Miscarriage

A pregnancy that ends on its own within the first 20 weeks of pregnancy is called a miscarriage. This is the most common type of miscarriage. Studies show that 10-25% of all clinically confirmed pregnancies end in miscarriage. Chemical pregnancies can account for 50-75% of all miscarriages. This occurs when a pregnancy is terminated shortly after implantation, resulting in bleeding that occurs during an expected period. A woman may not realize she has conceived when she has a biochemical pregnancy.

Warning signs of a miscarriage

If you're experiencing any or all of these miscarriage symptoms, it's important to see your doctor or health care provider to assess whether you might be having a miscarriage:

Mild to severe back pain (often worse than normal menstrual cramps)
Weight loss
White-pink mucus
True contractions (very painful happening every 5-20 minutes)
Brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)
Tissue with clot like material passing from the vagina
A sudden decrease in signs of pregnancy

Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but when so many miscarriages happen, it's worth being aware.

Why do miscarriages happen?

In the first trimester, the most common cause of miscarriage is a chromosomal abnormality, which means something is wrong with the baby's chromosomes. Most chromosomal abnormalities are caused by damage to the egg or sperm, or a problem when the zygote has gone through the division process. The causes of miscarriage are varied and most often cannot be identified.

Other causes of miscarriage include (but are not limited to):

Hormonal problems, infections or maternal health problems
Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
Implantation of the egg into the uterine lining does not occur properly
Maternal age
Maternal trauma

Factors that cause miscarriage have not been proven to include sex, work outside the home (except in harmful conditions), or moderate exercise.

What is the likelihood of a miscarriage?

Women under the age of 35 years old have about a 15% chance of miscarriage
An increase in maternal age affects the chances of miscarriage
Women who are 35-45 years old have a 20-35% chance of miscarriage,
Women over the age of 45 can have up to a 50% chance of miscarriage
A woman who has had a previous miscarriage has a 25% chance of having another (only a slightly elevated risk than for someone who has not had a previous miscarriage)

Types of miscarriage

A miscarriage is often a process rather than a single event. You may hear your doctor mention the types of miscarriages:

Threatened miscarriage: some degree of uterine bleeding in early pregnancy, accompanied by cramps or back pain. The collar remains closed. This bleeding is often the result of implantation.
Inevitable or incomplete miscarriage: pain in the abdomen or back, accompanied by bleeding when the cervix is open. Miscarriage is inevitable when the cervix dilates or flattens and/or the membranes rupture. Bleeding and spasms may persist if the miscarriage is not completed.
Complete miscarriage: A complete miscarriage occurs when the embryo or products of conception are emptied from the uterus. The bleeding should pass quickly, as should any pain or cramping. A complete miscarriage can be confirmed by ultrasound or surgical curettage.
Missed miscarriage: Women can have a miscarriage without even knowing it. A missed pregnancy occurs when the death of the embryo has occurred, but the expulsion of the embryo does not occur. We don't know why this is happening. Signs of this will be the loss of pregnancy symptoms and the absence of fetal heart sounds detected on ultrasound.
Recurrent miscarriage: defined as 3 or more miscarriages in a row in the first trimester. It may affect 1% of couples trying to conceive.

Related issues

Blighted ovum: Also called an embryonic pregnancy. The fertilized egg implants in the wall of the uterus, but the development of the fetus never begins. There is often a gestational sac with or without a yolk sac, but no fetal growth.
Ectopic pregnancy: A fertilized egg is implanted in a place other than the uterus, most commonly the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If treatment is not started on time, this can lead to serious complications for the mother.
Molar pregnancy: The result of a genetic error in the process of fertilization, which leads to the growth of abnormal tissue in the uterus. A molar pregnancy is rarely associated with a developing embryo, but often results in the most common symptoms of pregnancy, including missed periods, a positive pregnancy test, and severe nausea.

Understanding early fetal development and development in the first trimester can give you a good idea of what's going on during pregnancy and help you know what your doctor is looking for in the event of a miscarriage.

Treatment options for miscarriage

The main goal of treatment during or after a miscarriage is to prevent bleeding and infection. The sooner you get pregnant, the more likely your body will expel all of the fetal tissue on its own and not require further medical procedures. If the body does not remove all of the tissue, the most common procedure to stop bleeding and prevent infection is dilation and curettage. Medications may be given to help control bleeding after a curettage. Bleeding should be carefully monitored when you are at home; if you notice increased bleeding or the onset of chills or fever, it is best to see a doctor right away.

Prevention

Because most miscarriages are caused by chromosomal abnormalities, there is little that can be done to prevent them. An important step is to be as healthy as possible before conception in order to create a healthy environment for conception.

Regular exercise
Healthy food
To manage stress
Keep your weight within limits
Take folic acid daily
Do not smoke

Once you know you're pregnant, the goal is to be as healthy as possible to provide a healthy environment for your baby to grow:

Keep your abdomen safe
Do not smoke or be around smoke
Do not drink alcohol
Check with your doctor before taking any over-the-counter medications
Limit or eliminate caffeine
Avoid environmental hazards such as radiation, infectious disease, and x-rays
Avoid contact sports or activities that have a risk of injury

Emotional treatment for miscarriage

Unfortunately, miscarriage can affect anyone. Women often go unanswered about their physical recovery, their emotional recovery, and their attempts to conceive again. During this time, it is very important to keep in touch with family, friends and doctors.