Early miscarriage - 25 things to know when trying to conceive

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Stay tuned to the end for advice about getting pregnant again after an early miscarriage.

We cover a ton of stuff in this video but when you are done watching...

if you have a question about something we didn't cover please ask in the comments,

We will answer.

The first and maybe the most important thing to know about early miscarriage

is that it is extremely common. Between 50 to 60% of

all pregnancies end in miscarriage.

Of those about half are very early miscarriages.

which often occur before a woman even knows she is pregnant.

An early miscarriage is defined as a pregnancy loss that occurs during the

first thirteen weeks of pregnancy.

But really, most early miscarriages occur

before your doctor can see a fetus with heart motion on an ultrasound which is

typically around 7 to 8 weeks.

The good news is that if you have an early miscarriage

and are experiencing vaginal bleeding, but your doctor can see

fetal heart motion on ultrasound - 95% of those pregnancies will go on to result

in a viable baby. A slow heart rate on ultrasound, however, is a concerning sign.

A slow heart rate is seen in nearly 70% of early miscarriages.

Stated another way, the likelihood of having an early miscarriage is 30 times higher if

the ultrasound shows a low heart rate. A slow heart rate in combination with

vaginal bleeding is seen in 85% of early miscarriages.

How slow is slow ?

If the measured heart rate is less than 110 beats per minute then that is of concern.

A number of things can cause an early miscarriage. The most common cause is the

embryo or fetus does not have the correct number of chromosomes.

A normal fetus has 46 chromosomes - 23 from each parent.

60 to 70% of early miscarriages

are found to have an incorrect number of chromosomes.

As women get older, this number gets higher. So older women are more likely to have a miscarriage and

any given miscarriage is more likely to be from a chromosome problem.

Other things that probably increase the risk for early miscarriage include: smoking

drinking alcohol



taking supplements other than prenatal vitamins

Things that do not cause early miscarriage include: stress

having sex during pregnancy

exercise during pregnancy

using birth control before pregnancy

falling during pregnancy

getting hit in the abdomen or morning sickness.

In fact, women with morning sickness have a lower risk for miscarriage.

The most common signs and symptoms of early miscarriage are

vaginal bleeding and cramping.

However, these symptoms are also pretty common in

women who do not go on to have an early miscarriage.

If you are pregnant and have bleeding,

please contact your doctor for further evaluation!

Your doctor will want

to get a blood test to measure your HCG levels and an ultrasound.

This is important to do because some women with early pregnancy bleeding may actually

have a tubal pregnancy, which is less common, but much more dangerous.

One of the most common questions I get asked is: Can an early miscarriage be prevented?

The answer depends on whether you are already pregnant.

If you are not pregnant and you are trying to prevent an early miscarriage in your next

pregnancy, then there are a number of things you can do.

Stop those bad habits.

Avoid alcohol, cigarettes and caffeine.

If you are overweight, lose weight

If you are older, ask your doctor about IVF combined with testing the embryos for chromosome abnormalities.

If you've had multiple early miscarriages, meaning three or more...

see your doctor to be evaluated for recurrent pregnancy loss.

There may treatable problems that can be found

If you are already pregnant,

besides the things I discussed before, there is probably not much you can do.

Bed rest will not help.

Avoiding stress will not help, though it may make you feel better.

Taking progesterone supplements have been recommended in the past but there

really is very little evidence that it will reduce the chance for an early

miscarriage, but it probably won't harm anything.

Another question I get asked all the time is:

How soon can you try to conceive after having had a miscarriage?

In the past, doctors told patients, without any evidence, to wait at least

three months.

However, we have solid scientific data that shows attempting

pregnancy again right away, as soon as you start ovulating, will increase the

chance for a successful pregnancy.

This could happen within a few weeks of an early miscarriage.

Finally, if you need fertility treatment to conceive...

we recommend that you evaluate the uterine cavity before

starting treatment again

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