Pregnancy Loss: Miscarriage Overview
What is a Miscarriage?
A miscarriage is a type of pregnancy loss that takes place within the first twenty weeks of pregnancy. Also known as a spontaneous abortion, a miscarriage is defined by a loss of the fetus by natural means. If a miscarriage takes place after the twentieth week of pregnancy, it is considered a stillbirth. However, a miscarriage is most likely to take place within the first twelve weeks of pregnancy.
How common is a Miscarriage?
While many are unaware of it, experiencing a miscarriage is extremely common. Some estimates have suggested that up to 50% of pregnancies end in miscarriage before ever implanting in the womb. After implantation, the rate of pregnancy loss decreases to a 30% likelihood of miscarriage. The odds of experiencing a miscarriage once a pregnancy is clinically recognized is 25%.
It is very common for couples to experience a miscarriage before achieving a successful pregnancy. Approximately 1 in 36 women will experience two miscarriages without any explainable reason or as a result of an underlying infertility condition. However, for couples who experience recurrent miscarriages, it is generally advised to seek medical advice.
What Causes a Miscarriage?
There are several common factors that may cause pregnancy loss. The most common cause of a miscarriage is a fetal chromosomal defect. This accounts for up to 70% of all miscarriages, and is caused by an inability for an embryo to develop as a result of the sperm or egg. This is a very common cause of pregnancy loss, and does indicate an underlying fertility problem.
Other common causes of miscarriage as well as potential risk factors can include the following:
- multiple pregnancies
- maternal age
- uncontrolled diabetes
- scleroderma (a disease affecting the soft tissue)
- experiencing a fever over 100F
- uterine or cervical problems (including structural problems)
- hormonal imbalances
- exposure to environmental toxins or industrial solvents
- previous use of the birth control pill
- blighted ovum
If a couple experiences recurrent miscarriage, a diagnosis of a condition that may be the cause of infertility may be made.
The most common symptoms and signs of miscarriage include the following:
- bleeding, especially heavy bleeding
- abdominal cramping
- severe abdominal pain
It is important for pregnant women who are experiencing miscarriage symptoms to contact their health care provider immediately. If symptoms are severe or your health care provider is unavailable, it is important to receive medical attention promptly or visit the nearest hospital emergency room.
The type of treatment that a woman may receive following a miscarriage depends on the type of miscarriage experienced. Treatment options following a miscarriage typically include the following:
- expectant management. This refers to watchful waiting accompanied by medical monitoring to ensure that no complications or medical intervention is necessary
- medical management. This treatment involves prescribed medication to complete the natural process of a miscarriage
- surgical treatment. This will typically involve a process known as dilation and curettage (D&C) and is often recommended in cases of an incomplete or missed miscarriage, or if dangerous symptoms appear