Miscarriage Facts

by Anai Rhoads

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Intercourse, falling, and exercise does not typically cause a miscarriage. The fetus is well protected by the mother's bones and muscle as well as by the amniotic fluid. There is also no evidence that conceiving while taking birth control pills increases the risk of miscarriage. Becoming pregnant while using an IUD, however, does make you more likely to miscarry or develop an infection.

As many as 25 percent of all pregnancies end in miscarriage, half of them before the woman even realizes she is pregnant. Fortunately, most women who miscarry, even more than once, can become pregnant again and give birth to a healthy baby.

What are the warning signs?

Any bleeding from the vagina during pregnancy suggests the possibility of miscarriage. Call your doctor about any abnormal vaginal bleeding, even if you do not think you are pregnant. Bleeding or spotting may be the first sign that you are pregnant and that the pregnancy is at risk. Staining or bleeding does not necessarily mean that you will miscarry, however. About 15 to 25 percent of pregnant women have some spotting or bleeding early in pregnancy, and about half of these pregnancies carry successfully to term.

Bleeding that signals possible miscarriage is usually light. It can be brown or bright red and may repeatedly occur over many days. If the bleeding persists or increases, the chances of losing the baby are greater. Cramping or low backache usually develops at some point after the bleeding has started.

If you have been bleeding and an ultra sound scan (sonogram) indicates that the fetus is alive, your doctor probably will ask you to rest in bed as much as possible and avoid sexual activity. The doctor will monitor you to be sure that:

•Your cervix is closed (If it's open, it's more likely you will miscarry).
•He or she will check the discharge/blood for clotting that would indicate whether or not it contains the fetus.
•You will be given a sonogram to see if there are any fetal heart movements, and if the fetus is growing properly.

More than 90 percent of first trimester pregnancies continue when ultra sound scans indicate that the baby is alive.

Rarely, early in pregnancy, fluid is suddenly released from the vagina without bleeding or pain. If you experience this, call your doctor immediately. You will probably be instructed to stay in bed and watch for further discharge, bleeding, cramping, or fever.

Inevitable Miscarriage

When bleeding and pain are accompanied by the breaking of membranes (the amniotic sac surrounding the fetus) and the widening of the cervix, the pregnancy is viewed as an inevitable miscarriage. Uterine contractions to expel the fetus usually begin soon after these symptoms develop.

Incomplete and Missed Miscarriages

In some miscarriages, the body does not expel all the of pregnancy. This is called an incomplete miscarriage. In about 2 percent of pregnancies, the body does not discharge the fetus or placenta for several weeks, even though the fetus has died. This is known as a missed miscarriage. This can happen while a woman has neither menstrual periods nor any signs of pregnancy. Breasts may return to their pre-pregnancy state, or the woman may lose a few pounds. (Note: Not all missed miscarriages are preceded by warning signs).

An incomplete or missed miscarriage that takes place early in pregnancy is usually removed with either suction or dilation and curettage (D&C) - "opening" the uterus and scraping out its contents, through the vagina, with an instrument called a curette. These procedures not only clear the uterus but also prevent infection. When incomplete miscarriage occurs later in pregnancy, the doctor may have to induce labor to remove the fetus.

How can I minimise the risk?

Most miscarriages are caused by chromosomal (genetic) abnormalities and other physical factors that are beyond your control. There are, however, steps you can take to reduce the risk of losing a pregnancy.