August 31, 2015
A miscarriage is the spontaneous loss of a fetus before the 20th week of pregnancy. (Pregnancy losses after the 20th week are called stillbirths.)
A miscarriage may also be called a "spontaneous abortion." This refers to naturally occurring events, not to medical abortions or surgical abortions.
Other terms for the early loss of pregnancy include:
- Complete abortion: All of the products (tissue) of conception leave the body
- Incomplete abortion: Only some of the products of conception leave the body
- Inevitable abortion: Symptoms cannot be stopped and a miscarriage will happen
- Infected (septic) abortion: The lining of the womb (uterus) and any remaining products of conception become infected
- Missed abortion: The pregnancy is lost and the products of conception do not leave the body
The doctor may also use the term threatened miscarriage. The symptoms of this condition, abdominal cramps with or without vaginal bleeding, are a sign that a miscarriage may occur.
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Back to TopAlternative Names
Abortion - spontaneous; Spontaneous abortion; Abortion - missed; Abortion - incomplete; Abortion - complete; Abortion - inevitable; Abortion - infected; Missed abortion; Incomplete abortion; Complete abortion; Inevitable abortion; Infected abortion
Back to TopCauses
Most miscarriages are caused by chromosome problems that make it impossible for the baby to develop. Usually, these problems are not related to the mother or father's genes.
Other possible causes of miscarriage include:
- Drug and alcohol abuse
- Exposure to environmental toxins
- Hormone problems
- Physical problems with the mother's reproductive organs
- Problem with the body's immune response
- Serious body-wide (systemic) diseases in the mother (such as uncontrolled diabetes)
Around half of all fertilized eggs die and are lost (aborted) spontaneously, usually before the woman knows she is pregnant. Among women who know they are pregnant, the miscarriage rate is about 15-20%. Most miscarriages occur during the first 7 weeks of pregnancy. The rate of miscarriage drops after the baby's heart beat is detected.
The risk of miscarriage is higher in women:
- Who are older, with increases beginning by age 30, becoming greater between 35 and 40, and highest after 40.
- Who have had previous miscarriages.
Back to TopSymptoms
Possible symptoms include:
- Low back pain or abdominal pain that is dull, sharp, or cramping
- Tissue or clot-like material that passes from the vagina
- Vaginal bleeding, with or without abdominal cramps
Back to TopTreatment
When a miscarriage occurs, the tissue passed from the vagina should be examined. This is done to determine if it was a normal placenta or a hydatidiform mole. It is also important to determine whether any pregnancy tissue remains in the uterus.
If the pregnancy tissue does not naturally leave the body, the woman may be closely watched for up to 2 weeks. Surgery (D and C) or medication (such as misoprostol) may be needed to remove the remaining contents from the womb.
After treatment, the woman usually resumes her normal menstrual cycle within 4 - 6 weeks. Any further vaginal bleeding should be carefully monitored. It is often possible to become pregnant immediately. It is recommended that women wait one normal menstrual cycle before trying to become pregnant again.
Back to TopPrevention
Early, comprehensive prenatal care is the best prevention for complications of pregnancy, such as miscarriage.
Miscarriages that are caused by body-wide (systemic) diseases can be prevented by detecting and treating the disease before pregnancy occurs.
Miscarriages are also less likely if you avoid things that are harmful to your pregnancy. These include x-rays, recreational drugs, alcohol, high caffeine intake, and infectious diseases.
When a mother's body has difficulty keeping a pregnancy, signs such as slight vaginal bleeding may occur. This means there is a possibility of miscarriage. But it does not mean one will definitely occur. A pregnant woman who develops any signs or symptoms of threatened miscarriage should contact her prenatal provider immediately.
Back to TopReferences
American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 462: Moderate caffeine consumption during pregnancy. ObstetGynecol . 2010;116(2 Pt 1):467-8.
Katz VL. Spontaneous and recurrent abortion: etiology, diagnosis, treatment. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology . 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 16.
Laurino MY, Bennett RL, Saraiya DS, et al. Genetic evaluation and counseling of couples with recurrent miscarriage: Recommendations of the National Society of Genetic Counselors. J Genet Couns . June 2005;14(3). Reaffirmed April 2010.
Simpson JL, Jauniaux ERM. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies . 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 26.
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