|A miscarriage is the expulsion of a foetus from the uterus before it is able to live outside the uterus. Twenty weeks is said to be the time at which survival of the foetus becomes a possibility. |
The first 12 weeks (first trimester) of pregnancy present the greatest threat to the developing foetus. 1 in 3 or 1 in 4 normal pregnancies miscarry. Most miscarriages occur before the 12th week and it is possible that the greatest danger is about the time at which menstruation would have occurred if fertilisation had not intervened. After 12 weeks the chances of suffering a miscarriage lessen.
The commonest cause of miscarriage is a genetic abnormality of the feotus. A hormonal imbalance in the mother can cause it as can an emotional disturbance. Over-enthusiastic sexual intercourse, abnormalities of the uterus, drugs and medical disorders in the mother can also be a cause. Trauma such as a motor car accident can bring on a miscarriage in what was going to be a normal pregnancy.
Sometimes the cervix does not completely seal as it should once pregnancy is established. If this happens then a miscarriage can occur, generally after the 12th week.
Previous damage to the cervix can be a factor producing such miscarriages. If discovered early enough your gynecologist will stitch up the cervix and this will, in about 70% of cases, protect the pregnancy.
Vaginal bleeding, particularly in the early months of pregnancy indicates the possibility of miscarriage which is then called a threatened miscarriage. Bed rest even in hospital, is the best place to treat this.
A pregnancy test will be necessary to check if the foetus is alive, and ultrasound will be used to check that it is normal and in the correct position. Heavy bleeding, clots and period type pains indicate an inevitable miscarriage which, when it occurs, may be incomplete and need dilatation and curettage.
Sometimes, and fortunately fairly rarely, the foetus dies in the early months of pregnancy and the condition remains undiagnosed until symptoms and signs of pregnancy appear to be diminishing. In an advanced pregnancy, if this occurs, it may be necessary to initiate labour. In early pregnancy a dilatation and curettage to remove the dead foetus and placenta will be required after an ultrasound examination has been confirmed the absence of foetal heartbeats.
In the case of repeated miscarriages it will be necessary to have a full medical and gynecological examination, an ultrasound examination and blood tests in order to check for a possible cause.
Depression is the main aftermath of a miscarriage, particularly if it is the first pregnancy. A miscarriage does not mean that you will not be able to carry your next pregnancy to full term.
In the past women with large families may have had 2 or 3 miscarriages interspersed with their successful pregnancies.
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