Miscarriages A miscarriage also called spontaneous abortion is a termination of pregnancy before the 12th week of gestation as a result of abnormalities of the maternal environment. The reason for women having a miscarriage is varied, and most often the cause cannot be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality – meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell, or are due to a problem at the time that the zygote went through the division process. Other causes for miscarriage include:

  • Hormonal problems, infections or maternal health problems
  • Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
  • Implantation of the egg into the uterine lining does not occur properly
  • Maternal age
  • Trauma

There are 6 different types of miscarriages and they can take anywhere from hours to weeks to end.

  • Early miscarriage or Chemical Pregnancy ends a few days after implantation. Most women are not aware that they were pregnant. The only way this pregnancy is detectable is to have a blood test to determine hCG levels. A chemical pregnancy happens when a baby continues to develop normally however, a miscarriage can also occur before the fifth week of gestation, or within about a week of a missed period which, when it arrives, can considered a late period but is usually heavier than normal. This type of miscarriage is still dismayed even though the stages of life have yet to begin.
  • Missed miscarriage or Missed abortion is a condition in which a dead immature embryo is not expelled from the uterus for 2 or more months. The uterus diminishes in size, symptoms of pregnancy start to abate, and blood clots may form. The embryo or fetus becomes necrotic and the rest of the products of conception are reabsorbed. There are no warning symptoms of this type of abortion. Usually upon a scan there will be no fetal heart beat. There is a sac that kept growing but no fetus.
  • Threatening miscarriage is a condition in pregnancy before the 12th week where the uterus starts bleeding and cramping enough for a miscarriage to be the end result. Sometimes adequate amounts of progesterone are not made which can cause a miscarriage. Signs and symptoms could include; light bleeding, pain similar to having period cramps, the nausea and tender breasts associated with pregnancy may disappear, a sense of no longer 'feeling' pregnant.
  • Inevitable miscarriage is a spontaneous abortion and cannot be prevented. It is characterized by bleeding, cramping, and dilation of the cervix. When the cervix opens, the placenta breaks away from the uterine wall.  A transvaginal ultrasound makes it possible to determine if there is a fetal heart beat. If heavy bleeding occurs, immediate evacuation of the uterus may be required. Signs and symptoms are sudden absence of morning sickness and breast tenderness, no longer feeling pregnant, cramping like a bad or contractions, persistent heavy bleeding filling more than one sanitary pad in 30 minutes or less, passing pieces of placenta which look like blood clots, an unusual odor from the blood, you may see the fetus come out. If you are more than 16 weeks pregnant and start to have an inevitable miscarriage, the baby could be born alive and some doctors will insert a stitch in order to save future pregnancies.
  • Incomplete miscarriage happens when a pregnancy is terminated but the products of conception are not all expelled. This causes hemorrhage and some women require surgical evacuation by dilation and curettage (D&C). In order to prevent hemorrhage and infection, facilities will scrape and use suction to remove all the contents. Incomplete miscarriages usually occur between 6 and 12 weeks gestation.
  • Complete miscarriage is a termination of pregnancy in which embryo in its entirety are removed or expelled. Having a D&C is not needed since no products remain in the uterus. The earlier you are in the pregnancy, the more likely that your body will complete the miscarriage on its own. Once the uterus is empty the cervix closes, the pain stops and the bleeding slows down and should stop by seven days.

References Mosby’s Dictionary of Medicine, Nursing, & Health Professions. (2006). 7th ed. Mosby Elsivier. St. Louis, MO. Miscarriage Support Auckland Inc (2010). Types of miscarriage. Retrieved from: http://www.miscarriagesupport.org.nz/stages.html

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