Miscarriage is the end of a pregnancy before the baby is able to survive outside the uterus. Miscarriage can occur during the first or second trimester, before 20 weeks. Most happen in the first 12 weeks of pregnancy. They often are unexpected and isolated events.
Fetus in First Trimester
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For some, the cause of miscarriage is unknown. Miscarriages can also occur for the following reasons:
- Problems in the chromosomes (common cause)
Abnormal structure or issues in the uterine tract, such as
- Problem with hormones, such as not having enough hormone (progesterone) to support pregnancy
- Immune system-related problems, such as blood-clotting problems or rejection of the fetus
Miscarriages are more common in women 35 years and older. Other things that may increase the chance of a miscarriage are:
- Smoking, drinking
alcohol, or using
- Certain medicine
- Exposure to certain environmental toxins
Autoimmune disorders, such as
systemic lupus erythematosus
on the ovaries, uterus, or the pituitary gland during treatment of childhood cancers
Miscarriage may cause:
- Vaginal bleeding
- Pink or brown discharge
- Passing the fetus, placenta, and surrounding membranes through the vagina
Miscarriage is often a one-time occurrence. Couples who have 2 or more miscarriages should have a complete medical exam. It may help to understand the cause. This may prevent another miscarriage.
The doctor will ask about symptoms, length of pregnancy, and when changes happened. Physical and pelvic exams will be done. Passed tissue may be examined. The uterus may also be examined with:
Early or first trimester miscarriages may only need observation. Medicine may be needed if there is heavy bleeding or cramping.
A dilation and evacuation (D&E) may be needed if all tissue does not pass through the vagina. The doctor will remove remaining tissue.
Miscarriage carries emotional challenges as well. Many women have grief, anger, guilt, and more. A counselor or
Treatment may help prevent future miscarriages if a specific cause was found.
First trimester pregnancy loss. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/first-trimester-pregnancy-loss. Updated January 24, 2020. Accessed March 19, 2020.
Jurkovic D, Overton C, Bender-Atik R. Diagnosis and management of first trimester miscarriage. BMJ. 2013 Jun 19;346.
Miscarriage. American Pregnancy Association website. Available at: http://americanpregnancy.org/pregnancy-complications/miscarriage. Updated May 2, 2017. Accessed March 19, 2020.
Miscarriage. March of Dimes website. Available at: http://www.marchofdimes.com/loss/miscarriage.aspx. Updated July 2012. Accessed March 19, 2020.
Recurrent pregnancy loss. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/second-trimester-pregnancy-loss. Updated January 24, 2020. Accessed March 19, 2020.
Second trimester pregnancy loss. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T904101/Second-trimester-pregnancy-loss. Updated May 10, 2017. Accessed March 19, 2020.
Last reviewed September 2020 by
EBSCO Medical Review Board
Mary-Beth Seymour, RN
Last Updated: 9/4/2020