Health & Pregnancy

Understanding Miscarriage -- Diagnosis & Treatment

What Are the Warning Signs of a Miscarriage?

Vaginal bleeding during pregnancy may be the first warning sign of a miscarriage. However, about 20% of women have vaginal bleeding during the first 12 weeks of pregnancy, and less than half of them miscarry.

If you are pregnant and bleeding vaginally, your doctor will probably use an ultrasound to help assess whether your pregnancy is healthy. An ultrasound can help determine whether there is a fetal heartbeat and whether the amniotic sac that surrounds the fetus is normal. It can also help determine whether the pregnancy is ectopic (occurring outside the uterus, such as in one of the fallopian tubes) or whether you may have spontaneously aborted one fetus in a twins or triplets pregnancy.

A blood test can determine whether pregnancy hormones are being produced as they should. A complete blood count (CBC) may be done to determine the degree of blood loss, and several other tests may be done to rule out potential infection. Your doctor may also perform a pelvic exam, looking for signs of miscarriage, including changes to the cervix and ruptured membranes. Your blood type will also be checked. If you are Rh negative and have miscarried, a shot will be recommended to help prevent problems in future pregnancies.

Because chromosomal abnormalities of the embryo are identified in more than half of miscarriages occurring in the first 13 weeks, doctors don't usually recommend special testing to look for a cause. The chances are excellent that the next pregnancy will be healthy. After two or more miscarriages, consider consulting an ob-gyn who specializes in or has extensive experience with miscarriage. You and your partner should consider undergoing genetic testing.

An X-ray or ultrasound of your reproductive organs may be recommended to look for structural differences that may have played a role in your miscarriages. Special hormone tests and tests for connective tissue disorders in the mother may be helpful. Even among women who have had three or four miscarriages, 75% will go on to have a successful pregnancy.

What Are the Treatments for Miscarriage?

If your doctor determines that you are at risk for a miscarriage, he or she may recommend that you stay in bed, restrict activity, and abstain from intercourse until the signs are gone. Many doctors recommend this kind of bed rest, although there is little scientific evidence that being on bed rest will change the outcome.

More often than not, little can be done to stop a miscarriage.

Treatment of a miscarriage, once it has begun, depends on your symptoms. The primary goal of treatment during and after a miscarriage is to prevent hemorrhaging and infection.

If vaginal bleeding fills more than one sanitary pad in half an hour, you should contact your doctor. Heavier bleeding and cramping often indicate that a miscarriage is progressing. In most cases, a woman's body expels all of the pregnancy-related tissue. The earlier you are in the pregnancy, the more likely that your body will complete the miscarriage on its own.