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Miscarriage

When miscarriage happens to you, you may feel a range of emotions including sadness, anger, guilt - or you may feel numb at first. It is important to take care of yourself, and to ask for physical and emotional support during this difficult time.

 
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** Please note that since December 2022  the criteria for cytogenetic testing in British Columbia has changed. Cytogenetic testing (to look for changes in chromosomes) is now only being offered to people who have experienced recurrent pregnancy loss, meaning at least two or three losses in the first trimester. We are in the process of updating the video to reflect these changes.**

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Frequently asked questions

 

Miscarriage is the unexpected loss of a pregnancy before 20 weeks gestation.

Miscarriage is common. Nearly 1 in 4 people will experience a miscarriage in their lifetime. Most miscarriages occur in the first 12 weeks of pregnancy.

 

The cause of miscarriage is not always known. However, studies have shown that over 70% of miscarriages are caused by random genetic errors that occur before or during the development of the embryo. The most common of these is called aneuploidy. 

Aneuploidy happens at the cell level, before a pregnancy has even occurred. Human cells generally carry 46 chromosomes. If there is one chromosome too many, or too few, the cell is aneuploid.

The chance of having a pregnancy with aneuploidy increases as you get older.

Other causes of miscarriage

Although much less common, miscarriage is sometimes caused by other medical problems, such as:

  • Diabetes or thyroid disease
  • Problems with the uterus 
  • Autoimmune conditions such as lupus or antiphospholipid syndrome
  • Genetic variations in the parents
These medical conditions are often associated with recurrent pregnancy loss. Your provider can help you determine whether you should be tested for any of these conditions.

 

The criteria for cytogenetic testing in British Columbia has changed. Cytogenetic testing (a test to look for changes in chromosomes) is now only being offered to people who have experienced recurrent pregnancy loss, meaning at least two or three losses in the first trimester. 

If you have experienced 2 or more miscarriages in a row, talk to your doctor about testing, or for a referral to the Recurrent Pregnancy Loss clinic.

Most of the time, a miscarriage caused by aneuploidy or another genetic imbalance is followed by a healthy pregnancy. 

 

Miscarriage is not caused by anything you have done and it cannot be prevented. No activities or treatments (such as bed rest) have been proven to prevent or reduce the chance of miscarriage.


Stress does not cause miscarriage. Routine activities such as exercise, sex, travel and work do not cause miscarriage.
 


Bleeding in the early stages of pregnancy (between 6 and 12 weeks) does not always mean that a miscarriage will occur. Light bleeding or spotting in the first trimester is common; it can occur when the pregnancy attaches to the uterus, from changes to your cervix, or after sex. 


Bleeding can also be a result of

  • Problems in the vagina or cervix (opening of the uterus)
  • Subchorionic hematoma (bleeding between the pregnancy sac and the uterus)
  • Ectopic pregnancy (pregnancy outside of the uterus)

Contact your healthcare provider if you have light bleeding. A physical examination, ultrasound, and blood tests will be used to help determine the cause of the bleeding.


When should I go to the hospital? 

Go to the closest hospital emergency department immediately if you

  • Have sudden, severe pain in your abdomen
  • Suddenly feel faint or like passing out
  • Have very heavy bleeding (soaking more than 3 maxi pads in 3 hours)
  • Have a fever of greater than 38°C (103° F)

 
After a miscarriage, it is recommended that you wait until you have 1 normal period before trying to get pregnant. 

You can become pregnant shortly after miscarriage, before your first menstruation, so if you do not want to become pregnant, you should use some form of contraception.
 

 

Below are some terms you may hear providers use when talking about miscarriage and other forms of early pregnancy complication.


Cytogenetic testing -  a blood or tissue test to look for changes in chromosomes, including broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of a genetic disease or condition.


Complete miscarriage - a miscarriage has occurred and all pregnancy tissue is gone from the uterus.


Ectopic pregnancy - a pregnancy located outside the uterus; most commonly in the fallopian tube (the tube that carries the fertilized egg from the ovary to the uterus). This type of pregnancy can be dangerous and needs to be treated with either medication or surgery.


Incomplete miscarriage - a miscarriage has occurred but some pregnancy tissue is still inside the uterus.


Non-viable pregnancy - a pregnancy that has not progressed normally and will end in miscarriage. Also called early pregnancy loss.


Pregnancy of uncertain viability - when it is not clear at your first ultrasound if the pregnancy is progressing normally. A repeat ultrasound will be done 10 - 14 days after the first one to tell whether or not the pregnancy is progressing normally. It is possible to miscarry during this time.


Pregnancy of unknown location - when you have a positive pregnancy test but there are no signs of pregnancy on the ultrasound. This could be due to one of three reasons:

  1. The pregnancy is too early to be seen on ultrasound
  2. The pregnancy has already ended (complete miscarriage) before your ultrasound
  3. The pregnancy is outside the uterus (ectopic pregnancy).

Further blood tests or ultrasounds may be done to determine the location of the pregnancy. It is important to seek medical care If symptoms worsen (e.g. you develop severe pain, feel faint, or have heavy bleeding), as you may have an ectopic pregnancy).


Recurrent pregnancy loss - 2 or more unexplained consecutive miscarriages (1 miscarriage after another). 


Viable pregnancy - a pregnancy that is progressing normally. 


For information about treatment options for miscarriage, visit
SOURCE: Miscarriage ( )
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