Miscarriage
A miscarriage occurs when a
pregnancy terminates before 20 weeks and research suggests that around 10-20
percent of pregnancies end in this way.
An exact figure is hard to pinpoint,
since many women miscarry before they even realize they’re pregnant and pass it
off as a very heavy period.
What are the symptoms?
You may experience bleeding,
along with backache and possibly contractions. You may also notice that any
pregnancy symptoms, such as morning sickness and tender breasts, disappear.
There are three types of miscarriage:
Incomplete miscarriage where a miscarriage happens but some of the products of
conception are left inside the mother.
Complete miscarriage where the uterus expels the fetus and placenta entirely,
and an ultrasound scan shows that the uterus is completely empty.
Missed miscarriage where the fetus and placenta die but remain in the mother’s
uterus for some time before being expelled. There might be very minor symptoms,
such as a brownish discharge. An ultrasound can check whether the fetus’ heart
has stopped beating, or for an empty amniotic sac inside the uterus.
Early miscarriage
The majority of miscarriages
happen in the first trimester (weeks 0-12) and most are caused by chromosomal abnormalities which prevent the fetus from developing normally. Rarely, a
pregnancy can develop outside the uterus, usually in one of the fallopian
tubes. Called an ectopic pregnancy, it’s not capable of surviving and will normally
spontaneously miscarry.
If you’re bleeding in your first
trimester, call your OB-GYN or nurse-midwife and stop any sexual activity and
exercise. You’ll likely be given an ultrasound to see whether a miscarriage is
imminent or if it’s an ectopic pregnancy. If a miscarriage is inevitable,
there is little your caregivers can do to stop it.
Lots of women experience vaginal
bleeding in early pregnancy and go on to have a normal pregnancy and healthy
baby. Experts are not sure why this happens, but it affects roughly one woman
in four. However, if the uterus starts to expel the pregnancy there’s little
that can be done to save it. If this is the case, you’ll be given the option to
see if the pregnancy is expelled from your body naturally over the next few
days. If this doesn’t happen, you’ll likely be offered a D&C (dilatation
and curettage), which is a minor operation carried out under anesthetic to
clear any remaining tissue.
Late miscarriage
Late miscarriage (occurring in
the second trimester up to week 24 – miscarriage after week 24 is referred to
as stillbirth
is more likely to be a result of problems with your cervix or uterus, although
they are sometimes linked to genetic abnormalities such as Down syndrome, or
spina bifida. Symptoms are similar to those of early miscarriage – get them
checked out straightaway, as it’s possible you could have placental abruption.
It’s thought that an incompetent
cervix is the cause of 20-25 percent of miscarriages in the second trimester
(weeks 13-28). It’s a condition where the cervix opens under the pressure of
the growing baby and can be caused by a genetically weak cervix, damage during
a previously difficult birth, previous surgery on the cervix, and a cone biopsy
for surgical cancer or laser therapy. A stitch can be inserted in your cervix
to keep it closed, and will be removed at the end of your pregnancy before you
go into labor. The chances of carrying a baby to term with this procedure have
proven to be very successful.
Other causes of late miscarriage
are an abnormally shaped uterus and infections in pregnancy.
It can be very helpful to talk
to other people who’ve gone through miscarriage, so if you feel that you need
to talk to someone about your loss but don't know who, why not visit the chat section of the gurgle site in order to find support from women who’ve had
similar experiences. In addition, The March of Dimes can offer information on
pregnancy and newborn loss (www.marchofdimes.com).