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What is a Miscarriage? Print E-mail
Written by Glenn Rosenberg   
Wednesday, 28 October 2009

A miscarriage occurs when a woman is pregnant and her womb expels the fetal tissue. It results from natural causes within the first 20 weeks of pregnancy.

What is going on in the body?
A miscarriage takes place after the fetus and placenta stop growing. This makes pregnancy hormone levels fall. The following symptoms of pregnancy may no longer appear:
- breast tenderness
- nausea
- fatigue

A miscarriage starts when the womb begins to contract. This causes cramping and discomfort. It may also cause vaginal spotting or bleeding. A miscarriage is complete when the contents of the womb are expelled. When no fetal tissue remains, the cervix will close. The uterus will shrink in size. The bleeding will slow and then stop.

What are the causes and risks of the condition?
A fetus that fails to develop or is abnormal in some way is the most likely cause of a miscarriage that occurs in the first trimester of pregnancy.

Miscarriages in the second trimester are most often caused by factors linked to the mother, such as:
- an abnormal-shaped uterus
- autoimmune disorders, in which the woman's body creates antibodies to its own tissue, including fetal tissue
- bacterial infections, such as the sexually transmitted disease chlamydia
- certain diseases and conditions, including diabetes or hypothyroidism
- cervical incompetence, a condition in which the cervical opening from the womb does not stay closed through the whole pregnancy
- cocaine use
- drinking liquids, such as coffee, or eating foods, such as chocolate, that contain caffeine
- exposure to pesticides, chemicals, or other toxins
- noncancerous tumors in the uterus, which are also called fibroids
- hormonal disorders, such as a low level of the female hormone progesterone
- polycystic ovary syndrome, a condition in which abnormal hormone levels cause growths within the ovary
- posttraumatic stress disorder, also called PTSD, which may occur after a major traumatic event
- TORCH infections in the first trimester of pregnancy

Herbal remedies can cause birth defects as well as a miscarriage. The March of Dimes recommends that pregnant women avoid all of the following unless recommended by their doctors:

- dietary supplements
- over-the-counter medicines
- prescription medicine

What are the treatments for the condition?
Some providers suggest that a woman try to collect any tissue that passes from her vagina so it can be checked.

Other treatments for miscarriage include:
- antibiotics to prevent infection
- dilation and curettage, or D & C, a procedure to remove any fetal tissue remaining in the uterus
- medicines to help the uterus contract so that bleeding stops
- Rh immune globulin, if the mother's blood is Rh-negative

Sometimes, the woman may have an incomplete miscarriage. This means some fetal tissue stays in the uterus. To avoid infection, a procedure called a D & C will be done. The D & C helps empty the uterus.

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 uterus contract may cause rash, upset stomach, abdominal cramps, and allergic reaction.

What happens after treatment for the condition?
If a woman has a complete miscarriage without abnormal bleeding, she is sent home to get better. If a woman has a D & C for an incomplete miscarriage, she is usually able to go home within a few hours. She should rest in bed for 1 to 2 days. A woman should contact her doctor if she has any of these symptoms:
- any other new or worsening symptoms
- continued heavy bleeding
- a fever
- cramps that get worse or pain that won't go away

Birth control should be used if the woman does not want to get pregnant again. If a future pregnancy is desired, the couple may try to conceive again after 2 to 3 months.

They have an 85% chance of having 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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