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Experiencing a miscarriage can be incredibly overwhelming, with lasting emotional effects. A miscarriage, also known as a spontaneous abortion, happens when a pregnancy ends unexpectedly within the first 20 weeks.
Contrary to its name, miscarriage typically isn’t a result of any shortcomings in pregnancy care. In most cases, miscarriages occur because the foetus stops developing, and it’s usually beyond your control. This article discusses the causes and factors that increase the risk of miscarriage.
An incomplete miscarriage occurs when only some of the pregnancy tissues, such as the embryo or foetus, are expelled from the uterus, while some tissues remain inside. In this situation, medical intervention may be necessary to remove the remaining tissue to prevent complications such as infection or excessive bleeding.
A complete miscarriage occurs when all of the pregnancy tissues, including the embryo or foetus and the placenta, are expelled from the uterus. This type of miscarriage typically occurs before the 12th week of pregnancy. It means that the miscarriage process is fully completed, and there are no remaining tissues left in the uterus.
A missed miscarriage, also known as a silent miscarriage or an asymptomatic miscarriage, happens when the embryo or foetus stops developing or dies, but the body doesn’t expel the pregnancy tissues. This type of miscarriage typically occurs without any symptoms like bleeding or cramping, leading to a delay in diagnosis. Medical intervention is often needed to complete the miscarriage process and remove the remaining tissues from the uterus.
A threatened miscarriage occurs when a person experiences vaginal bleeding during early pregnancy, but the cervix remains closed, and the pregnancy continues normally. Despite the bleeding, there is no immediate threat to the pregnancy, and the cervix stays closed, indicating that the pregnancy is still viable. In many cases, the bleeding resolves on its own, and the pregnancy progresses without further complications.
An inevitable miscarriage occurs when symptoms such as vaginal bleeding and cramping are present, and the cervix begins to dilate, indicating that a miscarriage is likely to happen. In this situation, the body is showing signs that the pregnancy cannot continue, and the cervix opening suggests that the miscarriage process is underway.
A septic miscarriage occurs when a miscarriage is accompanied by an infection in the uterus. This condition is rare but can be life-threatening if not treated promptly. Symptoms of a septic miscarriage include fever, chills, abdominal pain, and foul-smelling vaginal discharge.
Recurrent miscarriage occurs when a person loses two or more pregnancies in a row before reaching 20 weeks of gestation each time. This type of miscarriage is relatively rare, affecting only about 1% of couples trying to conceive.
A chemical pregnancy, or a biochemical pregnancy, occurs very early in gestation, typically before six weeks. It’s called a chemical pregnancy because it’s detected through chemical means, such as a urine or blood test, rather than through visual confirmation on an ultrasound. Unfortunately, despite the positive test, the pregnancy ends shortly after implantation, often before any signs or symptoms are noticeable.
An incomplete miscarriage occurs when only some of the pregnancy tissues, such as the embryo or foetus, are expelled from the uterus, while some tissues remain inside. In this situation, medical intervention may be necessary to remove the remaining tissue to prevent complications such as infection or excessive bleeding.
A complete miscarriage occurs when all of the pregnancy tissues, including the embryo or foetus and the placenta, are expelled from the uterus. This type of miscarriage typically occurs before the 12th week of pregnancy. It means that the miscarriage process is fully completed, and there are no remaining tissues left in the uterus.
A missed miscarriage, also known as a silent miscarriage or an asymptomatic miscarriage, happens when the embryo or foetus stops developing or dies, but the body doesn’t expel the pregnancy tissues. This type of miscarriage typically occurs without any symptoms like bleeding or cramping, leading to a delay in diagnosis. Medical intervention is often needed to complete the miscarriage process and remove the remaining tissues from the uterus.
A threatened miscarriage occurs when a person experiences vaginal bleeding during early pregnancy, but the cervix remains closed, and the pregnancy continues normally. Despite the bleeding, there is no immediate threat to the pregnancy, and the cervix stays closed, indicating that the pregnancy is still viable. In many cases, the bleeding resolves on its own, and the pregnancy progresses without further complications.
An inevitable miscarriage occurs when symptoms such as vaginal bleeding and cramping are present, and the cervix begins to dilate, indicating that a miscarriage is likely to happen. In this situation, the body is showing signs that the pregnancy cannot continue, and the cervix opening suggests that the miscarriage process is underway.
A septic miscarriage occurs when a miscarriage is accompanied by an infection in the uterus. This condition is rare but can be life-threatening if not treated promptly. Symptoms of a septic miscarriage include fever, chills, abdominal pain, and foul-smelling vaginal discharge.
Recurrent miscarriage occurs when a person loses two or more pregnancies in a row before reaching 20 weeks of gestation each time. This type of miscarriage is relatively rare, affecting only about 1% of couples trying to conceive.
A chemical pregnancy, or a biochemical pregnancy, occurs very early in gestation, typically before six weeks. It’s called a chemical pregnancy because it’s detected through chemical means, such as a urine or blood test, rather than through visual confirmation on an ultrasound. Unfortunately, despite the positive test, the pregnancy ends shortly after implantation, often before any signs or symptoms are noticeable.
Symptoms of miscarriage that occur before or during can vary from person to person. You might not realise you’re having a miscarriage, as sometimes there are no obvious symptoms.
However, in those who do experience symptoms, the most common signs are bleeding and cramping, but having these symptoms doesn’t always mean you’re having a miscarriage. About one-third of pregnancies have some bleeding early on, and half of those turn out to be normal. Other symptoms include:
Miscarriages can happen for many reasons, though the exact cause is often unknown. During the first trimester (the first 3 months) of pregnancy, about 3 out of every 4 miscarriages are typically attributed to problems with the unborn baby (foetus). On the other hand, if a miscarriage occurs after the first trimester, it might be due to factors such as underlying health conditions in the mother.
Miscarriages in the First trimester are often caused by problems with the chromosomes of the foetus. Sometimes, at the point of conception, errors can occur, leading to the foetus receiving either too many or too few chromosomes.
These chromosomes carry important instructions for developing the body’s cells and various characteristics, such as eye colour. This can prevent the foetus from developing normally and often results in a miscarriage.
The placenta serves as the connection between your blood supply and your baby’s. If there are issues with the development of the placenta, it can disrupt the flow of nutrients and oxygen to the baby, potentially leading to a miscarriage.
Sometimes, the muscles of the cervix, which is the neck of the womb, are weaker than normal. This condition is called a weakened cervix or cervical incompetence.
A weakened cervix can be caused by a previous injury to this area, often after a surgical procedure. The muscle weakness can result in the cervix opening too early during pregnancy, which can lead to a miscarriage.
Structural issues with the womb can contribute to second-trimester miscarriages. These problems may include the presence of non-cancerous growths known as fibroids within the uterus or an abnormally shaped uterus. Fibroids can disrupt the implantation of the embryo or cause complications during pregnancy,
Certain medications can increase the risk of miscarriage. These include misoprostol, commonly used for treating stomach ulcers; retinoids, prescribed for conditions like eczema and acne; and methotrexate, used in treating conditions such as rheumatoid arthritis.
Food poisoning, resulting from the consumption of contaminated food, can elevate the risk of miscarriage. Certain pathogens, such as Listeria monocytogenes, responsible for listeriosis, are commonly found in unpasteurised dairy products like blue cheese.
Toxoplasmosis, another infection linked to miscarriage, can be acquired by ingesting raw or undercooked meat containing the Toxoplasma gondii parasite. Additionally, salmonella infection, often contracted from raw or partially cooked eggs, poses a risk to pregnant individuals and their unborn babies.
Infections are a potential cause of miscarriage, and several common infections are known to pose a risk during pregnancy. These include Parvovirus B19, which causes the fifth disease, a childhood illness. Additionally, cytomegalovirus and certain sexually transmitted infections (STIs) like genital herpes and syphilis can increase the likelihood of miscarriage.
STIs are infections that can be contracted through sexual contact with an infected person. It’s crucial to inform your healthcare provider if you suspect you may have an STI, as early testing and treatment can help safeguard both you and your baby’s health during pregnancy.
Certain factors can increase the likelihood of experiencing a miscarriage for some pregnant women more than others.
These factors, known as risk factors, can include:
Miscarriages are diagnosed through a combination of clinical symptoms, physical examinations, and medical tests. Common diagnostic methods include Transvaginal ultrasounds, which involve inserting a small probe into the vagina, and are often performed to check for the foetus’s heartbeat.
Alternatively, some women may opt for external abdominal ultrasounds to avoid discomfort. Blood tests can also determine if beta-human chorionic gonadotropin (hCG) and progesterone levels are normal – both hormones are associated with a healthy pregnancy. Your healthcare provider may also perform a pelvic exam to assess whether the cervix has thinned out or opened, which can indicate the onset of a miscarriage.
Suppose you’ve had two or more previous miscarriages. Your healthcare professional may suggest chromosomal tests for both you and your partner to determine if your chromosome makeup could be associated with an increased risk of miscarriage.
If tests indicate that you’re experiencing or will experience a miscarriage, your healthcare team may suggest one of the following treatment options:
Expectant management: In expectant management, the miscarriage is allowed to progress naturally without medical intervention. This means that the body is given time to expel the pregnancy tissue on its own, typically through vaginal bleeding and cramping. Expectant management may be chosen when the miscarriage is in its early stages, and there are no signs of complications such as infection or excessive bleeding.
If the pregnancy tissue does not naturally pass from the body, treatment with medication or surgery may be required.
Medical treatment: Medications can be used to help the uterus expel pregnancy tissue from the body. A combination of mifepristone (Korlym, Mifeprex) and misoprostol (Cytotec) is more effective than misoprostol alone. This combined treatment has a higher success rate in facilitating the release of all remaining pregnancy tissue.
Additionally, using mifepristone together with misoprostol is associated with a reduced risk of requiring surgery to complete treatment compared to using misoprostol alone.
Surgical treatment: Surgical treatment, such as suction dilation and curettage (D&C) or uterine aspiration, is another option for managing miscarriage. During this minor procedure, the cervix is opened, and tissue from the inside of the uterus is removed. Surgical treatment is typically recommended if there is heavy bleeding or signs of infection accompanying the miscarriage.
While complications are rare, they may include damage to the connective tissue of the cervix or the uterine wall. It’s essential to undergo surgical treatment under the care of a healthcare provider to ensure safety and proper management of the miscarriage.
Miscarriage cannot usually be prevented as it often stems from chromosomal abnormalities or foetal developmental issues. However, adopting healthy lifestyle choices can help prevent miscarriage.
There are misconceptions about what factors do or do not contribute to miscarriage. It’s crucial to discern the genuine risk factors from the misconceptions. According to the NHS (National Health Services), there is no association between an elevated risk of miscarriage and:
Experiencing a miscarriage may lead to concerns about having another if you conceive again. However, it’s important to know that for most women, miscarriage is a singular event.
Approximately 1 in 100 women encounter recurrent miscarriages, defined as experiencing three or more consecutive miscarriages. Despite this, many of these women ultimately go on to have a successful pregnancy.
The experience of a miscarriage varies from person to person. While some women may experience intense cramping, others may have cramps similar to those during their menstrual period. Additionally, the type of miscarriage can influence the level of pain. For instance, someone who has a complete miscarriage at home may experience more discomfort compared to someone who undergoes a surgical procedure for a missed miscarriage.
It’s difficult to say what occurs first during a miscarriage because symptoms vary among people. In some cases, there are no noticeable signs, and the loss of the pregnancy is discovered during a prenatal ultrasound. While most individuals will experience cramping and bleeding to some extent, the sequence of events can differ from person to person.
The decision of when to start trying to conceive again after a miscarriage should be made in consultation with your healthcare provider. Typically, most women can begin trying to conceive after experiencing one normal menstrual period following the miscarriage. It’s essential to allow yourself time to heal both physically and emotionally after a miscarriage, and seeking counselling or joining a pregnancy loss support group can be beneficial.
If you’ve had three consecutive miscarriages, it’s advisable to undergo tests to identify any underlying causes and remember not to blame yourself for the miscarriage and to take the necessary time to grieve and heal.
A miscarriage and a stillbirth are both devastating losses experienced during pregnancy, but they differ in the timing and circumstances of the pregnancy loss. A miscarriage typically occurs before 20 weeks gestation and can happen at any point during the first two trimesters, with the majority occurring in the first trimester.
On the other hand, a stillbirth occurs after 20 weeks gestation and involves the loss of the baby before or during delivery, with the baby being born without signs of life. Stillbirths are less common than miscarriages and often occur in the third trimester.
After a miscarriage, it can take some time for the body to complete the process. This could be as short as a few hours or as long as a few weeks. The length of time depends on factors like how far along the pregnancy was and how the miscarriage is managed. It’s common to have light bleeding for up to two weeks afterwards. Each person’s experience is different so that the timeline can vary.
The experience of a miscarriage varies from person to person. While some women may experience intense cramping, others may have cramps similar to those during their menstrual period. Additionally, the type of miscarriage can influence the level of pain. For instance, someone who has a complete miscarriage at home may experience more discomfort compared to someone who undergoes a surgical procedure for a missed miscarriage.
It’s difficult to say what occurs first during a miscarriage because symptoms vary among people. In some cases, there are no noticeable signs, and the loss of the pregnancy is discovered during a prenatal ultrasound. While most individuals will experience cramping and bleeding to some extent, the sequence of events can differ from person to person.
The decision of when to start trying to conceive again after a miscarriage should be made in consultation with your healthcare provider. Typically, most women can begin trying to conceive after experiencing one normal menstrual period following the miscarriage. It’s essential to allow yourself time to heal both physically and emotionally after a miscarriage, and seeking counselling or joining a pregnancy loss support group can be beneficial.
If you’ve had three consecutive miscarriages, it’s advisable to undergo tests to identify any underlying causes and remember not to blame yourself for the miscarriage and to take the necessary time to grieve and heal.
A miscarriage and a stillbirth are both devastating losses experienced during pregnancy, but they differ in the timing and circumstances of the pregnancy loss. A miscarriage typically occurs before 20 weeks gestation and can happen at any point during the first two trimesters, with the majority occurring in the first trimester.
On the other hand, a stillbirth occurs after 20 weeks gestation and involves the loss of the baby before or during delivery, with the baby being born without signs of life. Stillbirths are less common than miscarriages and often occur in the third trimester.
After a miscarriage, it can take some time for the body to complete the process. This could be as short as a few hours or as long as a few weeks. The length of time depends on factors like how far along the pregnancy was and how the miscarriage is managed. It’s common to have light bleeding for up to two weeks afterwards. Each person’s experience is different so that the timeline can vary.
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