How to Prevent Miscarriage: 11 Tips

1. Eat nutritious and well-balanced meals
2. Exercise regularly
3. Manage daily stress
4. Avoid smoking and secondhand smoke
5. Avoid alcohol and illicit drugs
6. Limit caffeine to no more than 1-2 cups a day
7. Avoid physical activities that can cause trauma to the abdomen
8. Avoid exposure to harmful radiation and chemicals such as formaldehyde, arsenic, benzene, ethylene oxide, etc.
9. Take 400 mcg folic acid supplements every day as recommended by your doctor as soon as you start planning for pregnancy
10. Treat underlying medical conditions such as autoimmune disorders or hormonal imbalances that can or have previously caused a miscarriage
11. Ensure that you are up to date on your immunizations

Miscarriage, also known as early pregnancy loss, occurs when an unborn baby dies in the mother’s womb before reaching 20 weeks of pregnancy.

Almost half of all pregnancies end in a miscarriage. About 10%-15% occur in the first trimester (up to 12 weeks), whereas about 5% occur in the second trimester (13-28 weeks).

Signs and symptoms of may miscarriage include:

• Bleeding from the vagina or spotting
• Abdominal cramps
• Severe pain in the abdomen

The occurrence of two or more repeated miscarriages is called recurrent pregnancy loss.

• Chromosomal abnormalities: Abnormal structure or number of chromosomes in the fertilized egg can lead to a blighted ovum, intrauterine fetal demise, or molar pregnancy.
• Problems with the uterus or cervix:
  • Septate uterus: Band of tissue (septum) that divides the uterus into two sections.
  • Asherman’s syndrome: Scar tissue in the uterus.
  • Fibroids (growths) in the uterus: Muscular lump inside the uterine cavity, within the wall of the uterus, or hanging out of the uterine wall.
  • Cervical insufficiency (incompetent cervix): Abnormal condition in which the cervix dilates (opens) too early during pregnancy, usually without pain or contractions.
• Infections: Sexually transmitted infections such as genital herpes and syphilis or listeriosis (a type of food poisoning).
• Autoimmune disorders: Conditions in which antibodies attack healthy cells. These include antiphospholipid syndrome (APS) and lupus (systemic lupus erythematosus).
• Obesity: Condition in which there is too much body fat and body mass index (BMI) is 30 kg/m2 or higher.
• Hormonal problems: Causes low levels of progesterone, such as with polycystic ovary syndrome (PCOS) and luteal phase defect.
• Diabetes: Preexisting diabetes (both type 1 or type 2 diabetes).
• Thyroid problems: Hypothyroidism and hyperthyroidism.
• Tests: Certain prenatal tests such as amniocentesis and chorionic villus sampling.

If you have repeat miscarriages in the first trimester or a miscarriage in the second trimester, tests to determine the cause of miscarriage may include:

• Chromosome tests: Karyotyping tests to check whether any chromosomes have changed.
• Hormone tests: Blood or endometrial biopsy that removes a small piece of the lining of the uterus.
• Blood tests to check your immune system: Used to test for autoimmune disorders such as antiphospholipid syndrome and lupus.
• Ultrasonogram: Includes ultrasound, hysteroscopy (special scope is inserted through the cervix to see your uterus), and hysterosalpingography (X-ray of the uterus)

If you have had a miscarriage, recommended procedures include:

• Dilation and curettage (also called D&C): Cleans the uterine lining and removes the remaining tissue of the dead fetus with an instrument called curette after dilatation (widening) of the cervix.
• Medication: You may be prescribed a medication that helps evacuate the remnant of dead fetal tissue inside the uterus.

You and your partner can plan your next pregnancy after you have had at least one normal period. 

Before planning your next pregnancy, however, it is prudent to detect and treat any underlying conditions that could lead to the miscarriage. Miscarriage can also take an emotional toll, and it may take time before you feel ready to try again.