Miscarriage: Symptoms, Causes & Treatment

Miscarriage is the spontaneous loss of pregnancy before the fetus becomes able to live outside the womb, that is, before roughly week 20 of pregnancy. It is more common than many people think, as a notable proportion of known pregnancies are estimated to end in miscarriage, most in the early weeks. It is very important for a woman to know that miscarriage in the vast majority of cases is not because of something she did or neglected, such as work, moderate exercise, or marital relations.

The most common cause of early miscarriage is an abnormality in the number or structure of the fetus's chromosomes, occurring randomly during fertilization or division, so the pregnancy cannot continue. There are other factors that may increase risk such as advanced maternal age, some uncontrolled chronic diseases (such as diabetes or thyroid disorders), problems in the uterus or its cervix, and hormonal or immune disorders. Signs of miscarriage include vaginal bleeding (which may be light or heavy with clots), cramps or pain in the lower abdomen or back, and pregnancy symptoms may stop. But early light bleeding does not always mean miscarriage, so evaluation is needed.

When miscarriage is suspected, an ultrasound and pregnancy-hormone tests are done to determine the pregnancy's status. Management differs by case: the miscarriage may complete on its own and need only monitoring, or a medication may be given to help complete it, or a minor procedure to clean the uterus may be needed in some cases. The emotional aspect is very important, as miscarriage is an emotionally painful experience in which the couple deserve support and understanding, and there is no need to feel guilt. The reassuring news is that most women who experience one miscarriage (even more) can conceive and have children successfully later. Recurrent miscarriage (three or more times), however, calls for specialized evaluation to look for a treatable cause.

• Vaginal bleeding (light or heavy with clots).
• Cramps or pain in the lower abdomen or back.
• Pregnancy symptoms stopping sometimes.
• (Early light bleeding does not always mean miscarriage.)

• A random chromosomal abnormality in the fetus (the most common cause of early miscarriage).
• Advanced maternal age.
• Uncontrolled chronic diseases (diabetes, thyroid disorders).
• Problems in the uterus or cervix, and hormonal or immune disorders.

• Ultrasound to assess the pregnancy's status and fetal heartbeat.
• Pregnancy-hormone tests (serial when needed).
• Gynecological examination and assessment of bleeding.

By case

• Monitoring if the miscarriage completes on its own.
• A medication to help complete the miscarriage.
• A minor procedure to clean the uterus in some cases.

Support

• Psychological and emotional support for the couple is important, and there is no need to feel guilt.
• Specialized evaluation with recurrent miscarriage (three or more times).

This content is educational and does not replace consulting a gynecologist.

• Heavy bleeding or infection when the miscarriage is incomplete.
• A psychological and emotional impact deserving support.
• Recurrent miscarriage may indicate a treatable underlying cause.

• Most early miscarriages cannot be prevented because they are chromosomally random.
• Controlling chronic diseases before and during pregnancy (diabetes, thyroid).
• A healthy lifestyle, avoiding smoking and alcohol, and early pregnancy follow-up.