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  • Michael Frey, MD

Miscarriage



  • Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy.

  • Some women have a miscarriage before they know they’re pregnant.

  • The main cause of miscarriage is a genetic problem in the fetus.

  • Other causes include: infection, cervical shortening, problems with the shape of the uterus, or scar tissue in the uterus.

  • It can take a few weeks to a month or more for your body to recover from a miscarriage. It may take longer to recover emotionally.

  • If you need emotional support Mount Sinai offers a Perinatal Bereavement Support program (212-241-4685)

  • Most women who miscarry go on to have a healthy pregnancy later.


ARE THERE CERTAIN ACTIVITIES THAT CAUSE MISCARRIAGE?

  • Yes, there are. Smoking, drinking alcohol, or drug use can increase the chances of having a miscarriage.

  • Having sex, exercising, and working, DO NOT CAUSE MISCARRIAGE.



RISK FACTORS FOR HAVING A MISCARRIAGE

  • age over 35

  • high blood pressure

  • uncontrolled diabetes

  • PCOS

  • fibroids

  • polyp in the uterus

  • having a previous miscarriage

  • thyroid disease

  • obesity

  • lupus

  • autoimmune disease

  • blood clotting disorders


SIGNS AND SYMPTOMS OF MISCARRIAGE

  • Bleeding from the vagina or spotting

  • Cramps like you feel with your period

  • Severe belly pain

-If you have these symptoms, email, text, or call right away.

-You will need to go to the ER if you experience heavy bleeding.

-There is not a lot that can be done to prevent a miscarriage early in pregnancy. The best advice is to rest, take it easy, and reduce stress. Probably, no sex is also a good idea though there is no hard science behind that statement.

-MOST women have these signs and symptoms in early pregnancy and don’t miscarry.



WHAT HAPPENS AFTER MISCARRIAGE?

  • When a pregnancy is lost, it is important to make sure all the pregnancy tissue is out of the uterus.

  • We check a beta hCG, which is a hormone in your body that rises with pregnancy. We want the levels of this hormone to reach 5 or less. This test may be performed weekly for several weeks.

  • Also if you continue to bleed heavier after the initial event that may signal there is tissue left inside.

  • We can perform a sonogram to check for pregnancy tissue and the remaining placenta.

  • Sometimes, this tissue needs to be removed. Usually, it passes on its own.

  • Options: medicine or surgery to remove the retained products of conception.

  • The options have similar risks: infection and heavy bleeding.

  • Another issue: If your blood type is Rh-negative, you will need a shot of Rho-Gam. Problems can arise in a future pregnancy if you are Rh-negative and the fetus is Rh-positive. These problems can be prevented by giving Rh immunoglobulin after a pregnancy loss.

  • Most of the time, none of this happens.

  • It is normal to have some bleeding and cramping for up to 4 weeks after pregnancy.



HOW LONG DOES IT TAKE TO RECOVER?

  • Most women get their period again 4 to 6 weeks after a miscarriage.

  • It may take longer to recover emotionally from a miscarriage. You may have strong feelings of grief about the death of your baby. Grief is all the feelings you have when someone close to you dies. Grief can make you feel sad, angry, confused or alone. It’s OK to take time to grieve after a miscarriage. Ask your friends and family for support, and find special ways to remember your baby. For example, if you already have baby things, like clothes and blankets, you may want to keep them in a special place. Or you may have religious or cultural traditions that you’d like to do for your baby. Do what’s right for you.

  • Certain things, like hearing names you were thinking of for your baby or seeing other babies, can be painful reminders of your loss. You may need help learning how to deal with these situations and the feelings they create.

  • If you feel you need help coping please let me know. I want to hear what you are going through emotionally.

  • Sometimes a short course of medication can help with depression.

  • Mount Sinai provides Perinatal Bereavement Support which is also a great resource. Call 212-241-4685.

  • Online support groups can also be helpful. SHARE: Pregnancy and Infant Loss Support, Inc. (www.nationalshare.org) lists local support groups and offers online resources to help with grief and healing.


WHEN CAN WE TRY AGAIN?

Let yourself have one normal period. After that, if you feel emotionally ready, there is no reason why you can't try again.



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