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    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. And, 75% of women who have had three or four miscarriages will go on to have a successful pregnancy.

    If you are pregnant and bleeding vaginally, your health care provider 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 tell whether the placenta is separating. An ultrasound will 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. 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 health care provider 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, an injection of rho (D) immune globulin will be given to help prevent problems associated with incompatible blood types 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 three or more miscarriages, consider consulting an OB/GYN who specializes in or has extensive experience with miscarriage. Testing for clotting and bleeding disorders may be performed. Special hormone tests and exams looking for connective tissue disorders in the mother may also be given. You and your partner should also discuss undergoing genetic testing with your health care provider.

    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.

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