Background

This is invariably a sad experience, whenever it happens and at whatever stage.
Grieving for the loss is natural and for some people may go on for a long time.
If this happens, don’t bottle it up – do talk to family, friends and/or your doctor and if
it feels the right thing to do, consider some form of counselling.
Never be afraid to ask for help. (And don’t forget that the prospective father
may feel very upset too.)

Miscarriage:

Losing a baby before it can survive outside the womb happens in about 15% of pregnancies and 25% of women who become pregnant will experience at least one miscarriage.

• In women ages 15-35, the incidence of miscarriage is approximately 12%.
• In women ages 35-39, the incidence of miscarriage is 18%.
• In women ages 40-44, the incidence of miscarriage is 33%
• In women ages 45-plus, the incidence of miscarriage is greater than 50%.

Very often the problem starts right at the beginning and the fertilised egg would never have developed into a healthy baby. Very often, the next pregnancy goes just fine so doctors tend not to do tests unless three or more consecutive miscarriages happen. If you are concerned, do talk to your doctor and/or go to see your gynaecologist. The Poundbury Clinic can fully investigate you and your partner if required. The most common cause for single miscarriages are chromosome abnormality of the foetus. Usually these genetic causes are just isolated cases and rarely occur. However, a small percentage of couples (between 3-5%) one partner possesses abnormal chromosomes. Investigating the chromosomes of both partners can therefore be useful and help eliminate genetic causes.

The importance of blood clotting disorders in conjunction with recurrent miscarriages has now been established. It is now well known that a woman’s blood becomes thicker in pregnancy and if the blood clots in the small blood vessels of the placenta then the blood flow to the pregnancy can be reduced. Therefore, when we are looking at recurrent miscarriage we look at hormones, chromosomes and thrombotic risk profile. Other investigations would also include a scan.

Ectopic pregnancy:

In one or two pregnancies per hundred, the fertilised egg implants outside
the womb, mostly in the fallopian tube. Unfortunately, the embryo can’t be
transplanted into the womb. The most usual cause is pre-existing tubal disease,
due to a range of problems including sexually transmitted diseases, endometriosis
or previous pelvic surgery. Because the condition can be life-threatening, it’s vital that
if a woman knows or suspects she is pregnant and has any of the symptoms below,
she consults her doctor or goes to hospital immediately.

Symptoms include delayed or abnormal period early in pregnancy, pelvic pain
and/or irregular vaginal bleeding later, tender feeling in pelvis.
You may have no symptoms.

Tests often used to diagnose an early ectopic include measuring
levels of human chorionic gonadotropin hormone (hCG), progesterone,
ultrasound scan and laparoscopy.

If diagnosed early, ectopic pregnancies can be removed with little damage
to the fallopian tube or ovary. In some cases, part of the fallopian tube may
be removed surgically. If the tube is badly damaged, or the ectopic pregnancy
is large and needs to be removed quickly, the tube may be totally
removed (salpingectomy). Remember that an ectopic pgregnancy
is an emergency and you should seek medical help urgently.

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