Miscarriage is the spontaneous pregnancy loss that occurs before 20 weeks of gestation. Physicians refer to this as spontaneous abortion.
According to the American Society for Reproductive Medicine (ASRM), about 25 percent of known pregnancies end in miscarriage. However, the rate is believed to be higher because many miscarriages occur very early in pregnancy, before a woman may know that she is pregnant.
The causes of miscarriage are not completely understood, but researchers believe that most miscarriages that occur in the first trimester (first 12 weeks of pregnancy) are caused by randomly occurring chromosomal abnormalities in the fetus that prevent it from developing normally. Medical conditions in the mother (e.g., uncontrolled diabetes) can also lead to miscarriage. Several autoimmune conditions as well as structural problems within the uterus may affect implantation and result in first trimester miscarriages. In addition, various risk factors, such as maternal smoking or drug abuse, can increase the likelihood of miscarriage.
Signs and symptoms of a miscarriage may include bleeding, pelvic pain or cramping in the abdomen or lower back and fluid or tissue being expelled from the vagina. Even though vaginal bleeding is usually a symptom that precedes nearly all pregnancy losses, it is not always indicative of a miscarriage. Many pregnant women experience spotting or bleeding at some point during their pregnancies.
Most women who have an early miscarriage do not require medical treatment. The uterus empties itself as it would during a heavy menstrual period. However, if an ultrasound examination shows that there is pregnancy tissue remaining in the uterus, a physician may recommend a dilation and curettage procedure or medication to induce the uterus to expel the tissue. All pregnancy tissue must be expelled and/or removed from the uterus to prevent infection. In cases of recurrent miscarriage, further testing and treatment is performed to determine the possible cause and prevent recurrence.
If a miscarriage is about to occur, it is not likely the fault of the mother and often cannot be prevented. However, a woman may decrease her chances of having a miscarriage by taking good care of herself. This includes eating a well-balanced diet, taking folic acid supplements and refraining from drinking alcoholic beverages or smoking. It is also important for pregnant women to receive good prenatal care by an obstetrician (OB) or other qualified healthcare professional.
It is common and normal for a woman to experience sadness after losing a wanted pregnancy. Many couples benefit from support groups or psychological counseling to help deal with the emotional impact of miscarriage.
Although it is possible to become pregnant right after a miscarriage, most physicians recommend waiting at least three months before trying to conceive. Usually, most women who experience a miscarriage go on to have full-term pregnancies and healthy deliveries.
About miscarriage
A miscarriage is a pregnancy that ends before the fetus is considered “viable” (before 20 weeks of gestation). A fetus is viable if it can live outside the mother’s womb. Pregnancy losses after the 20th week of gestation are known as preterm deliveries.
A woman’s reproductive system includes the uterus, cervix, two ovaries, two fallopian tubes and the vagina. The fallopian tubes are narrow tubes that connect the ovaries to the uterus. Once a month, an egg is released by one of the ovaries, and travels down the fallopian tube, where it may be fertilized by sperm.
Once the egg and sperm join, they rapidly begin to develop new cells. This bundle of cells, called the embryo, normally implants on the inner wall of the uterus. Once implanted, the embryo continues to grow inside a sac of amniotic fluid, contained within the placenta. After several weeks, the embryo is called a fetus.
In a miscarriage, the woman’s body expels all or some of the fetus, the placenta and the fluid surrounding the fetus. The medical term for miscarriage is spontaneous abortion. It is also referred as early pregnancy loss.
According to the National Institutes of Health (NIH), up to 50 percent of all fertilized eggs die and are spontaneously aborted, usually before a woman even realizes that she is pregnant. Among known pregnancies, the rate of miscarriage is approximately 25 percent, according to the American Society for Reproductive Medicine (ASRM). Miscarriage usually occurs between the 7th and 12th week of pregnancy (during the first trimester).
In many cases, chromosomal abnormalities in the fertilized egg prevent it from developing normally and the pregnancy terminates naturally. Typically, such problems are the result of errors that occur by chance as the embryo divides and grows.
In other cases, complications may occur during the delicate process of early human development that may prevent an embryo from continuing gestation. For example, the egg may not implant properly in the uterus or the embryo may have structural defects that do not allow it to continue growing inside the mother’s uterus (womb).
In all cases, spontaneous expulsion of the pregnancy is preceded by death of the embryo or fetus. Sometimes a miscarriage may be accompanied by an infection in the uterus (septic miscarriage). This is a serious condition that can result in shock and organ failure, which requires prompt medical treatment.
When a woman experiences the loss of two or more consecutive pregnancies in the first or second trimester OR the loss of three or more pregnancies before 20 weeks gestation, she is experiencing recurrent miscarriage. Other terms for this condition include: recurrent spontaneous miscarriage, recurrent spontaneous abortion and recurrent pregnancy loss.
According to the ASRM, less than 5 percent of women will experience two consecutive miscarriages, and only 1 percent will experience three or more miscarriages.
A woman who experiences recurrent miscarriage is typically subject to more diagnostic tests than a woman who has a single, first trimester miscarriage. However, in 50 to 75 percent of couples who experience recurrent miscarriage, no explanation is found, according to the ASRM. Treatment options for recurrent miscarriages depend on the cause of the miscarriages and usually differ from standard miscarriage treatment options.
Couples may be comforted to know that, according to the ASRM, pregnancy is successful in 60 to 70 percent of women who experience unexplained recurrent pregnancy losses.
Types and differences of miscarriage
The types of miscarriage are classified according to the physical signs a physician notes upon examination of a woman:
Threatened miscarriage. A woman has vaginal bleeding early in pregnancy, but her cervix has not begun to dilate. This condition, however, does not mean that a miscarriage will occur. In many women with threatened miscarriage, the bleeding subsides and the pregnancy continues to term. In such cases, physicians may order complete bed rest for a few weeks (or until delivery) to ensure continuation of pregnancy. Rarely, the bleeding becomes heavier and miscarriage follows.
Inevitable miscarriage. A woman has vaginal bleeding accompanied by contractions of her uterus and dilation of the cervix. This type of miscarriage cannot be prevented.
Incomplete miscarriage. A woman has expelled most of the pregnancy tissue through her vagina, but some remains in the uterus. Typically, the fetus has been passed, but bits and pieces of the placenta may remain inside the uterus. In this type of miscarriage, the cervix remains open, and bleeding may be heavy, usually requiring some intervention.
Complete miscarriage. A woman has a miscarriage and none of the tissue from the pregnancy remains in her uterus. This is common in miscarriages that occur before 12 weeks of pregnancy. After the miscarriage, a woman experiences bleeding and cramping that resolves without medical intervention. On examination, a physician typically finds that the cervix is closed, and there is no sign of a pregnancy sac in the uterus. Ultrasound examination may be used to confirm the diagnosis.
Septic miscarriage. A miscarriage is accompanied by an infection in the uterus. Symptoms include fever, chills, abdominal pain, vaginal bleeding and vaginal discharge, which may be thick and have an unpleasant odor.
Missed abortion. A miscarriage in which the fetus died prior to the 20 weeks of gestation, but neither the fetus or placenta were expelled by the uterus. In these cases, interventions may be offered but the tissue may be spontaneously expelled within a short time frame.
Recurrent miscarriage. A woman experiences the loss of two or more consecutive pregnancies in the first or second trimester OR the loss of three or more pregnancies before 20 weeks gestation.
Blighted ovum. This occurs when a gestational sac forms inside a woman’s uterus, but no fetus is present after seven weeks.
Molar pregnancy. This is a rare condition that is also known as gestational trophoblastic disease. It occurs when a pregnancy results in the growth of abnormal tissue rather than an embryo, and it typically ends in miscarriage before the fourth month of pregnancy. In a few cases, it may result in uterine cancer.
Risk factors and causes of miscarriage
The causes of miscarriage and recurrent miscarriage (the loss of two or more consecutive pregnancies in the first or second trimester OR the loss of three or more pregnancies before 20 weeks gestation) are not thoroughly understood. However, in most cases, miscarriages occur because of chromosomal abnormalities in the fetus.
Chromosomes are tiny structures in each cell that carry genes and determine an individual’s physical traits and how the internal organs work. Each person has 23 pairs of chromosomes (46 total), with one chromosome per pair supplied by the mother and the other supplied by the father.
Most chromosomal abnormalities result from a faulty egg or sperm cell. Before pregnancy, immature egg and sperm cells divide to form mature cells with 23 chromosomes. Sometimes, the cell splits unevenly, resulting in egg or sperm cells with too many or too few chromosomes (nondisjunction). If a cell has the wrong number of chromosomes, the embryo has a chromosomal abnormality and is usually miscarried.
These abnormalities are randomly occurring events that surface during cell division and are not inherited from the genes of either parent. They may also result in a blighted ovum, either because the embryo did not form or because it stopped developing very early. According to the American College of Obstetricians and Gynecologists (ACOG), recent studies show that chromosomal problems may cause nearly 50 percent of recurrent miscarriages.
Other conditions that may cause one or more miscarriages include:
Uterine and/or cervical abnormalities. Some women are born with a uterus that is abnormally shaped, or partly or completely divided. Others develop noncancerous tumors (fibroids) or scars in the uterus from past surgery. These abnormalities can limit space for the fetus to grow or interfere with the blood supply to the uterus. They may also affect the ability for the embryo to implant properly. In addition, a weakened or incompetent cervix (opening of the uterus) can lead to a miscarriage. According to the ACOG, uterine and cervical abnormalities may account for 10 to 15 percent of recurrent miscarriages. However, some of these structural abnormalities can be surgically corrected to improve the chances of a future pregnancy.
Chronic illness. Women with conditions such as systemic lupus erythematosus (lupus) and other autoimmune disorders, congenital heart disease, severe kidney disease, uncontrolled diabetes mellitus, thyroid disease and intrauterine infections have a higher risk of miscarriage. If a woman is diagnosed with these conditions, she should get proper treatment to control them before becoming pregnant.
Hormonal problems. When the body produces too much or too little of certain hormones, a miscarriage may occur. Researchers believe that insufficient secretion of the hormone progesterone by the ovaries may be associated with spontaneous abortion because progesterone is believed to be important in maintaining gestation. This hormonal imbalance is called luteal phase deficiency and it may make the inner lining of the womb (endometrium) unable to support a pregnancy. In addition, conditions associated with hormonal abnormalities (e.g., thyroid disease, polycystic ovarian syndrome) may result in a miscarriage of the fetus.
Infections. Maternal health conditions that have been associated with miscarriage include infectious diseases, such as listeriosis (caused by the listeria bacterium found in certain raw meats and dairy products), toxoplasmosis, mumps, rubella, measles, HIV, herpes and syphilis, among others.
Fever. Pregnant women who develop fevers of 100 degrees Fahrenheit or more (37.8 degrees Celsius) appear to have an increased risk of miscarriage.
Immune system problems. Some people produce certain antibodies (autoantibodies) that can attack their own tissues, causing a variety of health problems. For example, particular types of autoantibodies (e.g., anticardiolipin) cause blood clots that can clog blood vessels in the placenta, causing the fetus to die, such as when lupus is present. Another condition that is associated with blood clots in the veins or arteries and with miscarriage is antiphospholipid antibody syndrome (APS). According to the American Society for Reproductive Medicine, between 3 to 15 percent of recurrent miscarriage is due to APS.
Blood incompatibility. In some cases, the fetus’ and mother’s blood type do not match, causing the mother to develop antibodies to the fetus. This type of incompatibility between mother and fetus (Rh incompatibility) may result in a spontaneous abortion.
Previous miscarriages. Risk of miscarriage increases if a woman has a history of recurrent miscarriage.
In addition, studies have shown several factors associated with a higher rate of miscarriage:
Age. Advancing age of the mother is the most important risk factor for miscarriage in healthy women. Women over age 40 are at higher risk of miscarriage and recurrent miscarriage than younger women. A woman’s risk of miscarriage increases with age because chromosomal abnormalities become more common with aging.
In addition, advanced age of sperm may also significantly influence the rate of miscarriage. Women with male partners aged 35 years or older have nearly three times as many miscarriages than women who conceive with men younger than age 25, according to a recent large-scale study conducted at Columbia University’s Mailman School of Public Health and the New York Psychiatric Institute. Results from previous research also indicate that the genetic quality of sperm gradually deteriorates as men get older, increasing a man’s risk of infertility, fathering unsuccessful pregnancies (miscarriages) and passing along certain genetic defects to his offspring (e.g., dwarfism).
Number of pregnancies. The number of times a woman has been pregnant also affects her risk of miscarriage. Women who have had two or more pregnancies appear to have a greater risk.
Folate insufficiency. According to the National Institutes of Health (NIH), pregnant women who have low levels of folic acid (a B-complex vitamin that is essential for cell growth and reproduction) are more likely to experience early miscarriages than pregnant women who have adequate levels of the vitamin.
In addition, women who are underweight prior to becoming pregnant are at greater risk of suffering a miscarriage during the first trimester, according to a recent study published in the BJOG: An International Journal of Obstetrics ande Gynecology. The same study also found that folic acid or iron supplementation and a daily diet incorporating plenty of fresh fruits and vegetables can reduce risk of miscarriage by as much as 50 percent in underweight women.
Caffeine. Although evidence is inconclusive, some studies suggest an association between moderate to significant amounts of caffeine (in the range of four to five cups of coffee daily) and an increased risk of miscarriage.
Smoking. Excessive smoking (more than 10 cigarettes a day) is associated with an increased risk of miscarriage. In addition, smoking can harm the development of the fetus, even when miscarriage does not occur. Paternal smoking may also be associated with an increased risk of miscarriage.
Alcohol. Women who drink are twice as likely to have a miscarriage as women who abstain from alcohol during pregnancy. In addition, alcohol exposure can be harmful to the fetus even in cases where miscarriage does not occur, and often results in low-birth weight babies with learning and/or physical disabilities, among other damaging effects. Alcohol intake can also reduce sperm count in men.
Use of certain medications and/or illegal substances. Pregnant women who have taken certain prescription or over-the-counter drugs, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen have reported miscarriages. In addition, the use of illegal substances such as heroin, cocaine and ecstasy has been associated with miscarriage.
Use of donor eggs. Recent research indicates that women who achieve pregnancy via assisted reproductive technology (e.g., in-vitro fertilization) using donated eggs may be more likely to experience miscarriage. Scientists believe that miscarriage may occur as a result of the mother’s immune system reacting negatively against the foreign egg.
Prenatal testing. Certain types of prenatal genetic tests (e.g., amniocentesis, chorionic villus sampling) have been associated with an increased risk of miscarriage due to the invasive nature of the procedures. However, both amniocentesis and chorionic villus sampling appear to carry only a low risk of miscarriage, according to researchers at the University of California, San Francisco who recently conducted a large-scale review of numerous studies over the past 20 years.
Trauma. Severe trauma to the uterus (e.g., trauma from a serious accident or fall) can increase the risk of miscarriage. However, activities of daily living, such as exercising, sex, working or lifting heavy objects, do not provoke a miscarriage – even in very active women. Exercise, in general, is healthy for the mother and the developing baby. Pregnant women should consult with their physicians to discuss the extent and types of exercise to ensure the baby’s safety before engaging in such activities.
Environmental factors. Exposure to environmental toxins, radiation and immunologic factors has been associated with miscarriage. Lead, arsenic, mercury, some chemicals like formaldehyde, benzene, ethylene oxide, and large doses of radiation or anesthetic gases have been associated with miscarriage.
Signs and symptoms of miscarriage
Vaginal bleeding is the warning sign that precedes nearly all miscarriages. However, it does not always lead to miscarriage. Many women experience spotting in early pregnancy and most do not miscarry.
Regardless, a woman should contact a physician if she experiences any bleeding, even light spotting, during pregnancy or if she suspects she is having a miscarriage. A pregnant woman should also contact her physician is she notices tissue or clot-like material passing from the vagina. This type of material should be collected in a clean container and brought to a physician for examination, when possible.
Other signs and symptoms of a miscarriage may include:
Pelvic pain (usually worse than menstrual cramps)
Weight loss
White-pink mucus or discharge
Painful contractions (occurring every five to 20 minutes)
Frequent bowel movements
Brown or bright red bleeding or spotting
Decrease in signs of pregnancy (e.g., morning sickness or loss of breast tenderness)
Diagnosis methods for miscarriage
If a miscarriage is suspected, a physician will obtain a medical history and ask questions regarding the symptoms a woman may be experiencing, followed by a thorough pelvic examination.
The pelvic exam is performed to check the size of the uterus and determine whether the cervix is open or closed. If a miscarriage is in progress, the cervix is usually open and the pregnancy will not continue. If a miscarriage has already occurred, the cervix can be either open or closed, depending on whether all the pregnancy tissue has passed out of the mother’s uterus.
In addition, a physician may order an ultrasound to establish if a miscarriage has occurred or to help determine if the pregnancy is capable of progressing to term. With this imaging test, a physician can check for the presence of an embryo that has a heartbeat and determine if it is growing according to schedule and whether it is the appropriate size in relation to the placenta.
There also are several blood tests that measure pregnancy hormone titers. Titer levels should increase at a particular rate during a normal, healthy pregnancy. Theses tests can be used along with ultrasound to monitor the course of early pregnancies that are complicated by bleeding.
Physicians usually do not perform any tests following a first miscarriage that occurs in the first trimester (the first 12 weeks of pregnancy). The cause of these early losses is often unknown, even though chromosomal abnormalities are usually suspected.
However, if a woman has a miscarriage during the second trimester or experiencesrecurrent miscarriage, physicians will recommend various tests to determine the cause, such as:
Blood tests. Laboratory analysis of blood samples of both parents to check for chromosome abnormalities, as well as certain hormonal problems and immune system disorders (e.g., lupus) in the mother (e.g., karyotype test).
Transvaginal ultrasound. A procedure that uses a probe inserted into the vagina that emits sound waves to produce a picture of the body tissue. It is useful in finding abnormalities in the vagina, uterus, fallopian tubes, ovaries, bladder and other nearby structures.
Hysterosalpingography (HSG). X-ray of the uterus and fallopian tubes that is used to look for blockages and other problems.
Hysteroscopy. A test that allows a physician to view the uterus through a special scope inserted through the cervix. It is usually prescribed if results from the HSG are abnormal.
Sonohysterography. A technique that involves injecting saline solution into the uterus via the cervix in order to observe the image of these structures through an ultrasound. This type of test is very accurate in determining uterine and/or cervical abnormalities that may cause recurrent miscarriages.
Magnetic resonance imaging (MRI). A safe and noninvasive or minimally invasive test that uses powerful magnets to produce images on a computer screen and film. It is useful in confirming uterine abnormalities after a transvaginal ultrasound or HSG.
Endometrial biopsy. The removal and analysis of a sample of endometrial tissue to determine if the tissue that lines the uterus (uterine lining) is sufficiently hospitable to allow the embryo to implant and grow.
Analysis of tissue samples. Testing for chromosomal abnormalities in tissue from the miscarriage (if available).
Treatment following a miscarriage
Once a physician determines that a miscarriage is inevitable or is already occurring, there are several treatment options available depending on the stage of the miscarriage and the condition of the mother, among other factors. These may include:
Observation. In most cases, women who miscarry do not need further medical treatment because the uterus usually empties itself (similar to a heavy menstrual period) within a couple of weeks, although sometimes it can take as long as three to four weeks. Once the contents of the uterus have been expelled, an ultrasound is performed to ensure that the miscarriage is complete. Any remaining pregnancy tissue is removed to prevent infection.
Medication. Sometimes, medications (e.g., mifepristone, methotrexate, misoprostol, or a combination of the three) may be administered by the physician to stimulate the uterus to expel remaining pregnancy tissue. However, these medications may produce side effects, such as prolonged vaginal bleeding, nausea, diarrhea, fever, headache and/or pelvic pain. Also, another potential downside (although rare) is that pregnancy tissue might still remain after use of these medications and surgery may be needed to remove it.
Surgery. The conventional treatment for early miscarriage with incomplete dispelling of the uterus is a surgical procedure called dilation and curettage (D&C). In a D&C, the cervix is dilated (widened), and an instrument is inserted that uses suction and/or gentle scraping motion to remove the contents of the uterus. This procedure is performed in women who do not want to wait for spontaneous passage of the pregnancy, and in women with heavy bleeding or infection. However, risks involved with D&C include perforation of the uterus, formation of scar tissue in the uterus, trauma to the cervix and infection, which could lead to infertility.
If a woman experiences recurrent miscarriage, a physician may recommend further treatment, such as:
Surgery. Surgical procedures may be performed to correct any uterine and/or cervical abnormalities. Sometimes, a cervical cerclage procedure that stitches the cervix shut in women with incompetent cervix is helpful in preventing pregnancy loss resulting from this abnormality.
Hormone therapy. Human menopausal gonadotrophin (hMG) hormone, which stimulates ovulation, may be useful in treating women who experience recurrent miscarriage due to low levels of the hormone progesterone (luteal phase deficiency). This hormone promotes the formation of a thicker endometrium, thereby leading to better implantation of the embryo.
Also, studies have shown that treatment with clomiphene citrate, a type of ovulation drug, may promote pregnancy in some women with recurrent miscarriage due to a luteal phase deficiency.
Another type of treatment is the administration of the hormone progesterone, either via injections or vaginally (to achieve higher concentration in the uterus), to prevent miscarriage due to luteal phase deficiency. However, some studies suggest an association between mothers who undergo progesterone therapy during the first trimester of pregnancy and genital abnormalities in male and female babies.
In addition, it should be noted that there is no conclusive evidence to support the effectiveness in treating recurrent miscarriage with any of these types of hormonal treatments.
Medical treatment of chronic illness. Women with chronic diseases, such as diabetes mellitus, thyroid dysfunction and polycystic ovarian syndrome (PCOS), among others, should be treated medically to get their illness under control prior to attempting pregnancy. This will reduce their chance of miscarriage.
Treatment for immune system problems. Treatment administering a combination of low dose aspirin and low dose heparin (an anticoagulant drug) may be effective in improving pregnancy outcome in women with recurrent pregnancy loss due to lupus or antiphospholipid antibody syndrome (APS). However, this treatment is not effective in women with unexplained recurrent miscarriage. Also, aspirin alone does not reduce risk of miscarriage.
In-vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD). A combination of IVF and PGD is often successful in preventing recurrent miscarriage due to chromosomal abnormalities in the embryo. This is because PGD can identify and transfer only chromosomally normal embryos to the uterus.
Donor eggs. Even though use of donor eggs for assisted reproduction may increase the risk of miscarriage, it is still a good alternative in cases where recurrent miscarriage is occurring due to problems with a woman’s own eggs. This may help prevent recurrent miscarriage in women over age 40.
Following a miscarriage, a physician will advise a woman to maintain “pelvic rest” for up to two weeks. This involves not having sexual intercourse or inserting anything (e.g., tampons) into the vagina. It is also customary for a physician to advise a woman to wait two to three months before attempting to become pregnant again.
Medications may also be prescribed to help decrease bleeding and reduce infection. In the case of Rh incompatibility, women are prescribed a drug called Rh (D) immune globulin. This medicine helps protect future pregnancies against problems that can occur if a mother’s Rh factor is incompatible with that of the fetus, such as miscarriage.
It may take weeks to a month or longer for a woman to physically recover from a miscarriage. In addition, parents often experience grief or depression after a miscarriage. Sometimes these feelings are severe and long-lasting. In such cases, a physician may recommend a psychologist or grief counseling group for emotional support.
The majority of women who experience a miscarriage go on to have successful pregnancies.
Prevention methods for miscarriage
All women should have yearly checkups with their obstetrician-gynecologist (ObGyn) to monitor their reproductive health. For women considering pregnancy, early prenatal care is important for their health and to ensure optimum conditions for pregnancy to occur.
Because most miscarriages are caused by chromosomal abnormalities, there is little that can be done to prevent miscarriage from occurring. However, it is recommended that all women who are trying to conceive achieve a healthy lifestyle by:
Exercising regularly
Eating healthy
Managing stress
Maintaining a healthy weight
Taking a daily folic acid supplement
Avoiding the use of alcohol and recreational drugs (e.g., cocaine, ecstasy)
Refraining from smoking
If a woman is pregnant, she can reduce the risk of miscarriage by:
Receiving good prenatal care
Not smoking or being around cigarette smoke
Not drinking alcohol or using recreational drugs
Checking with a physician before taking any prescription or over-the-counter medications
Having someone else clean the cat’s litter box to help avoid toxoplasmosis
Limiting or eliminating caffeine
Avoiding environmental hazards, such as radiation and x-rays
Getting proper treatment for chronic illness, such as diabetes and thyroid disease
Avoiding contact sports or activities that have risk or injury
Avoiding certain foods that may contain harmful bacteria (e.g., listeria) that can cause miscarriage, such as raw or uncooked meats, deli meats, liver, fish, raw shellfish, raw eggs, soft cheeses, unpasteurized milk and pate
Washing all fruits and vegetables before consumption
Ongoing research on miscarriages
There are a number of organizations that are working in the area of research of miscarriages. The National Institute of Child Health & Human Development is continually conducting research on the cause and prevention of miscarriages, including:
Evaluation of the role of certain medical conditions such as polycystic ovarian syndrome (PCOS) in causing miscarriages. Studies have shown that women who have PCOS are three times more likely to miscarry in the early months of pregnancy. These women frequently have insulin resistance in addition to PCOS. Scientists have determined that the drug metformin reduces insulin resistance and promotes changes in the uterus that lowers the risk of miscarriage.
Gene studies in women who experience recurrent miscarriage. Researchers have conducted genetic studies that have revealed a common genetic mutation in women who have had repeated, unexplained miscarriages. If the mutation can be confirmed in additional studies, scientists may be able to develop a blood test that could predict the chances of miscarriage in future pregnancies.
Questions for your doctor about miscarriage
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Women may wish to ask their doctor or healthcare professional the following questions regarding miscarriage:
Am I at higher risk for miscarriage?
How will I know if I’m experiencing a miscarriage?
Can I do anything to stop a miscarriage once I develop symptoms?
What tests will be used following my miscarriage?
Can these tests help diagnose the reason for my miscarriage?
Will I need to undergo any surgery?
How soon can I try to conceive after experiencing miscarriage?
How will my miscarriage affect my fertility?
Am I at greater risk for another miscarriage?
Is there any treatment for recurrent miscarriages?
