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A miscarriage or spontaneous abortion refers to the loss of a fetus before the 20th week of pregnancy. This does not include medically induced or surgical abortions. A large percentage of miscarriages occur even before the woman knows that she is pregnant. Either the fertilized egg does not implant successfully in the walls of the uterus or the ovum does not develop properly. Once the heartbeat of the baby is detected, the chances of a spontaneous abortion or a miscarriage fall to five percent.

Causes of abortion cannot always be explained. The most common natural causes of abortion include:

• Chromosomal or genetic abnormalities result in an unviable fetus and spontaneous abortion. The chances of chromosomal abnormalities increase with age therefore increasing the risk of miscarriages in older women (over the age of 35).
• Collage vascular diseases such as systemic lupus erythematosus and antiphospholipid antibody syndrome cause the body’s immune system to attack its own organs. Such diseases pose a serious threat to a pregnancy and can often lead to a miscarriage.
• Diabetes can be controlled in most cases during a pregnancy but in situations where blood sugar and insulin levels are extremely unstable, there are higher chances of birth defects and a risk of a miscarriage.
• Hormonal imbalances associated with conditions such as Polycystic Ovarian Syndrome (PCOS) and thyroid problems may lead to a miscarriage.
• Fetal or placental infections such as listeria, rubella, herpes simplex and cytomegalovirus can also lead to loss of the pregnancy.
• Abnormalities in the anatomy of uterus can prevent proper implantation and growth of the fetus and lead to a miscarriage.
• Fibroids in the uterus may also interfere with fetal growth and cause complications during pregnancy.
• Surgical procedures like amniocentesis and chorionic villus sampling may increase the risk of a miscarriage.
• Incompetent cervix
• Radiation
• Malnutrition
• Certain medications
• Other possible factors that increase the risk of a miscarriage include drug, tobacco or alcohol abuse, and exposure to environmental toxins, obesity, age and previous miscarriages.

Symptoms of a Miscarriage may Include:

• Lower back pain
• Dull or sharp pain in the abdomen
• Cramping
• Vaginal bleeding that may progress from light to heavy
• Clots that pass from the vagina
• Fever
• Weakness

If you experience any of these symptoms, contact your doctor immediately. Your doctor will then assess whether a miscarriage has occurred and check if all the tissue from the fetus and placenta has been passed or if the miscarriage is incomplete. In cases where all the tissue has been passed, there is no need for any medical intervention. On the other hand, if the abortion is considered incomplete, the doctor may have to perform a D&C (dilation and curettage) to remove any products of the pregnancy.

In cases of first or second miscarriages, there is still a high chance of a subsequent normal pregnancy. Three consecutive miscarriages however require medical evaluation, treatment, and intervention.

Recurrent miscarriages are treated depending on the underlying causes. If chromosomal abnormalities are the cause of the miscarriages, the best that can be done is to offer genetic counseling in lieu of any corrective method for genetic problems. Structural or anatomical abnormalities may be remedied with surgical corrections. Diseases such as diabetes and thyroid problems can be controlled with medication while hormonal imbalances may be treated with progesterone therapy. With recurrent miscarriages it is important to realize that while steps may be taken to correct or treat the underlying cause, there is still no guarantee that another miscarriage will not occur. Ultimately, the best one can do is to identify any risk factors and provide the best possible care that may be required.