The loss of a pregnancy before the 20th week is what we usually refer to as a miscarriage. Even though we know about 10% to 20% of pregnancies result in miscarriages, the actual number is much higher. This is because most miscarriages happen so early on in the pregnancy that a woman may not have realized she is pregnant. It is a common misconception to think of a miscarriage as a failed pregnancy, but this is not the case. A miscarriage suggests that the fetus is not developing normally, and therefore the body cannot carry the pregnancy to term safely.
Symptoms
These symptoms refer to miscarriages that occur before the 12th week of pregnancy:
- Vaginal spotting or even bleeding
- Fluid or tissue passing from your vagina
- Cramping in your abdomen or lower back
It is actually quite common for women to experience spotting or bleeding in the first trimester, and it does not necessarily lead to a miscarriage. However, if you do pass fetal tissue, place it in a clean container and take it to your health care provider, or to the hospital, for analysis.
Causes
The main cause of a miscarriage is the abnormal development of the fetus, and half of known miscarriages are associated with either missing or extra chromosomes. These chromosome problems are not inherited from the parents, but rather occur as the embryo divides and grows.
Chromosomal abnormalities may lead to:
- Blighted ovum: when the embryo does not develop at all
- Intrauterine fetal demise: when the embryo forms bust stops developing before any symptoms of pregnancy are noticeable
- Molar pregnancy and partial molar pregnancy: these pregnancies have to do with abnormal growth of the placenta, and there is either no fetal development, or abnormal fetal development. In both cases, the uterus miscarries the fetus.
In fewer cases, the health condition of the mother may lead to a miscarriage. Health conditions such as uncontrolled diabetes, infections, hormonal problems, thyroid disease, and uterus or cervix problems can result in the mother’s body terminating a pregnancy.
Diagnoses
There is a multitude of tests you can get done to confirm whether you have experiences a miscarriage or not:
- Pelvic exam
- Ultrasound
- Blood, tissue and chromosomal tests
Future Pregnancies
Many women are worried about carrying on future successful pregnancies after a miscarriage, or even becoming pregnant. It is actually possible to conceive even in the first menstrual cycle immediately following a miscarriage, so the main factor to consider in this case is whether you are physically and emotionally ready. You should remember that a miscarriage is rarely a repeat phenomenon: most women experience it once and go on to have successful pregnancies after. Less than 5% of women have two consecutive miscarriages, and even 60% to 80% of women with undiagnosed causes of miscarriage have healthy pregnancies. If you do decide to try and conceive after a miscarriage, be sure to consult your health care provider for guidance.
More
If you’re pregnant or about to become pregnant, your number one priority is carrying your baby safely and healthily to full-term. No matter what your current state of health, or how prepared you feel you are to have a healthy pregnancy, every new mom should understand the warning signs of high-risk pregnancies.
What is a high-risk pregnancy?
Generally, a pregnancy is defined as high-risk if you or your baby has an increased chance of facing a health problem. Such problems could be caused by one of several underlying conditions, including:
These conditions put you and your baby at risk for complications like slowed fetal growth, a preterm labor, preeclampsia, or issues with the placenta.
Other factors that could result in a high-risk pregnancy include:
- If you are under 17 or over 35
- You use alcohol or illegal drugs
- You smoke
- You have an infection, such as HIV, hepatitis C, syphilis, cytomegalovirus (CMV), chickenpox, rubella, or toxoplasmosis
- You are having a multiple pregnancy
- You have had three or more miscarriages
- Your baby has been diagnosed with a genetic condition such as Down syndrome, or a heart, lung, or kidney condition
- You have been diagnosed with a serious condition such as heart valve problems, sickle cell disease, asthma, lupus, or rheumatoid arthritis
- You have had a serious problem with a previous pregnancy, such as a preterm labor, preeclampsia, or seizures (eclampsia)
- You are taking certain medications such as lithium, valproic acid, or carbamazepine
High-risk pregnancy treatment
Your OB-GYN will be able to diagnose whether or not your pregnancy is high-risk. If you are diagnosed as being high-risk, you should expect more frequent visits to your doctor than women whose pregnancies are not high-risk. Your OB-GYN will likely want you to receive more frequent ultrasound tests to confirm your baby is developing and growing at the proper rate. Your doctor will also closely monitor your blood pressure and more frequently test your urine for a protein that indicates preeclampsia or a urinary tract infection. If you have diabetes, asthma, or high blood pressure, your doctor may prescribe medications to help monitor such conditions.
Keep in mind that just because your pregnancy has been defined as high-risk does not mean that your baby will definitely be born with health issues. Under the care of your OB-GYN, and by following your prescribed treatment plan, you can welcome your new, healthy baby into the world without worry.
More
Miscarriages are saddening medical occurrences that happen more often than is realized, yet the couples who suffer them rarely speak of their losses. Whether their silence is born out of a fear that the sympathies of others may make the loss more emotionally distressing, or out of a greater fear that a pregnancy may never be possible, miscarriages are often an emotional burden that too many couples bear alone. Such isolation is unnecessary, however, as approximately 10 to 20 percent of known pregnancies end in miscarriage, and as many as 50 percent of pregnancies are miscarried so early that the pregnancy is not even known. Though the early termination of any pregnancy can be heart breaking, couples looking to conceive should take comfort in knowing that they are not to blame or at fault for the loss of their fetus. Understanding the truths and overcoming the misperceptions of miscarriages can give comfort to those recovering from such a loss.
Timing
The majority of miscarriages occur during the first 13 weeks after conception. Since many women wait to share news of their pregnancy with family and friends until after the first trimester, many of the miscarriages that occur during the first thirteen weeks are often unknown by anyone other than the mother and father.
Truth: A great number of miscarriages occur so early that even the couple is unaware that an embryo had formed.
Causes
Though it is commonly believed that lifting heavy objects, participating in dangerous activities, and long-term stress can cause miscarriages, none of these factors have been proven to be valid risk factors. It is believed that the majority of miscarriages are caused by genetic abnormalities within the embryo that would prevent a baby from fully developing healthily and surviving after birth. About 60 percent of the time, miscarriages occur when the embryo or fetus has an abnormal number of chromosomes. In addition, some illnesses may place a woman at a greater risk for miscarriage, including some viral infections, thyroid disease, and diabetes.
Truth: Fatal genetic errors are not usually caused by the mother’s genetics.
Risk Factors
Some of the risk factors that may lead to a miscarriage include:
- An older maternal age
- Extremely low or high maternal weight
- Moderate to high alcohol consumption during pregnancy
- Smoking or illicit drug use during pregnancy
- Use of nonsteroidal anti-inflammatory drugs (NSAID) around the time of conception
- Uterine trauma
- Previous miscarriage(s)
About 5 percent of women have recurrent miscarriages, a condition defined by three or more losses. In most of these cases, however, the recurrent miscarriages are caused by underlying health issues such as a structural problem with the uterus, thyroid problems, hormonal imbalances, or clotting disorders.
Truth: Most women who miscarry go on to have a successful pregnancy and give birth to a healthy baby.
Prevention
In order to be best positioned to deliver a baby to full term, women should maintain a healthy weight through proper nutrition and exercise, should not consume drugs or alcohol, and should be screened and treated if necessary for any sexually transmitted diseases (STD). In addition, pregnant women should take a folic acid supplement, avoid possible radiation exposure, and avoid contact sports.
Truth: In most cases, fully preventing a miscarriage is outside of a woman’s control.
The loss of any child at any time is devastating, however women must understand that as long as they lead a healthy lifestyle and avoid drugs and alcohol and other risky behaviors, they are giving their fetus the best possible chance for a healthy birth. For the many women who experience a miscarriage caused by genetic factors outside of their control, they should not take on the burden of guilt, or the feeling that the loss was their fault. Rather, they should emotionally and physically prepare themselves to try again to carry a baby full term, since for the great majority of women who miscarry, a healthy and happy baby is still on the horizon.
Whether you are pregnant or planning on becoming pregnant, it’s important to see your OB-Gyn. Our office is currently accepting new patients. Call for an appointment today.
More
The loss of a pregnancy before the 20th week is what we usually refer to as a miscarriage. Even though we know about 10% to 20% of pregnancies result in miscarriages, the actual number is much higher. This is because most miscarriages happen so early on in the pregnancy that a woman may not have realized she is pregnant. It is a common misconception to think of a miscarriage as a failed pregnancy, but this is not the case. A miscarriage suggests that the fetus is not developing normally, and therefore the body cannot carry the pregnancy to term safely.
