Eng Article 04_Miscarriage: Causes, Risks & Treatment

Source: Harvard Health Publishing
Link: https://www.health.harvard.edu/blog/will-miscarriage-care-remain-available-202304142912

April 14, 2023
By Sara Neill, MD, MPH, Contributor, and Scott Shainker, DO, MS, Contributor

When you first learned the facts about pregnancy from a parent, perhaps, or a friend

you probably didn't learn that up to one in three ends in a miscarriage.

 

What causes miscarriage? How is it treated? 

 

 

 

 

What is miscarriage?

Many people who come to us for care are excited 

and hopeful about building their families. 

It's devastating when a hoped-for pregnancy ends early.

Miscarriage is a catch-all term for a pregnancy loss before 20 weeks,

counting from the first day of the last menstrual period.

Miscarriage happens in as many as one in three pregnancies,

although the risk gradually decreases as pregnancy progresses.

By 20 weeks, it occurs in fewer than one in 100 pregnancies.

 

 

What causes miscarriage?
Usually, there is no obvious or single cause for miscarriage. 

Some factors raise risk, such as:

√ Pregnancy at older ages. 

√ Autoimmune disorders. 

√ Certain illnesses.

√ Certain conditions in the uterus. 

√ Previous miscarriages.

√ Certain medicines. 

 

 

How is miscarriage diagnosed?
Before ultrasounds in early pregnancy became widely available, 

many miscarriages were diagnosed based on symptoms like bleeding and cramping. 

Now, people may be diagnosed with a miscarriage 

or early pregnancy loss on a routine ultrasound before they notice any symptoms.

 

 

How is miscarriage treated?
Being able to choose the next step in treatment may help emotionally. 

When there are no complications and the miscarriage occurs 

during the first trimester (up to 13 weeks of pregnancy)

Take no action. 

Passing blood and pregnancy tissue often occurs at home naturally, 

without need for medications or a procedure. 

Within a week, 25% to 50% will pass pregnancy tissue; 

more than 80% of those who experience bleeding 

as a sign of miscarriage will pass the pregnancy tissue within two weeks.

 

 

What to know: This can be a safe option for some people, but not all. 

For example, heavy bleeding would not be safe for a person who has anemia 

(lower than normal red blood cell counts).

If you have a miscarriage during the second trimester of pregnancy 

(after 13 weeks), discuss the safest and best plan with your doctor. 

Generally, second trimester miscarriages will require a procedure 

and cannot be managed at home.

 

 

 

Red flags: When to ask for help during a miscarriage
During the first 13 weeks of pregnancy: 

Contact your health care provider or 

go to the emergency department immediately if you experience

 

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