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Miscarriage

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Jul.13.2022
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 Miscarriage

Miscarriage

A miscarriage is the loss of pregnancy before the 20th week. Most miscarriages happen during the first 3 months of pregnancy. Sometimes, a miscarriage can happen before a woman knows that she is pregnant.

Having a miscarriage can be an emotional experience. If you have had a miscarriage, talk with your health care provider about any questions you may have about the loss of your baby, the grieving process, and your plans for future pregnancy.

What are the causes?

Many times, the cause of a miscarriage is not known.

What increases the risk?

The following factors may make a pregnant woman more likely to have a miscarriage:

Certain medical conditions

  • Conditions that affect the hormone balance in the body, such as thyroid disease or polycystic ovary syndrome.
  • Diabetes.
  • Autoimmune disorders.
  • Infections.
  • Bleeding disorders.
  • Obesity.

Lifestyle factors

  • Using products with tobacco or nicotine in them or being exposed to tobacco smoke.
  • Having alcohol.
  • Having large amounts of caffeine.
  • Recreational drug use.

Problems with reproductive organs or structures

  • Cervical insufficiency. This is when the lowest part of the uterus (cervix) opens and thins before pregnancy is at term.
  • Having a condition called Asherman syndrome. This syndrome causes scarring in the uterus or causes the uterus to be abnormal in structure.
  • Fibrous growths, called fibroids, in the uterus.
  • Congenital abnormalities. These problems are present at birth.
  • Infection of the cervix or uterus.

Personal or medical history

  • Injury (trauma).
  • Having had a miscarriage before.
  • Being younger than age 18 or older than age 35.
  • Exposure to harmful substances in the environment. This may include radiation or heavy metals, such as lead.
  • Use of certain medicines.

What are the signs or symptoms?

Symptoms of this condition include:
  • Vaginal bleeding or spotting, with or without cramps or pain.
  • Pain or cramping in the abdomen or lower back.
  • Fluid or tissue coming out of the vagina.

How is this diagnosed?

This condition may be diagnosed based on:
  • A physical exam.
  • Ultrasound.
  • Lab tests, such as blood tests, urine tests, or swabs for infection.

How is this treated?

Treatment for a miscarriage is sometimes not needed if all the pregnancy tissue that was in the uterus comes out on its own, and there are no other problems such as infection or heavy bleeding.

In other cases, this condition may be treated with:
  • Dilation and curettage (D&C). In this procedure, the cervix is stretched open and any remaining pregnancy tissue is removed from the lining of the uterus (endometrium).
  • Medicines. These may include:
    • Antibiotic medicine, to treat infection.
    • Medicine to help any remaining pregnancy tissue come out of the body.
    • Medicine to reduce (contract) the size of the uterus. These medicines may be given if there is a lot of bleeding.

If you have Rh-negative blood, you may be given an injection of a medicine called Rho(D) immune globulin. This medicine helps prevent problems with future pregnancies.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you were prescribed antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activity

  • Rest as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Have someone help with home and family responsibilities during this time.

General instructions

  • Monitor how much tissue or blood clot material comes out of the vagina.
  • Do not have sex, douche, or put anything, such as tampons, in your vagina until your health care provider says it is okay.
  • To help you and your partner with the grieving process, talk with your health care provider or get counseling.
  • When you are ready, meet with your health care provider to discuss any important steps you should take for your health. Also, discuss steps you should take to have a healthy pregnancy in the future.
  • Keep all follow-up visits. This is important.

Where to find more information

Contact a health care provider if:

  • You have a fever or chills.
  • There is bad-smelling fluid coming from the vagina.
  • You have more bleeding instead of less.
  • Tissue or blood clots come out of your vagina.

Get help right away if:

  • You have severe cramps or pain in your back or abdomen.
  • Heavy bleeding soaks through 2 large sanitary pads an hour for more than 2 hours.
  • You become light-headed or weak.
  • You faint.
  • You feel sad, and your sadness takes over your thoughts.
  • You think about hurting yourself.

If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. Go to your nearest emergency department or:
  • Call your local emergency services (911 in the U.S.).
  • Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255 or 988 in the U.S. This is open 24 hours a day in the U.S.
  • Text the Crisis Text Line at 741741 (in the U.S.).

Summary

  • Most miscarriages happen in the first 3 months of pregnancy. Sometimes miscarriage happens before a woman knows that she is pregnant.
  • Follow instructions from your health care provider about medicines and activity.
  • To help you and your partner with grieving, talk with your health care provider or get counseling.
  • Keep all follow-up visits.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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