Global InformationMiscarriage information
| Miscarriage | |
|---|---|
| Other names | spontaneous abortion, early pregnancy loss |
 | |
| An ultrasound showing a gestational sac containing a yolk sac but no embryo | |
| Specialty | Obstetrics and Gynaecology, Neonatology, Pediatrics |
| Symptoms | Vaginal bleeding with or without pain[1] |
| Complications | Infection, bleeding,[2] sadness, anxiety, guilt[3] |
| Usual onset | Before 20 weeks of pregnancy[4] |
| Causes | Chromosomal abnormalities,[1][5] uterine abnormalities[6] |
| Risk factors | Being an older parent, previous miscarriage, exposure to tobacco smoke, obesity, diabetes, autoimmune diseases, drug or alcohol use[7][8][9] |
| Diagnostic method | Physical examination, human chorionic gonadotropin, ultrasound[10] |
| Differential diagnosis | Ectopic pregnancy, implantation bleeding.[1] |
| Prevention | Prenatal care[11] |
| Treatment | Expectant management, vacuum aspiration, emotional support[8][12] |
| Medication | misoprostol |
| Frequency | 10–50% of pregnancies[1][7] |
Miscarriage, also known in medical terms as a spontaneous abortion, is the death and expulsion of an embryo or fetus before it can survive independently.[1][4] The term miscarriage is sometimes used to refer to all forms of pregnancy loss and pregnancy with abortive outcomes before 20 weeks of gestation.
Miscarriage before 6 weeks of gestation is defined by ESHRE as biochemical loss.[13][14] Once ultrasound or histological evidence shows that a pregnancy has existed, the term used is clinical miscarriage, which can be "early" before 12 weeks and "late" between 12 and 21 weeks.[13] Fetal death after 20 weeks of gestation is also known as a stillbirth.[15] The most common symptom of a miscarriage is vaginal bleeding with or without pain.[1] Sadness, anxiety, and guilt may occur afterwards.[3][16] Tissue and clot-like material may leave the uterus and pass through and out of the vagina.[17] Recurrent miscarriage (also referred to medically as Recurrent Spontaneous Abortion or RSA)[18] may also be considered a form of infertility.[19]
Risk factors for miscarriage include being an older parent, previous miscarriage, exposure to tobacco smoke, obesity, diabetes, thyroid problems, and drug or alcohol use.[7][8] About 80% of miscarriages occur in the first 12 weeks of pregnancy (the first trimester).[1] The underlying cause in about half of cases involves chromosomal abnormalities.[5][1] Diagnosis of a miscarriage may involve checking to see if the cervix is open or sealed, testing blood levels of human chorionic gonadotropin (hCG), and an ultrasound.[10] Other conditions that can produce similar symptoms include an ectopic pregnancy and implantation bleeding.[1]
Prevention is occasionally possible with good prenatal care.[11] Avoiding drugs, alcohol, infectious diseases, and radiation may decrease the risk of miscarriage.[11] No specific treatment is usually needed during the first 7 to 14 days.[8][12] Most miscarriages will be completed without additional interventions.[8] Occasionally the medication misoprostol or a procedure such as vacuum aspiration is used to remove the remaining tissue.[12][20] Women who have a blood type of rhesus negative (Rh negative) may require Rho(D) immune globulin.[8] Pain medication may be beneficial.[12] Emotional support may help with processing the loss.[12]
Miscarriage is the most common complication of early pregnancy.[21] Among women who know they are pregnant, the miscarriage rate is roughly 10% to 20%, while rates among all fertilisation is around 30% to 50%.[1][7] In those under the age of 35, the risk is about 10% while in those over the age of 40, the risk is about 45%.[1] Risk begins to increase around the age of 30.[7] About 5% of women have two miscarriages in a row.[22] Some recommend not using the term "abortion" in discussions with those experiencing a miscarriage to decrease distress.[23] In Britain, the term "miscarriage" has replaced any use of the term "spontaneous abortion" for pregnancy loss and in response to complaints of insensitivity towards women who had suffered such loss.[24] An additional benefit of this change is reducing confusion among medical laymen, who may not realize that the term "spontaneous abortion" refers to a naturally occurring medical phenomenon and not the intentional termination of pregnancy.
- ^ a b c d e f g h i j k Cite error: The named reference
John20122was invoked but never defined (see the help page). - ^ "Spontaneous Abortion – Gynecology and Obstetrics". Merck Manuals Professional Edition. Archived from the original on December 4, 2020. Retrieved May 5, 2018.
- ^ a b Robinson GE (January 2014). "Pregnancy loss". Best Practice & Research. Clinical Obstetrics & Gynaecology. 28 (1): 169–178. doi:10.1016/j.bpobgyn.2013.08.012. PMID 24047642. S2CID 32998899.
- ^ a b /pregnancyloss/conditioninfo/Pages/default.aspx "What is pregnancy loss/miscarriage?". www.nichd.nih.gov/. July 15, 2013. Archived from the original on April 2, 2015. Retrieved March 14, 2015.
{{cite web}}: Check|url=value (help) - ^ a b Vaiman D (2015). "Genetic regulation of recurrent spontaneous abortion in humans". Biomedical Journal. 38 (1): 11–24. doi:10.4103/2319-4170.133777. PMID 25179715.
- ^ Chan YY, Jayaprakasan K, Tan A, Thornton JG, Coomarasamy A, Raine-Fenning NJ (October 2011). "Reproductive outcomes in women with congenital uterine anomalies: a systematic review". Ultrasound in Obstetrics & Gynecology. 38 (4): 371–382. doi:10.1002/uog.10056. PMID 21830244. S2CID 40113681.
- ^ a b c d e Cite error: The named reference
NIH2013Epi2was invoked but never defined (see the help page). - ^ a b c d e f Cite error: The named reference
Ol2014was invoked but never defined (see the help page). - ^ Cite error: The named reference
CarpSelmi2012was invoked but never defined (see the help page). - ^ a b "How do health care providers diagnose pregnancy loss or miscarriage?". www.nichd.nih.gov/. July 15, 2013. Retrieved March 14, 2015.
- ^ a b c "Is there a cure for pregnancy loss/miscarriage?". www.nichd.nih.gov/. October 21, 2013. Archived from the original on April 2, 2015. Retrieved March 14, 2015.
- ^ a b c d e "What are the treatments for pregnancy loss/miscarriage?". www.nichd.nih.gov. July 15, 2013. Archived from the original on April 2, 2015. Retrieved March 14, 2015.
- ^ a b Larsen EC, Christiansen OB, Kolte AM, Macklon N (June 26, 2013). "New insights into mechanisms behind miscarriage". BMC Medicine. 11 (1): 154. doi:10.1186/1741-7015-11-154. ISSN 1741-7015. PMC 3699442. PMID 23803387.
- ^ Messerlian C, Williams PL, Mínguez-Alarcón L, Carignan CC, Ford JB, Butt CM, et al. (November 1, 2018). "Organophosphate flame-retardant metabolite concentrations and pregnancy loss among women conceiving with assisted reproductive technology". Fertility and Sterility. 110 (6): 1137–1144.e1. doi:10.1016/j.fertnstert.2018.06.045. ISSN 0015-0282. PMC 7261497. PMID 30396558.
- ^ "Stillbirth: Overview". NICHD. September 23, 2014. Archived from the original on October 5, 2016. Retrieved October 4, 2016.
- ^ Radford EJ, Hughes M (June 2015). "Women's experiences of early miscarriage: implications for nursing care". Journal of Clinical Nursing. 24 (11–12): 1457–1465. doi:10.1111/jocn.12781. PMID 25662397.
- ^ "What are the symptoms of pregnancy loss/miscarriage?". www.nichd.nih.gov/. July 15, 2013. Archived from the original on April 2, 2015. Retrieved March 14, 2015.
- ^ Yu J, Yu S, Zhu L, Sun X, Lu B, Li J, et al. (August 30, 2022). "Is there an association between recurrent spontaneous abortion and mycoplasma infection?". The Journal of Infection in Developing Countries. 16 (8): 1302–1307. doi:10.3855/jidc.15134. ISSN 1972-2680. PMID 36099373. S2CID 252219683.
- ^ "Glossary | womenshealth.gov". womenshealth.gov. January 10, 2017. Retrieved September 11, 2017.
This article incorporates text from this source, which is in the public domain.
- ^ Tunçalp O, Gülmezoglu AM, Souza JP (September 2010). "Surgical procedures for evacuating incomplete miscarriage". The Cochrane Database of Systematic Reviews. 2010 (9): CD001993. doi:10.1002/14651858.CD001993.pub2. PMC 7064046. PMID 20824830.
- ^ National Coordinating Centre for Women's and Children's Health (UK) (December 2012). "Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage". NICE Clinical Guidelines, No. 154. Royal College of Obstetricians and Gynaecologists. PMID 23638497. Archived from the original on October 20, 2013. Retrieved July 4, 2013.
- ^ Garrido-Gimenez C, Alijotas-Reig J (March 2015). "Recurrent miscarriage: causes, evaluation and management". Postgraduate Medical Journal. 91 (1073): 151–62. doi:10.1136/postgradmedj-2014-132672. PMID 25681385. S2CID 207022511.
- ^ Greaves I, Porter K, Hodgetts TJ, Woollard M (2005). Emergency Care: A Textbook for Paramedics. London: Elsevier Health Sciences. p. 506. ISBN 978-0-7020-2586-0. Archived from the original on April 26, 2016.
- ^ Moscrop A (December 1, 2013). "'Miscarriage or abortion?' Understanding the medical language of pregnancy loss in Britain; a historical perspective". Medical Humanities. 39 (2): 98–104. doi:10.1136/medhum-2012-010284. PMC 3841747. PMID 23429567.
