The Facts about Miscarriage
Pregnancy loss, also known as spontaneous abortion or miscarriage, is the most common complication of early pregnancy.
It occurs in approximately 20 percent of all clinically recognized pregnancies.
It is the loss of a clinically recognized pregnancy before the 20th week of gestation.
Causes of Miscarriage
Most pregnancy losses are a single occurrence and should not impact a couple’s ability to conceive in a future pregnancy.
The majority of pregnancy losses are caused by spontaneous errors within the chromosomes of the fetus, also known as chromosomal aneuploidy.
Less common causes for miscarriage include structural abnormalities of the uterus, such as a uterine septum, clotting disorders in the mother, and certain maternal endocrinopathies such as thyroid disease.
The most common presenting symptom in miscarriage is vaginal bleeding. However, vaginal bleeding is common in pregnancy, and a significant number of patients with first trimester bleeding go on to have normal, healthy pregnancies. Cramping may also occur.
You should inform your physician if you are experiencing bleeding in pregnancy. Although vaginal bleeding is a common occurrence in healthy pregnancies, your doctor will likely perform a physical exam and an ultrasound for more detailed evaluation of the pregnancy and to assess for a possible miscarriage.
Treatment for Miscarriage
There are several options for management of a pregnancy loss.
- Expectant management: This is an option for first trimester pregnancy losses, as many will pass on their own.
- Medical management: A medication is administered to help the uterus expel the products of conception.
- Dilation and curettage (D&C): A small procedure in which the products of conception are evacuated surgically.
Deciding on the best treatment will depend on a number of factors, including:
- the gestational age at the time of pregnancy loss
- the extent of bleeding
- when medically safe, the patient’s preference.
The grief experienced during and after a miscarriage can be significant, and some studies have equated the emotional response of the couple to the loss of a child. It is important to have an open dialogue with your physician not only about your physical symptoms, but also about the emotional and psychological response you are experiencing, so that you can receive optimal support.
Dr. Jenna Friedenthal is a Fellow in Reproductive Endocrinology and Infertility at Reproductive Medicine Associates of New York. Dr. Friedenthal completed her undergraduate education at Yale University. She went on to complete her medical degree from the Albert Einstein College of Medicine with Distinction in Research. While in medical school, she received the Senior Research Fellowship award for her research accomplishments in reproductive endocrinology and immunology. Dr. Friedenthal then completed her residency training in Obstetrics and Gynecology at New York University. During her residency training, Dr. Friedenthal received the Mortimer Levitz Best Basic Science Award for her research on pre-implantation genetic testing