07/12/2020
Losing a pregnancy can be heartbreaking. And unfortunately, miscarriages are fairly common. On average, about 1 in 5 pregnancies will end in a miscarriage — usually in the first trimester.
A miscarriage usually happens in the first 3 months of pregnancy, before 12 weeks' gestation.
Why miscarriage could occur
The most common cause of pregnancy loss is a problem with the chromosomes that would make it impossible for the fetus to develop normally.
Other factors that could contribute to a miscarriage include:
Abnormal hormone levels in the mother, such as thyroid hormone
Uncontrolled diabetes
Exposure to environmental and workplace hazards, such as radiation or toxic agents
Certain infections
Uterine abnormalities
Incompetent cervix, or when the cervix begins to open (dilate) and thin (efface) before the pregnancy has reached term
Certain medications, such as the acne drug Accutane
Certain behaviors also increase the risk of a miscarriage. Smoking, for example, puts ni****ne and other chemicals into the bloodstream, causes the fetus to get less oxygen, and increases the chance of losing a pregnancy. Alcohol and illegal drug use also can lead to miscarriages.
SYMPTOMS OF A MISCARRIAGE
Many women don't even know that they've had a miscarriage (since they hadn’t known they were pregnant), thinking that it's just a particularly heavy menstrual flow.
Some women experience cramping, spotting, heavier bleeding, abdominal pain, pelvic pain, weakness, or back pain. Spotting is often not a sign of a miscarriage; many women experience it early on in pregnancy. But just to be safe, if you have spotting or any of these other symptoms anytime during your pregnancy, talk with your doctor.
Types Of Miscarriage
If you think you may have had a miscarriage, your doctor may use a number of terms to explain what has happened:
If a pregnant woman has bleeding, little or no pain, a closed cervix, and is found to still have a fetus with a heartbeat in her uterus, she may have had a threatened miscarriage. Most pregnancies with early bleeding but with a detectable heartbeat turn out fine.
An inevitable miscarriage is when bleeding and cramping happen during pregnancy, with an open cervix.
An incomplete miscarriage is when a miscarriage has happened, but the body does not expel all the tissue from the pregnancy.
A complete miscarriage is when all of the tissue from the pregnancy is expelled by the body.
If you have miscarried, your doctor may say you have a blighted o**m, which is a miscarriage that has happened so early that no clearly defined fetal tissues have formed.
A missed miscarriage is when the fetus has died or has not developed, but the body does not discharge the fetus or tissues from the pregnancy. Sometimes women with missed miscarriages notice that they no longer "feel pregnant."
STILLBIRTH
A stillbirth, which many experts define as the death of a baby after the 20th week of pregnancy, can happen before delivery or during labor or delivery. It is rare and happens in less than 1% of all births. A stillbirth also is sometimes referred to as intrauterine fetal death or antenatal death.
While there are some known risk factors for stillbirth (such as smoking, obesity, problems with the placenta, a pregnancy lasting longer than 42 weeks, and some infections), there is no way to predict when stillbirth will happen or who will have one, and the cause of many stillbirths remains unknown.
The common sign of a stillbirth is decreased movement in the baby. If you notice your baby moving less than usual, call your doctor immediately.
Your doctor can use an ultrasound to look for the heartbeat or, later in pregnancy, give you an electronic fetal non-stress test. This involves lying on your back with electronic monitors attached to your abdomen. The monitors record the baby's heart rate, movements, and contractions of the uterus.
AFTER A MISCARRIAGE
If you have miscarried, your doctor will do a pelvic exam and an ultrasound to confirm the miscarriage. If the uterus is clear of any fetal tissue, or it is very early in the pregnancy, then there often won't be any more treatment.
But if the uterus still contains the fetus or other tissues from the pregnancy, this will need to be removed. The doctor may give you medicine to help pass the tissue or may need to dilate the cervix to perform a dilation and curettage (D&C), a scraping of the uterine lining, or a dilation and extraction (D&E), a suction of the uterus to remove fetal or placental tissue. You may have bleeding or cramping after these procedures, which are done with anesthesia.
If it is determined that your baby has died later in pregnancy, the doctor might decide to induce labor and delivery. After the delivery, the doctor will have the baby and the placenta examined to help determine the cause of death if it's still unknown.
If you've had several miscarriages, you may want to be evaluated to see if any anatomic, genetic, or hormonal abnormalities are contributing to the miscarriages.
CAN MISCARRIAGES BE PREVENTED?
Although miscarriages usually can't be prevented, you can take precautions to increase your chances of having a healthy pregnancy:
Eat a proper diet with plenty of folic acid and calcium
Take prenatal vitamins daily
Exercise regularly after you've gotten your doctor's OK
Maintain a healthy weight (women who are overweight or too thin may be more likely to have miscarriages)
Avoid drugs and alcohol
Avoid contaminated food because could carry listeriosis
Limit caffeine intake
If you smoke, quit
Talk to your doctor about all medications you're currently taking. Unless your doctor tells you otherwise, many prescription and over-the-counter medicines should be avoided during pregnancy.
Avoid activities that could cause abdominal trauma.
Avoid stress
Get immunized against communicable diseases and know your family medical and genetic history
Go to all of your scheduled prenatal appointments and discuss any concerns with your doctor
Call your doctor right away if you have fever, feel ill, notice decreased fetal movements, or are having bleeding, spotting, or cramping.