Miscarriage represents one of the most difficult things a woman and her family may face. It is often associated with feelings of guilt and personal responsibility, but unfortunately occurs to many without warning. A miscarriage is defined as the loss of a fetus prior to 20 weeks gestation and often begins with bleeding and cramping like that of a menstrual period.
Why do Miscarriages Occur?
Miscarriage occurs in approximately 10-25% of all recognized pregnancies and most commonly happens in the first 13 weeks of pregnancy. The reason for miscarriage is varied, and most often the cause cannot be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality - meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell, or are due to a problem at the time that the zygote went through the division process. Other causes for 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 are not associated with miscarriage are sex, working outside the home (unless in a toxic environment) or moderate exercise.
The Warning Signs
- Mild to severe back pain often worse than normal menstrual cramps
- Severe cramping or contractions
- Heavy brown, or bright red bleeding with or without cramps
- Tissue with clot like material passing from the vagina
- Sudden decrease in signs of pregnancy
If you experience any of these symptoms, please notify our office immediately. Usually an ultrasound examination will demonstrate whether the pregnancy is continuing normally but blood work may also sometimes have to be performed.
Treatment of Miscarriage
The main goal of treatment for a miscarriage is to prevent hemorrhaging and infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed is a dilation and curettage, known as a D&C. Drugs may be prescribed to help control bleeding and prevent infection after the D&C is performed. Bleeding should be monitored closely once you are at home; if you notice an increase in bleeding or the onset of chills or fever, it is best to call our office immediately.