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Summary
Miscarriage is the spontaneous pregnancy loss that occurs before 20 weeks of
gestation. Physicians refer to this as spontaneous abortion.
According to the American Society for Reproductive Medicine (ASRM), about 25
percent of known pregnancies end in miscarriage. However, the rate is
believed to be higher because many miscarriages occur very early in
pregnancy, before a woman may know that she is pregnant.
The causes of miscarriage are not completely understood, but researchers
believe that most miscarriages that occur in the first trimester (first 12
weeks of pregnancy) are caused by randomly occurring chromosomal
abnormalities in the fetus that prevent it from developing normally. Medical
conditions in the mother (e.g., uncontrolled diabetes) can also lead to
miscarriage. Several automimmune conditions as well as structural problems
within the uterus may affect implantation and result in first trimester
miscarriages. In addition, various risk factors, such as maternal smoking or
drug abuse, can increase the likelihood of miscarriage.
Signs and symptoms of a miscarriage may include bleeding, pelvic pain or
cramping in the abdomen or lower back and fluid or tissue being expelled
from the vagina. Even though vaginal bleeding is usually a symptom that
precedes nearly all pregnancy losses, it is not always indicative of a
miscarriage. Many pregnant women experience bleeding at some point during
their pregnancies.
Most women who have an early miscarriage do not require medical treatment.
The uterus empties itself as it would during a heavy menstrual period.
However, if an ultrasound examination shows that there is pregnancy tissue
remaining in the uterus, a physician may recommend a dilation and curettage
procedure or medication to induce the uterus to expel the tissue. All
pregnancy tissue must be expelled and/or removed from the uterus to prevent
infection. In cases of recurrent miscarriage, further testing and treatment
is performed to determine the possible cause and prevent recurrence.
If a miscarriage is about to occur, it often cannot be prevented. However, a
woman may decrease her chances of having a miscarriage by taking good care
of herself. This includes eating a well-balanced diet, taking folic acid
supplements and refraining from drinking alcoholic beverages or smoking.
It is common and normal for a woman to experience sadness after losing a
wanted pregnancy. Many couples benefit from support groups or psychological
counseling to help deal with the emotional impact of miscarriage.
Although it is possible to become pregnant right after a miscarriage, most
physicians recommend waiting at least three months before trying to
conceive. Usually, most women who experience a miscarriage go on to have
healthy pregnancies.
About
miscarriage
A miscarriage is a pregnancy that ends before the fetus is considered
“viable” (before 20 weeks of gestation). A fetus is viable if it can live
outside the mother’s womb. Pregnancy losses after the 20th week of gestation
are known as preterm deliveries.
A woman’s reproductive system includes the uterus, cervix, two ovaries, two
fallopian tubes and the vagina. The fallopian tubes are narrow tubes that
connect the ovaries to the uterus. Once a month, an egg is released by one
of the ovaries, and travels down the fallopian tube, where it may be
fertilized by sperm.
Once the egg and sperm join, they rapidly begin to develop new cells. This
bundle of cells, called the embryo, normally implants on the inner wall of
the uterus. Once implanted, the embryo continues to grow inside a sac of
amniotic fluid, contained within the placenta. After several weeks, the
embryo is called a fetus.
In a miscarriage, the woman’s body expels all or some of the fetus, the
placenta and the fluid surrounding the fetus. The medical term for
miscarriage is spontaneous abortion. It is also referred as early pregnancy
loss.
According to the U.S. National Institutes of Health (NIH), up to 50 percent
of all fertilized eggs die and are spontaneously aborted, usually before a
woman even realizes that she is pregnant. Among known pregnancies, the rate
of miscarriage is approximately 25 percent, according to the American
Society for Reproductive Medicine. Miscarriage usually occurs between the
7th and 12th week of pregnancy (during the first trimester).
In many cases, chromosomal abnormalities in the fertilized egg prevent it
from developing normally and the pregnancy terminates naturally. Typically,
such problems are the result of errors that occur by chance as the embryo
divides and grows.
In other cases, complications may occur during the delicate process of early
human development that may prevent an embryo from continuing gestation. For
example, the egg may not implant properly in the uterus or the embryo may
have structural defects that do not allow it to continue growing inside the
mother’s uterus (womb).
In all cases, spontaneous expulsion of the pregnancy is preceded by death of
the embryo or fetus. Sometimes a miscarriage may be accompanied by an
infection in the uterus (septic miscarriage). This is a serious condition
that can result in shock and organ failure which requires prompt medical
treatment.
When a woman experiences the loss of two or more consecutive pregnancies in
the first or second trimester OR the loss of three or more pregnancies
before 20 weeks gestation, she is experiencing recurrent miscarriage. Other
terms for this condition include: recurrent spontaneous miscarriage,
recurrent spontaneous abortion and recurrent pregnancy loss.
According to the American Society for Reproductive Medicine (ASRM), less
than 5 percent of women will experience two consecutive miscarriages, and
only 1 percent will experience three or more miscarriages.
A woman who experiences recurrent miscarriage is typically subject to more
diagnostic tests than a woman who has a single, first trimester miscarriage.
However, in 50 to 75 percent of couples who experience recurrent
miscarriage, no explanation is found, according to the ASRM. Treatment
options for recurrent miscarriages depend on the cause of the miscarriages
and usually differ from standard miscarriage treatment options.
Couples may be comforted to know that, according to the ASRM, pregnancy is
successful in 60 to 70 percent of women who experience unexplained recurrent
pregnancy losses.
Types and differences of miscarriage
The types of miscarriage are classified according to the physical signs a
physician notes upon examination of a woman:
Threatened miscarriage
When a woman has vaginal bleeding early in pregnancy, but her cervix has not
begun to dilate. This condition, however, does not mean that a miscarriage
will occur. In many women with threatened miscarriage, the bleeding subsides
and the pregnancy continues to term. In such cases, physicians may order
complete bed rest for a few weeks (or until delivery) to ensure continuation
of pregnancy. Rarely, the bleeding becomes heavier and miscarriage follows.
Inevitable miscarriage
When a woman has vaginal bleeding accompanied by contractions of her uterus
and dilation of the cervix. This type of miscarriage cannot be prevented.
Incomplete miscarriage
When a woman has expelled most of the pregnancy tissue through her vagina,
but some remains in the uterus. Typically, the fetus has been passed, but
bits and pieces of the placenta may remain inside the uterus. In this type
of miscarriage, the cervix remains open, and bleeding may be heavy, usually
requiring some intervention.
Complete miscarriage
When a woman has a miscarriage and none of the tissue from the pregnancy
remains in her uterus. This is common in miscarriages that occur before 12
weeks of pregnancy. After the miscarriage, a woman experiences bleeding and
cramping that resolves without medical intervention. On examination, a
physician typically finds that the cervix is closed, and there is no sign of
a pregnancy sac in the uterus. Ultrasound examination confirms the
diagnosis.
Septic miscarriage
When a miscarriage is accompanied by an infection in the uterus. Symptoms
include fever, chills, abdominal pain, vaginal bleeding and vaginal
discharge, which may be thick and have an unpleasant odor.
Missed abortion
A miscarriage in which the fetus died prior to the 20 weeks of gestation,
but neither the fetus or placenta were expelled by the uterus. In these
cases, interventions may be offered, however, the tissue may be
spontaneously expelled within a short time frame.
Recurrent miscarriage
When a woman experiences the loss of two or more consecutive pregnancies in
the first or second trimester OR the loss of three or more pregnancies
before 20 weeks gestation.
Blighted ovum
This occurs when a gestational sac forms inside a woman’s uterus, but no
fetus is present after seven weeks.
Molar pregnancy
This is a rare condition that is also known as gestational tropho blastic
disease. It occurs when a pregnancy results in the growth of abnormal tissue
rather than an embryo, and it typically ends in miscarriage before the
fourth month of pregnancy. In a few cases, it may result in uterine cancer.
Risk factors and causes of miscarriage
The causes of miscarriage and recurrent miscarriage (the loss of two or more
consecutive pregnancies in the first or second trimester OR the loss of
three or more pregnancies before 20 weeks gestation) are not thoroughly
understood. However, in most cases, miscarriages occur because of
chromosomal abnormalities in the fetus.
Chromosomes are tiny structures in each cell that carry genes and determine
an individual’s physical traits and how the internal organs work. Each
person has 23 pairs of chromosomes (46 total), with one chromosome per pair
supplied by the mother and the other supplied by the father.
Most chromosomal abnormalities result from a faulty egg or sperm cell.
Before pregnancy, immature egg and sperm cells divide to form mature cells
with 23 chromosomes. Sometimes, the cell splits unevenly, resulting in egg
or sperm cells with too many or too few chromosomes (non disjunction). If a
cell has the wrong number of chromosomes, the embryo has a chromosomal
abnormality and is usually miscarried.
These abnormalities are randomly occurring events that surface during cell
division and are not inherited from the genes of either parent. They may
also result in a blighted ovum, either because the embryo did not form or
because it stopped developing very early. According to the American College
of Obstetricians and Gynecologists (ACOG), recent studies show that
chromosomal problems may cause nearly 50 percent of recurrent miscarriages.
Other conditions that may cause one or more miscarriages include:
Uterine and/or cervical abnormalities
Some women are born with a uterus that is abnormally shaped, or partly or
completely divided. Others develop noncancerous tumors (fibroids) or scars
in the uterus from past surgery. These abnormalities can limit space for the
fetus to grow or interfere with the blood supply to the uterus. They may
also affect the ability for the embryo to implant properly. In addition, a
weakened or incompetent cervix (opening of the uterus) can lead to a
miscarriage. According to ACOG, uterine and cervical abnormalities may
account for 10 to 15 percent of recurrent miscarriages. However, some of
these structural abnormalities can be surgically corrected to improve the
chances of a future pregnancy.
Chronic Illness
Women with conditions such as systemic lupus erythematosus (lupus) and other
autoimmune disorders, congenital heart disease, severe kidney disease,
uncontrolled diabetes mellitus, thyroid disease and intrauterine infections
have a higher risk of miscarriage. If a woman is diagnosed with these
conditions, she should get proper treatment to control them before becoming
pregnant.
Hormonal Problems
When the body produces too much or too little of certain hormones, a
miscarriage may occur. Researchers believe that insufficient secretion of
the hormone progesterone by the ovaries may be associated with spontaneous
abortion because progesterone is believed to be important in maintaining
gestation. This hormonal imbalance is called luteal phase deficiency and it
may make the inner lining of the womb (endometrium) unable to support a
pregnancy. In addition, conditions associated with hormonal abnormalities
(e.g., thyroid disease, polycystic ovarian syndrome) may result in a
miscarriage of the fetus.
Infections
Maternal health conditions that have been associated with miscarriage
include infectious diseases, such as listeriosis (caused by the listeria
bacterium found in certain raw meats and dairy products), toxoplasmosis,
mumps, rubella, measles, HIV, herpes and syphilis, among others.
Fever
Pregnant women who develop fevers of 100 degrees Fahrenheit or more (37.8
degrees Celsius) appear to have an increased risk of miscarriage.
Immune system problems
Some people produce certain antibodies (autoantibodies) that can attack
their own tissues, causing a variety of health problems. For example,
particular types of autoantibodies (e.g., anticardiolipin) cause blood clots
that can clog blood vessels in the placenta, causing the fetus to die, such
as when lupus is present. Another condition that is associated with blood
clots in the veins or arteries and with miscarriage is antiphospholipid
antibody syndrome (APS). According to the American Society of Reproductive
Medicine, between 3 to 15 percent of recurrent miscarriage is due to APS.
Blood incompatibility
In some cases, the fetus’ and mother’s blood type do not match, causing the
mother to develop antibodies to the fetus. This type of incompatibility
between mother and fetus–called Rh incompatibility-may result in a
spontaneous abortion.
Previous miscarriages
Risk of miscarriage increases if a woman has a history of recurrent
miscarriage.
In addition, studies have shown several factors associated with a higher
rate of miscarriage:
Age
Advancing age of the mother is the most important risk factor for
miscarriage in healthy women. Women over age 40 are at higher risk of
miscarriage and recurrent miscarriage than younger women. A woman’s risk of
miscarriage increases with age because chromosomal abnormalities become more
common with aging. Even though little is known about how the father’s age
may contribute to miscarriage, researchers suspect that as with a woman’s
eggs, advanced age of sperm may also influence the rate of miscarriage.
Number of pregnancies
The number of times a woman has been pregnant also affects her risk of
miscarriage. Women who have had two or more pregnancies appear to have a
greater risk.
Folate insufficiency
According to the U.S. National Institutes of Health (NIH), pregnant women
who have low levels of folic acid (a B-complex vitamin that is essential for
cell growth and reproduction) are more likely to experience early
miscarriages than pregnant women who have adequate levels of the vitamin.
Caffeine
Although evidence is inconclusive, some studies suggest an association
between moderate to significant amounts of caffeine (in the range of four to
five cups of coffee) and an increased risk of miscarriage.
Smoking
Excessive smoking (more than 10 cigarettes a day) is associated with an
increased risk of miscarriage. In addition, smoking can harm the development
of the fetus, even when miscarriage does not occur. Paternal smoking may
also be associated with an increased risk of miscarriage.
Alcohol
Women who drink are twice as likely to have a miscarriage as women who
abstain from alcohol during pregnancy. In addition, alcohol exposure can be
harmful to the fetus even in cases where miscarriage does not occur, and
often results in low-birth weight babies with learning and/or physical
disabilities, among other damaging effects. Alcohol intake can also reduce
sperm count in men.
Use of certain medications and/or illegal substances. Pregnant women who
have taken certain prescription or over–the–counter drugs, including
nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen have reported
miscarriages. In addition, the use of illegal substances such as heroin,
cocaine and ecstasy has been associated with miscarriage.
Use of donor eggs
Recent research indicates that women who achieve pregnancy via assisted
reproductive technology using donated eggs may be more likely to experience
miscarriage. Scientists believe that miscarriage may occur as a result of
the mother’s immune system reacting negatively against the foreign egg.
Prenatal testing
Certain types of prenatal genetic tests (e.g., amniocentesis, chorionic
villus sampling) have an increased risk of miscarriage due to the invasive
nature of the procedures.
Trauma
Severe trauma to the uterus (e.g., trauma from a serious accident or fall)
can increase the risk of miscarriage. However, activities of daily living,
such as exercising, sex, working or lifting heavy objects, do not provoke a
miscarriage – even in very active women. Exercise, in general, is healthy
for the mother and the developing baby. Pregnant women should consult with
their physicians to discuss the extent and types of exercise to ensure the
baby’s safety before engaging in such activities.
Environmental factors
Exposure to environmental toxins, radiation and immunologic factors has been
associated with miscarriage. Lead, arsenic, mercury, some chemicals like
formaldehyde, benzene, ethylene oxide, and large doses of radiation or
anesthetic gases have been associated with miscarriage.
Signs and symptoms of miscarriage
Vaginal bleeding is the warning sign that precedes nearly all miscarriages.
However, it does not always lead to miscarriage. Many women experience
spotting in early pregnancy and most do not miscarry.
Regardless, a woman should contact a physician if she experiences any
bleeding, even light spotting, during pregnancy or if she suspects she is
having a miscarriage. A pregnant woman should also contact her physician is
she notices tissue or clot-like material passing from the vagina. This type
of material should be collected in a clean container and brought to a
physician for examination, when possible.
Other signs and symptoms of a miscarriage may include:
- Pelvic pain (usually worse than menstrual cramps)
- Weight loss
- White-pink mucus or discharge
- Painful contractions (occurring every 5 to 20 minutes)
- Frequent bowel movements
- Brown or bright red bleeding or spotting
- Decrease in signs of pregnancy (e.g., morning sickness or loss of breast
tenderness)
Diagnosis methods for miscarriage
If a miscarriage is suspected, a physician will perform a medical history
and ask questions regarding the symptoms a woman may be experiencing,
followed by a thorough pelvic examination.
The pelvic exam is performed to check the size of the uterus and determine
whether the cervix is open or closed. If a miscarriage is in progress, the
cervix is usually open and the pregnancy will not continue. If a miscarriage
has already occurred, the cervix can be either open or closed, depending on
whether all the pregnancy tissue has passed out of the mother’s uterus.
In addition, a physician may order an ultrasound to establish a diagnosis
and/or to help determine if the pregnancy is capable of progressing to term.
With this imaging test, a physician can check for the presence of an embryo
that has a heartbeat and determine if it is growing according to schedule
and whether it is the appropriate size in relation to the placenta.
There also are several blood tests that measure pregnancy hormone titers.
Titer levels should increase at a particular rate during a normal, healthy
pregnancy. Theses tests can be used along with ultrasound to monitor the
course of early pregnancies that are complicated by bleeding.
Physicians usually do not perform any tests following a first miscarriage
that occurs in the first trimester (the first 12 weeks of pregnancy). The
cause of these early losses is often unknown, even though chromosomal
abnormalities are usually suspected.
However, if a woman has a miscarriage during the second trimester or
experiences recurrent miscarriage, physicians will recommend various tests
to determine the cause, such as:
Blood tests
Laboratory analysis of blood samples of both parents to check for chromosome
abnormalities, as well as certain hormonal problems and immune system
disorders (e.g., lupus) in the mother (e.g., karyotype test).
Transvaginal ultrasound
A procedure that uses a probe which emits sound waves that is inserted into
the vagina and produces a picture of the body tissue. It is useful in
finding abnormalities in the vagina, uterus, fallopian tubes, ovaries,
bladder and other nearby structures.
Hysterosalpingography (HSG)
X-ray of the uterus and fallopian tubes that is used to look for blockages
and other problems.
Hysteroscopy
A test that allows a physician to view the uterus through a special scope
inserted through the cervix. It is usually prescribed if results from the
HSG are abnormal.
Sonohysterography
A technique that involves injecting saline solution into the uterus via the
cervix in order to observe the image of these structures through an
ultrasound. This type of test is very accurate in determining uterine and/or
cervical abnormalities that may cause recurrent miscarriages.
Magnetic resonance imaging (MRI)
A safe and noninvasive test that uses powerful magnets to produce images on
a computer screen and film. It is useful in confirming uterine abnormalities
after a transvaginal ultrasound or HSG.
Endometrial biopsy
The removal and analysis of a sample of endometrial tissue to determine if
the tissue that lines the uterus (uterine lining) is sufficiently hospitable
to allow the embryo to implant and grow.
Analysis of tissue samples
Testing for chromosomal abnormalities in tissue from the miscarriage (if
available).
Treatment following a miscarriage
Once a physician determines that a miscarriage is inevitable or is already
occurring, there are several treatment options available depending on the
stage of the miscarriage and the condition of the mother, among other
factors. These may include:
Observation
In most cases, women who miscarry do not need further medical treatment
because the uterus usually empties itself (similar to a heavy menstrual
period) within a couple of weeks, although sometimes it can take as long as
three to four weeks. Once the contents of the uterus have been expelled, an
ultrasound is performed to ensure that the miscarriage is complete. Any
remaining pregnancy tissue is removed to prevent infection.
Medication
Sometimes, medications (e.g., mifepristone, methotrexate, misoprostol, or a
combination of the three) may be administered by the physician to stimulate
the uterus to expel remaining pregnancy tissue. However, these medications
may produce side effects, such as prolonged vaginal bleeding, nausea,
diarrhea, fever, headache and/or pelvic pain. Also, another potential
downside (although rare) is that pregnancy tissue might still remain after
use of these medications and surgery may be needed to remove it.
Surgery
The conventional treatment for early miscarriage with incomplete dispelling
of the uterus is a surgical procedure called dilation and curettage (D&C).
In a D&C, the cervix is dilated (widened), and an instrument is inserted
that uses suction and/or gentle scraping motion to remove the contents of
the uterus. This procedure is performed in women who do not want to wait for
spontaneous passage of the pregnancy, and in women with heavy bleeding or
infection. However, risks involved with D&C include perforation of the
uterus, formation of scar tissue in the uterus, trauma to the cervix and
infection, which could lead to infertility.
If a woman experiences recurrent miscarriage, a physician may recommend
further treatment, such as:
Surgery
Surgical procedures may be performed to correct any uterine and/or cervical
abnormalities. Sometimes, a cervical cerclage procedure that stitches the
cervix shut in women with incompetent cervix is helpful in preventing
pregnancy loss resulting from this abnormality.
Hormone therapy
Human menopausal gonadotrophin (hMG) hormone, which stimulates ovulation,
may be useful in treating women who experience recurrent miscarriage due to
low levels of the hormone progesterone (luteal phase deficiency) by
promoting the formation of a thicker endometrium, thereby leading to better
implantation of the embryo.
Also, studies have shown that treatment with clomiphene citrate, a type of
ovulation drug, may promote pregnancy in some women with recurrent
miscarriage due to a luteal phase deficiency.
Another type of treatment is the administration of the hormone progesterone,
either via injections or vaginally (to achieve higher concentration in the
uterus), to prevent miscarriage due to luteal phase deficiency. However,
some studies suggest an association between mothers who undergo progesterone
therapy during the first trimester of pregnancy and genital abnormalities in
male and female babies.
In addition, it should be noted that there is no conclusive evidence to
support the effectiveness in treating recurrent miscarriage with any of
these types of hormonal treatments.
Medical treatment of chronic illness. Women with chronic diseases, such as
diabetes mellitus, thyroid dysfunction and polycystic ovarian syndrome (PCOS),
among others, should be treated medically to get their illness under control
prior to attempting pregnancy. This will reduce their chance of miscarriage.
Treatment for immune system problems. Treatment administering a combination
of low dose aspirin and low dose heparin (a type of anticoagulant drug) may
be effective in improving pregnancy outcome in women with recurrent
pregnancy loss due to lupus or antiphospholipid antibody syndrome (APS).
However, this treatment is not effective in women with unexplained recurrent
miscarriage. Also, aspirin alone does not reduce risk of miscarriage.
In vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD). A
combination of IVF and PGD is often successful in preventing recurrent
miscarriage due to chromosomal abnormalities in the embryo. This is because
PGD can identify and transfer only chromosomally normal embryos to the
uterus.
Donor eggs
Even though use of donor eggs for assisted reproduction may increase the
risk of miscarriage, it is still a good alternative in cases where recurrent
miscarriage is occurring due to problems with a woman’s own eggs. This may
help prevent recurrent miscarriage in women over age 40.
Following a miscarriage, a physician will advise a woman to maintain “pelvic
rest” for up to two weeks. This involves not having sexual intercourse or
inserting anything (e.g., tampons) into the vagina. It is also customary for
a physician to advise a woman to wait two to three months before attempting
to become pregnant again.
Medications may also be prescribed to help decrease bleeding and reduce
infection. In the case of Rh incompatibility, women are prescribed a drug
called Rh (D) immune globulin. This medicine helps protect future
pregnancies against problems that can occur if a mother’s Rh factor is
incompatible with that of the fetus, such as miscarriage.
It may take weeks to a month or longer for a woman to physically recover
from a miscarriage. In addition, parents often experience grief or
depression after a miscarriage. Sometimes these feelings are severe and
long-lasting. In such cases, a physician may recommend a psychologist or
grief counseling group for emotional support.
The majority of women who experience a miscarriage go on to have successful
pregnancies.
Prevention methods for miscarriage
All women should have yearly check ups with their obstetrician-gynecologist
(ObGyn) to monitor their reproductive health. For women considering
pregnancy, early prenatal care is important for their health and to ensure
optimum conditions for pregnancy to occur.
Since most miscarriages are caused by chromosomal abnormalities, there is
little that can be done to prevent miscarriage from occurring. However, it
is recommended that all women who are trying to conceive achieve a healthy
lifestyle by:
- Exercising regularly
- Eating healthy
- Managing stress
- Maintaining a healthy weight
- Taking a daily folic acid supplement
- Avoiding the use of alcohol and illegal drugs (e.g., cocaine, ecstasy)
- Refraining from smoking
If a woman is pregnant, she can reduce the risk of miscarriage by:
- Not smoking or being around cigarette smoke
- Not drinking alcohol or using illegal drugs
- Checking with a physician before taking any prescription or
over-the-counter medications
- Having someone else clean the cat’s litter box to help avoid toxoplasmosis
- Limiting or eliminating caffeine
- Avoiding environmental hazards, such as radiation and x-rays
- Getting proper treatment for chronic illness, such as diabetes and thyroid
disease
- Avoiding contact sports or activities that have risk or injury
- Avoiding certain foods which may contain harmful bacteria (e.g., listeria)
that can cause miscarriage, such as raw or uncooked meats, deli meats,
liver, fish, raw shellfish, raw eggs, soft cheeses, un pasteurized milk and
pate
- Washing all vegetables before consumption
Questions for your doctor about miscarriage
Preparing questions in advance can help patients to have more meaningful
discussions with their physicians regarding their conditions. Patients may
wish to ask their doctor the following miscarriage-related questions:
- What are the symptoms of miscarriage?
- Is miscarriage a sign of infertility?
- What can I do to prevent a miscarriage?
- How is recurrent miscarriage diagnosed?
- Will exercising cause me to have a miscarriage?
- Should I refrain from taking ibuprofen during pregnancy?
- Can I have a miscarriage without even knowing it?
- How soon can I try to conceive after experiencing a miscarriage?
- I am experiencing terrible grief; can you recommend someone to help me?
Courtesy:
Rasool Simjee |
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Rasool Simjee