MBBS, MS (OBS & GYNAE), MRCOG (UK)
Consultant Gynaecologist & Laparoscopic Surgeon
A miscarriage is a spontaneous loss of a pregnancy that occurs during the first 20 weeks of gestation.
Miscarriages are common, affecting 1 in four pregnancies. Most of the miscarriages occur within the first 10 weeks of pregnancy.
The cause of a miscarriage is often unknown. Generally miscarriage occurs because foetus did not develop properly. At least half of all miscarriages are believed to be related to a problem with the genetic makeup of the foetus. Miscarriage is almost never caused by anything the woman did or failed to do. In most cases, the next pregnancy will be successful.
Age: Risk increases in women older than 40 years, with a significant increase in women over 35.
The use of some medications, Use of alcohol/ drug/ cigarettes.
Previous surgery and Abnormalities of uterus.
Poorly controlled diabetes/ kidney/ thyroid disease, Infections.
Fetal chromosomal disorders.
Types of Miscarriage.
- Threatened miscarriage: pregnancy with vaginally bleeding and little pain. Basically, there is still a chance that pregnancy can continue. You might be prescribed certain medications to support the pregnancy.
- Incomplete miscarriage: is a failed pregnancy where uterus may still contain the foetus, placenta or membranes.
- Complete miscarriage: failed pregnancy in which the foetus and all the products of pregnancy have passed out of the uterus and the vagina without the need of any treatment.
- Missed miscarriage: occurs when a pregnancy has stopped but typically without bleeding or other symptoms.
Usual symptoms include vaginal bleeding, abdominal cramps and pain, and the passage of tissue.
The approach to treatment depends on the type of miscarriage.
In case of threatened miscarriage some medications might be prescribed and a close watch on pregnancy is kept.
For women who have had a complete miscarriage usually do not require medical or surgical treatment
However, women with a missed or incomplete miscarriage often require prompt medical of surgical treatment to remove any pregnancy tissue left inside the uterus
There are different treatment options. Together the woman and the doctor should decide on the best course of action
Surgery:Surgery is done to take out the tissues which have remained inside the uterus. If they are not removed, bleeding may continue and an infection may develop the Uterus is gently scraped to remove pregnancies tissues. This procedure is known as a D&C (dilatation and curettage). It is usually performed under a general anaesthetic and the women are often able to return home the same day. After D&C most women will have light bleeding for 5-10 days.
The expectant approach:In some cases the miscarriage has already happened by the time women sees her doctor. If the ultrasound shows an empty or nearly empty uterus, then no treatment may be required. The woman’s condition is monitored over several days. This is called an expectant approach or wait and watch
The Medical approach:The prescription drug misoprostol can be an effective alternative to a D&C for some women with early pregnancy loss. Usually all the tissue comes out following treatment. However, some women (as many as three in 10) need follow up D& C treatment to remove retained products of pregnancy
- Rest for few days
- Avoid using tampons and having sex for about 2 weeks
- Depending upon your doctor’s advice, you may consider becoming pregnant anytime after the normal menstrual cycle has resumed.
When can we try for another baby?
You can try for a baby as soon as you and your partner feel physically and emotionally ready.
Am I at higher risk of a miscarriage next time?
You are not at higher risk of another miscarriage if you have had one or two early miscarriages. Most miscarriages occur as a one-off event and there is a good chance of having a successful pregnancy in the future.