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Miscarriage

What is a miscarriage?
A miscarriage, sometimes called pregnancy loss, is defined as the loss of pregnancy from natural causes before the 20th week of pregnancy. Many miscarriages occur very early in the pregnancy, often before a woman even knows she is pregnant.

What causes a miscarriage?
There are many different causes for a miscarriage, some known and others unknown. In most cases, there is nothing a woman can do to prevent a miscarriage.

There are some factors that may contribute to miscarriage.

* The most common cause of miscarriage in the first trimester is a chromosomal abnormality in the fetus. This is usually results from a problem with the sperm or egg that prevents the fetus from developing properly. (In addition if you have a blood disorder called antiphospholipid antibodies syndrome, or cardiolipin antibodies you are at high risk for a miscarriage early in your pregnancy). Talk to your obstetrician about this and make sure she or he is aware of this. A simple blood test can determine if you have this. Most women with Lupus will have these antibodies.

Why get tested for these antibodies if you miscarry early?
To help investigate inappropriate blood clot formation, to help determine the cause of recurrent miscarriage, or as part of an evaluation for antiphospholipid syndrome. On a personal note, I knew I had these antibodies, but my physician at that time wasn't overly concerned about them and he should have been. Very often the treatment for this is aspirin or heparin, both are serious drugs, so please discuss this with your health care provider.

* During the second trimester, problems with the uterus or cervix can contribute to miscarriage.

* Women with a disorder called polycystic ovary syndrome are three times more likely to miscarry during the early months of pregnancy than women who don’t have the syndrome.

Women who have miscarriages can and often do become pregnant again, with normal pregnancy outcomes.

What are the symptoms of and treatments for miscarriage?
Signs of a miscarriage can include:

* Vaginal spotting or bleeding
* Cramping or abdominal pain, often worse than menstrual cramping
* 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.

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.

Yes, in most cases you can have a normal pregnancy the next time you try to get pregnant. Good luck to you.

Source: National Institute of Child Health and Human Development

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