A Discussion of Miscarriage, Infertility and Early Pregnancy Loss
Understanding Why Miscarriages Happen
Miscarriages are heartbreaking, but not unusual. Miscarriages occur in about 15 percent of all pregnancies and happen for reasons often beyond your control.
By Madeline R. Vann, MPH
Medically Reviewed by Cynthia Haines, MD
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In clinical terms, miscarriage is the death of a fetus before the 20th week of pregnancy, but to a couple it is likely to mean heartache and frustration. Miscarriages are relatively common, occurring in 15 to 20 percent of all pregnancies, most often during the first three months. Many miscarriages occur early on; before the availability of drugstore pregnancy tests, a woman might experience a miscarriage before ever knowing she was pregnant. In fact, miscarriages may seem more common these days than in the past partly because women can now get positive results from a pregnancy test early on.
“Most losses prior to 13 weeks reflect fundamental problems in the development of the baby or the placenta,” says Carl P. Weiner, MD, MBA, professor and chair of obstetrics and gynecology at the University of Kansas School of Medicine in Kansas City. “Somewhere between two-thirds and three-fourths of the losses before 13 weeks are chromosome abnormalities or errors in fertilization. They are nobody’s fault.”
There are some risk factors that make miscarriages more likely, including:
- A diagnosis of polycystic ovarian syndrome in the mother, which increases the risk of early miscarriage three-fold; with this syndrome, women have cysts on their ovaries, irregular periods, and increased amounts of the so-called male hormone androgen in their systems.
- Chronic health conditions, such as heart disease, diabetes, thyroid disease, or autoimmune disorders
“As we go further out,” Dr. Weiner continues, certain factors will “affect the likelihood of a loss prior to 20 weeks.” These are:
- Growths in the uterus
- Structural problems with the uterus
- A cervix which opens too soon or cannot carry the fetus to term
- Infection in the uterus
- Anti-phospholipid syndrome (blood clotting issues) in the mother
- Hormone problems, such as making too little progesterone
- Blood disorders that increase clotting
- Malformations of the genitourinary tract of the mother
- Quality of the site where the placenta has implanted
If you are having a miscarriage, you may have these symptoms: Spotting Cramping Bleeding, like a period Passing other fluid or tissue from your vagina
If you have these symptoms, contact your doctor immediately. Some, such as spotting, are common even in women who are not having a miscarriage, but your doctor should evaluate your situation. An ultrasound is often used to confirm the diagnosis that the fetus has died.
If your pregnancy ends with miscarriage, you may need to take these next steps:
- Delivery of the fetus.Your body will pass the fetus itself or with the help of medication, or your doctor will arrange a dilation and curettage, an outpatient procedure done under anesthesia to remove the fetus and other tissues from your uterus.
- Testing.Your doctor may test your fetus and recommend that you and your partner be tested to look for chromosomal abnormalities.
- Grieving.It helps some couples to plan a ceremony to recognize their loss. You may want to seek counseling or the support of others who have had a miscarriage.
Guarding Against Miscarriages
Most miscarriages probably could not have been prevented, but you can take steps to increase your odds of a healthy pregnancy in the future:
- Make healthy lifestyle choices, such as eating a nutritious diet and getting appropriate exercise, even before conception.
- Go for regular prenatal checkups and follow your doctor’s recommendations for testing or screening.
- Quit smoking cigarettes.
- Steer clear of alcohol.
- Avoid illegal drugs.
- Work with your doctors to keep chronic health conditions under control before and during pregnancy.
And remember: A miscarriage doesn’t mean you can’t have a healthy pregnancy in the future. Most women who miscarry go on to have a successful pregnancy and delivery.
Video: 5 major reasons of Miscarriages that every woman should know!
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