Types Of Pregnancy Loss
There are a number of different types of miscarriage, depending on when and why it happens. A few of the most common include:
While the following complications aren’t technically considered miscarriage, they are still a pregnancy loss:
- Ectopic pregnancy. In an ectopic pregnancy, the embryo implants, but not in the right place usually it implants in a fallopian tube or the cervix instead of the uterus. The cramping and bleeding caused by an ectopic pregnancy are similar to the usual signs of a miscarriage, but they can lead to even more severe complications if the embryo ruptures, breaking off the area it incorrectly implanted into. To rule out an ectopic pregnancy, always get bleeding and cramping in early pregnancy checked out by a health care practitioner.
- Molar pregnancy. When an egg thats missing some of its parts namely the genetic material ends up fertilized by a sperm, it may start to grow into a mass of cysts in the uterus. While the cells never begin developing into a fetus, they can cause an increase in pregnancy hormones, making a woman think shes pregnant for a short time, though these pregnancies always end in miscarriage.
When Do Most Miscarriages Occur
Early miscarriages occur in the first trimester and account for 80 percent of all miscarriages. Of these, a large number occur in the first weeks of pregnancy, often before a woman even knows shes pregnant.
During the first trimester, a lot is happening in your pregnancy: An embryos cells start dividing to form organs, the embryo implants into the side of the uterus, the placenta must establish connections between your and your babys blood flow, and your immune system needs to get used to the new fetus inside of you. All of this means there are a lot of steps that can go wrong and result in a miscarriage.
Late miscarriages are much less common, occurring in 6 in 1,000 pregnancies, and happen between the end of the first trimester and week 20. Theyre also more likely to be caused by placenta or cervix problems, exposure to toxins or the mothers health.
What Is My Risk Of Miscarriage By Week
Your risk of pregnancy loss declines each week youre pregnant. Around 15% of pregnancies end in miscarriage. Miscarriage risk in the second trimester is between 1% and 5%. Many factors affect your risk of miscarriage such as your age and health. However, everyones risk of miscarriage declines each week of pregnancy if the pregnant person has no other health conditions.
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Miscarriage After Fetal Heartbeat
Most doctors agree that seeing a fetal heartbeat on ultrasound means the risk of miscarriage is much lower. Confirmation of a fetal heartbeat means that the baby has passed the initial stages of development wherein the majority of first trimester miscarriages occur.
According to research from Monash University, the overall risk of miscarriage after the detection of a fetal heartbeat is around 4%, dropping to 1.5% after 8 weeks and 0.9% by 9 weeks.
The risk of miscarriage doesn’t disappear at this time. But seeing the baby’s heartbeat is a good sign. It means the baby is growing as it should be, and there’s little reason to be concerned at this point.
Unfortunately, there is one exception to this rule: slow fetal heart rate may signal an impending miscarriage, especially as the pregnancy advances.
How Common Is Miscarriage
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Some pregnant people may worry about having a miscarriage during the early stages of pregnancy. This may be because they know someone who has been through this experience or because it has happened to them.
Everybody hopes for a healthy pregnancy and its natural to worry about things going wrong. Unfortunately, there is nothing to you can do that will guarantee a successful pregnancy. But there are some things you can do to try and reduce the risk.
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Enhancing Healthcare Team Outcomes
Treating patients who experience pregnancy loss requires close coordination between all members of the care team. Follow-up care with an obstetrician needs to be coordinated. Clear and concise discharge instructions need to be given to the patient. This experience for the patient can be very emotionally taxing and needs to be handled with extreme compassion and sensitivity.
The Different Kinds Of Pregnancy Loss
According to the SOGC, there are two main types of pregnancy loss: miscarriage and stillbirth.
Most miscarriages happen in the first eight weeks, while stillbirths typically happen after 20 weeks of gestational age.
The most common reason for a first-trimester miscarriage would be abnormal chromosomes, said Garbedian. Probably about 70 per cent of all early pregnancy loss is due to abnormal chromosomes meaning that the parents both have completely normal genetics, but either the wrong sperm or egg is chosen.
She says that while pregnancy loss is still devastating, abnormal chromosomes is the answer we want because it means, most likely, everything else is OK and it was just a spontaneous event.
That really is the bulk of abnormal pregnancies in the first trimester, she said. The risk of miscarriage increases in women older than 40.
Miscarriage in the second trimester would require more investigation and testing, said Garbedian.
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A stillbirth is typically more traumatizing because it happens after the patient has known theyre pregnant for several weeks, Garbedian said.
After about five months of pregnancy, a loss can be extremely difficult to process.
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What Happens If You Think You’re Having A Miscarriage
If you have the symptoms of a miscarriage, you’ll usually be referred to a hospital for tests.
In most cases, an ultrasound scan can determine if you’re having a miscarriage.
When a miscarriage is confirmed, you’ll need to talk to your doctor or midwife about the options for the management of the end of the pregnancy.
Often the pregnancy tissue will pass out naturally in 1 or 2 weeks.
Sometimes medicine to assist the passage of the tissue may be recommended, or you can choose to have minor surgery to remove it if you do not want to wait.
You Can Be Fertile Immediately After A Miscarriage
It can take anywhere from a few hours to several weeks for the blood and tissue from a miscarriage to completely expel from the uterus . If a miscarriage happens within the first eight weeks of pregnancy, it usually takes 4â6 weeks for menstruation to return . It is possible to be fertile again immediately after a miscarriage, meaning a person can become pregnant even before their menstruation returns .
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How Can I Cope With My Miscarriage
Losing a pregnancy can be devastating and leave you with a range of emotions and lots of questions. Healing emotionally from a miscarriage is often harder and longer than the physical healing. Take the time you need to grieve your loss. Talk to your partner, friends and family about your feelings or find a pregnancy loss support group online. Surround yourself with supportive people or seek professional counseling to help you cope with the loss.
A note from Cleveland Clinic
A miscarriage is a very emotional moment for expectant parents and its natural to grieve the loss. Remember that a miscarriage cant be prevented, and its not caused by something you did wrong. It doesnt mean that you cant have children or that youll have another miscarriage. If youre planning to become pregnant, reach out to your healthcare provider to discuss the timing of your next pregnancy and ask any questions you have. Its OK to be sad. Find support from family, friends online support groups or a licensed counselor.
Last reviewed by a Cleveland Clinic medical professional on 07/19/2022.
References
Stillbirth And Neonatal Death
In the UK, about 4,000 babies are stillborn every year. Stillbirth is when a pregnancy has lasted for at least 24 weeks and the baby is dead when it is born. About the same number of babies die after birth, often without a clear cause.
Sometimes a baby dies in the uterus , but labour does not start spontaneously. If this happens, you will be given medicines to induce labour. This is the safest way of delivering the baby. It also gives you and your partner the chance to see and hold the baby at birth, if you want to.
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Risk Of Miscarriage May Increase During The Summer
- Date:
- Boston University School of Public Health
- Summary:
- A new study found that miscarriage risk in North America increased by 44 percent in late August, compared to late February, indicating the need to explore possible links between extreme heat and pregnancy loss.
Up to 30 percent of pregnancies end in miscarriage, defined as pregnancy loss before 20 weeks of pregnancy. As many as half of miscarriages are unexplained, and there are few known risk factors for these pregnancy losses, which can lead to posttraumatic stress disorder, depression, and anxiety.
Now, a new study led by School of Public Health researchers has found that risk of miscarriage may increase in the summer months.
Published in the journal Epidemiology, the study investigated seasonal differences in miscarriage risk and found that pregnant people in North America had a 44 percent higher risk of an early miscarriage in the summer months — particularly in late August — than they did six months earlier in February. Risk of miscarriage during any week of pregnancy was 31 percent higher in late August, compared to late February. Geographically, the results showed that pregnant people in the South and Midwest, where summers are hottest, were more likely to experience this loss in late August and early September, respectively.
Story Source:
Materials provided by Boston University School of Public Health. Original written by Jillian McKoy. Note: Content may be edited for style and length.
Journal Reference:
Most Common Reasons For Miscarriage
Once a miscarriage has happened, many ask themselves what could have been done to stop the miscarriage during its process, but the truth of the matter is that once a miscarriage starts there is nothing anyone can do to prevent it, as its natures way indicating something is wrong with the developing pregnancy and baby.
Our body provides nutrients to the developing baby during pregnancy to help with its normal development, and one of the main causes of miscarriage during the first trimester is that there is an abnormal development.
Genetic issues
Half of miscarriages usually occur because of chromosome issues. Chromosomes carry the DNA and genetic code for cells to function which errors can occur randomly during the rapid division of foetal cells and as a result of damaged sperm or egg cells. At the time, most early miscarriages cannot always be explained in depth and unless a biopsy is taken it is difficult to the know the reason, which is why embryo testing can help. Pre-implantation genetic screening or pre-implantation genetic diagnosis testing can be carried out to identify embryos that have chromosome issues or known genetic disorders for the prevention of miscarriage particularly for those with recurrent miscarriages or whom are carriers of specific chromosome and genetic illnesses.
However, some miscarriages can be identified and termed with the following causes:
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Why Miscarriage Happens
We have information on the known causes of early, late and recurrent miscarriage here.
But too often health professionals are not able to tell women why they have had a miscarriage. This area of research is underfunded, with many taking an unhelpful approach of It was not meant to be.
Research into why miscarriage happens is the only way we can save lives and prevent future loss. In 2016, Tommys opened the UKs first national centre dedicated to miscarriage research.
What Is Pregnancy Loss
How pregnancy loss is categorized largely depends on when in the pregnancy it occurred. The U.S. medical community most often definesmiscarriage as the spontaneous loss of a nonviable, intrauterine pregnancy before 20 weeks gestational age , while stillbirth describes this event at 20 weeks GA. A late stillbirth or late intrauterine fetal demise occurs after 28 weeks. Pregnancy loss serves as an umbrella term for all gestational ages . Consensus around these terms does not fully exist for example, other countries use different gestational ages to distinguish miscarriage from stillbirth, while many journalists use miscarriage to describe pregnancy loss at any stage of pregnancy. The terms miscarriage and stillbirth have been found to be preferred by people experiencing these events, therefore will be used in this brief as opposed to alternative terms .
Common symptoms of pregnancy loss include vaginal bleeding and cramping, which may prompt presentation to a healthcare facility. Alternatively, some miscarriages and stillbirths have no symptoms and are discovered during routine prenatal care .
How are miscarriages different from abortions?
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Knowing Your Options Can Help
Most miscarriages do not necessarily need intervention and can be medically managed with a process called “watchful waiting” . Some people may choose intervention to have some control over the experience, and/or they would like it to be over more quickly. Others may have an intervention because they are at risk of a complication, or because a miscarriage didn’t complete on its own. Depending on timing, interventions include an aspiration procedure to remove the uterine contents, or a pill to help shed it more quickly .
Contact a healthcare provider if you think you may be having a miscarriage. They will ask you some questions and make sure everything is okay. Some people may need a blood test. In certain cases a miscarriage doesn’t complete on its own, requiring treatment. If you experience sharp pain, dizziness, fever, or shoulder pain, see your healthcare provider or go to the emergency room to rule out complications like ectopic pregnancy.
Tracking bleeding patterns and other symptoms with Clue during and/or after a miscarriage can help provide a record of how things are changing. It may also help spot when something might be off, or when a miscarriage may need further treatment. If you are concerned about your cycle or any symptoms, talk to a healthcare provider.
Remember, you can make sure a miscarriage won’t affect Clue’s predictions by excluding any irregular cycles later on.
to learn more about your period and keep track of changes.
If You Go To Hospital
If you go to your hospitals emergency department, you will be seen first by a triage nurse, who will assess how urgently you need to be seen by a doctor. Depending on your symptoms, you will either be taken in to see a doctor immediately, or you will be asked to wait.
If you are waiting to be seen and your symptoms become worse or you feel like you need to go to the toilet, let the staff know immediately.
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How Soon Can I Get Pregnant After A Miscarriage
The decision on when you should begin trying to get pregnant again is between you and your pregnancy care provider. Most people can get pregnant again after theyve had one normal menstrual period.
Taking time to heal both physically and emotionally after a miscarriage is important. Counseling is available to help you cope with your loss. A pregnancy loss support group might also be a valuable resource to you and your partner. Ask your healthcare provider for more information about counseling and support groups. Above all, dont blame yourself for the miscarriage. Take the time you need to grieve.
If youve had three miscarriages in a row, ask your provider about performing tests to figure out an underlying cause. You should use birth control until you receive the results. After your provider reviews the test results, they may suggest going off birth control and trying to conceive again.
If You Miscarry When Can You Try To Get Pregnant Again
This is a decision for you to make with your partner and your provider. Its probably OK to get pregnant again after youve had at least one normal period. If youre having medical tests to try to find out more about why you miscarried, you may need to wait until after youve had these tests to try to get pregnant again.
You may not be emotionally ready to try again so soon. Miscarriage can be hard to handle, and you may need time to grieve. Its OK if you want to wait a while before trying to get pregnant again.
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Symptoms Following A Miscarriage
Bleeding and mild discomfort are common symptoms after a miscarriage. If you have heavy bleeding with fever, chills, or pain, contact your doctor right away. These may be signs of an infection.
Besides the physical effects, you may also feel a range of emotions, from sadness and guilt to grief and worry about future pregnancies. What youâre feeling is normal. Let yourself grieve.
If youâre up to it, talk to people in your life who are supportive like your partner, a friend, or family member. You can also talk to a professional mental health counselor. Pregnancy loss support groups may also be a valuable resource to you and your partner. Ask your doctor for more information about these resources. And remember that everyone heals at a different pace and in different ways.
