Miscarriage

A pregnancy that ends spontaneously before the 28th week is termed a miscarriage. As many as one in six pregnancies of up to twelve weeks' duration end in miscarriage. Probably the true figure is even higher than this, since miscarriages can occur before a woman is aware that she is pregnant. Early miscarriages are usually due to abnormality of the fetus; those that occur later in pregnancy may reflect a defect in the placenta or cervix. The first sign of miscarriage is usually vaginal bleeding, which may be heavy or slight. A 'threatened' miscarriage, which is often painless, is not uncommon in early pregnancy, but after a small amount of bleeding the pregnancy proceeds normally. Some miscarriages are inevitable, however, since the fetus has died in the uterus. The uterus will begin to contract and pain will be felt, perhaps for several days.

At the first sign of a possible miscarriage, tell your doctor and rest in bed. This may succeed in stopping any light bleeding, but nothing can be done medically to prevent an inevitable miscarriage. After a miscarriage, dilatation and curettage (D&C) may be necessary if any products of the pregnancy have been retained. In this minor operation, the cervix is dilated and the lining of the womb scraped.

A single miscarriage does not significantly affect a woman's chances of a successful subsequent pregnancy. However, repeated miscarriages usually require a gynaecologist to discover their cause.

Cause

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

Other possible causes for miscarriage include:

• Infection
• Physical problems in the mother
• Hormonal factors
• Immune responses
• Serious systemic diseases of the mother ( diabetes or thyroid )

Symptoms

The most common symptom is vaginal bleeding, which can range from light spotting to heavier than a period. You may see blood clots, brown discharge or other tissue that is not clearly identifiable. Sometimes a sac-like structure is seen.

Often there is cramping, with pelvic or back-pain. You may find that the usual symptoms of pregnancy, such as breast tenderness, feeling sick and having to pass urine more frequently than usual, stop unexpectedly.

Prevention

• Get prenatal care and follow the advice of your health care provider .
• Avoid alcohol, nicotine, and street drugs, especially cocaine, during pregnancy.
• Avoid or cut down on caffeine.
• Control high blood pressure and diabetes.
  
• Identify and treat any bacterial and certain viral infections.