Miscarriage

What is a miscarriage?

Miscarriage is a condition in which there is a sudden loss of a pregnancy before the end of the 23rd week. This most commonly occurs within the first 7 weeks. Although there are many possible causes, in many cases the exact cause is unknown. The most common symptom is bleeding from the vagina, which may be associated with a cramping pain in the lower abdomen. The diagnosis is commonly made with a series of blood tests and an ultrasound scan. Some people may choose to let the miscarriage pass naturally, and some people may prefer to have medical management following a miscarriage. Emotional support for the family is an important part of the management and counseling may be helpful. In many cases, a miscarriage is a single event, and a woman who has had a miscarriage may go on to fall pregnant again without difficulty.

Risks

A miscarriage is a loss of a pregnancy before the end of the 23rd week. Most of miscarriages occur during the first 7 weeks of pregnancy. There are many conditions which can cause miscarriage, but in many cases the exact cause is unknown. Women who are older than 30 years of age have an increased risk of miscarriage, and this increases with age. Some medical conditions can cause multiple miscarriages, especially autoimmune (where the immune system attacks the body's own tissues) and hormonal conditions. Some infections can cause miscarriage. Other things which increase the risk of miscarriage include drug and alcohol use during pregnancy, obesity and smoking.

Symptoms

The most common symptom of miscarriage is vaginal bleeding. There may be cramping and lower abdominal pain. Some clots or fluid might pass through the vagina.

Diagnosis

The diagnosis of a miscarriage is made based on the symptoms and gynecological exam, along with blood tests and an ultrasound scan. Blood tests for a pregnancy hormone called beta-hCG (human chorionic gonadotropin) may be done over a period of days to see if the pregnancy is continuing. The levels of this hormone fall if a miscarriage has taken place. An ultrasound of the uterus (womb) may be be done to see if there is any sign of the pregnancy. This can be unreliable in the early weeks of a pregnancy, so the blood tests tend to give the more reliable information. If a woman has had multiple miscarriages, further tests can be done to look for the underlying cause.

Treatment

There are a few management options following a miscarriage. Many people may choose to wait, and allow the the miscarriage to progress naturally. A follow-up scan and blood test is done to see if any further treatment is needed. Some people may need to take medication or have a surgical procedure to remove the remaining tissue. A miscarriage can be a difficult event, so good emotional support and counseling may be helpful for some families.

Prevention

In many cases, a miscarriage cannot be prevented. It may be useful for women who have a ongoing medical condition to discuss pregnancy with their doctor before falling pregnant, to see if any steps need to be taken to reduce the risk of miscarriage. There are some conditions which can cause a woman to have multiple miscarriages, so these should be investigated for and managed. Some general steps that may reduce the risk of having a miscarriage include giving up alcohol and cigarettes before falling pregnant, making sure that vaccinations are up to date, getting treated for infections and maintaining a healthy weight.

Other names for miscarriage

  • spontaneous abortion