Miscarriage (cont.)

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What treatment can a woman expect when she has had a miscarriage?

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The central goal of the doctor in this situation will be to try to figure out whether the woman has passed all of the tissue from the fetus and placenta. If she has passed all the tissue, she may only require observation by medical personnel. On the other hand, a woman who has not passed all of the tissue (incomplete abortion) will usually need suction dilation and curettage (D&C) of the uterus to remove any retained products of the pregnancy. This procedure is done with local anesthesia, and sometimes antibiotics may be prescribed for the woman to prevent infection.

When should a woman receive evaluation for underlying causes of pregnancy loss?

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Currently, most practitioners will not initiate an extensive medical evaluation for a single pregnancy loss, because a woman has a high probability of having a normal pregnancy even after two consecutive miscarriages.

Recurrent pregnancy loss (RPL) has been inconsistently defined. When defined as 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period, it affects approximately 1% to 2% of women. Because of the risk of subsequent miscarriages is similar among women that have had 2 versus 3 miscarriages, and the probability of finding a treatble etiology is similar among the two groups, most experts agree there is a role for evaluation after two losses.

For women with recurrent pregnancy loss, an evaluation will focus on the pattern and history of the prior miscarriages. Three consecutive miscarriages would suggest a woman should receive further evaluation.

Thus, the following tests are considered for women with three consecutive miscarriages.

Blood testing can be ordered to identify chromosomal abnormalities in the couple that could be transmitted to the fetus. The couple can each appear completely normal but still carry chromosomal defects, which, when combined, can be lethal to the embryo. This type of testing is called karyotyping, and it is performed on both members of the couple. A hysterosalpingogram (HSG) can identify anatomical abnormalities within the uterus.

Antinuclear antibody, anticardiolipin antibody, VDRL, RPR, and lupus anticoagulant are some of the blood tests used to diagnose autoimmune diseases that can cause recurrent miscarriage.

As described above, some of these illnesses will already by apparent to the woman and her doctor, but not all cases. Other antibody tests may be performed as well.

Medically Reviewed by a Doctor on 3/7/2014

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Miscarriage - Causes Question: Please share your experience if you've had a miscarriage.
Miscarriage - Symptoms Question: What symptoms did you experience leading up to your miscarriage?
Miscarriage - Treatment Question: What treatments did your doctor administer after your miscarriage?
Miscarriage - Recurrent Miscarriages Question: Are you suffering from recurrent miscarriages? What is the underlying cause? Please share your experience.

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