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Encyclopedia > Miscarriage
Miscarriage
Classification & external resources
ICD-10 O03.
ICD-9 634
MedlinePlus 001488
eMedicine topic list
MeSH D000022

Miscarriage or spontaneous abortion is the natural or spontaneous end of a pregnancy at a stage where the embryo or the fetus is incapable of surviving, generally defined in humans at a gestation of prior to 20 weeks. Miscarriage is the most common complication of early pregnancy.[1] The medical term "spontaneous abortion" is used in reference to miscarriages because the medical term "abortion" refers to any terminated pregnancy, deliberately induced or spontaneous, although in common parlance it refers specifically to active termination of pregnancy. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // O00-O99 - Pregnancy, childbirth and the puerperium (O00-O08) Pregnancy with abortive outcome (O00) Ectopic pregnancy (O01) Hydatidiform mole (O02) Other abnormal products of conception (O03) Spontaneous abortion (O04) Medical abortion (O05) Other abortion (O06) Unspecified abortion (O07) Failed attempted abortion (O08) Complications following abortion and ectopic and molar pregnancy... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... This article is about human pregnancy in biological females. ... For other uses, see Embryo (disambiguation). ... For other uses, see Fetus (disambiguation). ... Gestation is the carrying of an embryo or fetus inside a female viviparous animal. ...

Contents

Terminology

Very early miscarriages - those which occur before the sixth week LMP (since the woman's Last Menstrual Period) are medically termed early pregnancy loss[2] or chemical pregnancy.[3] Miscarriages that occur after the sixth week LMP are medically termed clinical spontaneous abortion.[2] Gestational age is age of a fetus (or newborn infant) from presumed conception. ...


In medical contexts, the word "abortion" refers to any process by which a pregnancy ends with the death and removal or expulsion of the fetus, regardless of whether it's spontaneous or intentionally induced. Many women who have had miscarriages, however, object to the term "abortion" in connection with their experience, as it is generally associated with induced abortions. In recent years there has been discussion in the medical community about avoiding the use of this term in favor of the less ambiguous term "miscarriage."[4]


Labour resulting in live birth before the 37th week of pregnancy is termed "premature birth," even if the infant dies shortly afterward. Although long-term survival has never been reported for infants born from pregnancy shorter than 21 weeks, infants born as early as the 16th week of pregnancy may cry and live a few minutes or hours.[5] In most systems of human pregnancy, the condition, premature birth (also known as a preterm birth), occurs when the baby is born within sooner than 36 weeks of completed gestation. ...


A fetus that dies while in the uterus after about the 20th week of pregnancy is termed a "stillbirth". Premature births or stillbirths are not generally considered miscarriages, though usage of the terms and causes of these events may overlap. This article or section is in need of attention from an expert on the subject. ...


Forms and types

The clinical presentation of a threatened abortion describes any bleeding seen during pregnancy prior to viability, that has yet to be assessed further. At investigation it may be found that the fetus remains viable and the pregnancy continues without further problems. It has been suggested that bed rest improves the chances of the pregnancy continuing when a small subchorionic hematoma has been found on ultrasound scans.[6] Hematoma on thigh, 6 days after a fall down stairs, 150ml of blood drained a few days later A hematoma, or haematoma, is a collection of blood, generally the result of hemorrhage, or, more specifically, internal bleeding. ...


Alternatively the following terms are used to describe pregnancies that do not continue:

  • An empty sac is a condition where the gestational sac develops normally, while the embryonal part of the pregnancy is either absent or stops growing very early. Other terms for this condition are blighted ovum and anembryonic pregnancy.
  • An inevitable abortion describes where the fetal heart beat is shown to have stopped and the cervix has already dilated open, but the fetus has yet to be expelled. This usually will progress to a complete abortion.
  • A complete abortion is when all products of conception have been expelled. Products of conception 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.
  • An incomplete abortion occurs when tissue has been passed, but some remains in utero.[7]
  • A missed abortion is when the embryo or fetus has died, but a miscarriage has not yet occurred. It is also referred to as delayed miscarriage.

The following two terms consider wider complications or implications of a miscarriage: An anembryonic gestation (aka blighted ovum) is a pregnancy in which a visible embryo never develops within a normal-appearing gestational sac, which likely occurs as a result of early embryonic death with continued development of the trophoblast. ... The trophoblast (from Greek threphein: to feed) is considered to be the first of all embryonic annexes. ... Chorionic villi are villi that sprout from the chorion, in order to give a maximum area of contact with the maternal blood. ... The gestational sac is the only available intrauterine structure that can be used to determine if an intrauterine pregnancy (IUP) exists, until the embryo is identified. ... The yolk sac is the first element seen in the gestational sac during pregnancy, usually at 5 weeks gestation. ... The fetal pole is a thickening on the margin of the yolk sac of a fetus during pregnancy. ... For other uses, see Embryo (disambiguation). ... For other uses, see Fetus (disambiguation). ... In placental mammals, the umbilical cord is a tube that connects a developing embryo or fetus to the placenta. ... The placenta is a sack of fat present in placental vertebrates, such as some mammals and sharks during gestation (pregnancy). ... A drawing of the amniotic sac from Grays Anatomy. ... Biological tissue is a collection of interconnected cells that perform a similar function within an organism. ... In Utero is the third and final studio album by the American grunge band Nirvana, released on September 21, 1993 by DGC Records. ...

  • A septic abortion occurs when the tissue from a missed or incomplete abortion becomes infected. The infection of the womb carries risk of spreading infection (septicaemia) and is a grave risk to the life of the woman.
  • Recurrent pregnancy loss (RPL) or recurrent miscarriage (medically termed habitual abortion) is the occurrence of 3 consecutive miscarriages. A large majority (85%) of women who have had two miscarriages will conceive and carry normally afterwards, so statistically the occurrence of three abortions at 0.34% is regarded as "habitual".[8]

Sepsis (in Greek Σήψις) is a serious medical condition caused by a severe systemic infection leading to a systemic inflammatory response. ... Habitual abortion or recurrent pregnancy loss (RPL) is the occurrence of repeated pregnancies that end in miscarriage of the fetus, usually before 20 weeks of gestation. ...

Causes

Miscarriages can occur for many reasons, not all of which can be identified.


First trimester

Most miscarriages (more than three-quarters) occur during the first trimester.[9]


Chromosomal abnormalities are found in more than half of embryos miscarried in the first 13 weeks. A pregnancy with a genetic problem has a 95% chance of ending in miscarriage. Most chromosomal problems happen by chance, have nothing to do with the parents, and are unlikely to recur.[10] Genetic problems are more likely to occur with older parents; this may account for the higher miscarriage rates observed in older women.[11]


Another cause of early miscarriage may be progesterone deficiency. Women diagnosed with low progesterone levels in the second half of their menstrual cycle (luteal phase) may be prescribed progesterone supplements, to be taken for the first trimester of pregnancy.[10] However, no study has shown that general first-trimester progesterone supplements reduce the risk of miscarriage,[12] and even the identification of problems with the luteal phase as contributing to miscarriage has been questioned.[13] Progesterone is a C-21 steroid hormone involved in the female menstrual cycle, pregnancy (supports gestation) and embryogenesis of humans and other species. ... The luteal phase is the latter phase of the estrous cycle in animals. ...


Second trimester

Up to 15% of pregnancy losses in the second trimester may be due to uterine malformation, growths in the uterus (fibroids), or cervical problems.[10] These conditions may also contribute to premature birth.[9] A uterine malformation is the result of an abnormal development of the Mullerian duct(s) during embryogenesis. ... Uterine fibroids (leiomyomata, singular leiomyoma) are the most common neoplasm in females, and may affect about of 25 % of white and 50% of black women during the reproductive years. ... Cervical incompetence is a condition in which the cervix begins to open (dilate) and thin (efface) before a pregnancy has reached term. ... In most systems of human pregnancy, the condition, premature birth (also known as a preterm birth), occurs when the baby is born within sooner than 36 weeks of completed gestation. ...


One study found that 19% of second trimester losses were caused by problems with the umbilical cord. Problems with the placenta may also account for a significant number of later-term miscarriages.[14] In placental mammals, the umbilical cord is a tube that connects a developing embryo or fetus to the placenta. ... The placenta is a sack of fat present in placental vertebrates, such as some mammals and sharks during gestation (pregnancy). ...


General risk factors

Pregnancies involving more than one fetus are at increased risk of miscarriage.[10]


Uncontrolled diabetes greatly increases the risk of miscarriage. Women with controlled diabetes are not at higher risk of miscarriage. Because diabetes may develop during pregnancy (gestational diabetes), an important part of prenatal care is to monitor for signs of the disease.[10] Gestational diabetes is a form of diabetes found in pregnant women. ... A doctor performs a prenatal exam. ...


Polycystic ovary syndrome is a risk factor for miscarriage, with 30-50% of pregnancies in women with PCOS being miscarried in the first trimester. Two studies have shown treatment with the drug metformin to significantly lower the rate of miscarriage in women with PCOS (the metformin-treated groups experienced approximately one-third the miscarriage rates of the control groups).[15] However, a 2006 review of metformin treatment in pregnancy found insufficient evidence of safety and did not recommend routine treatment with the drug.[16] Polycystic ovary syndrome (PCOS, also known clinically as Stein-Leventhal syndrome), is an endocrine disorder that affects 5–10% of women. ... Metformin (INN; trade names Glucophage, Diabex, Diaformin, Fortamet, Riomet, Glumetza and others) is an anti-diabetic drug from the biguanide class of oral hypoglycemic agents. ...


High blood pressure and certain illnesses (such as rubella and chlamydia) increase the risk of miscarriage.[10] For other forms of hypertension, see Hypertension (disambiguation). ... Rubella, commonly known as German measles, is a disease caused by the rubella virus. ... Chlamydia is a common term for Chlamydiae. ...


Tobacco (cigarette) smokers have an increased risk of miscarriage.[17] An increase in miscarriage is also associated with the father being a cigarette smoker.[2] The husband study observed a 4% increased risk for husbands who smoke less than 20 cigarettes/day, and an 81% increased risk for husbands who smoke 20 or more cigarettes/day.


Severe cases of hypothyroidism increase the risk of miscarriage. The effect of milder cases of hypothyroidism on miscarriage rates has not been established. Certain immune conditions such as autoimmune diseases greatly increase the risk of miscarriage.[10] This article or section does not cite its references or sources. ... Autoimmunity is the failure of an organism to recognize its own constituent parts (down to the sub-molecular levels) as self, which results in an immune response against its own cells and tissues. ...


Cocaine use increases miscarriage rates.[17]


Physical trauma, exposure to environmental toxins [18], obesity, high caffeine intake (> 300 mg/day), high levels of alcohol consumption, high fever (100°F or higher) , use of an IUD during the time of conception [18] and use of NSAIDs have also been linked to increased risk of miscarriage.[citation needed] Caffeine is a xanthine alkaloid compound that acts as a stimulant in humans. ... This article does not cite any references or sources. ... An intrauterine device (intra meaning within, and uterine meaning of the uterus) is a birth control device also known as an IUD or a coil( this colloquialism is based on the coil-shaped design of early IUDs). ... Non-steroidal anti-inflammatory drugs, usually abbreviated to NSAIDs, are drugs with analgesic, antipyretic and anti-inflammatory effects - they reduce pain, fever and inflammation. ...


Prevalence

Determining the prevalence of miscarriage is difficult. Many miscarriages happen very early in the pregnancy, before a woman may know she is pregnant. Treatment of women with miscarriage at home means medical statistics on miscarriage miss many cases.[19] Prospective studies using very sensitive early pregnancy tests have found that 25% of pregnancies are miscarried by the sixth week LMP (since the woman's Last Menstrual Period).[20][21] The risk of miscarriage decreases sharply after the 8th week, i.e. when the fetal stage begins.[22] Clinical miscarriages (those occurring after the sixth week LMP) occur in 8% of pregnancies.[21] In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ... Gestational age is age of a fetus (or newborn infant) from presumed conception. ... For other uses, see Fetus (disambiguation). ...


The prevalence of miscarriage increases considerably with age of the parents. Pregnancies from men younger than twenty-five years are 40% less likely to end in miscarriage than pregnancies from men 25-29 years. Pregnancies from men older than forty years are 60% more likely to end in miscarriage than the 25-29 year age group.[23] The increased risk of miscarriage in pregnancies from older men is mainly seen in the first trimester.[24] In women, by the age of forty-five, 75% of pregnancies may end in miscarriage.[25]


Detection

The most common symptom of a miscarriage is bleeding;[26] bleeding during pregnancy may be referred to as a threatened abortion. Of women who seek clinical treatment for bleeding during pregnancy, about half will go on to have a miscarriage.[19] Symptoms other than bleeding are not statistically related to miscarriage.[26]


Miscarriage may also be detected during an ultrasound exam, or through serial human chorionic gonadotropin (HCG) testing. Women pregnant from ART methods, and women with a history of miscarriage, may be monitored closely and so detect a miscarriage sooner than women without such monitoring. Human chorionic gonadotropin (hCG) is a peptide hormone produced in pregnancy, that is made by the embryo soon after conception and later by the syncytiotrophoblast (part of the placenta). ... Assisted reproductive technology (ART) is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means. ...


Several medical options exist for managing documented nonviable pregnancies that have not been expelled naturally.


Management

Blood loss during early pregnancy is the most common symptom of both miscarriage and of ectopic pregnancy. Pain does not strongly correlate with miscarriage, but is a common symptom of ectopic pregnancy.[26] In the case of concerning blood loss, pain, or both, transvaginal ultrasound is performed. If a viable intrauterine pregnancy is not found with ultrasound, serial βHCG tests should be performed to rule out ectopic pregnancy, which is a life-threatening situation.[27][28] Obstetric sonogram of a fetus at 16 weeks. ... Human chorionic gonadotropin (hCG) is a peptide hormone produced in pregnancy, that is made by the embryo soon after conception and later by the syncytiotrophoblast (part of the placenta). ...


If the bleeding is light, making an appointment to see one's doctor is recommended. If bleeding is heavy, there is considerable pain, or there is a fever, then emergency medical attention should be sought.


No treatment is necessary for a diagnosis of complete abortion (as long as ectopic pregnancy is ruled out). In cases of an incomplete abortion, empty sac, or missed abortion there are three treatment options:

  • With no treatment (watchful waiting), most of these cases (65-80%) will pass naturally within two to six weeks.[29] This path avoids the side effects and complications possible from medications and surgery.[30]
  • Medical management usually consists of using misoprostol (a prostaglandin, brand name Cytotec) to encourage completion of the miscarriage. About 95% of cases treated with misoprostol will complete within a few days.[29]
  • Surgical treatment (most commonly vacuum aspiration, sometimes referred to as a D&C or D&E) is the fastest way to complete the miscarriage. It also shortens the duration and heaviness of bleeding, and is the best treatment for physical pain associated with the miscarriage.[29] In cases of repeated miscarriage or later-term pregnancy loss, D&C is also the best way to obtain tissue samples for pathology examination.

Watchful waiting, also referred to as observation, is an approach to a medical problem in which time is allowed to pass before further testing or therapy is pursued. ... Misoprostol is a drug that is United States Food and Drug Administration (FDA)-approved for the treatment and prevention of stomach ulcers. ... E1 - Alprostadil I2 - Prostacyclin A prostaglandin is any member of a group of lipid compounds that are derived enzymatically from fatty acids and have important functions in the animal body. ... Vacuum or suction aspiration abortion is a form of abortion using aspiration. ...

Pathology

When looking for gross or microscopic pathologic symptoms of miscarriage, one looks for the products of conception. Microscopically, these include villi, trophoblast, fetal parts, and background gestational changes in the endometrium. Genetic tests may also be performed to look for abnormal chromosome arrangements. A renal cell carcinoma (chromophobe type) viewed on a hematoxylin & eosin stained slide Pathologist redirects here. ... The term conception can refer to more than one meaning: Concept Fertilisation This is a disambiguation page — a navigational aid which lists pages that might otherwise share the same title. ... Villi (singular: villus) are tiny, finger-like structures that protrude from the wall of the intestine to help absorb nutrients in the lumen. ... The trophoblast (from Greek threphein: to feed) is considered to be the first of all embryonic annexes. ... The endometrium is the inner membrane of the mammalian uterus. ... A scheme of a condensed (metaphase) chromosome. ...


Psychological aspects

Although a woman physically recovers from a miscarriage quickly, psychological recovery for parents in general can take a long time. People differ a lot in this regard: some are 'over it' after a few months, others take more than a year. Still others may feel relief or other less negative emotions.


For those who do go through a process of grief, it is often as if the baby had been born but died. How short a time the fetus lived in the womb may not matter for the feeling of loss. From the moment pregnancy is discovered, the parents can start to bond with the unborn child. When the child turns out not to be viable, dreams, fantasies and plans for the future are disturbed roughly. It has been suggested that Anticipatory Grief be merged into this article or section. ...


Besides the feeling of loss, a lack of understanding by others is often important. People who have not experienced a miscarriage themselves may find it hard to empathize with what has occurred and how upsetting it may be. This may lead to unrealistic expectations of the parents' recovery. The pregnancy and miscarriage are hardly mentioned anymore in conversation, often too because the subject is too painful. This can make the woman feel particularly isolated. Not to be confused with Pity, Sympathy, or Compassion. ...


Interaction with pregnant women and newborn children is often also painful for parents who have experienced miscarriage. Sometimes this makes interaction with friends, acquaintances and family very difficult.[31]


ICD10 codes

  • Habitual abortion
  • Incomplete abortion
  • Missed abortion
  • Threatened abortion

N96
O03.0-O06.4
O02.1
O20.0

Notes

  1. ^ Petrozza, John C (August 29, 2006). Early Pregnancy Loss. eMedicine. WebMD. Retrieved on 2007-07-20.
    Early Pregnancy Loss (Miscarriage). Pregnancy-bliss.co.uk. The Daily Telegraph (2007). Retrieved on 2007-07-20.
  2. ^ a b c Venners S, Wang X, Chen C, Wang L, Chen D, Guang W, Huang A, Ryan L, O'Connor J, Lasley B, Overstreet J, Wilcox A, Xu X (2004). "Paternal smoking and pregnancy loss: a prospective study using a biomarker of pregnancy.". Am J Epidemiol 159 (10): 993-1001. PMID 15128612. 
  3. ^ What is a chemical pregnancy?. Baby Hopes. Retrieved on 2007-04-27.
  4. ^ Hutchon D, Cooper S (1998). "Terminology for early pregnancy loss must be changed". BMJ 317 (7165): 1081. PMID 9774309. 
    Hutchon D (1998). "Understanding miscarriage or insensitive abortion: time for more defined terminology?". Am. J. Obstet. Gynecol. 179 (2): 397-8. PMID 9731844. 
  5. ^ Patricia Lee June (November 2001). "A Pediatrician Looks at Babies Late in Pregnancy and Late Term Abortion". Presbyterians Pro-Life. Retrieved on 2006-12-24.
  6. ^ Ben-Haroush A, Yogev Y, Mashiach R, Meizner I (2003). "Pregnancy outcome of threatened abortion with subchorionic hematoma: possible benefit of bed-rest?". Isr. Med. Assoc. J. 5 (6): 422-4. PMID 12841015. 
  7. ^ MedlinePlus (2004-10-25). Abortion - incomplete. Medical Encyclopedia. Retrieved on 2006-05-24.
  8. ^ Royal College of Obstetricians and Gynaecologists (May 2003). "The Investigation and Treatment of Couple with Recurrent Miscarriage" (PDF). Guideline No 17. Retrieved on 2006-05-24. 
  9. ^ a b Rosenthal, M. Sara (1999). The Second Trimester. The Gynecological Sourcebook. WebMD. Retrieved on 2006-12-18.
  10. ^ a b c d e f g Miscarriage: Causes of Miscarriage. HealthSquare.com. Retrieved on 2007-09-18.
    taken word-for-word from pp. 347-9 of:
    (1994) "Chapter 27. What To Do When Miscarriage Strikes", The PDR Family Guide to Women's Health and Prescription Drugs. Montvale, NJ: Medical Economics, pp. 345-50. ISBN 1-56363-086-9. 
  11. ^ Pregnancy Over Age 30. MUSC Children's Hospital. Retrieved on 2006-12-18.
  12. ^ Wahabi HA, Abed Althagafi NF, Elawad M (2007). "Progestogen for treating threatened miscarriage". Cochrane database of systematic reviews (Online) (3): CD005943. doi:10.1002/14651858.CD005943.pub2. PMID 17636813. Retrieved on 2007-11-12. 
  13. ^ Bukulmez O, Arici A (2004). "Luteal phase defect: myth or reality". Obstet. Gynecol. Clin. North Am. 31 (4): 727–44, ix. doi:10.1016/j.ogc.2004.08.007. PMID 15550332. 
  14. ^ Peng H, Levitin-Smith M, Rochelson B, Kahn E. "Umbilical cord stricture and overcoiling are common causes of fetal demise.". Pediatr Dev Pathol 9 (1): 14-9. PMID 16808633. 
  15. ^ Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Roberts KA, Nestler JE (2002). "Effects of metformin on early pregnancy loss in the polycystic ovary syndrome". J. Clin. Endocrinol. Metab. 87 (2): 524-9. PMID 11836280. Retrieved on 2007-07-17. 
    Khattab S, Mohsen IA, Foutouh IA, Ramadan A, Moaz M, Al-Inany H (2006). "Metformin reduces abortion in pregnant women with polycystic ovary syndrome". Gynecol. Endocrinol. 22 (12): 680-4. doi:10.1080/09513590601010508. PMID 17162710. 
  16. ^ Lilja AE, Mathiesen ER (2006). "Polycystic ovary syndrome and metformin in pregnancy". Acta obstetricia et gynecologica Scandinavica 85 (7): 861-8. doi:10.1080/00016340600780441. PMID 16817087. 
  17. ^ a b Ness R, Grisso J, Hirschinger N, Markovic N, Shaw L, Day N, Kline J (1999). "Cocaine and tobacco use and the risk of spontaneous abortion.". N Engl J Med 340 (5): 333-9. PMID 9929522. 
  18. ^ a b Miscarriage: An Overview. Armenian Medical Network (2005). Retrieved on 2007-09-19.
  19. ^ a b Everett C (1997). "Incidence and outcome of bleeding before the 20th week of pregnancy: prospective study from general practice.". BMJ 315 (7099): 32-4. PMID 9233324. 
  20. ^ Wilcox AJ, Baird DD, Weinberg CR (1999). "Time of implantation of the conceptus and loss of pregnancy.". New England Journal of Medicine 340 (23): 1796-1799. PMID 10362823. 
  21. ^ a b Wang X, Chen C, Wang L, Chen D, Guang W, French J (2003). "Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study.". Fertil Steril 79 (3): 577-84. PMID 12620443. 
  22. ^ Q&A: Miscarriage. (August 6 , 2002). BBC News. Retrieved January 17, 2007. Also see Lennart Nilsson, A Child is Born 91 (1990)(At eight weeks, "the danger of a miscarriage . . . diminishes sharply.")
  23. ^ Kleinhaus K, Perrin M, Friedlander Y, Paltiel O, Malaspina D, Harlap S (2006). "Paternal age and spontaneous abortion". Obstet Gynecol 108 (2): 369-77. PMID 16880308. 
  24. ^ Slama R, Bouyer J, Windham G, Fenster L, Werwatz A, Swan S (2005). "Influence of paternal age on the risk of spontaneous abortion.". Am J Epidemiol 161 (9): 816-23. PMID 15840613. 
  25. ^ Nybo Andersen A, Wohlfahrt J, Christens P, Olsen J, Melbye M (2000). "Maternal age and fetal loss: population based register linkage study". BMJ 320 (7251): 1708-12. PMID 10864550. 
  26. ^ a b c Gracia C, Sammel M, Chittams J, Hummel A, Shaunik A, Barnhart K (2005). "Risk factors for spontaneous abortion in early symptomatic first-trimester pregnancies". Obstet Gynecol 106 (5 Pt 1): 993-9. PMID 16260517. 
  27. ^ Yip S, Sahota D, Cheung L, Lam P, Haines C, Chung T (2003). "Accuracy of clinical diagnostic methods of threatened abortion". Gynecol Obstet Invest 56 (1): 38-42. PMID 12876423. 
  28. ^ Condous G, Okaro E, Khalid A, Bourne T (2005). "Do we need to follow up complete miscarriages with serum human chorionic gonadotrophin levels?". BJOG 112 (6): 827-9. PMID 15924545. 
  29. ^ a b c Kripke C (2006). "Expectant management vs. surgical treatment for miscarriage". Am Fam Physician 74 (7): 1125-6. PMID 17039747. Retrieved on 2006-12-31. 
  30. ^ Tang O, Ho P (2006). "The use of misoprostol for early pregnancy failure.". Curr Opin Obstet Gynecol 18 (6): 581-6. PMID 17099326. 
  31. ^ David Vernon (2005). Having a Great Birth in Australia.

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See also

Parturition redirects here. ... This article or section is in need of attention from an expert on the subject. ... There are very few or no other articles that link to this one. ... In most systems of human pregnancy, the condition, premature birth (also known as a preterm birth), occurs when the baby is born within sooner than 36 weeks of completed gestation. ...

External links


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MedlinePlus Medical Encyclopedia: Miscarriage (914 words)
A miscarriage may also be called a "spontaneous abortion." This refers to naturally occurring events, not elective or therapeutic abortion procedures, which a woman may choose to have done.
Among known pregnancies, the rate of miscarriage is approximately 10% and usually occurs between the 7th and 12th weeks of pregnancy.
If a miscarriage occurs, the tissue passed from the vagina should be examined to determine if it was a fetus or a hydatidiform mole.
Understanding miscarriage (1252 words)
Miscarriage is a relatively common experience — but that doesn't make it any easier.
Miscarriage is the loss of a pregnancy without obvious cause before the 20th week.
After one miscarriage, your risk of miscarriage is the same as that of a woman who's never had a miscarriage.
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