Published: 18 Jun 2025

ICD9: V23.2      ICD10: O09.291      ICD11: GA33

The "Risk of Miscarriage, Failing Pregnancy" refers to the possibility that a pregnancy will end spontaneously before the fetus is viable, meaning it cannot survive outside the womb.
It's a broad term encompassing various scenarios where a pregnancy doesn't progress to a live birth. Here's a more detailed breakdown:

Key Aspects:

Miscarriage (also called Spontaneous Abortion): The loss of a pregnancy before the 20th week of gestation. This is the most common term used.
Failing Pregnancy: A more general term encompassing situations where a pregnancy isn't progressing normally, potentially leading to miscarriage. This can include:
Blighted Ovum (Anembryonic Pregnancy): A fertilized egg implants in the uterus, but an embryo doesn't develop.
Ectopic Pregnancy: The fertilized egg implants outside the uterus, most commonly in the fallopian tube. This is never viable and is life-threatening to the mother.
Molar Pregnancy (Gestational Trophoblastic Disease): An abnormal growth forms inside the uterus after conception. It's a rare complication of pregnancy and requires treatment to prevent serious complications.
Missed Miscarriage (Silent Miscarriage): The embryo or fetus has died, but the body hasn't expelled the pregnancy tissue. There may be no symptoms.

Risk Factors:

Several factors can increase the risk of miscarriage. These include:

Age: The risk increases with maternal age, particularly after 35.
Previous Miscarriages: Having had multiple previous miscarriages increases the risk of future pregnancy loss.
Underlying Health Conditions: Conditions like uncontrolled diabetes, thyroid disorders, polycystic ovary syndrome (PCOS), autoimmune diseases (e.g., lupus, antiphospholipid syndrome), and certain infections can increase the risk.
Genetic or Chromosomal Abnormalities: Chromosomal abnormalities in the embryo or fetus are a common cause of miscarriage, especially in the first trimester.
Lifestyle Factors: Smoking, excessive alcohol consumption, and drug use during pregnancy increase the risk.
Weight: Being significantly underweight or overweight can increase the risk.
Certain Medications: Some medications are known to be harmful during pregnancy.
Uterine Abnormalities: Structural problems with the uterus can sometimes interfere with pregnancy.
Invasive Prenatal Tests: Procedures like chorionic villus sampling (CVS) and amniocentesis carry a small risk of miscarriage.
Fever: High fevers in early pregnancy can increase the risk of miscarriage.
Exposure to Environmental Toxins: Exposure to high levels of radiation or certain toxins may increase the risk.

Symptoms:

Symptoms of a potential miscarriage or failing pregnancy can vary, but some common signs include:

Vaginal Bleeding: This is often the most concerning symptom. It can range from light spotting to heavy bleeding with clots.
Cramping: Abdominal cramping, which can range from mild to severe.
Passing Tissue or Clots: Expulsion of tissue from the vagina.
Decrease in Pregnancy Symptoms: A sudden disappearance of pregnancy symptoms like nausea or breast tenderness (though this can also happen normally).
No Fetal Heartbeat: If a heartbeat was previously detected and is no longer present, it can indicate a miscarriage.

Diagnosis:

Diagnosis usually involves:

Physical Exam: A doctor will perform a physical exam, including a pelvic exam.
Ultrasound: To visualize the pregnancy and assess the development of the embryo or fetus.
Blood Tests: To measure hormone levels, such as hCG (human chorionic gonadotropin) and progesterone. Declining levels can indicate a problem.

Management:

Management of a miscarriage or failing pregnancy depends on the specific situation and the woman's preferences. Options include:

Expectant Management: Allowing the body to naturally expel the pregnancy tissue.
Medical Management: Using medication (usually misoprostol) to induce uterine contractions and expel the tissue.
Surgical Management: Dilation and Curettage (D&C), a procedure to surgically remove the pregnancy tissue from the uterus.

Important Considerations:

Emotional Support: Miscarriage can be emotionally devastating. It's important to seek support from loved ones, support groups, or a therapist.
Recurrent Miscarriage: Women who experience multiple miscarriages should be evaluated by a specialist (reproductive endocrinologist) to identify potential underlying causes.
Prevention: While not all miscarriages can be prevented, maintaining a healthy lifestyle, managing underlying health conditions, and avoiding known risk factors can help reduce the risk.

If you suspect you are experiencing a miscarriage or have concerns about your pregnancy, it's crucial to seek immediate medical attention. Don't hesitate to contact your doctor or go to the emergency room. They can provide accurate diagnosis, appropriate management, and emotional support.