Miscarriage During Pregnancy

Early pregnancy loss is so common that many obstetricians consider these miscarriages a normal part of reproduction.That doesn't make the loss any easier. Doctors believe most first-trimester miscarriages happen because of factors outside anyone's control, and rarely can anyone pinpoint the cause of a specific miscarriage.

Causes of Miscarriage

The causes of miscarriage are not well understood. Most of the miscarriages that occur in the first trimester are caused by chromosomal abnormalities in baby.Chromosomes are tiny structures inside the cells of the body which carry many genes. Genes determine all of a person's physical attributes,such as sex, hair and eye color, and blood type. Most chromosomal problems occur by chance and are not related to the mother's or father's health.

Miscarriages are also caused by a variety of other factors, including:

• Infection.
• Exposure to environmental and workplace hazards such as high levels of radiation or toxic agents.
• Hormonal problems.
• Uterine abnormalities.
• Incompetent cervix (the cervix begins to widen and open too early, in the middle of pregnancy, without signs of pain or labor).
• Lifestyle factors such as smoking, drinking alcohol, or using illegal drugs.
• Disorders of the immune system, including lupus.
• Severe kidney disease.
• Congenital heart disease.
• Diabetes that is not controlled.
• Thyroid disease.
• Radiation.
• Certain medications, such as the acne drug Accutane.
• Severe malnutrition.

In addition, women may be at increased risk for miscarriage based on their age. Studies show that the risk of miscarriage is 10% to 17% for women in their 20s and rises to about 30% for women at age 40. The increased incidence of chromosomal abnormalities contributes to the age-related risk of miscarriage.

Symptoms of a miscarriage

• Bleeding which progresses from light to heavy
• Cramps
• Abdominal pain
• Fever
• Weakness
• Vomiting
• Back pain

If you experience the symptoms listed above, contact your obstetric health care provider right away.He or she will tell you to come in to the office or go to the emergency room.

Bleeding During Pregnancy 

Bleeding during all phases of pregnancy may be dangerous, a woman should call her health care professional if she has any signs of vaginal bleeding during her pregnancy.Vaginal bleeding is any blood coming from the vagina (the canal leading from the uterus to the external genitals). This usually refers to abnormal bleeding not associated with a regular menstrual period.First trimester bleeding is any vaginal bleeding during the first 3 months of pregnancy. Vaginal bleeding may vary from light spotting to heavy bleeding with clots.

Vaginal bleeding is a common problem in early pregnancy, complicating 20%-30% of all pregnancies.Any vaginal bleeding during the second and third

trimesters of pregnancy (the last 6 months of a 9-month pregnancy) involves concerns different from bleeding in the first 3 months of the pregnancy. 

Any bleeding during the second and third trimesters is abnormal.Bleeding from the vagina after the 28th week of pregnancy is a true emergency.

The bleeding can range from very mild to extremely brisk and may or may not be accompanied by abdominal pain. Hemorrhage (another word for bleeding)

is the most common cause of death of the mother. It complicates about 4% of all pregnancies.

What You Can Do

If you have one miscarriage, be patient. The odds are strongly in your favor that you will get pregnant again and deliver a healthy baby. 

If you miscarry again, however, consider preserving the tissue you pass (if possible, save it in a sterile saline contact-lens solution) and take it to your physician to be sent to a lab for chromosomal testing.

How Is a Miscarriage Diagnosed and Treated?

Your health care provider will perform a pelvic exam and an ultrasound test to confirm a miscarriage. If the miscarriage is complete and the uterus is clear, then no further treatment is usually required. Occasionally, the uterus is not completely emptied, so a dilation and curettage (D&C) procedure is performed. During this procedure, the cervix is dilated and any remaining fetal or placental tissue is gently removed from the uterus.

 As an alternative to a D&C, certain medications can be given to cause your body to expel the contents in the uterus. This option may be more ideal in someone who wants to avoid surgery and whose condition is otherwise stable.

tab: miscarriage, pregnancy loss, abortion, causes of miscarriage, infection, abnormalities, bleeding, bleeding during pregnancy, vaginal bleeding, dilation and curettage