Miscarriage

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What is miscarriage?

Pregnancy occurs when an egg is fertilized by male sperm and travels down a fallopian tube into the womb, or uterus. In some cases, the fertilized egg (fetus) is unable to survive a full term, which is 40 weeks. If the loss occurs during the first 20 weeks of pregnancy, it is called a miscarriage. Most miscarriages occur during the first 13 weeks of pregnancy (Source: ACOG).

Miscarriages occurring after the first half of pregnancy are called preterm deliveries, or fetal demise. Overall, the rate of miscarriage is about 15 to 20% of pregnancies. The widespread popularity of at-home pregnancy tests (and early pregnancy confirmation) has caused miscarriage rates to rise to a level higher than previously believed (Source: NIH).

Many theories exist regarding loss of pregnancy, but no one knows for sure why miscarriage occurs. Potential causes of miscarriage include pre-existing gynecologic conditions, exposure to toxicities (including pollution, drugs or alcohol, and chemicals), autoimmune diseases, diabetes, smoking, obesity, and genetic factors. Contrary to common belief, exercise and maternal sexual activity are not risk factors for miscarriage.

Miscarriage is accompanied by symptoms of bleeding, spotting, cramping, nausea, and pelvic pain. Some women do not realize they are pregnant until they miscarry. Miscarriage can be devastating for a woman and her partner. Counseling is available to assure the woman that the miscarriage was not her fault and to provide help dealing with other emotional or mental symptoms.

It is important to know the warning signs of miscarriage. Seek immediate medical care (call 911) if you, or someone you are with, haveserious symptoms such as spotting or bleeding, heavy or persistent cramping, gushing of fluid or blood without pain or other symptoms, and discharged fetal tissue, especially if you are or suspect you may be pregnant.

What are the symptoms of miscarriage?

Symptoms of miscarriage include bleeding, spotting, cramping, and lower back pain. You may also experience a gushing of fluid or blood that occurs without cramping or other symptoms. Bleeding is the most common sign of miscarriage. Most women who have some degree of vaginal spotting or bleeding during the early months of pregnancy have healthy babies. However, some of these women will have a miscarriage. This is why bleeding during early pregnancy is called threatened miscarriage.

Common symptoms of miscarriage

Symptoms of miscarriage include:

  • Abdominal, pelvic or lower back pain, which may be severe
  • Bleeding or spotting
  • Heavy cramping accompanied by bleeding or discharge

Serious symptoms that might indicate a life-threatening condition

In some cases, miscarriage can be life threatening, especially if there is an infection. Seek immediate medical care (call 911) if you, or someone you are with, are pregnant or suspect you may be pregnant and have any of these life-threatening symptoms including:

  • Heavy cramping
  • Severe abdominal or low back pain
  • Uncontrolled or heavy bleeding, hemorrhage

What causes miscarriage?

It is not known exactly what causes miscarriage, although many theories exist. Suspected causes of miscarriage include pre-existing gynecologic conditions, exposure to toxicities (including pollution, drugs or alcohol, and chemicals), autoimmune diseases, diabetes, smoking, obesity, and genetics. Several misconceptions exist surrounding the cause of miscarriage. Contrary to belief, exercise, sex, and working outside the home are not risk factors for miscarriage. Contrary to belief, exercise, maternal sexual activity, and working outside the home are not risk factors for miscarriage.

About half of early-term miscarriages are caused by chromosomal problems.  http://www.acog.org/publications/patient_education/bp090.cfm

You may inherit certain genes that increase your risk of miscarriage, but having these genes does not automatically prevent you from a successful conception.

Gynecologic health can affect your chances for a healthy pregnancy, especially if you have a past history of endometriosis (the abnormal growth of uterine cells outside the uterus), sexually transmitted diseases, or ovarian cysts. The shape of the uterus (where the baby will grow) and the cervix (where it will come out) are important as well. A cervix that opens too early can jeopardize the health of the pregnancy.

What are the risk factors for miscarriage?

A number of factors increase your risk of having a miscarriage. These include:

  • Age over 35 years
  • Alcohol consumption
  • Excessive BMI (low or high)
  • Exposure to radiation or toxins
  • Fever
  • Folate acid deficiency
  • History of previous miscarriages
  • Multiple previous pregnancies (multiparity)
  • Smoking
  • Substance abuse

Reducing your risk of miscarriage

You may be able to lower your risk of miscarriage by:

  • Avoid alcohol or illegal substances
  • Consuming a nutritious, balanced diet
  • Quitting smoking
  • Seeing your health care provider regularly if you are pregnant

How is miscarriage treated?

If you think you have suffered a miscarriage, contact your health care provider. He or she will perform a pelvic examination and check your cervix for dilation and lost fetal tissue. If you have been bleeding, you may be asked to keep and bring in a sample to confirm the diagnosis.

Remaining tissue often must be removed by dilation and curettage (D&C) to avoid infection. During this procedure, the cervix is slightly dilated to accommodate the insertion of a curette to remove any residual tissue from the uterine lining. Medications may also be required to help remove any remaining tissue.

What are the potential complications of miscarriage?

Complications of untreated miscarriage can be serious and even life threatening. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of miscarriage include:

  • Adverse effects of treatment
  • Depression or grief over the miscarriage
  • Infections from fetal tissue remaining in the uterus following a miscarriage
  • Severe blood loss
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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