Spontaneous Abortion

Spontaneous Abortion
Spontaneous Abortion

Overview Of Spontaneous Abortion

A miscarriage is the spontaneous loss or abortion of a fetus before the 20th week of pregnancy (pregnancy losses after the 20th week are called stillbirths). Miscarriage is a naturally occurring event, unlike medical or surgical abortions.

A miscarriage may also be called a “spontaneous abortion.” 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.

Your health care provider may also use the term “threatened miscarriage.” The symptoms of this condition are abdominal cramps with or without vaginal bleeding. They are a sign that a miscarriage may occur.

Commonly Associated With

Abortion – spontaneous; Spontaneous abortion; Abortion – missed; Abortion – incomplete; Abortion – complete; Abortion – inevitable; Abortion – infected; Missed abortion; Incomplete abortion; Complete abortion; Inevitable abortion; Infected abortion

Causes Of Spontaneous Abortion

Most miscarriages are caused by chromosome problems that make it impossible for the baby to develop. In rare cases, these problems are related to the mother’s or father’s genes.

Other possible causes of miscarriage may include:

  • Drug and alcohol abuse
  • Exposure to environmental toxins
  • Hormone problems
  • Infection
  • Overweight
  • 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)
  • Smoking
  • 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, about 10% to 25% will have a miscarriage. Most miscarriages occur during the first 7 weeks of pregnancy. The rate of miscarriage drops after the baby’s heartbeat is detected.

The risk of miscarriage is higher:

  • In women who are older — The risk increases after 30 years of age and becomes even greater between 35 and 40 years, and is highest after age 40.
  • In women who have already had several miscarriages.

Symptoms of Spontaneous Abortion

Possible symptoms of miscarriage may 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

Exams & Tests

During a pelvic exam, your provider may see that your cervix has opened (dilated) or thinned out (effacement).

An abdominal or vaginal ultrasound may be done to check the baby’s development and heartbeat, and the amount of your bleeding.

The following blood tests may be performed:

  • Blood type (if you have an Rh-negative blood type, you would require a treatment with Rh-immune globulin).
  • Complete blood count (CBC) to determine how much blood has been lost.
  • HCG (qualitative) to confirm pregnancy.
  • HCG (quantitative) done every several days or weeks.
  • White blood count (WBC) and differential to rule out infection.

Treatment Of Spontaneous Abortion

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 (a rare growth that forms inside the womb early in pregnancy). It is also important to find out whether any pregnancy tissue remains in the uterus. In rare cases, an ectopic pregnancy can look like a miscarriage. If you have passed tissue, ask your provider if the tissue should be sent for genetic testing. This can be helpful to determine if a treatable cause of miscarriage is present.

If the pregnancy tissue does not naturally leave the body, you may be closely watched for up to 2 weeks. Surgery (suction curettage, D and C) or medicine may be needed to remove the remaining contents from your womb.

After treatment, women usually resume their normal menstrual cycle within 4 to 6 weeks. Any further vaginal bleeding should be carefully monitored. It is often possible to become pregnant immediately. It is suggested that you wait for one normal menstrual cycle before trying to become pregnant again.