Miscarriage

Definition & Causes

A miscarriage occurs whenever a pregnancy ends from natural causes before the 20th week of pregnancy. Miscarriages commonly occur in the first few days or weeks in the pregnancy, often before a woman knows she is pregnant.

There are many causes of miscarriages, the most common being a chromosomal abnormality in the fetus. This usually results from a problem with the sperm or egg preventing the fetus from developing properly. If the miscarriage occurs during the second trimester, problems with the uterus or cervix may be a significant factor.

Age is also a factor: after age 40, more than one-third of pregnancies end in miscarriage.

Women suffering multiple and consecutive miscarriages are diagnosed with recurrent pregnancy loss (RPL), defined as two or more miscarriages in the first trimester or early second trimester.

Some women who miscarry suffer from a condition called polycystic ovarian syndrome (PCOS), a disorder that triples the risks of miscarriage during the early months of pregnancy. In fact, PCOS is believed to be the most commonly found reason for menstrual irregularities in women of reproductive age.

PCOS often starts as early as the teen years and has no cure, although its symptoms – including infertility – can be treated.

Symptoms & Treatments

Signs of a miscarriage can include:

  • Vaginal spotting or bleeding
  • Cramping or abdominal pain
  • Fluid or tissue passing from the vagina

Although vaginal bleeding is a common symptom when a woman has a miscarriage, many pregnant women have spotting early in their pregnancy but do not miscarry. But, pregnant women who have symptoms such as bleeding should contact their health care provider immediately.

In most cases, there is nothing a woman can do to prevent a miscarriage. Women who have miscarriages can and often do conceive again and have healthy pregnancies.

Women who miscarry early in their pregnancy usually do not need any treatment. In some cases, a woman may need a procedure called a dilatation and curettage (D&C) to remove tissue remaining in the uterus. A D&C can be done in a health care provider’s office, an outpatient clinic, or a hospital.

For women suffering recurrent pregnancy loss, underlying factors may be hormonal, metabolic, or uterine related, among other factors. Treatments for RPL include aspirin, anticoagulants, hormone therapy, and surgery for uterine abnormalities.

Dr. Hinckley Explains Miscarriages and Recurrent Pregnancy Loss