Early miscarriage - 25 things to know when trying to conceive

Dr Randy Morris MD teaches everything you should know about Early Miscarriage.



Stay tuned to the end for advice about getting pregnant again after an early miscarriage.



#earlymiscarriage #miscarriage #ttc



The first and maybe the most important thing to know about early miscarriage is that is extremely common. Between 50 to 60% of all pregnancies end in miscarriage. Of those, about half are very early miscarriages which often occur before a woman even knows she is pregnant.



An early miscarriage is defined as a pregnancy loss that occurs during the first 13 weeks of pregnancy. But really, most early miscarriages occur before your doctor can see a fetus with heart motion on an ultrasound which is typically around 7 to 8 weeks.



The good news is that if you have an early pregnancy and are experiencing vaginal bleeding, but your doctor can see fetal heart motion on ultrasound, 95% of those pregnancies will go on to result in a viable baby.



A slow heart rate on ultrasound, however, is a concerning sign. A slow heart rate is seen in nearly 70% of early miscarriages. Stated another way, the likelihood of having an early miscarriage is 30 times higher if the ultrasound shows a low heart rate. A slow heart rate in combination with vaginal bleeding is seen in 85% of early miscarriages. How slow is slow? If the measured heart rate is less than 110 bpm, then that is of concern



A number of things can cause an early miscarriage. The most common cause is the embryo or fetus does not have the correct number of chromosomes. A normal fetus has 46 chromosomes, 23 from each parent. 60-70% of early miscarriages are found to have an incorrect number of chromosomes. As women get older, this number gets higher. So older women are more likely to have a miscarriage and any given miscarriage is more likely to be from a chromosome problem.



Other things that probably increase the- risk for early miscarriage include:

-- Smoking

-- Drinking Alcohol

-- Caffeine

-- Obesity

-- Taking supplements (other than prenatals)



Things that do NOT cause early miscarriage include

-- Stress

-- Having sex during pregnancy

-- Exercise during pregnancy

-- Using birth control before pregnancy

-- Falling during pregnancy

-- Getting hit in the abdomen

-- Morning sickness



In fact, women with morning sickness have a lower risk of miscarriage. 



The most common signs and symptoms of early miscarriage are vaginal bleeding and cramping. However, these symptoms are also pretty common in women who do not go on to have an early miscarriage.



If you are pregnant and have bleeding, please contact your doctor for further evaluation. Your doctor will want to get a blood test to measure your hCG levels and an ultrasound. This is important to do because some women with early pregnancy bleeding may actually have a tubal pregnancy which is less common but much more dangerous.



One of the most common questions I get asked is: Can an early miscarriage be prevented? The answer depends on whether your are already pregnant. If you are not pregnant and you are trying to prevent an early miscarriage in your next pregnancy, then there are a number of things you can do.



Stop those bad habits, Avoid alcohol, cigarettes and caffeine. If you are overweight - lose weight. If you are older, ask your doctor about IVF combined with testing the embryos for chromosome abnormalities.



If you have had multiple early miscarriages, meaning three or more, see you doctor to be evaluated for recurrent pregnancy loss. There may be treatable problems that can be found



If you are already pregnant, besides the things I discussed before, there is probably not much you can do. Bed rest will not help. Avoiding stress will not help though it may make you feel better. Taking progesterone supplements have been recommended in the past but there really is very little evidence that it will reduce the chance for an early miscarriage. But, it probably won’t harm anything.



Another question I get all the time is: How soon can you try to conceive after having had a miscarriage? In the past, doctors told patients, without any evidence, to wait at least three months. However, we have solid scientific data that shows; attempting pregnancy again right away, as soon as you start ovulating will increase the chance for a successful pregnancy. This could happen within a few weeks of an early miscarriage.



Finally, if you need fertility treatment to conceive, we recommend that you evaluate the uterine cavity before starting treatment again.





Dr Morris is a practicing IVF and infertility expert who sees patients at IVF! located in the Naperville Fertility Center.



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