Miscarriage
The occurrence of a miscarriage is a tragic loss for a couple trying to have a child and can be associated with significant psychological problems for the woman, their partner and family. Miscarriage is usually a single occurrence, and often followed by successful pregnancy. Recurrent miscarriage is defined as the loss of three or more consecutive pregnancies.
Even after 3 consecutive losses, the chance of a successful pregnancy is over 60%. Most miscarriage occurs within the first 14 weeks of pregnancies.
Vaginal bleeding is the most common symptom of a miscarriage; the bleeding may be slight spotting but sometimes very heavy with clots. The bleeding is usually followed by crampy lower abdominal pain.
Types of miscarriage (abortion)
When vaginal bleeding is slight, there is no or mild pain, the cervix is closed and the uterus feels the correct size for date. The diagnosis of "threatened miscarriage" is made. The woman is usually advised bed rest, bleeding and pain may settle down and pregnancy may proceed normally.
If the fetus and placenta pass out of the womb completely, this is called "complete abortion".
If any bits remain inside the cavity of the uterus it is called "incomplete abortion". The patient will then undergo evacuation of retained products of conception (ERPC) under a general anesthetic. Should any tissue be left in the uterus there is a serious risk of infection.
Sometimes, the fetus dies in the womb but not expelled, and the term "missed abortion" is used.
The diagnosis of all these kinds of miscarriage is made by ultrasound scan, this may show an empty sac, viable pregnancy, retained pregnancy tissue or a dead baby.
If the woman blood group is Rhesus negative and she miscarries or experiences bleeding in the pregnancy; it is important that she have Anti-D injection to prevent antibodies developing.
In the vast majority of women, fertility is not impaired after miscarriage.
