A miscarriage is the loss of a pregnancy in the first 23 weeks.
Miscarriage is common. It is possible that as many as 50% of pregnancies ‘miscarry’ before implantation in the womb occurs, so you do not realise you are pregnant.
Most miscarriages occur in the first 12 weeks of pregnancy. Overall about 1 in 6 of all pregnancies (15%) end in miscarriage. The risk of miscarriage decreases as pregnancy progresses. Early after implantation, pregnancy loss rate is about 3 in 10 (30%). Again this is still before a pregnancy is clinically recognised.
After a pregnancy may be clinically recognised with a pregnancy test (between days 35-50), about 1 in 4 (25%) will end in miscarriage.
The most common symptom of miscarriage is vaginal bleeding. The amount of bleeding can vary from spotting to the passage of clots. There may also be associated lower abdominal cramping and pain in your back or pelvis. In this situation it would be advisable to contact your GP. Another feature of miscarriage is that the symptoms of pregnancy may stop unexpectedly. It is possible to experience no symptoms of miscarriage and the miscarriage is only picked up during a routine ultrasound scan performed to date your pregnancy.
Causes of miscarriage
About 50% of all early miscarriages happen because of a problem in the way the genetic material (chromosomes) combined when your egg and your partner’s sperm joined during fertilisation. There are many other causes of miscarriage too numerous to mention however maternal age, smoking and alcohol consumption all do increase miscarriage risk.
Diagnosis of miscarriage
A miscarriage is usually confirmed following an early pregnancy ultrasound scan. If your pregnancy is early in development (less than 7 weeks) a further ultrasound scan may be required 7-10 days alter to confirm the diagnosis.
If your pregnancy at this time is suspected to be within your Fallopian tube (an ectopic pregnancy) then additional blood tests may be required in order to assist in the diagnosis.
Management of miscarriage
Unless your miscarriage is complete you may need treatment with either medicines or surgery to remove any pregnancy tissue from your womb. It is possible to let nature take its course (expectant management), however this can sometimes be associated with a higher chance of excessive bleeding. Your Doctor can discuss the options available to you so that an informed choice can be made.
If you have more than 3 miscarriages then the management of recurrent miscarriage may need to be considered.
The anxieties we had with our IVF pregnancy were allayed with the extra scans at Thornbury hospital with Tom Farrell.Helen (Sheffield)