Miscarriage is the end of a pregnancy before the baby is able to survive outside the uterus. It can occur during the first or second trimester. Most happen in the first 12 weeks of pregnancy, but they can happen up to 20 weeks.
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In some people, the cause is not known. In others, it may happen due to:
- Problems in the chromosomes (common cause)
- Abnormal structure or issues in the uterine tract, such as fibroids
- Problem with hormones, such as not having enough hormone (progesterone) to support pregnancy
- Immune system-related problems, such as blood-clotting problems or rejection of the fetus
This problem is more common in people 35 years of age and older. Other things that may raise the risk are:
- Smoking, drinking alcohol, or using drugs during pregnancy
- Taking certain medicines
- Exposure to certain toxins in the environment
- Problems with the immune system, such as systemic lupus erythematosus
- High-dose radiation therapy on the ovaries, uterus, or the pituitary gland during childhood cancer treatment
Problems may be:
- Vaginal bleeding or pink or brown discharge
- Passing the fetus, placenta, and surrounding tissues through the vagina
The doctor will ask about symptoms, health history, and when the miscarriage happened. Physical and pelvic exams will be done. Passed tissues may be tested. The uterus may need to be viewed. This can be done with an ultrasound.
Early or first trimester miscarriages may only need observation. Medicine may be needed if there is heavy bleeding or cramping.
A dilation and evacuation (D&E) may be needed if all tissue does not pass through the vagina. The doctor will remove remaining tissue.
Treatment may help prevent future miscarriages if a specific cause was found.
It can be hard to cope after a miscarriage. A counselor or support group can help.
- First trimester pregnancy loss. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/first-trimester-pregnancy-loss.
- Miscarriage. March of Dimes website. Available at: http://www.marchofdimes.com/loss/miscarriage.aspx.
- Recurrent pregnancy loss. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/second-trimester-pregnancy-loss.
- Second trimester pregnancy loss. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T904101/Second-trimester-pregnancy-loss.
- Signs of miscarriage. American Pregnancy Association website. Available at: https://americanpregnancy.org/getting-pregnant/pregnancy-loss/signs-of-miscarriage.
- Elizabeth Margaret Prusak, MD
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