PREGNANCY AND MISCARRIAGES

A miscarriage is the loss of a fetus
before the 20th week of
pregnancy . The medical term for a
miscarriage is spontaneous
abortion , but 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% 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
Fever
Weakness
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?

The causes of miscarriage are not
well understood. Most
miscarriages that occur in the first
trimester are caused by
chromosomal abnormalities in the
baby. Chromosomes are tiny
structures inside the cells of the
body which carry many genes.
Genes determine all of a person’s
physical attributes, such as sex,
hair and eye color, and blood type.
Most chromosomal problems occur
by chance and are not related to
the mother’s or father’s health.
Miscarriages are also caused by a
variety of other factors, including:
Infection
Exposure to environmental and
workplace hazards such as high
levels of radiation or toxic agents
Hormonal problems
Uterine abnormalities
Incompetent cervix (the cervix
begins to widen and open too
early, in the middle of pregnancy,
without signs of pain or labor)
Lifestyle factors such as smoking,
drinking alcohol, or using illegal
drugs
Disorders of the immune system,
including lupus
Severe kidney disease
Congenital heart disease
Diabetes that is not controlled
Thyroid disease
Radiation
Certain medications, such as the
acne drug Accutane
Severe malnutrition
In addition, women may be at
increased risk for miscarriage as
they get older. Studies show that
the risk of miscarriage is 12% to
15% for women in their 20s and
rises to about 25% for women at
age 40. The increased incidence of
chromosomal abnormalities
contributes to the age-related risk
of miscarriage.
There is no proof that stress or
physical or sexual activity causes
miscarriage.

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.