Miscarriage (Pregnancy Loss)
Loss of pregnancy before 20 weeks, most commonly in first trimester due to chromosomal abnormalities.
Affects: 10-20% of known pregnancies, often before 12 weeks
Overview
Miscarriage is the loss of a pregnancy before 20 weeks. Most occur in the first trimester, often before a woman even knows she's pregnant. The most common cause is chromosomal abnormalities in the embryo - not something the mother did or didn't do.
Signs include vaginal bleeding, cramping, and passing tissue. However, some miscarriages are "missed" with no symptoms, discovered during ultrasound when no heartbeat is detected.
Miscarriage is emotionally devastating and requires time to grieve. Most women who miscarry go on to have successful pregnancies, though some experience recurrent miscarriage requiring investigation.
🩺 Symptoms
- •Vaginal bleeding (light spotting to heavy bleeding)
- •Cramping or abdominal pain
- •Passing tissue or clots
- •Disappearance of pregnancy symptoms
- •Lower back pain
- •Fluid or tissue passing from vagina
- •Missed miscarriage: No symptoms, diagnosed on ultrasound
🔍 Causes
- →Chromosomal abnormalities (50-70% of first trimester losses)
- →Genetic problems in embryo
- →Uterine abnormalities
- →Cervical insufficiency
- →Immune system problems
- →Uncontrolled diabetes
- →Severe infections
- →Hormone problems
- →Trauma to uterus
- →Often no identifiable cause
⚠️ Risk Factors
- •Maternal age over 35 (20% risk) or over 40 (40% risk)
- •Previous miscarriages
- •Chronic conditions (diabetes, thyroid, autoimmune)
- •Uterine or cervical problems
- •Smoking, alcohol, or drug use
- •Severe malnutrition
- •Exposure to environmental toxins
- •Certain medications
- •Chromosomal abnormalities in parents
🔬 Diagnosis
- →Ultrasound showing no heartbeat or empty gestational sac
- →Declining hCG levels (pregnancy hormone)
- →Pelvic exam showing dilated cervix
- →Complete miscarriage: All tissue passed
- →Incomplete: Some tissue remains
- →Missed: Embryo died but body hasn't expelled it
- →Threatened: Bleeding but pregnancy may continue
💊 Treatment
- ✓Expectant management: Wait for natural passage (1-2 weeks)
- ✓Medical: Medication (misoprostol) to induce passage
- ✓Surgical: D&C (dilation and curettage) to remove tissue
- ✓Pain medication
- ✓Monitoring hCG levels to ensure they return to zero
- ✓RhoGAM if mother is Rh-negative
- ✓Follow-up to ensure complete passage
- ✓Emotional support and counseling
- ✓Can try to conceive after one normal period
🛡️ Prevention
- →Most miscarriages cannot be prevented
- →Take prenatal vitamins with folic acid
- →Maintain healthy weight
- →Avoid smoking, alcohol, drugs
- →Limit caffeine to 200mg daily
- →Manage chronic conditions
- →Avoid environmental toxins
- →Practice safe food handling
- →After 2-3 miscarriages, testing for underlying causes
⚠️ Potential Complications
- !Heavy bleeding requiring medical attention
- !Infection if tissue remains
- !Emotional trauma and grief
- !Anxiety in future pregnancies
- !Depression
- !Rare: Asherman's syndrome (uterine scarring from D&C)
- !Very rare: Septic miscarriage (infection)
🚨 When to Call Your Doctor
Contact your healthcare provider immediately if you experience:
- ⚠Heavy bleeding (soaking more than 2 pads per hour)
- ⚠Severe abdominal pain
- ⚠Fever or chills
- ⚠Foul-smelling discharge
- ⚠Dizziness or fainting
- ⚠Any vaginal bleeding in pregnancy
- ⚠Seek support for grief and depression
Related Conditions
This information is for educational purposes and should not replace medical advice. Always consult your healthcare provider for personalized guidance.