Miscarriage is the loss of a pregnancy before the age of viability (22-24 weeks of pregnancy). Miscarriage is estimated to occur in at least 15% of confirmed pregnancies and thus is very common: sadly, around 1 in 4 women will suffer at least one miscarriage during their lives. Losing a baby at any stage in pregnancy can be devastating. Often, a period of bereavement occurs which can be complicated by feelings of guilt and profound sadness and even depression and anxiety.
Most miscarriages occur early (before 12 weeks of pregnancy) and are due to the pregnancy having the wrong number of chromosomes. Chromosomes are the structures which carry our genes. There are 23 pairs of chromosomes (numbered 1 to 22, plus two sex chromosomes) in each cell in our bodies. Half the chromosomes come from our mother and half from our father.
Frequently a mistake happens during the development of a sperm or an egg, and one of them has the wrong number of chromosomes, so that a pregnancy resulting from this abnormal egg or sperm also has the wrong number of chromosomes. The most well-known example of this which does not always result in miscarriage, is Down Syndrome, in which the affected baby or child has 3 copies of chromosome number 21 instead of 2 copies. Most pregnancies with an abnormal number of chromosomes end in a miscarriage. As women get older, their eggs are more prone to have the wrong number of chromosomes and hence the miscarriage risk and the risk of Down Syndrome increases with age of the woman. Most chromosome abnormalities in pregnancies are sporadic and tend not to recur with different pregnancies.
Most women with early miscarriage can choose the method most suitable for them. Allowing a natural miscarriage, medical treatment or surgical treatment are all safe.
Some women want to allow the miscarriage to happen without any medical treatment. However, the bleeding can be prolonged and the miscarriage can take several weeks to occur. Medical treatment with tablets can speed up the process. Surgical treatment, under either local or general anaesthetic is used to remove the pregnancy tissue by suction. This procedure itself takes only 5 minutes and you can go home the same day. The tissue removed is sent for examination in the pathology lab to check for a molar pregnancy (a rare form of abnormal pregnancy which can cause miscarriage and which requires follow up) and in addition, the chromosomes of the pregnancy can be tested. Surgical treatment usually leads to the shortest duration of bleeding and quickest resolution of the miscarriage.
All forms of managing a miscarriage carry a small risk of excessive bleeding, which may require a blood transfusion, and infection, which may require antibiotics. In addition, the surgical procedure under general anaesthetic carries a very small risk of injury to the womb or the neck of the womb, and risks associated with the anaesthetic.
Holly House Hospital
Clinics Thursdays 9.00-12.00
Tel: 0208 936 1201
BMI London Independent Hospital
Clinics Thursdays 1-4pm
Tel: 0207 780 2400
Surgery is also performed at Spire Roding Hospital, Redbridge IG4 5PZ 02087097878