What Is Abortion versus Miscarriage?
A miscarriage is called a spontaneous abortion, and refers to a pregnancy loss before the 20th week of gestation or the expulsion an embryo or fetus weighing 500 g or less. Miscarriage at this stage occurs in about 31% of pregnancies.
What Are Symptoms of Miscarriage?
Some women may have no symptoms of miscarriage and it is discovered on a routine ultrasound in early pregnancy.
When symptoms of miscarriage occur, they may include:
- Vaginal bleeding
- May be light or heavy
- Bleeding can depend on how far along you are in the pregnancy
- Abdominal cramping
- Sudden loss or reduction of pregnancy symptoms, such as decreased breast tenderness and/or nausea and vomiting
- Passage of pregnancy tissue
- Mild to severe back pain
- Weight loss
- Painful contractions that occur every 5-20 minutes
If you are pregnant and have any signs of a miscarriage, see your doctor right away.
What Causes Miscarriage?
Causes of miscarriage include:
- Chromosomal abnormalities
- Present in up to 70% of pregnancy losses before 20 weeks
- Maternal anatomical abnormalities
- Penetrating injuries
- Gunshot wounds
- Intimate partner violence
Risk factors for miscarriage include:
- Increasing maternal age, over 35 years
- Medical conditions
- Medication and/or substance use
- Environmental exposures
- Ionizing radiation
- Lead or arsenic exposure
- Air pollution
- Race and ethnicity
- Women of color have an increased risk of miscarriage compared to white women
How Is Miscarriage Diagnosed?
Once a pregnancy has been diagnosed, a miscarriage may be diagnosed by a doctor with:
- Pelvic exam
- Blood tests
- Tests on tissue you may have passed to confirm a miscarriage
- Chromosomal tests if you have had previous miscarriages to determine if your chromosomes or your partner’s chromosomes play a role
What Is the Treatment for Miscarriage?
If an ultrasound confirms a miscarriage and determines the embryo is no longer viable or has not fully formed, there are several treatment options:
- Expectant management
- Let the miscarriage progress naturally and allow the embryo to pass on its own
- This may take up to 4 weeks and can be difficult emotionally
- If the embryo does not pass on its own within 4 weeks, medical or surgical intervention is recommended because of the risk of infections, potential for loss of the uterus, or threat to the mother’s life
- Medical treatment
- Surgical treatment
- Suction dilation and curettage (D&C) is a procedure in which the cervix is dilated and tissue from the inside of the uterus is removed
- If miscarriage occurs with heavy bleeding or signs of infection, surgical treatment is recommended