A miscarriage is an intensely sad and devastating experience. It is a loss of pregnancy that occurs before 20 weeks gestational age (approximately up to 5th month). Many women who lose a pregnancy do not even know they are pregnant and about 20 % of them have "Silent Miscarriages". Some experience cramping, bleeding and pain, which may eventually end in a miscarriage.
There are a number of factors that cause early pregnancy miscarriages. The most common is a chromosomal abnormality in the foetus. This results from a faulty egg or sperm cell. Before pregnancy, egg and sperm cells divide to form a cell with 23 chromosomes. Sometimes, the cell splits unevenly in egg or sperm cells with one having too many or one with too few chromosomes. If a pregnancy occurs involving an egg or sperm cell with the wrong number of chromosomes, the embryo has a chromosomal abnormality -- these do not serve, leading to a miscarriage. This is only a random event, and is essentially bad luck. A variation of this is Blighted Ovum, where the pregnancy sac contains no foetus, and the woman may notice brownish vaginal discharge and a cessation of pregnancy symptoms. This will eventually end in miscarriage, but may take a few weeks and doctors recommend a dilatation and curettage (D&C) to empty the uterus.
There are, however, other factors that may cause a miscarriage like infections, hormonal factors and health problems of the mother. Factors that do not increase the risk of miscarriage include sex, working outside the home and exercise.
Occasionally, 1 in 20 couples experience 2 miscarriages in a row and 1 in 100 have 3 miscarriages, which merit detailed evaluation.
Supplementation with the hormone Progesterone is not shown to have a proven benefit in early pregnancy bleeding. Progesterone support may be required in the face of undergoing advanced fertility treatment, or proven luteal phase defects.
Most women resume a normal period about 4-6 weeks after miscarriage. It takes a few weeks to recover physically, and much longer to recover emotionally. Medically it appears safe to conceive again after one or two normal menstrual periods (or later if she needs further tests and investigations). If a woman has had two or more miscarriages, she should consult a specialist before planning the next pregnancy.
Miscarriage is common and may be caused by a number of problems. Fortunately 90 % of women who have had one miscarriage will go on to have a successful pregnancy the next time, as will 75% of those who have experienced two or three losses. However consult your gynecologist who can recommend the most appropriate tests prior to another pregnancy, and can receive the best treatment to increase her chances that the next pregnancy will be a healthy outcome.
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