A miscarriage occurs when a pregnant woman's womb expels the fetal tissue before the infant is fully-grown. This may result from natural causes within the first 20 weeks of pregnancy. In an incomplete miscarriage, part of the fetal tissue stays inside the womb.
What is going on in the body?
Eighty-five percent of miscarriages take place in the first 12 weeks of pregnancy. This time is called the first trimester. These early miscarriages are most often the result of problems with the fetus. For example, the fetus may have abnormal chromosomes, or a genetic defect, that affects health and development. Miscarriages in the early part of the second trimester of pregnancy, which is from 12 to 20 weeks, are most often caused by factors related to the mother.
A miscarriage takes place after the fetus and placenta stop growing, which causes pregnancy hormone levels to fall. The following symptoms of pregnancy may disappear:
- breast tenderness
- nausea
- fatigue
A miscarriage occurs when the uterus, or womb, starts to contract. This causes cramping, discomfort, and vaginal spotting or bleeding. A miscarriage is complete once the womb expels its contents. An incomplete miscarriage occurs when some of the tissue remains in the uterus and the cervix stays open. This may increase a woman's risk of infection and continued bleeding.
What are the causes and risks of the condition?
A fetus that fails to develop or that is malformed most often causes miscarriages in the first 12 weeks of pregnancy.
Miscarriages in the second trimester are most often caused by factors related to the mother, such as:
- an abnormal-shaped womb, including one with a wall down the middle of it
- an age of 35 years or older
- autoimmune disorders, in which the woman's body creates antibodies to its own tissue, including fetal tissue. Systemic lupus erythematosus, an autoimmune disorder that involves many organ systems and is linked with a high risk of miscarriage, is one example.
- bacterial infections, such as the sexually transmitted disease chlamydia
- certain conditions and diseases, such as diabetes or hypothyroidism, a condition caused by low levels of thyroid hormones
- cervical incompetence, which means that the opening from the womb does not stay closed through the whole pregnancy
- cocaine use
- eating foods, such as chocolate and drinking liquids, such as coffee, that have caffeine in them
- noncancerous tumors in the womb, called fibroids
- exposure to chemical solvents and other toxins, such as paint thinners
- herbal remedies, which can cause birth defects as well as miscarriage. The March of Dimes advises that pregnant women avoid all dietary supplements, over-the-counter medicines, and prescription medicines unless recommended by their doctors.
- hormonal disorders, such as a low level of the female hormone progesterone
- infertility lasting longer than 1 year
- polycystic ovary syndrome, a condition in which abnormal hormone levels cause growths within the ovary
- posttraumatic stress disorder, called PTSD, which occurs in some people who have gone through a major traumatic event
- viral infections, such as herpes, rubella, and cytomegalovirus, known as CMV, in the first trimester
A woman who has had three or more miscarriages in a row has a condition called habitual abortion.
What are the treatments for the condition?
The treatments that may be used for an incomplete miscarriage include the following:
- dilatation and curettage, also called D & C, which is a procedure to remove any fetal tissue that remains in the womb following the miscarriage
- antibiotics to prevent infection
- medicines to help the womb contract so that bleeding subsides
- Rh immune globulin, if the mother's blood is Rh-negative. Otherwise, Rh sensitivity could affect later pregnancies and cause blood incompatibilities between the mother and fetus.
What are the side effects of the treatments?
A D & C may cause bleeding, infection, and allergic reaction to anesthesia. Antibiotics and medicines to help the womb contract may cause rash, upset stomach, abdominal cramps, and allergic reaction.
What happens after treatment for the condition?
Within hours of having a D & C, a woman is usually sent home to get better. She should rest in bed for 1 to 2 days. A woman should contact her doctor if she has any of these symptoms:
# a fever
# cramps that get worse or pain that lasts
# continued heavy bleeding
# any other new or worsening symptoms
Birth control should be used if the woman does not wish to get pregnant again. If a future pregnancy is desired, a couple can try to conceive again after 2 to 3 months. They have an 85% chance of a successful, full-term pregnancy after 1 year.
How is the condition monitored?
A woman's doctor may do weekly blood tests to follow the HCG level until it is nearly zero. This ensures that the pregnancy has ended. Sometimes, tests are done on the fetal tissue to learn about its genetic makeup.
If a woman has had several miscarriages, her doctor may recommend a complete evaluation for infertility.
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