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DESCRIPTION
A miscarriage, also known as a spontaneous abortion, is a premature termination of a pregnancy before the fetus can survive outside of the uterus, usually prior to 20 weeks gestation. It occurs in about 20 to 30 percent of first pregnancies and frequently occurs so early that the woman is unaware that she is pregnant.
A "missed spontaneous abortion" or a "missed miscarriage" is when the fetus dies, but is not passed from the body with the blood discharge. Instead it is reabsorbed back into the mother's body.
MoonDragon's Pregnancy Information: Intrauterine Fetal Demise (Stillborn)
FREQUENT SIGNS & SYMPTOMS
Uterine cramps.
Vaginal bleeding from slight to heavy.
Many miscarriages are only "threatened," and the pregnancy continues to term. Symptoms may be the same for threatened miscarriages as for those in progress.
CAUSES
During the first trimester (first 12 weeks of pregnancy):
- An abnormal or defective fetus.
- Uterine abnormalities that prevent the fertilized egg from growing normally.
- Smoking, alcohol or drug abuse.
During the second trimester (13 to 28 weeks):
- Uterine abnormalities that cause detachment of the fetus and placenta.
- Severe stress (nutritional, psychological).
Anytime:
- Use of substances that harm the fetus (cocaine and other drugs of abuse, smoking).
- Infections, especially viral infections (rubella or influenza).
- Trauma or severe medical conditions (diabetes mellitus, hypertension).
RISK INCREASES WITH
Stress.
Smoking.
Alcohol and/or drug abuse.
Poor nutrition.
Illness that lowers immune system resistance.
Recent serious infection.
Medical history of endocrine diseases, such as diabetes mellitus or hypothyroidism.
PREVENTIVE MEASURES
During pregnancy:
- Obtain regular medical checkups with your midwife or health care provider. Early prenatal care is important for the safety and well-being of both the mother and her baby.
- Eat normal, well-balanced diet. See Nutrition Information for more help with your prenatal diet.
- Don't drink alcohol, smoke cigarettes or use recreational drugs.
- Don't use any medications, including non-prescription drugs without medical advice. Always consult with your midwife or health care provider before using any medication, herbal remedy or nutritional supplement during pregnancy.
EXPECTED OUTCOME
With treatment, a miscarriage is not a life-threatening condition. It does not affect a woman's ability to carry a healthy baby to term in the future.
Feelings of loss and grief are common. Feelings of guilt may also be present. If these persist, seek professional psychological help.
POSSIBLE COMPLICATIONS
Uterine infection, signaled by fever, chills and aching.
Hemorrhaging from other body parts.
"Incomplete" abortion, in which some placenta or fetal tissue remains in the uterus, or missed abortion, in which the fetus dies but remains in the uterus.
TREATMENT
GENERAL MEASURES
Ultrasound examination and laboratory blood studies may be needed for diagnosis.
For a threatened miscarriage, follow your midwife's or health care provider's orders. Bed rest at home is often enough to stabilize the pregnancy. Bleeding is occasionally severe requiring hospitalization and blood transfusion as indicated.
Following a miscarriage:
- Expect a small amount of vaginal bleeding or spotting for 8 to 10 days. Don't use tampons for 2 to 4 weeks.
- Wait through 2 or 3 normal menstrual cycles before attempting to become pregnant.
- Surgery ( D & C -- dilation and curettage, or D & E -- dilation and extraction) to remove any remaining tissue or a dead fetus may be needed.
- Psychotherapy or grief counseling for the patient and her partner my be helpful.
MEDICATION
For a threatened miscarriage: Medicine usually is not necessary. Don't take any medication without medical advice.
Oxytocin to control bleeding in some women.
Pain medication may be prescribed.
After a miscarriage, antibiotics may be prescribed to fight infection.
Blood transfusions for severe blood loss.
An Rh-negative female may be given RhoD (immune globulin) to prevent developing Rh Antibodies.
ACTIVITY
For a threatened miscarriage: Rest in bed until symptoms disappear. Avoid sexual intercourse until the outcome is known. See Bed Rest Links above.
After a miscarriage: Reduce activity and rest often during the next 48 hours.
DIET
For a threatened miscarriage: Drink fluids only, if bleeding and cramping are severe.
BENEFICIAL DIETARY SUPPLEMENTS TO PREVENT MISCARRIAGE
Raspberry helps strengthen the uterus and may be taken as a tea.
False Unicorn helps strengthen the uterus.
Wild Yam helps improve hormonal balance for maintaining pregnancy.
Prenatal Vitamin Supplements provide general nutrition, which is very important for fetal development and to support pregnancy.
Folic Acid helps prevent birth defects and supports pregnancy.
Vitamin C with Bioflavonoids strengthens blood vessels.
Vitamin E helps balance hormones.
Herbal Remedies: Miscarriage Prevention Products
Herbal Remedies: Vitamin E Products
Wise Woman Herbal For The Childbearing Year By Susun S. Weed, Janice Novet
HERBAL SUGGESTIONS TO PREVENT MISCARRIAGE
Black haw and crampbark are the two herbs most commonly used by European physicians, Native Americans and modern herbalists to calm the uterus.
Mountain Rose Herbs, Bulk Herbs B: Black Haw Bulk Herbs
Mountain Rose Herbs, Bulk Herbs C: Cramp Bark Bulk Herbs
Red raspberry has a long history of use in pregnancy for threatened miscarriage. Standard dosage: 2 capsules three times daily.
Mountain Rose Herbs, Bulk Herbs R: Red Raspberry Leaf Bulk Herbs
False unicorn is prized by herbalists for its adaptogenic effect on the ovaries (normalizes function).
Herbal Remedies: False Unicorn Products
False Unicorn Tincture, 100% Organic, 2 fl. oz.
Miscarriage Tincture (Helps Prevent), 100% Organic, 2 fl. oz.
Wild yam (dioscorea villosa) may benefit those women who are threatening miscarriage due to stimulation to the adrenal glands as well as the antispasmodic effects of the herb.
Herbal Remedies: Wild Yam Products
Mountain Rose Herbs, Bulk Herbs W: Wild Yam Bulk Herbs
AFTER A MISCARRIAGE
After a miscarriage: No special diet. However, if you have had significant bleeding, you may become anemic. You should follow a proper diet used to treat anemia.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
Vaginal bleeding occurs during pregnancy.
Fever and chills occur during a threatened miscarriage or following a miscarriage.
Bleeding and cramps worsen during a threatened miscarriage or you pass tissue (save the tissue for medical examination).
Bleeding (other that vaginal) or unexplained bruising occurs after a miscarriage.
Infection develops while you are pregnant.
Midwife: Checklist to Assist Grieving Parents
For Parents: Grieving For Parents - A Way To Heal - Loss of a Baby
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