Review of methods of early development of children. How to help the development of babies with the help of modern techniques
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Easily download and save what you find. Type or paste a DOI name into the text box. For usage in law, see Miscarriage of justice. An ultrasound showing a gestational sac containing a yolk sac but no embryo. Differential diagnosis Ectopic pregnancy, implantation bleeding. Miscarriage, also known as spontaneous abortion and pregnancy loss, is the natural death of an embryo or fetus before it is able to survive independently.
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Risk factors for miscarriage include an older parent, previous miscarriage, exposure to tobacco smoke, obesity, diabetes, thyroid problems, and drug or alcohol use. Prevention is occasionally possible with good prenatal care. Avoiding drugs, alcohol, infectious diseases, and radiation may decrease the risk of miscarriage. Miscarriage is the most common complication of early pregnancy. Signs of a miscarriage include vaginal spotting, abdominal pain or cramping, and fluid or tissue passing from the vagina. Miscarriage may occur for many reasons, not all of which can be identified. Risk factors are those things that increase the likelihood of having a miscarriage but don’t necessarily cause a miscarriage.
Successful implantation of the zygote into the uterus is most likely 8 to 10 days after conception. If the zygote has not implanted by day 10, implantation becomes increasingly unlikely in subsequent days. A chemical pregnancy refers to a pregnancy that was detected by testing but ends in miscarriage before or around the time of the next expected period. Chromosomal abnormalities are found in more than half of embryos miscarried in the first 13 weeks.
There is no evidence that progesterone given in the first trimester reduces the risk of miscarriage, and luteal phase progesterone deficiency may or may not be a contributing factor to miscarriage. The age of the pregnant woman is a significant risk factor. Miscarriage rates increase steadily with age, with more substantial increases after age 35. Risk begins to increase around the age of 30. Not only is obesity associated with miscarriage, it can result in sub-fertility and other adverse pregnancy outcomes. Recurrent miscarriage is also related to obesity. Women with bulimia nervosa and anorexia nervosa may have a greater risk for miscarriage.
Caffeine consumption also has been correlated to miscarriage rates, at least at higher levels of intake. However, such higher rates have been found to be statistically significant only in certain circumstances. Vitamin supplementation has generally not shown to be effective in preventing miscarriage. Chinese traditional medicine has not been found to prevent miscarriage. Disorders of the thyroid may affect pregnancy outcomes.
Related to this, iodine deficiency is strongly associated with an increased risk of miscarriage. The risk of miscarriage is increased in those with poorly controlled insulin-dependent diabetes mellitus. Ingesting food that has been contaminated with listeriosis, toxoplasmosis, and salmonella is associated with an increased risk of miscarriage. Amniocentesis and chorionic villus sampling are procedures conducted to assess the fetus. A sample of amniotic fluid is obtained by the insertion of a needle through the abdomen and into the uterus.
Chorionic villus sampling is a similar procedure with a sample of tissue removed rather than fluid. These procedures are not associated with pregnancy loss during the second trimester but they are associated with miscarriages and birth defects in the first trimester. The effects of surgery on pregnancy are not well-known including the effects of bariatric surgery. Abdominal and pelvic surgery are not risk factors in miscarriage.
Ovarian tumors and cysts that are removed have not been found to increase the risk of miscarriage. The exception to this is the removal of the corpus luteum from the ovary. This can cause fluctuations in the hormones necessary to maintain the pregnancy. Immunizations have not been found to cause miscarriage.
There is no significant association between antidepressant medication exposure and spontaneous abortion. Ionizing radiation levels given to a woman during cancer treatment cause miscarriage. The use of chemotherapeutic drugs used to treat childhood cancer increases the risk of miscarriage. PCOS may increases the risk of miscarriage. Mycoplasma genitalium infection is associated with increased risk of preterm birth and miscarriage. Autoimmunity is possible cause of recurrent or late-term miscarriages. In the case of an autoimmune-induced miscarriages the woman’s body attacks the growing fetus or prevents normal pregnancy progression.
Autoimmune disease may cause genetic abnormalities in embryos which in turn may lead to miscarriage. Fifteen percent of women who have experienced three or more recurring miscarriages have some anatomical defect that prevents the pregnancy from being carried for the entire term. The structure of the uterus has an effect on the ability to carry a child to term. Anatomical differences are common and can be congenital.
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In some women, cervical incompetence or cervical insufficiency occurs with the inability of the cervix to stay closed during the entire pregnancy. There is an increased risk regardless of which parent smokes, though the risk is higher when the gestational mother smokes. Several possible causes have been suggested for morning sickness but there is still no agreement. Chemical and occupational exposures may have some effect in pregnancy outcomes. A cause and effect relationship almost can never be established. Alcohol increases the risk of miscarriage.
Progesterone has not been found to be effective in preventing miscarriage. Cocaine use increases the rate of miscarriage. In the case of blood loss, pain, or both, transvaginal ultrasound is performed. If hypotension, tachycardia, and anemia are discovered, exclusion of an ectopic pregnancy is important. A miscarriage may be confirmed by an obstetric ultrasound and by the examination of the passed tissue. When looking for microscopic pathologic symptoms, one looks for the products of conception. Mean gestational sac diameter of at least 25 mm and no embryo.
Absence of embryo with heartbeat at least 2 weeks after an ultrasound scan that showed a gestational sac without a yolk sac. 13 days after an ultrasound scan that showed a gestational sac without a yolk sac. Absence of embryo with heartbeat at least 11 days after an ultrasound scan that showed a gestational sac with a yolk sac. 10 days after a scan that showed a gestational sac with a yolk sac. Absence of embryo at least 6 weeks after last menstrual period. Amniotic sac seen adjacent to yolk sac, and with no visible embryo.
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Yolk sac of more than 7 mm. A threatened miscarriage describes any bleeding during pregnancy, prior to viability, that has yet to be assessed. At investigation it may be found that the fetus remains viable and the pregnancy continues without further problems. This accounts for approximately half of miscarriages. An inevitable miscarriage occurs when the cervix has already dilated, but the fetus has yet to be expelled. This usually will progress to a complete miscarriage.
The fetus may or may not have cardiac activity. Transvaginal ultrasonography after an episode of heavy bleeding in an intrauterine pregnancy that had been confirmed by a previous ultrasononography. An incomplete miscarriage occurs when some products of conception have been passed, but some remains inside the uterus. A missed miscarriage is when the embryo or fetus has died, but a miscarriage has not yet occurred. It is also referred to as delayed miscarriage, silent miscarriage, or missed abortion. The physical symptoms of a miscarriage vary according to the length of pregnancy, though most miscarriages cause pain or cramping.
The size of blood clots and pregnancy tissue that are passed become larger with longer gestations. After 13 weeks’ gestation, there is a higher risk of placenta retention. Prevention of a miscarriage can sometimes be accomplished by decreasing risk factors. This may include good prenatal care, avoiding drugs and alcohol, preventing infectious diseases, and avoiding x-rays. Maintaining a healthy weight and good pre-natal care can reduce the risk of miscarriage. Women who miscarry early in their pregnancy usually do not require any subsequent medical treatment but they can benefit from support and counseling. In cases of an incomplete miscarriage, empty sac, or missed abortion there are three treatment options: watchful waiting, medical management, and surgical treatment.
In delayed or incomplete miscarriage, treatment depends on the amount of tissue remaining in the uterus. Treatment can include surgical removal of the tissue with vacuum aspiration or misoprostol. An induced abortion may be performed by a physician for women who do not want to continue the pregnancy. Self-induced abortion performed by a woman or non-medical personnel is extremely dangerous and is still a cause of maternal mortality in some countries. Organizations exist that provide information and counseling to help those who have had a miscarriage. Family and friends often conduct a memorial or burial service. Hospitals also can provide support and help memorialize the event.
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Depending on locale others desire to have a private ceremony. Experiencing a miscarriage “is a major loss for all pregnant women. A miscarriage can result in anxiety, depression or stress for those involved. Some health organizations recommend that sexual activity be delayed after the miscarriage. The menstrual cycle should resume after about three to four months. Women report that the medical management of their miscarriage can be performed in a manner that can make the experience even worse than the event. Some parents want to try to have a baby very soon after the miscarriage.
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The decision of trying to become pregnant again can be difficult. Reasons exist that may prompt parents to consider another pregnancy. For older mothers, there may be some sense of urgency. Other parents are optimistic that future pregnancies are likely to be successful. Many are hesitant and want to know about the risk of having another or more miscarriages. The risks of having another miscarriage vary according to the cause.
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The risk of having another miscarriage after a molar pregnancy is very low. The risk of another miscarriage is highest after the third miscarriage. Pre-conception care is available in some locales. There is a significant association between miscarriage and later development of coronary artery disease, but not of cerebrovascular disease. The precise rate is not known because a large number of miscarriages occur before pregnancies become established and before the woman is aware they are pregnant.
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Additionally, those with bleeding in early pregnancy may seek medical care more often than those not experiencing bleeding. The prevalence of miscarriage increases with the age of both parents. In 2010, 50,000 inpatient admissions for miscarriage occurred in the UK. Many women, fathers and partners refer to miscarriage as the loss of a ‘baby’ rather than an embryo or fetus. Clinical terms can suggest blame and even cause anger. Pregnancy loss’ is a term that describes miscarriage, ectopic and molar pregnancies.