Pregnancy and Miscarriage
A miscarriage is the loss of a fetus before the 20th week of pregnancy. The medical term for a miscarriage is spontaneous abortion, but "spontaneous" is the key word here because the condition is not an abortion in the common definition of the term.
According to the March of Dimes, as many as 50% of all pregnancies end in miscarriage -- most often before a woman misses a menstrual period or even knows she is pregnant. About 15-25% of recognized pregnancies will end in a miscarriage.
More than 80% of miscarriages occur within the first three months of pregnancy. Miscarriages are less likely to occur after 20 weeks gestation; these are termed late miscarriages.
What Are the Symptoms of a Miscarriage?
Symptoms of a miscarriage include:
- Bleeding which progresses from light to heavy
- Severe cramps
- Abdominal pain
- Back pain
If you experience the symptoms listed above, contact your obstetric health care provider right away. He or she will tell you to come in to the office or go to the emergency room.
What Causes Miscarriage?
How Is a Miscarriage Diagnosed and Treated?
Your health care provider will perform a pelvic exam, an ultrasound test and bloodwork 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.
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 recurrent miscarriage). Some diagnostic procedures used to evaluate the cause of repeated miscarriage include pelvic ultrasound, hysterosalpingogram (an X-ray of the uterus and fallopian tubes), and 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).