Whether it occurs in the first trimester or later in a pregnancy, a miscarriage is always an emotionally traumatic event, sometimes a physically daunting one, and all too often an isolating experience. Here are some common miscarriage questions.
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Q: How common are miscarriages? Do you see it a lot in your practice?
A: Unfortunately miscarriages are extremely common. They occur in one of every five pregnancies. So although there are 4 million babies born in the United States each year, another one million couples undergo the emotional trauma of having a miscarriage. Having practiced obstetrics over the last 22 years I have seen thousands of couples go through miscarriages. they occur so commonly, I generally see to 2 to 3 such couples a week. No matter how sophisticated a woman and her partner may be, no matter how many healthy children they might already have, a miscarriage is always an extremely upsetting event.
Q: Are there different types of miscarriages?
A: Yes. The majority of miscarriages--60 percent or so--come about because of a miscombination of the chromosomes of the egg and sperm when they fuse at conception. Four out of five times when the egg and sperm fuse a healthy embryo results. One out of five times, however, the chromosomes of the egg and sperm don't combine correctly resulting in the embryo having abnormal chromosomes.
But there are other causes for miscarriage as well. These range from abnormalities of a woman's reproductive organ--such as a uterus that has large fibroids--to hormonal inadequacy, infection, or harmful environmental influences.
Q: Is it useful to try to detect the specific cause for every miscarriage?
A: Since 60 percent of all miscarriages occur because of the accidental event of chromosomal miscombination, trying to find the "cause" of this random event will not help a couple avoid a similar outcome in a future pregnancy. However, if there is some reason to suspect that another factor is at work -- such as an anatomic, hormonal, environmental, infectious, or genetic abnormality -- then further testing is appropriate. Such testing may enable a treatment to be found that can significantly increase the chances of the next pregnancy being successful.
Since women who have had three or more miscarriages are more likely than others to have a specific, nonrandom cause for their miscarriages, it is worthwhile for such women to undergo a comprehensive evaluation. By so doing, a treatable cause for these recurrent miscarriages can often be found.