* Author Topic: Guide to Early Miscarriage  (Read 5335 times)

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Offline Dory10

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Guide to Early Miscarriage
« on: 26/07/15, 11:44 »
Guide to Early Miscarriage

Sadly around 1 in 4 pregnancies end in an early miscarriage, before 13 weeks of pregnancy.  There are many reasons why a miscarriage may happen and sometimes these occur before a woman has even realised she is pregnant.   Early miscarriages are often caused by abnormal chromosomes in the baby. Chromosomes are genetic "building blocks" that guide the development of a baby. If a baby has too many or not enough chromosomes, it won't develop properly and the mother will miscarry.  In the majority of pregnancies this occurs within the first 13 weeks of pregnancy but in some cases at a later stage during the second trimester (please see our guide to late miscarriage).


There are several types of early miscarriage

Incomplete miscarriage –This is where the miscarriage has taken place but some of the pregnancy matter has remained in the womb. The cervix is usually found to be opened.

Complete miscarriage –This is when the pregnancy has been completely lost, the cervix is open and there is no evidence left inside of the womb of pregnancy.

Missed miscarriage – This is where the baby stop growing weeks before but the pregnancy was not lost. This can be indicated buy the loss of dark brownish red blood and the sudden disappearance of any pregnancy symptoms.

Blighted Ovum- This is where the sack is present but no baby is inside.


Early miscarriage symptoms


Some women experience abdominal cramps and pain, like period pains and some vaginal bleeding.  For others, they may notice that some of their early pregnancy symptoms disappear; no longer feeling sick or having tender breasts may be an indication.  In some cases of a missed miscarriage a woman may have no indication that anything is wrong until a routine ultra sound scan.


What should I do?

Any episode of bleeding or strong abdominal cramps/pains should be investigated.  Spotting/light bleeding in early pregnancy is not uncommon and many ladies go on after such episodes to have healthy pregnancies, however it does need to be investigated.  Equally it is common for early pregnancy symptoms to come and go day to day but if you are concerned seek medical advice.  A home pregnancy test is not useful for diagnosing miscarriage as often a woman’s hormone levels can remained raised for some time after the loss.  An ultra sound scan is the only way to confirm a miscarriage.  If a pregnancy is less than around 7 weeks you will usually be asked to return the following week to check for fetal growth and the presence of a heartbeat.  Sometimes you will be asked to return to the hospital again after waiting for a few more days as they want to make sure the pregnancy is not going to progress before offering any treatment.  This can add to the anxiety and emotions of an already heartbreaking and difficult time so please reach out for support.


If an early miscarriage is confirmed what are my options?


Natural management – You can opt to go home, stop any medication given to you to support the pregnancy and wait to miscarry naturally.  If this hasn’t occurred within 2 weeks your hospital will usually want to see you again for a check up and to discuss other options.

Medical management – You are given medication to help your body miscarry.  Usually this involves oral tablets and vaginal pessaries.  Hospitals differ in their approach to medical management, most ask you to stay in as a day case so that you miscarry in hospital, others allow the woman to go home after receiving the medication and miscarry at home. 

ERPC (Emergency Removal of Products of Conception) – This is a surgical option usually performed under general anaesthetic where the uterus is cleared surgically.

Your hospital should talk through your options with you and give you time to think about what is best for you.  In certain cases, for medical reasons, an option may be advised but it is important to remember that in the vast majority of cases this is a very personal decision.


How can I prepare myself?

At home – Stock up on sanitary pads (tampons should not be used during a miscarriage or the bleeding afterwards) and pain killers (paracetamol  or cocodamol).  A hot water bottle can help with the cramps and keep the phone number of your EPAU or gynae ward handy in case you have any concerns.  It is really important to seek medical attention straight away if you experience any symptom you are concerned about or:

•   Are bleeding at such a rate that you need more than one sanitary towel per hour. In this case, too much blood is being lost and        the flow must be stopped.
•   You feel weak or faint, again a sign you may be loosing too much blood.
•   Painkillers are not easing your pain.
•   You experience fever, shivering or a smelly vaginal discharge; this can be a sign of an infection or inflammation.

In hospital – Take sanitary pads with you and spare underwear and a change of clothes.  The staff will fill up a hot water bottle for you so if you find this soothing then pack one.  There is often a lot of waiting, especially before an ERPC so take magazines, books or hand held games etc.  If you’re having a general anaesthetic you will be nil by mouth but it is worth taking snacks for your partner or a favourite drink/snack for after the procedure.


What happens next?

It is usually advised that women take things easy for a couple of weeks after a miscarriage.  No heavy exercise or housework.  Many women take this time off work but others find they wish to return to a normal routine more quickly.  This is down to personal choice but remember you do need to give your body a change to recover physically and emotionally.  There is no magic time, some people need longer off work than others, some find counselling helps, others find a holiday or time away helps.  Do what feels right for you and look after yourself and your partner.  There is a very supportive Coping after pregnancy loss thread on FF https://www.fertilityfriends.co.uk/forum/index.php?topic=334678.70

It is important to remember that for most women a miscarriage is a one off event and they do go on to have a healthy pregnancy in the future.  Sadly some women may suffer more than one miscarriage and may get referred for recurrent miscarriage investigations. Please see our Guide to Trying again after a loss https://www.fertilityfriends.co.uk/forum/index.php?topic=337963.0


Support sites for early miscarriage:-

The Miscarriage Association http://www.miscarriageassociation.org.uk/support/how-we-can-help/?gclid=CK73-7fS-MYCFcJe2wodDgQErg

Tommy's http://www.tommys.org/pregnancy/problems/miscarriage




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