Determining the cause, symptoms and odds of miscarriage

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Miscarriage is the spontaneous loss of a pregnancy before the 20th week; usually occurring before the 12th week during the first trimester. The chances of miscarriage increase considerably as a woman ages. Some studies even suggest pregnancies from men older than 40 increases the odds of miscarriage as well. A miscarriage may occur because the embryo or fetus isn’t developing properly due to chromosomal abnormalities.

Signs and symptoms of miscarriage

Spotting or bleeding
Abdomen or lower back pain
Cramps
Vaginal fluid or tissue discharge
Fever (usually due to septic miscarriage)
Chills (usually due to septic miscarriage)
Body aches and pains (usually due to septic miscarriage)
Thick discharge with foul odor (usually due to septic miscarriage)

Causes of miscarriage

Miscarriage typically occurs due to embryonic abnormalities during the division and growth of the embryo during the first 12 weeks; not usually due to inherited issues from the parents. In some cases though, a mother with uncontrolled diabetes, uterine and cervix issues, thyroid disease, infections or hormonal problems may be at more of a risk of miscarriage.

Intrauterine Fetal Demise occurs when an embryo is present but there is no heartbeat and the embryo has died before there are any signs of miscarriage/pregnancy loss. This may be due to chromosomal and/or genetic abnormalities. This usually occurs during the first trimester.

Blighted Ovum is a very common cause of miscarriage, occurring when a fertilized egg develops a placenta and membrane but no embryo. This usually transpires during the first trimester.

Molar Pregnancy is more of a rarity and occurs in approximately 1 in 1000 pregnancies. Also known as Gestational Trophoblastic Disease, it is an abnormality of the placenta caused by an issue or problem at fertilization where the placenta develops into a fast-growing mass of cysts that may or may not contain an embryo.

Invasive prenatal testing such as CVS (chorionic villus sampling) and/or amniocentesis carry a slight risk of miscarriage. Smoking or consuming alcohol or drugs increases the risk of miscarriage greatly.

Determining miscarriage at the doctor’s office

During a pelvic exam, your doctor will check for cervical dilation. An ultrasound checks for the heartbeat and development of the embryo. Blood tests provide levels of the pregnancy hormone HCG and determination of placental tissue passing. If you have passed tissue and bring it in to your OB/GYN, it can be sent to the lab to confirm miscarriage.

Common medical miscarriage terms

Threatened Miscarriage occurs if you are spotting or bleeding but your cervix has not dilated. Some pregnancies remain viable even though they may be threatened initially.

Inevitable Miscarriage occurs when you are bleeding, your uterus is contracting and your cervix is dilated. Miscarriage is inevitable.

Incomplete Miscarriage occurs when some placental/fetal material passes but some remains in uterine.

Missed Miscarriage occurs when the placental/embryonic tissue remains but the embryo has died or not formed.

Complete Miscarriage is the most common of miscarriages. All pregnancy tissues have passed. Usually takes place within the first twelve weeks of pregnancy. The entire process may take up to four weeks if done naturally.

Septic Miscarriage is when an infection develops within the uterus. A severe infection, this must be handled by medical professionals immediately. Some signs include severe abdominal pain, fever, chills and vomiting.

Medical and surgical miscarriage treatment

After medically confirming pregnancy loss or the inevitable loss, there are medical treatments available that speed up the process and get one back on track quicker like oral medications or vaginal ointments to expel all remaining pregnancy tissue. Some side effects may include nausea, cramps and diarrhea. About 70% of women will bring miscarriage to a close within 24-48 hours.

A surgical procedure called suction dilation and curettage also known as D and C dilates your cervix and suctions the non-viable pregnancy tissues. Uterine walls may be gently scraped of unnecessary tissue as well. To stop the bleeding, a D and C procedure might be necessary for some women.

Recovery

After a miscarriage, whether natural or with medical assistance, recovery time varies. For some it may only be hours, for others a few days to weeks. Generally a period will return within 4-6 weeks. Women must watch for signs of infection throughout recovery and consult a doctor immediately if symptoms develop like fever, chills, severe pain and/or heavier than normal bleeding. Additionally, doctors advise no tampons, douching or sex for two weeks following a miscarriage.

Pregnancy after miscarriage

Most OB/GYN’s recommend waiting one menstrual cycle after a miscarriage to try and conceive again; however it is possible to become pregnant before the next cycle.

Doctors advise additional testing for women who have experienced two or more miscarriages to identify underlying problems and/or abnormalities. After addressing issues, more than 60% of women will go on to deliver healthy babies.

GetPregnant.org