Miscarriage (cont.)

Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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In this Article

• What is a miscarriage?
• What causes a miscarriage, and what are the tests for the different causes?
• What does NOT cause miscarriage?
• Are there lifestyle factors associated with miscarriage?
• What are the symptoms of a miscarriage?
• What will the doctor look for during an examination with suspected miscarriage?
• How is threatened abortion evaluated?
• What are common terms a woman might hear during evaluation for miscarriage?
• What treatment can a woman expect when she has had a miscarriage?
• When should a woman receive evaluation for underlying causes of pregnancy loss?
• Can something be done to prevent future miscarriages?
• Miscarriage At A Glance
• Miscarriage Index

A woman's cervix might have some bloody discharge, but nothing else unusual will be characteristic of threatened abortion. Some women will have mild uterine tenderness during the manual examination of the uterus. The doctor may look to see if the cervix is dilated and will check to see if the uterus is enlarged to an extent appropriate for gestational age of the pregnancy.

Pelvic ultrasound is used to visualize fetal heartbeat and to determine whether a pregnancy is still viable. The ultrasound examination can also distinguish between intrauterine and ectopic pregnancies. The doctor may also order blood levels of serial human chorionic gonadotrophin (HCG) to help determine the viability of a pregnancy if the ultrasound examination is not conclusive. During the evaluation, the woman may be advised to rest and avoid sexual intercourse (activity).

1. "Miscarriage" (spontaneous abortion) is termination of pregnancy before the fetus is viable (able to survive).
   
   
2. "Complete abortion" describes spontaneous (not intentionally induced by medication or procedures) passage of all fetal and placental tissue. This is common prior to 12 weeks' gestation.
   
   
3. "Incomplete abortion" is when some, but not all, the fetal and placental tissue is expelled.
   
   
4. "Products of conception" refers to the combination of fetal and placental tissue.
   
   
5. "Threatened abortion" is when a miscarriage does not actually occur, but there is vaginal bleeding from the uterus. The cervix will not be dilated and does not show signs of imminent passage of fetal and placental tissue.
   
   
6. "Missed abortion" describes a fetal death in the uterus prior to viability, but the products of conception are not passed.
   
   
7. A "septic (infectious) abortion" is caused by bacterial infection and accompanied by fever, chills, pain, and a pus-containing discharge.