What is a Miscarriage?

Miscarriage is the spontaneous loss of a pregnancy before the 20th week. About 15 to 20 percent of known pregnancies end in miscarriage. But the actual number is probably much higher because many miscarriages occur so early in pregnancy that a woman does not even know she was pregnant. Most miscarriages occur because the fetus isn't developing normally.

Miscarriage is a relatively common experience, but that does not make it any easier. Take a step toward emotional healing by understanding what can cause a miscarriage, what increases the risk and what medical care might be needed.

Symptoms

Most miscarriages occur before the 12th week of pregnancy. Signs and symptoms include:

1) Vaginal spotting or bleeding (although spotting or bleeding in early pregnancy is fairly common)
2) Pain or cramping in your abdomen or lower back
3) Fluid or tissue passing from your vagina

In most cases, women who experience light bleeding in the first trimester go on to have successful pregnancies. Sometimes even heavier bleeding doesn't result in miscarriage.

Causes

Abnormal genes or chromosomes

Most miscarriages occur because the fetus is not developing normally. Problems with the babys genes or chromosomes are typically the result of errors that occur by chance as the embryo divides and grows, not problems inherited from the parents. Some examples of abnormalities include:

Blighted ovum. Blighted ovum occurs when a fertilized egg develops a placenta and membrane but no embryo. Blighted ovum is common, the cause of about half of all miscarriages that occur in the first 12 weeks.

Intrauterine fetal demise. In this situation the embryo is present but has died before any symptoms of pregnancy loss have occurred. This situation may also be due to genetic abnormalities within the embryo.

Molar pregnancy. A molar pregnancy, also called gestational trophoblastic disease, is less common, occurring in about 1 in 1,000 pregnancies. It is an abnormality of the placenta caused by a problem at fertilization. In a molar pregnancy, the early placenta develops into a fast-growing mass of cysts in the uterus. This mass may or may not contain an embryo. If it does contain an embryo, the embryo will not reach maturity.

A mothers health conditions

In a few cases, a mothers health condition may lead to miscarriage. Examples include:

1) Uncontrolled diabetes
2) Thyroid disease
3) Infections
4) Hormonal problems
5) Uterus or cervix problems

What does NOT cause miscarriage

Routine activities such as these do not provoke a miscarriage:

1) Exercise
2) Lifting or straining
3) Having sex
4) Working, provided you are not exposed to harmful chemicals

Western Medicine Treatment

If you are having a threatened miscarriage, your doctor may recommend resting until the bleeding or pain subsides. You may be asked to avoid exercise and sex as well. Although these steps have not been proved to reduce the risk of miscarriage, they may reduce bleeding and improve your comfort.

It is also a good idea to avoid traveling, especially to areas where it would be difficult to receive prompt medical care.

With ultrasound, it is now much easier to determine whether the embryo has died or was never formed. Either finding means that a miscarriage will definitely occur. In this situation there are several choices to consider:

Expectant management. You may choose to let the miscarriage progress naturally. Usually this happens within a couple of weeks of determining that the embryo has died. Unfortunately it may take up to three or four weeks. This can be an emotionally difficult time.

Medical treatment. If, after a diagnosis of certain pregnancy loss, you'd prefer to speed the process, medication can cause your body to expel the pregnancy tissue and placenta. Although you can take the medication by mouth, your doctor may recommend applying the medication vaginally to increase its effectiveness and minimize side effects such as nausea, stomach pain and diarrhea. For about 70
percent of women, this treatment works within 24 hours. If treatment does not work within 24 hours, you may experience the miscarriage within several days to weeks.

Surgical treatment. Another option is a minor surgical procedure called suction dilation and curettage (D and C). During this procedure, the doctor dilates your cervix and gently suctions the tissue out of your uterus. Sometimes a long metal instrument with a loop on the end (curet) is used after the suction to scrape the uterine walls. Complications are rare, but they may include damage to the connective tissue of your cervix or the uterine wall.

In the case of an inevitable miscarriage, surgical treatment may be necessary to stop the bleeding.

Adopted from mayoclinic.com