Prof. (Dr.) Subhas Ch. Biswas

Miscarriage

A miscarriage is the loss of a fetus before the 20th week of pregnancy. The medical term for a miscarriage is spontaneous abortion, but "spontaneous" is the key word here because the condition is not an abortion in the common definition of the term.

According to the March of Dimes, as many as 50% of all pregnancies end in miscarriage -- most often before a woman misses a menstrual period or even knows she is pregnant. About 15-25% of recognized pregnancies will end in a miscarriage.

More than 80% of miscarriages occur within the first three months of pregnancy. Miscarriages are less likely to occur after 20 weeks gestation; these are termed late miscarriages.

Causes:

Most miscarriages happen when the unborn baby has fatal genetic problems. Usually, these problems are unrelated to the mother.

Other causes of miscarriage include:
• Infection
• Medical conditions in the mother, such as diabetes or thyroid disease
• Hormone problems
• Immune system responses
• Physical problems in the mother
• Uterine abnormalities



A woman has a higher risk of miscarriage if she:

• Is over age 35
• Has certain diseases, such as diabetes or thyroid problems
• Has had three or more miscarriages
• Cervical Insufficiency :
A miscarriage sometimes happens because there is a weakness of the cervix, called an incompetent cervix, which cannot hold the pregnancy. A miscarriage from an incompetent cervix usually occurs in the second trimester.

There are usually few symptoms before a miscarriage caused by cervical insufficiency. A woman may feel sudden pressure, her "water" may break, and tissue from the fetus and placenta may be expelled without much pain. An incompetent cervix can usually be treated with a "circling" stitch in the cervix in the next pregnancy, usually around 12 weeks. The stitch holds the cervix closed until it is pulled out around the time of delivery. The stitch may also be placed even if there has not been a previous miscarriage if cervical insufficiency is discovered early enough, before a miscarriage does occur.

Symptoms

Symptoms of a miscarriage include:



• Bleeding which progresses from light to heavy
• Severe cramps
• Abdominal pain
• Fever
• Weakness
• Back pain

If you experience the symptoms listed above, contact your obstetric health care provider right away. He or she will tell you to come in to the office or go to the emergency room.