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9828 MA Preg Loss 24/04/2013 11:43 Page 17 33456_WhyMe_3425_DM:9828 MA preg loss 24/04/2013 11:43 Page 17 Why me? 33456_WhyMe_3425_DM:9828 MA preg loss 24/04/2013 11:43 Page 2 Miscarriages happen for lots of different reasons. Sometimes the cause is known but often it isn’t. Some women benefit from treatment but others don’t need it. This leaflet looks at the possible causes of miscarriage and the tests and treatment that might help you. What is a miscarriage? What happens now? Miscarriage is when you lose your If this is your first or second baby any time up to 24 weeks of miscarriage, you probably won’t be pregnancy. After 24 weeks losing a offered tests or treatment. That’s baby during pregnancy or labour is because most women go on to have a called a stillbirth. successful pregnancy next time. Miscarriage is very common. No one But if you think there is a good reason knows exactly how many miscarriages for having tests now, perhaps because happen, but experts think that more of your age or the time it took you to than one pregnancy in every five ends conceive, you might want to talk to in miscarriage. your GP about an earlier referral. There is still a lot that we don’t know If you’ve had three miscarriages or about miscarriage, and you may never more in a row, you should be offered find out why it happened to you. That tests. That’s because a cause is more can be hard to cope with. likely to be found at this stage. But even then, there may not be a What we can say is that miscarriage is treatment that can help. hardly ever caused by something you did – or didn’t do. And the chances are That doesn’t mean your next that your next pregnancy will result in pregnancy won’t be successful. Even if a healthy baby. there is no treatment, you should still get extra support from doctors and midwives next time. And research Miscarriages are so shows that this alone can improve common, but you “ your chances of having a healthy “don’t really think pregnancy. 1,2 about it until it happens to you. 2 33456_WhyMe_3425_DM:9828 MA preg loss 24/04/2013 11:43 Page 3 Different types of I was told yesterday miscarriage that my baby “stopped growing at Doctors use various different terms to six weeks but I describe miscarriage. Here we explain should be 12 “ weeks what they mean. now and I had no idea anything was Threatened miscarriage wrong. This term is often used when you have some bleeding – or ‘spotting’ – from your vagina. Sometimes a scan shows that the baby Many women still go on to have a has died or not developed even healthy pregnancy, even if the bleeding though you haven’t had a miscarriage. is heavy. But sometimes the baby has There are different ways of describing already died. And sometimes a scan this: shows a healthy heartbeat but the Missed miscarriage baby dies later. (also called ‘delayed’ or ‘silent’ miscarriage) It can be very stressful if the first scan isn’t clear and you have to go back for This means the baby has died but is another one a week or two later. still in your uterus. This is sometimes discovered during a routine scan; and It is important to know that scans and you may have had no sign that internal (vaginal) examinations do not anything was wrong. cause miscarriages. It can come as a shock because you Complete miscarriage may still feel pregnant and have a positive pregnancy test. This means that the baby has died or has not developed and your uterus (womb) has emptied naturally. This sometimes happens over several days. You may need a scan to confirm that the miscarriage is complete. 3 33456_WhyMe_3425_DM:9828 MA preg loss 24/04/2013 11:43 Page 4 Blighted ovum I was told I had a This term is sometimes used when a missed miscarriage “and was then sent scan shows a pregnancy sac with nothing inside it. The early cells of the home to think baby and/or the beginning embryo about the various have failed to grow; but the sac where options. I decided the baby should develop continues to to wait for things grow. As with a missed miscarriage, to happen naturally you may still feel pregnant and have a as I wanted to keep positive pregnancy test. control of what“ was happening to Some doctors call this ‘anembryonic me – as much as pregnancy’, which means a pregnancy you can. without an embryo. Other doctors call it ‘early embryo loss’. Incomplete miscarriage Late miscarriage This means that the pregnancy is over This is a miscarriage that happens after but the uterus has not emptied 14 weeks of pregnancy. It may start completely. You will probably still have with bleeding, cramps or your waters pain and heavy bleeding. breaking. But sometimes there are no signs and a routine scan shows that In all these situations where you the baby has died. haven’t yet miscarried, it will happen in time; but you may be offered one of If a late miscarriage is not complete, these choices: you will probably need to be admitted to hospital. You will probably have your • Go home and wait for the labour induced rather than an miscarriage to start or finish operation and this can be a very naturally; distressing time. • Have a minor operation to remove You may be admitted to the any pregnancy tissue left in your gynaecology ward or the labour ward. uterus. This is called Surgical Wherever you are treated, everything Management of Miscarriage (SMM) should be fully explained to you. or ERPC and can be done under general or local anaesthetic; For more detail see our leaflet Late • Take tablets to start or complete miscarriage. the miscarriage. You may need time to think about what you want to do. Our leaflet Management of miscarriage may be helpful. 4 33456_WhyMe_3425_DM:9828 MA preg loss 24/04/2013 11:43 Page 5 Recurrent miscarriage The tests may be carried out at your This is the medical term for three or local hospital or at a specialist centre. more miscarriages in a row. They may Having tests doesn’t necessarily mean have different causes or the same you will have an answer as to why you underlying cause. Sometimes there is miscarried. And even if a cause is more than one problem that might found, it may not be something that cause your miscarriages. can be treated. But you might still feel Doctors usually offer to do tests for better if you know what might have possible causes only after three caused your miscarriages. miscarriages. But sometimes they will Half of the people who have tests refer you for tests after two, e.g.: after recurrent miscarriage don’t have • If you had a late miscarriage, where a specific problem found. That can be the baby died after 14 weeks of difficult to accept, but it is actually pregnancy good news. It means there is a very good chance that you will have a • If you have fertility problems, such healthy pregnancy without any as taking a long time to conceive particular treatment. There is more detailed information in our leaflet Recurrent miscarriage. Being told all my tests were ‘normal’ was initially “ heartbreaking. I remember feeling angry with the consultant for not finding something and I couldn’t “ help but feel this was the worst news possible. I wanted a reason and a cure. 5 33456_WhyMe_3425_DM:9828 MA preg loss 24/04/2013 11:43 Page 6 Other types of Molar pregnancy pregnancy loss (hydatidiform mole) There are two other ways that This is when an abnormal fertilised egg pregnancy loss can happen: starts to grow in the uterus. The cells that should become the placenta grow Ectopic pregnancy too quickly and leave no room for a baby to develop. This is a pregnancy that is growing in the wrong place – usually in one of Because pregnancy hormones are the fallopian tubes leading to the made by the placenta, you will have a uterus. In this case, it is sometimes positive pregnancy test and may feel called a tubal pregnancy. extremely tired and sick. A tubal ectopic pregnancy can’t Sometimes a molar pregnancy can be develop because there isn’t enough seen on a scan. But it is more likely to room for the embryo to grow beyond be discovered after a miscarriage about eight weeks. There is also a risk through routine tests. that the tube could burst, which can be life-threatening. If you have had a molar pregnancy you will be referred to a specialist centre Ectopic pregnancy may be diagnosed for follow-up; and this can be a very before you even know you are worrying time. pregnant. Often the first sign is bad pain, usually on one side of your There is more information in our abdomen. leaflet Molar pregnancy. Some women with ectopic pregnancies can be treated with The blood tests medication called methotrexate; but showed that my others need an emergency operation “hormone levels to remove the pregnancy and were far beyond sometimes the tube too. It can be a anything normal.“ very frightening time. That explained why There is more information in our I had been feeling leaflet Ectopic pregnancy. so unwell. 6 33456_WhyMe_3425_DM:9828 MA preg loss 24/04/2013 11:43 Page 7 Causes, tests and Hormonal causes treatment Women with high levels of a chemical This section looks at the known called ‘luteinising hormone’ (LH) in causes of miscarriage and tests and their blood may find it harder to treatments that may help.
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