Miscarriage Investigation & Follow-up Clinic
Despite your miscarriage you may still be feeling pregnant. This is because when the baby dies the placenta continues to function for several weeks, producing the hormones that cause the symptoms of pregnancy.
This kind of miscarriage is called a missed abortion because usually it would have gone undetected until bleeding began. Other names sometimes used for this kind of miscarriage are blighted ovum and anembryonic pregnancy.
Sadly, miscarriage is a common event, occurring in approximately 1 in 6 pregnancies. You may be asking why this has happened and may even be thinking that you might have done something that caused it. However, miscarriage is not due to anything that you or your partner have done, nor is there anything that you could have done to prevent it.
There are a number of well-recognized causes of miscarriage:
After assessment and investigations, you will need to consider what you want to do next. There are two choices:
In the next few weeks, the placenta will stop functioning and you will start to bleed. By waiting for this to happen on its own, you may be able to avoid hospital admission. Sometimes, if the bleeding is heavy or does not settle, it is necessary to perform a scrape operation called an ERPC or a D&C .
Hospital admission can be arranged within the next couple of days for an ERPC to be performed. This usually involves having a brief general anaesthetic and staying in hospital for a day.
The risk of a miscarriage happening in any pregnancy is 15%. This figure does not seem to change even if you have had one or two previous miscarriages. After three miscarriages in a row, the risk increases to about 30%. We will do our best to find out why your miscarriage has happened. It is only through gathering as much information as possible that we can try to advise you about the chance of a miscarriage happening again or to suggest any treatment to improve the likelihood of a successful pregnancy next time.
We run a Miscarriage Clinic and arrange appointments for all women who have a miscarriage diagnosed to come back 5-6 weeks later. We use this opportunity to discuss the results of tests that have already been performed and to continue a series of investigations aimed at finding the cause. The following tests are routinely offered:
We will discuss the results and implications of the chromosome studies which were carried out on the placenta. The studies will look for abnormalities such as Down syndrome.
A blood sample, taken from your arm, will be used to measure the level of several hormones and antibodies. If an abnormality is found then a further blood test may be necessary.
Miscarriage can be a very distressing experience. Both you and your partner may need some time to come to terms with the loss of your pregnancy. You may have feelings of sadness, emptiness and guilt which are all normal reactions to loss. It may be helpful to share your emotions with each other, or with a relative, a friend or your GP. The Miscarriage Clinic is staffed with a psychologist who can provide additional emotional support and counselling to help you cope during this difficult time.
Your cycle should get back to normal in the next 6-8 weeks. Once you have had your first period it is possible to conceive again. There are no medical reasons not to try for another baby soon, if you feel emotionally ready to become pregnant. From the point of view of investigating this miscarriage, it is preferable that you are not pregnant at the time that you come back for your follow-up visit.
This leaflet aims to answer your initial questions about miscarriage and our Miscarriage Follow-up Clinic. If you have other questions, or you simply need to talk to someone, one of us will be happy to speak to you.
In addition, the Miscarriage Association provides an information helpline and can put you in touch with local contacts, both individuals and support groups.
The Miscarriage Follow-up Clinic is held on the 9th floor of Ruskin Wing but separately from the main Harris Birthright clinic.
The clinic is run by Dr. Vivienne Souter, Research Fellow & Ms Ana Nikcevic, MSc
It is important to remember that most women who have a miscarriage go on to have a successful pregnancy next time.