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Pregnancy Complications

Miscarriage — A Pregnancy Ended

Sometimes complications arise during pregnancy. One common complication is miscarriage. Miscarriage is the spontaneous separation and discharge through the vagina of a developing fetus before it is ready to be born. Miscarriage seems to be the body's natural solution to a pregnancy that is not developing properly. Most miscarriages occur early in the first trimester and it is estimated that about 20 percent of all pregnancies end in miscarriage.

Early miscarriages are usually not physically painful. The main signs are cramping and bleeding, much like a heavy menstrual flow. Medical care following an early miscarriage is recommended in order to insure that all of the fetal tissue is removed form the woman's body. Because there is a risk of infection if some tissue remains, a doctor may suggest a procedure called dilation and curettage (D&C) to remove it.

It is estimated that 75 percent of all miscarriages occur during the first trimester of pregnancy. The remainder occurs in the second trimester. Any fetus passed out of the body after the end of the second trimester (24th week) is called a premature birth.

Signs of second trimester miscarriage are severe, labor-like cramps and heavy bleeding followed by the discharge of the developing fetus. Medical attention is required to be certain that all fetal tissue has passed out of the body.

Generally an egg and sperm dividing or implanting improperly cause miscarriages. Sometimes a woman's hormonal level is lower than necessary, causing the lining of the uterus to weaken and to become unable to hold a fertilized egg. Often, however, the exact cause of miscarriage remains unknown.

In the majority of cases, having a miscarriage does not affect a woman's ability to get pregnant again. Miscarriage at any stage of pregnancy can be an emotionally difficult experience for couples. It is very common to experience sadness, depression, and a sense of loss as a couple's feelings of joy and hope about the pregnancy turn to loss, grief, and often feelings of blame and guilt. Providing each other with support or seeking support from other couples who have experienced a miscarriage, or from a professional, are healthy ways to help work through the feelings resulting from experiencing a miscarriage.

Ectopic Pregnancy

Another pregnancy complication is an ectopic pregnancy. An ectopic pregnancy is the growth of the fertilized egg outside the uterus. They usually occur in a Fallopian tube (which is why they are referred to as a "tubal pregnancy"). On rare occasion a fertilized egg can implant in a woman's abdomen, in an ovary, or in the cervix.

Ectopic pregnancies result in the death of the fetus and can be fatal to the mother as well. They may cause sudden bursting of the Fallopian tube, massive internal bleeding, sharp pain and weakness resulting from the loss of blood. These problems typically occur late in the first trimester, usually between the eighth and twelfth weeks.

An ectopic pregnancy may show as a "positive pregnancy test" and a physician may not see any early signs of abnormality when examining the woman. Typical signs of ectopic pregnancy are pain and cramping on the lower right or left side of the abdomen, bleeding through the vagina, weakness, dizziness or fainting (signs of internal bleeding) and a regular period, even after a pregnancy has been detected.

If any of these signs appear, a non-intrusive ultrasound examination can show whether the fetus is growing in the uterus or elsewhere. Surgery is usually performed as soon as the condition is diagnosed to avoid the possible bursting of a Fallopian tube and heavy bleeding that can seriously harm the mother.

Intervention generally involves the removal of the burst Fallopian tube, though sometimes the tube can be repaired. After such surgery a woman can still become pregnant, but her chances will be reduced by the absence of one tube. Also, a woman's chances of having another ectopic pregnancy increase after having one such pregnancy.


Toxemia is another relatively common pregnancy complication. Also known as pre-eclampsia, toxemia is a condition that occurs in some women during the fifth or sixth month of pregnancy.

The cause of toxemia is uncertain, but many doctors believe poor nutrition is a large contributor. Symptoms of toxemia include weight gain and rising blood pressure, then swelling of the hands and ankles due to water retention, abdominal pain, headache and poor vision.

Toxemia affects the developing baby because the placenta does not do its job properly, resulting in a smaller baby, premature delivery or delivery by caesarian. Toxemia can be managed through rest and a properly balanced diet with the avoidance of excess salt. Toxemia must be treated and monitored by a physician because if left unchecked it could lead to the death of the fetus and even the mother.