Miscarriage

What is a miscarriage?

A miscarriage, also called a spontaneous abortion, is a pregnancy that ends by itself within the first 20 weeks. Abortion is a word used by health providers to describe both the intentional and unintentional ending of a pregnancy up until the time the fetus can survive outside the woman's body.

An estimated 10 _ 20% of confirmed pregnancies result in a miscarriage. Miscarriages usually happen within the first 12 weeks of pregnancy, but can occur in the second or third trimester as well. In most miscarriages there is no specific cause. A miscarriage may be caused by a problem with fetal development, a problem with the uterus or cervix, or a problem with the body's hormones.

Are some women more likely to have a miscarriage?

Anyone can have a miscarriage but some conditions will put a woman at greater risk for a miscarriage. It is important to know that even if you have or had one or more of the conditions below _ that may not be the reason for your miscarriage.

Conditions:

• One or more previous miscarriages
• Having a stillbirth when you were between 4 and 8 months pregnant.
• History of early labor in a previous pregnancy.
• You had a hard time getting pregnant.
• You have a chronic medical condition such as: diabetes, lupus, hypothyroidism, endometriosis, an infection, and fibroids.
• Having rubella or toxoplasmosis during pregnancy.
• Abnormal uterus or weak cervix.

If I have a miscarriage does that mean I will have trouble if I get pregnant again?

If you have had one miscarriage your chances of having a healthy pregnancy next time is good. If you have had more than one you should probably see an OB-GYN specialist for more testing. Even women who have had 3 or 4 miscarriages about 75% of them can still have a healthy pregnancy.

What can be done to help if I have signs of a miscarriage?

During the first 14 weeks there is not much that can be done to stop a miscarriage. Sometimes if a miscarriage begins later in your pregnancy, there may be few things that can decrease your chance of losing the baby. When there is a definite miscarriage, the main goal is to prevent infection and hemorrhaging (losing too much blood) of the mother.

If you have signs of a threatened abortion, you should rest in bed, limit your activities and not have sexual intercourse until the signs are gone. Reducing activities will not guarantee that you do not have a miscarriage.

What are the symptoms of a miscarriage?

• Brown or bright red bleeding with or without cramps.
• Low back pain or belly cramps, or pain that is there all the time or comes and goes.
• Tissue, clot-like stuff, or a gush of clear or pink fluid that comes from your vagina.
• Nausea.
• Pregnancy signs are not as strong.
• Your breasts are not as sensitive as they were.
• Dizziness.

Usually these symptoms get worse as the miscarriage progresses. Spotting changes to heavier bleeding and\ the cramps hurt more.

What causes a miscarriage?

In most miscarriages there is no specific cause. Usually there is a problem when the fetus is developing. Sometimes it is due to a problem with the uterus or cervix or a problem with hormones.

How can the doctor tell if it is a miscarriage?

Vaginal bleeding is usually one of the first signs, but this can be seen in about 20% of all women who are pregnant with less than half of those actually having a miscarriage. You should keep any clot-like material or tissue that you pass and show it to the doctor.

• An internal pelvic exam can help the doctor tell if your cervix is open or closed.
• An ultrasound can show if the pregnancy is progressing normally or not. It can show that the pregnancy is ectopic (outside the uterus like in one of the tubes) or if you have more than one fetus growing.
• A blood test can show the level of pregnancy hormones in your blood. Another blood test may be done to see how much blood you have lost and may show if you have an infection. Blood will be taken to check your blood type. If you have Rh negative blood you should get rhogam. Ask your doctor about this.

Go to the Emergency Department or call your doctor IF:

• You are pregnant and have vaginal bleeding with or without cramps
• You pass tissue or clots. Save the tissue or clot and bring it with you.
• You have already seen your doctor and your vaginal bleeding is heavy. Heavier bleeding and cramping often means the threatened abortion is progressing.
• After you have a miscarriage you may still have heavy bleeding with clots. You may need a procedure called dilation and curettage (D and C). The doctor will open the cervix and scrape the lining in your uterus.

Recovering from a miscarriage?

It is normal to feel sad and upset about losing a wanted pregnancy. You need to give yourself and your partner time to grieve. Remember not to blame yourself, because it is most likely nothing that you or your partner has done. Also there is usually nothing you can do to prevent it. It is possible to get pregnant right away but it is usually a good idea to wait until after you have a 1 or 2 normal periods.