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Miscarriage Overview

A miscarriage (also termed spontaneous abortion) is any pregnancy that spontaneously ends before the fetus can survive. Any vaginal bleeding, other than spotting, during early pregnancy is considered a threatened miscarriage. Vaginal bleeding is very common in early pregnancy. About one out of every four pregnant women has some bleeding during the first few months. About half of these women stop bleeding and complete a normal pregnancy.

  • Threatened miscarriage - Vaginal bleeding during early pregnancy. The bleeding and pain with threatened miscarriage are usually mild and the cervical os (the mouth of the womb) is closed. A health care professional will be able to determine if the cervical os is open upon performing a pelvic exam. Typically, no tissue is passed from the womb. The womb and Fallopian tubes may be tender.
  • Inevitable miscarriage - Vaginal bleeding along with opening of the cervical os. In this situation, vaginal bleeding is present, and the mouth of the womb is open (dilated). Bleeding is usually more severe, and abdominal pain and cramping often occur.
  • Incomplete miscarriage - Expulsion of some, but not all, of the products of conception before the 20th week of pregnancy. With incomplete miscarriage, the bleeding is heavier, and abdominal pain is almost always present. The mouth of the womb is open, and the pregnancy is being expelled. Ultrasound would show some material still remaining in the womb.
  • Complete miscarriage - Expulsion of all products of conception from the womb including fetus and placental tissues. Complete miscarriage is just as it sounds. Bleeding, abdominal pain, and the passing of tissue have all occurred, but the bleeding and pain have usually stopped. If the fetus can be seen, you have miscarried. Ultrasound shows an empty womb.

A miscarriage occurs when a pregnancy ends without obvious cause before the fetus is capable of survival, typically corresponding to the 20th week. This time is measured from the first day of the woman's last menstrual period. Miscarriage is a common complication of pregnancy. It can occur in up to 20% of all recognized pregnancies. This ending of pregnancy is called a spontaneous abortion. In the medical field, the term abortion is often used to describe a miscarriage.

Miscarriage Causes

Miscarriage is caused by the separation of the fetus and placenta from the uterine wall. Although the actual cause of the miscarriage is frequently unclear, the most common reasons include the following:

  • An abnormal fetus causes almost all miscarriages during the first three months of pregnancy (first trimester). Problems in the genes are responsible for an abnormal fetus and are found in more than half of miscarried fetuses. The risk of defective genes increases with the woman's age, especially if she is older than 35 years.
  • Miscarriage during the fourth through sixth months of pregnancy (second trimester) is usually related to an abnormality in the mother rather than in the fetus.
    • Diseases and abnormalities of the internal female organs can also cause miscarriage. Some examples are an abnormal womb, fibroids, poor muscle tone in the mouth of the womb, abnormal growth of the placenta (also called the afterbirth), and being pregnant with multiples.
    • Other factors, especially certain drugs, including alcohol, tobacco, and cocaine, may be related to miscarriage.
Medically Reviewed by a Doctor on 3/18/2015
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Pregnancy Loss

Pregnancy loss is a harsh reality faced by many expecting couples. If you have lost your baby, you know how devastating and painful this loss can be. You might wonder if you'll ever have a baby to hold and call your own. But surviving the emotional impact of pregnancy loss is possible. And many women go on to have successful pregnancies.

Why pregnancy loss happens

As many as 10 to 15 percent of confirmed pregnancies are lost. The true percentage of pregnancy losses might even be higher as many take place before a woman even knows that she is pregnant. Most losses occur very early on - before eight weeks. Pregnancy that ends before 20 weeks is called miscarriage. Miscarriage usually happens because of genetic problems in the fetus. Sometimes, problems with the uterus or cervix might play a role in miscarriage. Health problems, such as polycystic ovary syndrome, might also be a factor.

After 20 weeks, losing a pregnancy is called stillbirth. Stillbirth is much less common. Some reasons stillbirth occur include problems with placenta, genetic problems in the fetus, poor fetal growth, and infections. Almost half of the time, the reason for stillbirth is not known.

Coping with loss

After the loss, you might be stunned or shocked. You might be asking, "Why me?" You might feel guilty that you did or didn't do something to cause your pregnancy to end. You might feel cheated and angry. Or you might feel extremely sad as you come to terms with the baby that will never be. These emotions are all normal reactions to loss. With time, you will be able to accept the loss and move on. You will never forget your baby. But you will be able to put this chapter behind you and look forward to life ahead. To help get you through this difficult time, try some of these ideas:

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