Those chemicals that are implicated in increasing the risk for miscarriage are DDT , lead , formaldehyde , arsenic , benzene and ethylene oxide. Video display terminals and ultrasound have not been found to have an effect on the rates of miscarriage. In dental offices where nitrous oxide is used with the absence of anesthetic gas scavenging equipment , there is a greater risk of miscarriage.
For women who work with cytotoxic antineoplastic chemotherapeutic agents there is a small increased risk of miscarriage. No increased risk for cosmetologists has been found. Alcohol increases the risk of miscarriage. Infections of Chlamydia trachomatis, Camphylobacter fetus , and Toxoplasma gondii have not been found to be linked to miscarriage. In the case of blood loss, pain, or both, transvaginal ultrasound is performed. If hypotension , tachycardia , and anemia are discovered, exclusion of an ectopic pregnancy is important.
A miscarriage may be confirmed by an obstetric ultrasound and by the examination of the passed tissue. When looking for microscopic pathologic symptoms, one looks for the products of conception.
Microscopically, these include villi , trophoblast , fetal parts, and background gestational changes in the endometrium. When chromosomal abnormalities are found in more than one miscarriage, genetic testing of both parents may be done. A review article in The New England Journal of Medicine based on a consensus meeting of the Society of Radiologists in Ultrasound in America SRU has suggested that miscarriage should be diagnosed only if any of the following criteria are met upon ultrasonography visualization: .
A threatened miscarriage describes any bleeding during pregnancy, prior to viability, that has yet to be assessed.
- Cause of ectopic pregnancies.
- Non-puerperal uterine inversion without underlying tumour.
At investigation it may be found that the fetus remains viable and the pregnancy continues without further problems. An anembryonic pregnancy also called an "empty sac" or "blighted ovum" is a condition where the gestational sac develops normally, while the embryonic part of the pregnancy is either absent or stops growing very early. This accounts for approximately half of miscarriages. All other miscarriages are classified as embryonic miscarriages, meaning that there is an embryo present in the gestational sac.
Half of embryonic miscarriages have aneuploidy an abnormal number of chromosomes. An inevitable miscarriage occurs when the cervix has already dilated,  but the fetus has yet to be expelled.
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This usually will progress to a complete miscarriage. The fetus may or may not have cardiac activity. A complete miscarriage is when all products of conception have been expelled; these may include the trophoblast , chorionic villi , gestational sac , yolk sac , and fetal pole embryo ; or later in pregnancy the fetus , umbilical cord , placenta , amniotic fluid, and amniotic membrane. The presence of a pregnancy test that is still positive as well as an empty uterus upon transvaginal ultrasonography does, however, fulfill the definition of pregnancy of unknown location.
Therefore, there may be a need for follow-up pregnancy tests to ensure that there is no remaining pregnancy, including an ectopic pregnancy. An incomplete miscarriage occurs when some products of conception have been passed, but some remains inside the uterus. The use of a Doppler ultrasound may be better in confirming the presence of significant retained products of conception in the uterine cavity.
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A missed miscarriage is when the embryo or fetus has died, but a miscarriage has not yet occurred. It is also referred to as delayed miscarriage, silent miscarriage, or missed abortion. A septic miscarriage occurs when the tissue from a missed or incomplete miscarriage becomes infected, which carries the risk of spreading infection septicaemia and can be fatal. Recurrent miscarriage "recurrent pregnancy loss" RPL or "habitual abortion" is the occurrence of multiple consecutive miscarriages; the exact number used to diagnose recurrent miscarriage varies.
The physical symptoms of a miscarriage vary according to the length of pregnancy, though most miscarriages cause pain or cramping. The size of blood clots and pregnancy tissue that are passed become larger with longer gestations. After 13 weeks' gestation, there is a higher risk of placenta retention. Prevention of a miscarriage can sometimes be accomplished by decreasing risk factors. Often there is little a person can do to prevent a miscarriage. Maintaining a healthy weight and good pre-natal care can reduce the risk of miscarriage.
Women who miscarry early in their pregnancy usually do not require any subsequent medical treatment but they can benefit from support and counseling.
Miscarriage - Wikipedia
Significant distress can often be managed by the ability of the clinician to clearly explain terms without suggesting that the woman or couple are somehow to blame. Evidence to support Rho D immune globulin after a spontaneous miscarriage is unclear. No treatment is necessary for a diagnosis of complete miscarriage so long as ectopic pregnancy is ruled out.
In cases of an incomplete miscarriage, empty sac, or missed abortion there are three treatment options: watchful waiting, medical management, and surgical treatment. Medical treatment usually consists of using misoprostol a prostaglandin to contract the uterus, expelling remaining tissue out of the cervix. In delayed or incomplete miscarriage, treatment depends on the amount of tissue remaining in the uterus. Treatment can include surgical removal of the tissue with vacuum aspiration or misoprostol. An induced abortion may be performed by a physician for women who do not want to continue the pregnancy.
In some locales it is illegal or carries heavy social stigma. Some organizations recommend delaying sex after a miscarriage until the bleeding has stopped to decrease the risk of infection. Organizations exist that provide information and counseling to help those who have had a miscarriage.
Hospitals also can provide support and help memorialize the event. Depending on locale others desire to have a private ceremony. Those who experience unexplained miscarriage can be treated with emotional support. Every woman's personal experience of miscarriage is different, and women who have more than one miscarriage may react differently to each event.
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In Western cultures since the s,  medical providers assume that experiencing a miscarriage "is a major loss for all pregnant women". Providing family support to those experiencing the loss can be challenging because some find comfort in talking about the miscarriage while others may find the event painful to discuss. The father can have the same sense of loss. Expressing feelings of grief and loss can sometimes be harder for men. Some women are able to begin planning their next pregnancy after a few weeks of having the miscarriage.
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For others, planning another pregnancy can be difficult. Parents can name and hold their infant.
They may be given mementos such as photos and footprints. Some conduct a funeral or memorial service. They may express the loss by planting a tree. Some health organizations recommend that sexual activity be delayed after the miscarriage. The menstrual cycle should resume after about three to four months.
Some parents want to try to have a baby very soon after the miscarriage. The decision of trying to become pregnant again can be difficult. Reasons exist that may prompt parents to consider another pregnancy. For older mothers, there may be some sense of urgency.
Other parents are optimistic that future pregnancies are likely to be successful. Many are hesitant and want to know about the risk of having another or more miscarriages.