Pregnancy Loss and Potential Causes of Miscarriage
Parents experiencing pregnancy loss may seek additional testing in an effort to determine the cause of loss. Most of the time, loss occurs for reasons parents have no control over. In fact, it's often difficult to pinpoint the exact cause. On the other hand, learning the cause of a pregnancy loss may help put your mind at ease and help you improve your chances for having a healthy, full-term pregnancy in the future.
You can choose whether you want testing done to help determine the cause of pregnancy loss. If the loss occurred after the 20th week, you can also choose whether you want your baby to have a post-mortem exam. Your healthcare provider is a great resource to help you make the right decision for your family. To discover the cause, your healthcare provider may perform one or more of the following tests:
Blood Tests. Blood tests will show if the mother had preeclampsia, obstetric cholestasis or diabetes.
Examination of the umbilical cord, membranes and placenta. These tissues attach to your fetus. An abnormality could prevent your baby from receiving oxygen, blood and nutrients.
Tests for infection. Healthcare providers will take a sample of the mother’s urine, blood, or cells from her vagina or cervix to test for infection.
Thyroid function test. This test will determine if there’s something wrong with the mother’s thyroid gland that may have impacted the pregnancy.
Genetic tests. Your healthcare provider will take a sample of the umbilical cord to determine if your baby had genetic problems such as Down’s syndrome.
Your healthcare provider will also review medical records and the circumstances surrounding the stillbirth. With your consent, an autopsy can be performed to determine the cause of your baby's death. In some cases, an autopsy may be legally required. An autopsy is a surgical procedure performed by a skilled pathologist. Incisions are made carefully to avoid any disfigurement, and the incisions are surgically repaired afterward. You have the right to limit the autopsy to eliminate any incisions on your baby that are uncomfortable for you.
Common Causes of Miscarriage
A miscarriage is defined as a pregnancy loss that occurs before the 20th week. When a miscarriage happens in the first 12 weeks, more than half the time it’s because of a problem with the baby's chromosomes. There’s no way to prevent chromosome problems from happening. As the mother ages, especially after age 35, her risk for chromosome problems goes up. An abnormality in an unborn baby’s chromosomes could cause one of several problems. Among the most common are:
Blighted ovum (anembryonic pregnancy). No embryo develops.
Molar pregnancy. Both sets of chromosomes come from the father, while none come from the mother. The placenta doesn’t grow normally, and the fetus doesn’t develop.
Partial molar pregnancy. The father gives two sets of chromosomes in addition to the set from the mother. The embryo may start to develop but soon stops.
Other chromosomal abnormalities can also cause the loss of a pregnancy. These include trisomy 13, 18, 21 (Down Syndrome), monosomy (Turner's Syndrome), and other sex chromosome issues.
A miscarriage may also result from a medical condition related to the mother’s health. Some of these include:
An infection such as cytomegalovirus or rubella
Poorly controlled long-term diseases (such as diabetes or high blood pressure)
Thyroid disease, lupus, and other autoimmune disorders
Problems with the mother’s uterus or cervix, such as fibroids, an abnormally shaped uterus, or a cervix that opens and widens too early (called cervical insufficiency)
STD infections such as chlamydia, gonorrhea, syphilis, or HIV
Blood clotting issues that block blood vessels carrying blood flow to the placenta
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