Miscarriage/ Early Pregnancy Loss
Miscarriage/ Early Pregnancy Loss
This is also known as a spontaneous abortion and occurs in the first trimester (12 weeks) of pregnancy. Miscarriage is common occurring in more than 10% of pregnancies.
Diagnosis
Diagnosis is made by ultrasound scan and the findings are varied - there is an intrauterine pregnancy with either an empty gestation sac or a fetus without fetal heart activity. Most women go on to have successful pregnancies after miscarriage. Recurrent pregnancy loss is rare.
Causes of Early Pregnancy Loss
Research indicates that chromosomal anomalies in the embryo are the commonest cause of miscarriage. There is strong evidence that cigarette smoking and heavy consumption of alcohol is associated with miscarriage.
Symptoms of Early Pregnancy Loss
Vaginal bleeding is the most common with or without lower abdominal cramps. While bleeding in early pregnancy is common, many women experience bleeding in the first trimester and the pregnancy continues normally.
Diagnosis of Early Pregnancy Loss
The primary investigation will be a pelvic ultrasound scan to help determine the location and viability of the pregnancy. Also, included is measuring the blood level of b-HCG which is the hormone made by the developing placenta. Serial assessments of the b-HCG level may be required to diagnose an ectopic pregnancy, or to help determine the viability of a pregnancy.
Management of Early Pregnancy Loss
Expectant management of miscarriage
If you have started having pain and bleeding, it may be possible to allow the tissue to pass naturally, and this usually takes 1-2 weeks. You will be managed with regular outpatient follow up, and will be given pain killers to help with uterine cramps.
Surgical management of miscarriage
Uterine evacuation
This is recommended for miscarriage above 10 weeks gestation or in cases of heavy vaginal bleeding. This is performed as a day case procedure under general anesthesia.
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