Miscarriage
Miscarriage is a tragic event. A pregnancy seems normal and then all of a
sudden, your baby is gone. Miscarriage occurs in about 15 to 20 percent of all
pregnancies. A miscarriage is defined as a pregnancy loss that occurs before the
baby is 20 weeks old. Most miscarriages occur during the first trimester (the
first 12 weeks of pregnancy).
Why does a miscarriage occur? -
The causes of miscarriage are varied and sometimes the cause is not able to be
determined. During the first trimester, the most common cause of miscarriage is
chromosomal abnormality. This simply means that there is something wrong with
the baby’s chromosomes that will not allow the baby to live. Most chromosomal
abnormalities are the cause of a faulty egg or sperm cell. Chromosomal
abnormalities become more common as a woman becomes older. Other causes of first
trimester miscarriages are hormonal problems, infections, and health problems in
the mother. Your lifestyle can also increase the risk of a first trimester
miscarriage. If you drink 2 or more alcoholic beverages per day, you double your
risk of miscarriage. If you smoke cigarettes, you have a 20 to 80 percent higher
chance of miscarriage than if you did not smoke. If you drink 3 or more cups of
coffee per day (or the equivalent amount of caffeine), you are at an increased
risk for miscarriage.
Second trimester miscarriages are usually caused by problems with the uterus or
by a weakened cervix that dilates too early. Infections in the mother and
chromosomal abnormalities can also cause a miscarriage in the second trimester.
Some immune system problems can also cause miscarriage.
What factors do not cause miscarriage? -
Sex, working outside the home (unless you work with harmful chemicals), and
exercise do not cause miscarriage.
What tests are done following a miscarriage? -
If this is your first miscarriage and it occurred during the first trimester,
tests are not usually performed. The cause of a first trimester miscarriage is
often not known. If you are having a first trimester miscarriage, you should try
to save the tissue from the miscarriage because sometimes tests can be done to
find the cause of the miscarriage.
If your miscarriage occurred during the second trimester, doctors will usually
order tests, including blood tests, to determine the cause.
What causes repeated miscarriages? -
Miscarriage is usually a one time occurrence, but 1 in 20 couples experience 2
miscarriages in a row and 1 in 100 couples experience 3 or more. When a couple
has recurrent miscarriages, there is an underlying problem causing them. If you
experience 2 or more miscarriages in a row, you should have tests to determine
the reason. Tests can reveal the cause of recurrent miscarriages in at least 75
percent of couples.
The most common causes of repeated miscarriages are chromosomal problems,
uterine abnormalities, endocrine causes, immune system problems, and infections.
How long does it take to recover from a miscarriage? -
It can take a few weeks to a few months for a woman to recover physically from a
miscarriage. It depends on how long the pregnancy lasted. Most women will have a
menstrual cycle 4 to 6 weeks after miscarriage.
It usually takes much longer to recover emotionally from a miscarriage. Men and
women respond differently to a loss. Support groups or a counselor can be
helpful. My personal experience is that it has been over 2 years since my
miscarriage and I still struggle with the death of my child. It has gotten
easier and some days are better than other. I think of my child daily though.
How long should a woman wait to try to conceive again after a miscarriage? -
A woman must be physically and emotionally ready to conceive again. Medically, a
woman can try to conceive again after one normal menstrual cycle. It may take
longer than that to be ready emotionally to try and conceive again.
used
with permission by Christie "Cee Cee" Almon
For other articles and to visit CeeCee’s website, please go to
http://www.miscarriagesupport.org
Miscarriage
Pregnancy loss can be emotionally devastating to both mother and father.
Frequently, the response tends to be why me, and what could we have done
differently? It is important for these couples to realize that the miscarriage
is usually not a result of something that they have done, it is also important
for them to realize that they are not alone.
Miscarriage before the 20th week of pregnancy is unfortunately quite common. It occurs in up to 20% of women who have missed a period and know that they are pregnant. This means 1 out of every 5 pregnancies. The number of losses is even higher if we consider all conceptions, meaning each time that fertilization occurs. Of all conceptions, 50% do not progress to a viable pregnancy. These losses will occur before the woman misses her period, so she never knows that she was even pregnant.
After one miscarriage, a couples chance of becoming pregnant again, and carrying that pregnancy to term is still very good. The odds start to work against you after 3 or more miscarriages, which is referred to as recurrent pregnancy loss. This is usually the point that most doctors would begin investigating the possible causes. However, if a couple has suffered through 2 losses and if they are concerned enough, most doctors will begin the investigation early. The important point here is that even after a lengthy and usually expensive work-up to determine the cause, the reason for the miscarriage will only be discovered in 40-50% of the cases. But there is some good news, even without treatment, couples who have had 3 miscarriages will be able to have a full term pregnancy 50-70% of the time.
As previously mentioned, the cause of recurrent miscarriage is often never known. Sometimes, however, the cause can be identified as a result of either: genetic problems, certain maternal infections, hormonal imbalances such as diabetes or thyroid problems, immune system disorders, or anatomic problems of the uterus. For cases in which a particular cause can be identified, treatment could potentially improve a couples chance of successful pregnancy. Another area of concern are environmental factors. For example, women who smoke are at a higher risk of pregnancy loss than non-smokers. In addition, heavy use of alcohol or illegal drugs, especially cocaine, could increase the risk of miscarriage.
An area of this problem not to be overlooked is the emotional impact on both parents. As an OB/GYN physician, having to tell a couple that they have had a miscarriage is one of the toughest parts of my job. It is perfectly normal for these couples to experience significant grief and despair. It is also likely that self-blame and sometimes even denial will occur. Resist the urge to blame yourself. Neither one of you needs this type of self -punishment at this critical time. Instead, reach out to your family, your friends and your physician. These people can provide the support that is so crucial at this stressful time.
In summary, even though it is difficult to determine the cause of miscarriage, the chance of a subsequent successful pregnancy is good. When your next pregnancy occurs, be sure to see your physician early, so that close monitoring can be initiated.
Used with permission from: Bradley Goldberg, MD – http://www.coffeewomenscenter.com
Bibliography
1) Novak’s Gynecology, Twelfth Edition, Jonathan S. Berek, MD, Williams &Wilkins, Baltimore, 1996.
2) Predicting Recurring Miscarriage: What is Important? Quenby, S.M., et. al., Obstet and Gynec, Vol. 82, No. 1, July 1993.
3) Clinical Gynecologic Endocrinology and Infertility, Fifth Edition, Leon Speroff, MD, Williams & Wilkins, Baltimore, 1994.
4) Repeated Miscarriage, ACOG Patient Education, #AP100,1995.
5) Early Pregnancy Loss, ACOG Technical Bulletin #212, September 1995.