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ReproductiveICD-10: O0310–20% of known pregnancies end in miscarriage

Miscarriage

Also known as: Spontaneous Abortion, Pregnancy Loss

A miscarriage is the spontaneous loss of a pregnancy before the 20th week of gestation, with most occurring during the first trimester. It is the most common complication of early pregnancy, affecting an estimated 10–20% of known pregnancies. Most miscarriages are caused by chromosomal abnormalities in the embryo and are not preventable.

Symptoms

Vaginal bleeding ranging from light spotting to heavy flow
Cramping and pain in the lower abdomen or back
Passing of tissue or clot-like material from the vagina
Sudden decrease in pregnancy symptoms (nausea, breast tenderness)
Fluid discharge from the vagina

Causes

  • Chromosomal abnormalities in the embryo (most common cause)
  • Uterine structural abnormalities (fibroids, septum)
  • Hormonal imbalances (progesterone deficiency, thyroid disorders)
  • Infections
  • Maternal health conditions (uncontrolled diabetes, autoimmune disorders)

Risk Factors

  • Advanced maternal age (over 35)
  • Previous miscarriage
  • Smoking, alcohol use, or illicit drug use during pregnancy
  • Chronic conditions such as diabetes or thyroid disease
  • Uterine or cervical abnormalities
  • Antiphospholipid syndrome

Diagnosis

  • Pelvic examination to assess cervical dilation
  • Transvaginal ultrasound to evaluate fetal viability
  • Serial beta-hCG blood tests to assess pregnancy hormone trends
  • Blood typing and Rh factor determination

Treatment

  • Expectant management (allowing tissue to pass naturally)
  • Medical management with misoprostol
  • Surgical management (dilation and curettage, or vacuum aspiration)
  • RhoGAM injection if the mother is Rh-negative
  • Emotional support and grief counseling

Prevention

  • Most miscarriages due to chromosomal issues cannot be prevented
  • Manage chronic health conditions before and during pregnancy
  • Take prenatal vitamins with folic acid
  • Avoid smoking, alcohol, and illicit substances during pregnancy

When to See a Doctor

  • Vaginal bleeding during pregnancy, especially with cramping
  • Passage of tissue or fluid from the vagina
  • Heavy bleeding soaking more than one pad per hour
  • Signs of infection such as fever, chills, or foul-smelling discharge

Frequently Asked Questions

Related Conditions

Preeclampsia

Reproductive

Polycystic Ovary Syndrome

Endocrine

Postpartum Depression

Mental Health

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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