Missed miscarriage
| Miscarriage | |
|---|---|
| Synonyms | Spontaneous abortion, early pregnancy loss |
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| An ultrasound showing a gestational sac containing a yolk sac but no embryo. This is a type of miscarriage. | |
| Specialty | Obstetrics and gynecology |
| Symptoms | Vaginal bleeding with or without pain |
| Complications | Sadness, anxiety, guilt |
| Usual onset | Before 20 weeks of pregnancy |
| Risk factors | Older parent, previous miscarriage, exposure to tobacco smoke, obesity, diabetes, drug or alcohol use |
| Diagnostic method | Examination, human chorionic gonadotropin, ultrasound |
| Similar conditions | Ectopic pregnancy, implantation bleeding. |
| Prevention | Prenatal care |
| Treatment | None, misoprostol, vacuum aspiration |
| Frequency | 10–50% of pregnancies |
| Classification | |
|---|---|
| External resources |
Miscarriage, also known as spontaneous abortion and pregnancy loss, is the natural death of an embryo or fetus before it is able to survive independently. Some use the cutoff of 20 weeks of gestation after which fetal death is known as a stillbirth. The most common symptom of a miscarriage is vaginal bleeding with or without pain.Sadness, anxiety and guilt may occur.Tissue or clot-like material may also come out of the vagina.
Risk factors for miscarriage include an older parent, previous miscarriage, exposure to tobacco smoke, obesity, diabetes, and drug or alcohol use, among others. In those under the age of 35 the risk is about 10% while it is about 45% in those over the age of 40. Risk begins to increase around the age of 30. About 80% of miscarriages occur in the first 12 weeks of pregnancy (the first trimester). The underlying cause in about half of cases involves chromosomal abnormalities. Other conditions that can produce similar symptoms include an ectopic pregnancy and implantation bleeding. Diagnosis of a miscarriage may involve checking to see if the cervix is open or closed, testing blood levels of human chorionic gonadotropin (hCG), and an ultrasound.
Prevention is occasionally possible with good prenatal care. Avoiding drugs and alcohol, infectious diseases, and radiation may prevent miscarriage. No specific treatment is usually needed during the first 7 to 14 days. Most miscarriages will complete without additional interventions. Occasionally the medication misoprostol or a procedure such as vacuum aspiration is required to remove the failed pregnancy. Women who are rhesus negative may require Rho(D) immune globulin.Pain medication may be beneficial. Emotional support may help with negative emotions.
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