Bleeding in early pregnancy is common, and does not necessarily mean that a miscarriage will occur. However, if you have bleeding in early pregnancy, you should ALWAYS consult with a doctor to find out why you are bleeding, and to exclude a serious problem such as ectopic pregnancy ( when a fertilised egg implants outside of the womb). Bleeding in early pregnancy may simply represent implantation, when the fertilised egg is settling into the lining of the womb. No further action may be required in this instance, provided a clinical review has happened. In the case of bleeding in early pregnancy, where there is still a viable embryo, this is termed “threatened miscarriage”. Sometimes, the pregnancy is not viable ( ie no heart beat) but there is no bleeding or passage of pregnancy tissue. This is a “missed miscarriage”. If a pregnancy ends and the body expels all the products of conception (usually leading to bleeding and pain) it is termed a “complete miscarriage”. In order to look after you properly, if you start bleeding in pregnancy, you should see your doctor and have a pelvic ultrasound scan. Miscarriage is a common event even in healthy women. Probably around 25% of all conceptions will miscarry. Most of these are very early, when a woman does not realise she is pregnant. Miscarriage is nature’s way of filtering out pregnancies which may have problems. Usually they occur due to a serious genetic flaw in the fertilised egg, which will probably not recur in future pregnancies. Most women who have a miscarriage will go on to have a completely normal pregnancy next time. Most miscarriages occur naturally and completely ie a “complete miscarriage” in which case, no further treatment is required. For a missed miscarriage, a D&C is usually required. and at our Sydney north shore women’s health centre, Clinic 66, we provide D and C (dilatation and curettage) treatment to complete the process and reduce the length of bleeding. This should not affect future fertility . A D&C is performed using intravenous sedation so there is no discomfort or recollection of the procedure. For a threatened miscarriage, observation is required, and possibly repeat ultrasound scans to ensure the pregnancy is progressing normally.
It is common for women to feel sad, and experience grief after a miscarriage, but these feelings usually lessen with time, and talking about the feelings you have will help. There is no need to feel guilt, though many women attribute a miscarriage to something they have done, such as carry heavy shopping, eat the wrong food or have sex. There is rarely anything that can be done to prevent miscarriage, though it is more common in some women, such as those over 35, women who smoke, drink or take drugs, or women who have ongoing medical conditions, such as diabetes or Systemic Lupus Erythematosis ( SLE).
For women who experience recurrent miscarriage ie more than 3 in a row, we can help with undertaking preliminary investigations, prior to referral to a specialist infertility clinic, who will undertake further investigation. However, by seeing us first, the costs of out patient specialist visits will be reduced.