Miscarriage: About Early Pregnancy Loss


Losing a pregnancy is one of the most devastating events a couple can endure. Though you may feel alone, confused or even at fault, know that most of the time the loss could not have been prevented.

In fact, pregnancy loss is quite common. It is estimated that about 15 percent to 20 percent of all pregnancies end in loss. Pregnancy loss is called:

•Miscarriage (spontaneous abortion) if it happens before 20 weeks gestation
•Stillbirth if it occurs after 20 weeks
Most losses occur early on, within the first trimester (the first 13 weeks of pregnancy). Many happen before a woman even knows she’s pregnant.

Reasons for the loss
Usually, a miscarriage is nature’s way of ending a pregnancy because the unborn fetus is not developing normally, and wouldn’t survive. It can occur for these reasons:

•Genetic factors. Half of all miscarriages in the first trimester are due to chromosomal abnormalities. Chromosome problems are usually not caused by the parents’ health (but they can be). They often just occur by chance, and are often not likely to happen again in a future pregnancy. But be aware that the chance of chromosome issues goes up as a woman ages.
•Maternal health issues. Some medical problems with the mother can cause miscarriage:
◦Hormonal imbalances. When pregnancy hormones aren’t at normal levels – for example, when progesterone is too low – miscarriage can occur. Your doctor may be able to help treat these imbalances if found early.
◦Problems with the uterus or cervix. An abnormally shaped uterus or incompetent cervix (when the cervix opens too early) can lead to pregnancy loss.
◦Infection. An infection of the uterus or unborn baby can cause the pregnancy to end.
◦Illnesses. Women who have polycystic ovarian syndrome (PCOS) or high blood sugar levels from diabetes have a higher risk for miscarriage. Work with your doctor to get your blood sugar in check before you get pregnant. Women with thyroid disease, lupus and other auto immune diseases also have a higher risk of miscarriage.
•Lifestyle factors. Smoking cigarettes, drinking alcohol and using illegal drugs raises the chance of miscarriage. Don’t use any of these substances if you’re pregnant or trying to conceive.
Most of the time, miscarriages happen for unknown reasons. And there is nothing the mother could have done to stop the loss. Note that exercising, having sex or using birth control pills does not raise the risk for miscarriage.

Warning signs
Vaginal bleeding is the most common sign of miscarriage. Yet, many women have some spotting in pregnancy and go on to give birth to healthy babies. If you have bleeding in early pregnancy, your doctor may call it a “threatened miscarriage” but it does not mean the pregnancy is bound to fail.

These symptoms could signal a miscarriage. Call your doctor if you have:

•Spotting.
•Heavy vaginal bleeding with clots, stomach pain or cramps
•A gush of fluid from your vagina.
•Passed fetal tissue. If you pass what you think is fetal tissue, put it in a clear container and take it with you to the doctor so that it can be tested. The results may help future pregnancies be successful.
Your doctor will do blood tests, a pelvic exam and an ultrasound to confirm if you’ve had a miscarriage.

Treatment
You may not need any treatment if the loss occurred early in the pregnancy. The fetal tissue may empty from the uterus on its own and look like a heavy period.

This doesn’t always happen naturally, though, so a dilation and curettage (D&C) procedure may be needed. This surgery is done to clean the tissue out of the uterus. Or, your doctor may prescribe medicine to help your body pass the tissue.

Miscarriages are fairly common, so your doctor likely won’t do any tests to find out why it happened unless you’ve had more than one.

Physical recovery
Your body will take from a few weeks to months to recover from miscarriage. It depends on how far along you were at the time of miscarriage. Your doctor may suggest avoiding vaginal intercourse or strenuous exercise until you’re fully healed. Recovery from miscarriage usually takes about four weeks.

Most women get their period within four to six weeks after a miscarriage. It’s possible to ovulate and get pregnant again two weeks after your loss. But your doctor may advise you wait a few cycles before trying to get pregnant again. And it may take a bit longer for you to be emotionally ready to try to conceive.

Emotional healing
It’s normal to feel intense sadness, anger, numbness and guilt after your loss. Take time to grieve with your partner. Seeing a counselor or joining a pregnancy loss support group can help. Ask your doctor to suggest one.

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