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Pregnancy and Miscarriage

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How Is a Miscarriage Diagnosed and Treated?

Your health care provider will perform a pelvic exam and an ultrasound test to confirm a miscarriage. If the miscarriage is complete and the uterus is empty, then no further treatment is usually required. Occasionally, the uterus is not completely emptied, so a dilation and curettage (D&C) procedure is performed. During this procedure, the cervix is dilated and any remaining fetal or placental tissue is gently removed from the uterus. As an alternative to a D&C, certain medications can be given to cause your body to expel the contents in the uterus. This option may be more ideal in someone who wants to avoid surgery and whose condition is otherwise stable.

If a miscarriage was not confirmed, but you had symptoms of a miscarriage, bed rest may be prescribed for several days, and you may be admitted to the hospital overnight for observation. Blood work to determine the amount of a pregnancy hormone (hCG) is checked to monitor the progress of the miscarriage.

When the bleeding stops, usually you will be able to continue with your normal activities. If the cervix is dilated, you may be diagnosed with an incompetent cervix and a procedure to close the cervix (called cerclage) may be performed if the pregnancy is still viable. If your blood type is Rh negative, your doctor may give you a blood product called Rh immune globulin (Rhogam). This prevents you from developing antibodies that could harm your baby as well as any of your future pregnancies.

Blood tests, genetic tests, or medication may be necessary if a woman has more than two miscarriages in a row (called repeated miscarriage). Some diagnostic procedures used to evaluate the cause of repeated miscarriage include endometrial biopsy (a procedure involving the removal of a small amount of tissue from the lining of the uterus for study under a microscope), hysterosalpingogram (an X-ray of the uterus and fallopian tubes), hysteroscopy (a test in which the doctor views the inside of the uterus with a thin, telescope-like device inserted through the vagina and cervix), and laparoscopy (a surgical procedure in which the doctor views the pelvic organs with a lighted device).

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