Having a miscarriage is an usual common problem for couples in the United States. Pregnancy loss ( miscarriage) is defined as a pregnancy loss that occurs before the 20th week of pregnancy or before the first 5 months of gestation. However, miscarriage is a term used in the general population but the exact scientific name is an spontaneous abortion. There are different types of Miscarriages, however they end up the same way, by loosing the pregnancy.
There are two main types of Miscarriage:
1) Anembryonic pregnancy loss: It means the loss of a pregnancy when no fetus has yet been identified. Other terms for this conditions are called: missed abortion or blighted ovum. Blighted ovum means a gestational sac where the ultrasound only reveals the sac but not the fetus.
2) Embryonic pregnancy loss: This is when an embryo is in fact identified by means of ultrasound however is non viable or does not have heart activity.
In fact , a miscarriage can have happen between two different stages during pregnancy. 1) First trimester pregnancy loss, which includes the time of conception until the week #14 or 3.5 months of gestation. 2) Second trimester pregnancy loss, or late miscarriage, which can happen after 14 weeks of pregnancy.
What is the initial workup for a pregnancy loss or a Miscarriage ?
As always, it includes a complete physical exam to rule out physical abnormalities and social factors contributing to the couple having a miscarriage. Social factors that lead to this problem are the following: 1) Smoking 2) Alcohol 3) excessive caffeine use 4) illicit drug use 5) Exposure to environmental toxins 6) Stress or poor working conditions
What medical conditions can lead to a Miscarriage ?
There are multiple conditions associated with having a miscarriage. For example: Diabetes Mellitus ( uncontrolled), Uncontrolled Hypertension, Systemic Lupus , thyroid disease and Antiphospholipid syndrome. For the latter, up to 15% of women with recurrent miscarriage , have this condition. There are blood test that can be done t determine if the patient suffers from this condition, as it is a treatable condition. There are sometTests called anticardiolipin antibodies, lupus anticoagulant and B2 glycoprotein antibodies. However, they must be done on two separate occasions 12 weeks apart to confirm this diagnosis. In the majority of cases of first trimester pregnancy loss however, chromosomal abnormalities of the fetus are found. What does this means: It means that fetuses with abnormal genes undergo a process of natural selection where the body ” feels” there is a problem with the pregnancy and tries to select only fetuses with a normal gene pool and this theory is confirmed by noting that more babies that were going to be born with Down syndrome or any other chromosomal abnormalties end up in miscarriage.
There is a misconception that a miscarriage can be caused by cervical problems ( lower part of the uterus, also called cervix). Women with a first trimester pregnancy loss, or miscarriage, is most of the time not associated with cervical insufficiency, as this is a condition that can lead to preterm birth as opposed to miscarriage.
Recurrent pregnancy loss or miscarriage can be traumatic for any family expecting a child. Some women blame themselves for what happened during her pregnancy and this most of the time should not be the case. There are forms of unexplained pregnancy loss or miscarriage that not even a physician can determine what happened, and we must accept this as an act of nature. If you however have recurrent miscarriage, don’t hesitate to call your OBGYN or call Pink Women’s Center, as a miscarriage workup and therapy is part of our expertise.
What to do if I have Recurrent pregnancy loss or miscarriage?
If you find yourself having two or more recurrent, back to back pregnancy losses, call your doctor, as there are available blood test to determine causes of this problem and there are alternative remedies to help you achieve a healthy pregnancy.
Pink Women’s Center is a board certified OBGYN group located in Katy and west Houston Texas. We care for normal and high risk pregnancies, gynecologic and menopausal problems, including abnormal vaginal bleeding, abnormal pap smear, stress incontinence, osteoporosis, sexual dysfunction, endometriosis and much more. We are a certified menopause OBGYN group, the only one in Houston Texas. We manage all types of Miscarriage