A miscarriage is the loss of a fetus before the 20th week of pregnancy. The medical term for a miscarriage is spontaneous abortion. As many as 60% of all pregnancies end in miscarriage; most often before a woman even knows she is pregnant. Greater than 80% of miscarriages occur within the first three months of pregnancy. Studies reveal that anywhere from 10-25% of all clinically recognized pregnancies will end in miscarriage. Chemical pregnancies may account for 50-75% of all miscarriages. This occurs when a pregnancy is lost shortly after implantation, resulting in bleeding that occurs around the time of the expected period.

What Are the Symptoms of a Miscarriage?
Symptoms of a miscarriage include vaginal bleeding, abdominal/uterine cramping, and either abdominal or back pain.

What Causes Miscarriage?
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 genes. Our genes determine all of a person’s physical attributes, such as sex, hair color, eye color, and blood type. Most chromosomal abnormalities are the cause of a damaged egg or sperm cell, or are due to a problem at the time that the zygote went through the division process.

Miscarriages can also be caused by infections; lifestyle factors such as smoking, drinking alcohol, excessive caffeine use, and using illegal drugs; environmental exposures to chemicals in the workplace; hormonal problems; uterine abnormalities; and several medical conditions (i.e. Immunological, diabetes, kidney disease, thyroid disease).

In addition, women may be at increased risk for miscarriage as they get older. Studies show that the risk of miscarriage is 15% for women in their 20s and increases to approximately 40% for women at age 40. The increased incidence of chromosomal abnormalities contributes to the age-related risk of miscarriage.

MYTH: Miscarriages can be caused by stress, physical activity (exercise/heavy lifting), or sexual activity. There is no scientific literature that these things will cause miscarriage.

Can I prevent a miscarriage?
Since the cause of most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. Currently there is no known way to prevent an impending miscarriage. Identifying the cause of the miscarriage may help prevent it from happening again in a future pregnancy. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur.

What are my options for treatment?
Unfortunately, there is no way to stop most miscarriages once they have started. When a miscarriage is inevitable or is already occurring , several options are available, depending upon the stage of the miscarriage, the condition of the mother, and several other factors. The three main options are: observation, medical treatment, or surgical treatment.

Observation — Some women having a miscarriage require little treatment. In addition, women who miscarry at less than 12 weeks of pregnancy and have stable vital signs and no signs of infection can often be managed without medical or surgical treatment. An ultrasound should be performed to ensure that the miscarriage is complete.

Medical treatment — In some cases, medications can be given to stimulate the uterus to pass the pregnancy tissue. The medicine can be given by mouth or vaginally, and works over several days. An ultrasound should be performed to ensure that the miscarriage is complete.

Surgical treatment — The conventional treatment for early miscarriage is a surgical procedure called dilation and curettage, or D&C. The cervix (the opening to the uterus) is dilated, and an instrument is inserted that uses suction and/or a gentle scraping motion to remove the contents of the uterus. D&C is generally recommended for women who do not want to wait for spontaneous passage of the pregnancy, and in women with heavy bleeding or infection.

As always, you should contact your physician and discuss your specific causes of miscarriage, chances of miscarriage, and how to have a healthy, successful pregnancy. I hope this information helps!

Sources: www.asrm.com, www.acog.org, American Pregnancy Association

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