A spontaneous abortion, more commonly referred to as a miscarriage, is the loss of a pregnancy before 20 weeks’ gestation. About 12 percent of pregnancies end in miscarriage before the end of the first trimester, or the 12th week, Dr. Marjorie Greenfield writes on the Dr. Spock website. After that, the statistic drops dramatically to about 1 percent.
Cramping and bleeding are normal symptoms of miscarriage, as is the passage of fluid and placental tissue through the vagina. The expelling of all placental tissue is called a complete miscarriage. A septic miscarriage results because of a uterine infection. Septic miscarriage is identified by fever, chills, body aches and a foul-smelling discharge. Call your health-care provider to schedule an appointment if you suspect a miscarriage. If you can, collect any tissue samples in a clean jar for the pathologist to examine.
When you meet with your health care provider, she will do several tests. First, she will check your cervix to determine whether it’s dilated. She will then perform an ultrasound to confirm a fetal heartbeat. If she cannot detect a heartbeat, she will draw your blood to evaluate pregnancy hormone levels, the purpose of which is to determine whether you’ve passed any placental tissue. If the ultrasound does not detect a heartbeat and you’ve not passed tissue, your health care provider can prescribe an oral medication or vaginal insert to expedite the miscarriage process. In lieu of medication, she may perform a suction dilation and curettage, or a “D&C,” to dilate the cervix and suction out any remaining placental tissue. Health care providers generally opt for the D&C method for miscarriages occurring after 10 weeks’ gestation.
According to the Mayo Clinic, most first-trimester miscarriages result from an abnormality in the developing fetus such as in the genes or chromosomes. A condition called blighted ovum accounts for almost 50 percent of early miscarriages. A blighted ovum occurs when the fertilized egg does not form an embryo, even though it develops a placenta and membrane. Intrauterine fetal demise is when the embryo dies before the woman detects any symptoms of miscarriage. About one in 1,000 miscarriages happens because of a molar pregnancy, a placental abnormality in which the placenta develops as uterine cysts. Infrequently, miscarriage is the result of underlying maternal health problems such as diabetes, thyroid disease, infection, hormonal imbalance, and uterine or cervical abnormalities.
After age 35, your risk for miscarriage increases. By the time you are 40, your risk is 40 percent. At 45, your risk jumps to 80 percent. If you’ve had two or more miscarriages, your risk for a future miscarriage also increases. Smoking, drinking and illegal drugs puts you at a greater risk for miscarriage as well. Some prenatal testing, such as amniocentesis and chorionic villus sampling, carry more risk.
If you’ve experienced a miscarriage, you might be tempted to blame yourself. Miscarriage is not the result of something you did or did not do. Exercise, lifting or straining, sexual intercourse and working do not cause a miscarriage. Equally frustrating is the fact there generally is nothing you can do to prevent a miscarriage from happening. To ensure your chances of a healthy pregnancy, take good care of yourself, attend prenatal visits and avoid known miscarriage risks.
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