Miscarriage

October 19, 2011

A miscarriage is a loss of pregnancy that occurs within the first 20 weeks of gestation. The medical term for miscarriage is spontaneous abortion. The chance of having a miscarriage increases with age.

Miscarriages are common. Between 15 and 20 percent or more of confirmed pregnancies end in miscarriage. It is possible that as many as 75 percent of conceptions are lost, but most occur before a woman misses her period or realizes that she is pregnant.

It is estimated that more than 80 percent of miscarriages happen during the first 12 weeks of pregnancy.

What Causes Miscarriage?

The most frequent cause of miscarriage is chromosomal abnormalities. These are not generally inherited genetic defects, rather they are due to some sort of chromosome defect that occurred during the time of conception. Chromosomal abnormalities are found in about half of all spontaneous abortions for which medical treatment is given.

Other causes of miscarriage include:

  • hormonal imbalances
  • maternal health problems
  • infection
  • immune disorders
  • trauma
  • smoking
  • drug use
  • exposure to toxic substances
  • failure of the fertilized embryo to implant correctly
  • disorders of the cervix
  • abnormalities of the uterus

Miscarriage is not caused by exercising, sexual intercourse, heavy lifting, working, sudden fright, nausea or vomiting (even if severe). Miscarriage is also unlikely to be caused by a fall or injury unless it is serious and life threatening.

What are the Signs and Symptoms of Miscarriage?

The symptoms of miscarriage include:

Vaginal bleeding- one quarter of pregnant women will have bleeding during pregnancy . Of those, about 50 percent will have a miscarriage.

  • Cramping
  • low back pain
  • abdominal pain

If you have vaginal bleeding that continues for more than 24 hours, moderate or heavy bleeding, or bleeding that is accompanied by abdominal pain, cramping or fever, or if you pass tissue from your vagina contact your health care provider.

How is a Miscarriage Diagnosed?

Your health care provider will perform a pelvic exam and possibly an ultrasound and blood test.

What are the Different Types of Miscarriages?

  • Threatened Miscarriage- A threatened miscarriage is when there is bleeding during the first half of pregnancy. This bleeding occurs while the cervix is closed. Bleeding may last for days or weeks. There may be cramping or not. Twenty percent of pregnant women will have bleeding in early pregnancy and will not miscarry. In the case of a threatened miscarriage your health care provider may recommend bed rest, although activity has not been proven to cause miscarriage.
  • Inevitable Miscarriage- In an inevitable miscarriage, there is a rupture of membranes, the cervix dilates, and blood clots and tissue pass through the vagina.
  • Incomplete Miscarriage- An incomplete miscarriage occurs when part of the pregnancy passes and part remains in the uterus. Bleeding and cramping will likely continue until the miscarriage is complete. Bleeding may be heavy.
  • Missed Miscarriage- A missed miscarriage is when an embryo has died but has not been expelled from the uterus. Often times there are no symptoms and it can be several weeks before it may be discovered.
  • Habitual Miscarriage- Habitual miscarriage is usually defined as 3 or more first trimester miscarriages.
  • Ectopic Pregnancy- Ectopic pregnancy occurs when the fertilized egg attaches outside of the uterus
  • Molar Pregnancy- Molar pregnancy occurs when an abnormal mass develops inside the uterus instead of a growing baby.

How is a Miscarriage Treated?

In the situation of a threatened abortion, it may be treated with bed rest.

If it is early in your pregnancy, and you have a miscarriage, your healthcare provider may monitor your condition to see if your body expels the pregnancy on its own. If your body does not expel all of the tissue, or if there is excessive bleeding, your health care provider may recommend a D&C procedure.

How Can I Prevent a Miscarriage?

Unfortunately, there is not much that can be done to prevent a miscarriage. Most miscarriages are due to chromosomal abnormalities, which are a chance occurrence.

The most important thing that you can do to prevent a miscarriage is to take care of your body. Eat a healthy diet, get plenty of exercise and fresh air. Manage your stress levels, and do not engage in smoking, drinking, or drug use.

If you are pregnant or planning to become pregnant, be sure that you are taking a prenatal vitamin or a folic acid supplement.

What are the Chances of a Successful Future Pregnancy?

The majority of women who have miscarriages will have a later successful pregnancy. Even women who have had 3 or more miscarriages in a row still have a 70 to 85 percent chance of carrying a future full-term pregnancy.

It is advisable in many cases to wait 3 months following a miscarriage before trying to conceive again. Talk with your health care provider to find out what may be best for you.

Grieving for a Lost Pregnancy

Miscarriage is often an event that can be difficult to come to terms with. You and those close to you may be feeling a variety of intense emotions. Grief is normal and natural. The loss of a pregnancy, even if it was only a few weeks along, can bring with it a wide variety of feelings which can be overwhelming.

Please know that the loss of a pregnancy is never anyone’s fault. Your chances of having a future healthy baby are very high.

Your grieving process may include feeling shock, denial, guilt, anger, and depression.

Your partner and family may be grieving also, but it a different way. Everyone handles loss in their own way.

If you are having difficulty coping with your feelings, talk to someone, or seek the help of a professional such as a therapist, counselor, or support group to help you get through your grief process.

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