Miscarriage refers to the premature end of a pregnancy before the developing baby is able to survive outside the uterus. Miscarriage can occur during the first or second trimester, before 20 weeks. Most occur in the first 12 weeks of pregnancy. They often are unexpected and isolated events. About 15%-20% of recognized pregnancies end this way.
Fetus in First Trimester
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Miscarriages often occur for the following reasons:
In some cases, the cause of miscarriage is unknown.
Miscarriages are more common in women 35 years and older. Other factors that may increase your chance of having a miscarriage include:
Miscarriage may cause:
While miscarriage usually is a one-time occurrence, up to 1 in 20 couples experience 2 miscarriages in a row, and 1 in 100 have 3 or more. In some cases, these couples have an underlying problem. Couples who have experienced 2 or more miscarriages should have a complete medical evaluation to learn the cause and how they can prevent another one from occurring.
Cause of repeat miscarriages may include:
You will be asked about your symptoms, the length of your pregnancy, and when you first noticed a change in your condition. Physical and pelvic exams.
Prior to miscarriage, tests may include:
After miscarriage, tests may include:
Imaging tests may be used to evaluate the uterus and surrounding structures. These may include:
Immediate care usually involves observation only, especially in early or first trimester miscarriages. Medication may be indicated in the event of heavy bleeding or cramping.
A dilation and evacuation (D&E) may be needed if uterine contents are not spontaneously passed through the vagina. During a D&E, the doctor dilates the cervix, inserts a tool into the uterus, and suctions out remaining material.
A counselor or support group may be needed to help deal with the emotions surrounding a miscarriage.
Before you start to plan your next pregnancy consider the following regarding your health:
If a specific cause of the miscarriage was found, certain treatments may help prevent future miscarriages. Treatments may include:
The American Congress of Obstetricians and Gynecologists
March of Dimes
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
First trimester pregnancy loss. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113658/First-trimester-pregnancy-loss . Updated March 17, 2017. Accessed September 8, 2017.
Miscarriage. American Pregnancy Association website. Available at:
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Updated MAy 2, 2017. Accessed September 8, 2017.
Miscarriage. March of Dimes website. Available at:
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Updated July 2012. Accessed September 8, 2017.
Second trimester pregnancy loss. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T904101/Second-trimester-pregnancy-loss . Updated May 10, 2017. Accessed September 8, 2017.
Recurrent pregnancy loss. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116364/Recurrent-pregnancy-loss . Updated March 17, 2017. Accessed September 8, 2017.
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4/16/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113658/First-trimester-pregnancy-loss : Bhattacharya S, Townend J, Shetty A, Campbell D, Bhattacharya S. Does miscarriage in an initial pregnancy lead to adverse obstetric and perinatal outcomes in the next continuing pregnancy? BJOG. 2008;115:1623-1629.
6/25/2010 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T904411/Risk-factors-for-first-and-second-trimester-pregnancy-loss : Nakhai-Pour HR, Broy P, Bérard A. Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ. 2010;182(10):1031-1037
Last reviewed September 2018 by
EBSCO Medical Review Board
Beverly Siegal, MD, FACOG
Last Updated: 9/30/2013