Termination of a pregnancy before the embryo or foetus can live apart from its mother. An abortion refers to an induced termination. Spontaneous termination is usually referred to as a miscarriage. See: ABORTION.
Lupus erythematosis – accounts for a significant number of unexplained miscarriages. Some lupus sufferers may have ten or more miscarriages (Swedish study). In lupus there is a sluggish blood supply – microscopic blood vessels between baby and the mother may silt up, the nutrient supply cut off and the baby dies. Agents with blood-thinning properties (anti-coagulants) can keep blood flowing smoothly to the baby. Some women with severe lupus symptoms may require the stronger anti-coagulants of general medicine (heparin).
Pregnancy. Should be carefully monitored with one-month scans to make sure the baby is alive. All women who miscarry should be tested to see if they are carrying lupus antibodies, and have a lupus test after their first miscarriage.
Influenza. Epidemiologists found that women whose pregnancies were more likely to have had flu-like illness during pregnancy can miscarry. Evidence of a link between influenzal infection during pregnancy and miscarriage or stillbirth has been uncovered. Such infection during pregnancy may also cause schizophrenia in offspring.
Information. Miscarriage Association, C/O Clayton Hospital, Northgate, Wakefield, West Yorks WF1 3JS, UK. Send SAE.
Loss of the fetus before the 24th week of pregnancy or viability (the ability to survive outside the uterus without artificial support). The medical term is spontaneous abortion.
The majority of miscarriages occur in the first 12 weeks of pregnancy, and may be mistaken for a late menstrual period. Miscarriages may occur because of chromosomal abnormalities or developmental defects in the fetus, or because of severe illness, exposure to toxins, or an autoimmune disorder in the mother. Miscarriages later in pregnancy may be caused by genetic disorders, cervical incompetence, a defect in the uterus, or large uterine fibroids.
The symptoms are heavy bleeding with cramping. Slight blood loss with severe pain can be a symptom of either a threatened miscarriage or ectopic pregnancy.
Miscarriages are classified medically as different types of abortion. In a threatened abortion, the fetus remains alive in the uterus. In an inevitable abortion, the fetus dies and is expelled from the uterus. In a missed abortion, the fetus dies but remains in the uterus.
A pelvic examination and ultrasound scanning may be performed to assess the pregnancy. If all of the contents of the uterus are expelled, no further treatment may be necessary. Otherwise, a D and C may be performed. Missed abortion requires a D and C or induction of labour depending on the duration of the pregnancy. Rh-negative women are given anti-D (Rho) immunoglobulin to prevent complications related to Rhesus incompatibility in future pregnancies.
(See also abortion.)
n. spontaneous loss of pregnancy before 24 weeks, formerly known as spontaneous abortion. In threatened miscarriage there is vaginal bleeding (often minimal) associated with mild period-type pains; the cervix is closed and ultrasound confirms a viable pregnancy. In inevitable miscarriage, vaginal bleeding is associated with crampy pelvic pains and an open cervix; the pregnancy has not yet been expelled, but eventually will be. The miscarriage is incomplete if the cervix remains open and the uterus still contains some fetal tissue (which may need to be removed to prevent further haemorrhage). The miscarriage is complete if the cervix has closed and ultrasound scanning shows an empty uterus. Failure of a nonviable fetus to be expelled from the uterus is called a silent (or missed) miscarriage. A late miscarriage is one occurring after 20–24 weeks when the fetus has shown no signs of life after delivery. Recurrent miscarriage is the loss of three or more pregnancies consecutively; there are many possible causes, including *antiphospholipid antibody syndrome.
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