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Below you will find summaries of articles & websites on Miscarriage i.e. latest research on Causes, Treatment and Information.
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Karene
Jade Howie
The medical definition of miscarriage is the spontaneous loss of a pregnancy before 24 weeks’ gestation, when the foetus has a chance of survival outside the womb.
The most sensitive studies suggest that with fertile couples pregnancy occurs in 60% of natural cycles. The studies also suggest that as many as 50% of pregnancies miscarry before implantation in the womb occurs. Early after implantation (before a pregnancy is clinically recognised) pregnancy loss rate is around 30%. And even after a pregnancy is clinically recognised as many as one quarter of pregnancies miscarry, usually during the first 14 weeks.
After one miscarriage, your risk of miscarriage is the same as that of a woman who's never had a miscarriage. Even without treatment, the ACOG reports that about 60 percent to 70 percent of women with repeated miscarriages go on to have successful pregnancies.
The most risky time is between six and eight weeks from the last menstrual
period.
Over half the babies who are miscarried during this period have a chromosomal
abnormality. The second most common cause of miscarriage is the baby not
implanting itself correctly in the womb lining - another chance occurrence.
Threatened miscarriage: describes bleeding in early pregnancy, where the
cervix is found to be tightly closed. The pregnancy is most likely to continue.
Inevitable miscarriage: describes bleeding in early pregnancy where the
cervix is found to be open, suggesting that the pregnancy will be lost.
Incomplete miscarriage: miscarriage has definitely started, but there is
still some pregnancy tissue left in the womb. The cervix is usually found
to be open.
Complete miscarriage: when the pregnancy has been lost, the womb is now
empty and the cervix has closed.
Missed miscarriage: when the pregnancy stopped growing some weeks ago, but
there was no bleeding at this time. This type of miscarriage usually causes
a slight, dark-brown blood loss and the sudden end of normal pregnancy symptoms.
It is sometimes called a blighted ovum.
The most common symptom is vaginal bleeding, which can range from light spotting to heavy. The blood may contain clots or other tissue. There can often be cramping, with period-like pains, and back pain.
If a miscarriage is complete then no further treatment is needed. When
miscarriage occurs under 10 weeks, it is more likely to complete by itself.
The other types of miscarriage frequently require treatment, though in some
cases it is appropriate to see first if nature takes its course. The decision
on whether medical treatment is needed depends on the stage of pregnancy,
the amount of bleeding, any risk to health, and each woman's personal choice.
For missed miscarriage or when there is significant bleeding, treatment
with drugs or surgery may be needed to remove the remaining pregnancy tissue.
Although bleeding may be more prolonged afterwards, research suggests that
avoiding an operation may halve the risk of an infection. However, it is
very important that the woman is monitored closely to ensure that all the
pregnancy tissue is expelled naturally, as a significant delay can occasionally
result in infection.
http://www.babyloss.com/pdfs/miscarriage.pdf
D&C, also known as dilation and curettage, is a surgical procedure performed after a first trimester miscarriage. Dilation means to open up the cervix; curettage means to remove the contents of the uterus. Curettage may be performed by scraping the uterine wall with a curette instrument or by a suction curettage (also called vacuum aspiration), using a vacuum-type instrument.
About 50% of women who miscarry do not undergo a D&C procedure. Women can safely miscarry on their own, with few problems in pregnancies that end before 10 weeks. After 10 weeks, the miscarriage is more likely to be incomplete, requiring a D&C procedure to be performed. Choosing whether to miscarry naturally (called expectant management) or to have a D&C procedure is often a personal choice.
A D&C procedure may be done as an outpatient or inpatient procedure in a hospital or other type of surgical center. Most often, general anesthesia is used, but IV anesthesia or paracervical anesthesia may also be used.
1) You may receive antibiotics intravenously or orally to help prevent infection.
2) The cervix is examined to evaluate if it is open or not. If the cervix is closed, dilators (narrow instruments in varying sizes) will be inserted to open the cervix to allow the surgical instruments to pass through. A speculum will be placed to keep the cervix open.
3) The vacuum aspiration (also called suction curettage) procedure uses a plastic cannula (a flexible tube) attached to a suction device to remove the contents of the uterus. The cannula is approximately the diameter in millimeters as the number of weeks gestation the pregnancy is. For example, a 7mm cannula would be used for a pregnancy that is 7 weeks gestation. The use of a curette (sharp edged loop) to scrape the lining of the uterus may also be used, but is often not necessary.
4) The tissue removed during the procedure may be sent off to the pathology lab for testing.
5) Once the health care provider has seen that the uterus has firmed up and that the bleeding has stopped or is minimal, the speculum will be removed and you will be sent to recovery.
* Risks associated with anesthesia such as adverse reaction to medication
and breathing problems
* Hemorrhage or heavy bleeding
* Infection in the uterus or other pelvic organs
* Perforation or puncture to the uterus
* Laceration or weakening of the cervix
* Scarring of the uterus or cervix, which may require further treatment
* Incomplete procedure which requires another procedure to be performed.
http://www.americanpregnancy.org/pregnancycomplications/dandc.html
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http://sexuality.spaceandmotion.com/miscarriage.htm
Miscarriage: Causes, Treatment, Information
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