labor,

dok druga imitira molekul koji izaziva porođaj,

stimulating uterine contractions and causing the cervix to soften and dilate.

stimulišući kontrakcije materice i uzrokujući omekšavanje i širenje cerviksa.

After taking the second pill, the process normally takes 1 to 6 hours.

Nakon uzimanja druge pilule, proces uglavnom traje jedan do šest sati.

It’s often safely self-managed, and can be done privately at home.

Ceo proces je uglavnom bezbedan i može se obaviti u privatnosti doma.

The third possible treatment option is known as vacuum aspiration.

Treća terapijska opcija se zove vakuum aspiracija.

During this five-minute procedure, the healthcare provider numbs the cervix,

Tokom ove petominutne procedure, zdravstveni radnik anestezira cerviks,

then places a thin tube connected to a syringe-like device

a zatim postavi tanku cev povezanu na uređaj sličan špricu

to remove the pregnancy tissue.

da bi uklonio tkivo trudnoće.

Treatment choice is often based on the pregnant person’s medical history,

Izbor terapije se uglavnom zasniva na medicinskoj istoriji trudne osobe,

timeline, expectations, and personal preferences,

vremenskom okviru, očekivanjima i ličnim preferencama,

and all three methods have proven to be safe and effective.

a sve tri metode su dokazano bezbedne i efikasne.

However, without the medication or vacuum aspiration options,

Međutim, bez opcija medikamentozne i vakuum aspiracijske terapije,

an untreated or an incomplete miscarriage can lead to life-threatening infections

nelečeni ili nepotpuni spontani pobačaj može izazvati po život opasne

and hemorrhage.

infekcije i krvarenje.

And because they are the same treatments used in induced abortion care,

A pošto je terapija ista kao i u postupcima indukovanog pobačaja,

they can be harder to access and even criminalized in some areas.

može biti teže dostupna ili čak zakonom zabranjena u nekim mestima.

Beyond this, over half the world’s population lacks access

Osim toga, više od polovine svetske populacije nema pristup

to reliable basic healthcare,

pouzdanoj primarnoj zdravstvenoj zaštiti,

including these essential reproductive health services.

uključujući i ove osnovne usluge za reproduktivno zdravlje.

While pregnancy means different things to different people

Iako trudnoća ima različito značenje za različite ljude

at different points in their lives,

u različitim fazama njihovog života,

for many, losing a pregnancy can be devastating and overwhelming.

mnogi se nakon gubitka trudnoće osećaju razoreno i ophrvano.

During this difficult time,

Tokom ovako teške situacije,

everyone deserves to be met with care and support,

svako zaslužuje pažnju i podršku

and to have access to these life-saving treatments.

i pristup terapijama koje spašavaju život.