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Miscarriage

Miscarriage is the spontaneous loss of a pregnancy before the 20th week. About 10 to 20 percent of known pregnancies end in miscarriage. But the actual number is probably much higher because many miscarriages occur so early in pregnancy that a woman doesn't even know she's pregnant.

Miscarriage is a somewhat loaded term — possibly suggesting that something was amiss in the carrying of the pregnancy. This is rarely true. Most miscarriages occur because the fetus isn't developing normally. However, because these abnormalities are rarely understood, it's often difficult to determine what causes them.

Miscarriage is a relatively common experience — but that doesn't make it any easier. Take a step toward emotional healing by understanding what can cause a miscarriage, what increases the risk and what medical care might be needed.

Symptoms Causes Risk factors Complications Prevention

Most miscarriages occur before the 12th week of pregnancy.

Signs and symptoms of a miscarriage might include:

  • Vaginal spotting or bleeding
  • Pain or cramping in your abdomen or lower back
  • Fluid or tissue passing from your vagina

If you have passed fetal tissue from your vagina, place it in a clean container and bring it to your health care provider's office or the hospital for analysis.

Keep in mind that most women who experience vaginal spotting or bleeding in the first trimester go on to have successful pregnancies.

Abnormal genes or chromosomes

Most miscarriages occur because the fetus isn't developing normally. Problems with the baby's genes or chromosomes are typically the result of errors that occur by chance as the embryo divides and grows — not problems inherited from the parents.

Examples of abnormalities include:

  • Blighted ovum. Blighted ovum occurs when no embryo forms.
  • Intrauterine fetal demise. In this situation the embryo is present but has stopped developing and died before any symptoms of pregnancy loss have occurred.
  • Molar pregnancy. A molar pregnancy is a noncancerous (benign) tumor that develops in the uterus. A molar pregnancy occurs when there is an extra set of paternal chromosomes in a fertilized egg. This error at the time of conception transforms what would normally become the placenta into a growing mass of cysts. This is a rare cause of pregnancy loss.

Maternal health conditions

In a few cases, a mother's health condition might lead to miscarriage. Examples include:

  • Uncontrolled diabetes
  • Infections
  • Hormonal problems
  • Uterus or cervix problems
  • Thyroid disease

What does NOT cause miscarriage

Routine activities such as these don't provoke a miscarriage:

  • Exercise
  • Having sex
  • Working, provided you're not exposed to harmful chemicals or radiation.

Various factors increase the risk of miscarriage, including:

  • Age. Women older than age 35 have a higher risk of miscarriage than do younger women. At age 35, you have about a 20 percent risk. At age 40, the risk is about 40 percent. And at age 45, it's about 80 percent. Paternal age also might play a role. Some research also suggests that women who become pregnant by older men are at slightly higher risk of miscarriage.
  • Previous miscarriages. Women who have had two or more consecutive miscarriages are at higher risk of miscarriage.
  • Chronic conditions. Women who have a chronic condition, such as uncontrolled diabetes, have a higher risk of miscarriage.
  • Uterine or cervical problems. Certain uterine abnormalities or weak cervical tissues (incompetent cervix) might increase the risk of miscarriage.
  • Smoking, alcohol and illicit drugs. Women who smoke during pregnancy have a greater risk of miscarriage than do nonsmokers. Heavy alcohol use and illicit drug use also increase the risk of miscarriage.
  • Weight. Being underweight or being overweight has been linked with an increased risk of miscarriage.
  • Invasive prenatal tests. Some invasive prenatal genetic tests, such as chorionic villus sampling and amniocentesis, carry a slight risk of miscarriage.

Some women who miscarry develop a uterine infection, also called a septic miscarriage. Signs and symptoms of this infection include:

  • Fever
  • Chills
  • Lower abdominal tenderness
  • Foul-smelling vaginal discharge

Often, there's nothing you can do to prevent a miscarriage. Simply focus on taking good care of yourself and your baby. Seek regular prenatal care, and avoid known risk factors — such as smoking and drinking alcohol. If you have a chronic condition, work with your health care team to keep it under control.

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