Understanding Miscarriage: A Comprehensive Guide

This revised guide expands upon the original set of multiple-choice questions about miscarriage, providing a more complete understanding of this common pregnancy complication.

1. Miscarriage: A General Overview

• What is a Miscarriage? A miscarriage occurs when a pregnancy ends before the 22nd week of gestation, or when the fetus weighs less than 500 grams.
• Types of Miscarriage:
  • Early Miscarriage: Happens before the 12th week of gestation.
  • Late Miscarriage: Occurs between the 12th and 22nd weeks of gestation.
• Recurrent Miscarriage: Refers to experiencing multiple miscarriages consecutively.

2. Causes of Miscarriage

• Maternal Factors:
  • Age: Women over 35 are at a higher risk for miscarriage.
  • Medical Conditions: Conditions like uterine fibroids, incompetent cervix, uterine abnormalities, infections, thyroid disorders, and autoimmune diseases can contribute to miscarriage.
  • Lifestyle: Smoking, alcohol and drug use, exposure to hazardous chemicals, and certain medications can increase the risk of miscarriage.
• Fetal Factors:
  • Chromosomal Abnormalities: The most common cause of miscarriage, especially early miscarriage.
  • Fetal Structural Abnormalities: Birth defects in the developing fetus can also lead to miscarriage.

3. Symptoms of Miscarriage

• Threatened Miscarriage:
  • Light vaginal bleeding, which may be bright red or brown.
  • Lower abdominal cramping, often described as a dull ache or feeling of heaviness.
  • A closed cervix.
  • The uterus is consistent with the gestational age of the pregnancy.
• Miscarriage in Progress:
  • Heavy vaginal bleeding, often with clots.
  • Intermittent, intense lower abdominal cramps.
  • A partially dilated cervix (opening).
  • The placenta may be visible at the cervix.
• Complete Miscarriage:
  • Lower abdominal cramping.
  • Heavy vaginal bleeding with clots.
  • A fully dilated cervix.
  • The fetus and placenta have been expelled from the uterus.

4. Management of Miscarriage

• Threatened Miscarriage:
  • Bed rest.
  • Medications to reduce uterine contractions, such as natural progesterone.
  • Abstinence from sexual activity.
  • Monitoring fetal health through ultrasound.
• Miscarriage in Progress:
  • Dilation and curettage (D&C) to remove the fetus and placenta.
  • Antibiotics to prevent infection.
  • Fluids and blood transfusions to replenish fluids and electrolytes.
  • Intensive care support if needed.
• Complete Miscarriage:
  • Dilation and curettage (D&C) to remove the fetus and placenta.
  • Antibiotics to prevent infection.
  • Fluids and blood transfusions to replenish fluids and electrolytes.
  • Intensive care support if needed.

5. Important Considerations

• Miscarriage is a common occurrence, but early diagnosis and proper management can reduce the risk of recurrent miscarriage.
• If you experience any symptoms suggestive of miscarriage, seek immediate medical attention for diagnosis and treatment.
• Consult with your doctor for personalized advice on preventing miscarriage based on your individual circumstances.

Clarifications for Multiple Choice Questions

• Question 1376: While sexual intercourse during pregnancy is not the primary cause of miscarriage, it can increase the risk of infection.
• Question 1377: Early miscarriage is defined as occurring before the 12th week of gestation, not the 14th week.
• Question 1383: Bed rest plays a crucial role in managing threatened miscarriage, not medications for reducing uterine contractions like progesterone.
• Question 1384: The “baby turning” sensation is often associated with an incompetent cervix, not threatened miscarriage.
• Question 1397: Intermittent, intense lower abdominal cramping is typical of a miscarriage in progress, not threatened miscarriage.
• Question 1404: The definition of miscarriage is when a pregnancy ends before the 22nd week or the fetus weighs less than 500 grams.
• Question 1414: Intensive care support, fluid and blood transfusions should be prioritized before performing a D&C.
• Question 1416: hCG levels and ultrasounds are the most important tests in diagnosing threatened miscarriage.
• Question 1431: Cervical cerclage (stitching of the cervix) for an incompetent cervix is usually performed between 14 and 16 weeks of gestation, not 10 or 12 weeks.
• Question 1432: Natural progesterone is the preferred medication for managing threatened miscarriage.

Disclaimer: This information is intended for general knowledge and should not be substituted for professional medical advice. If you have concerns about your health, especially during pregnancy, seek guidance from a qualified healthcare provider.