Bleeding during the first 20 weeks of pregnancy is common. This is called a
threatened miscarriage; a pregnancy that is threatening to end before the twentieth
week of pregnancy. Often this bleeding stops and the pregnancy continues without
any more problems. Sometimes a threatened miscarriage can progress to a
complete or incomplete miscarriage. This may or may not require further treatment.
Some miscarriages occur before a woman misses a menstrual period and knows she
is even pregnant.
Miscarriages occur in 15 to 20% of all pregnancies and usually during the first 13
weeks. The exact cause of a miscarriage is usually never known. A miscarriage is
nature’s way of ending a pregnancy that is abnormal. There are some things that
may put you at risk to have a miscarriage, such as:
Hormone problems.
Infection of the uterus or cervix.
Abnormally shaped uterus.
Fibroids in the uterus.
Incompetent cervix (the cervix is too weak to hold the baby).
When a miscarriage becomes complete and all products of conception (all the tissue
in the uterus) have been passed, no treatment is needed. If the miscarriage is
incomplete (parts of the fetus or placenta remain in the uterus), further treatment
may be needed. The most common reason for further treatment is continuous
bleeding because the pregnancy tissue did not pass out of the uterus. Tissue left
behind may also become infected. Treatment is usually dilatation and curettage (the
removal of the remaining products of pregnancy). This can be done by a sucking
procedure (suction curettage), or by scraping the inside of the uterus.
Miscarriages are often a very emotional time for prospective parents. Nearly all
miscarriages occur because the pregnancy started off wrongly. At east half of these
pregnancies have a chromosomal abnormality. It is almost always not inherited.
This does not always show up even when the products miscarried are studied under
the microscope. The miscarriage is nearly always not your fault.
HOME CARE INSTRUCTIONS:
Your doctor may order bed rest depending on how much bleeding and
cramping you have.
You may receive a follow up appointment for a re-evaluation of your
pregnancy and a repeat blood test. Re-evaluations often occur after 2 days
and again in 4 to 6 weeks. It is very important that you follow-up in the
recommended time period.
If you are Rh negative and the father is Rh positive, or you do not know the
father’s blood type, you may receive a shot (Rh immune globulin) to help
prevent abnormal antibodies that can develop and affect the baby in any
future pregnancies.
SEEK IMMEDIATE MEDICAL ATTENTION IF:
You have severe cramps in your stomach, back or abdomen.
You have a sudden onset of severe pain in the lower part of your abdomen
You develop chills
You run an unexplained temperature of 101° F (38.3° C) or higher.
You pass large clots or tissue. Save any tissue for your caregiver to inspect
Your bleeding increases or you become light-headed, weak, or have fainting
episodes.
You have a gush of fluid from you vagina