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Miscarriage means the termination of pregnancy prior to the 22nd week of pregnancy, with the fetus usually weighing less than 500 grams. Miscarriage can occur at a very early stage, in which case the woman in question may not even know she is pregnant. In these cases, her period may be a few days late and more painful than usual, and bleeding may be heavier. In these cases, no treatment is required. Approximately 15 per cent of confirmed pregnancies end in a miscarriage. The majority of these miscarriages occur at the early stages of pregnancy, prior to the 13th week. The most common reason for a miscarriage is severe fetal chromosome abnormalities. As a result, there is no way of medically preventing an impending miscarriage or of stopping a miscarriage once it has begun.
A miscarriage usually starts with light, gradually increasing bleeding. Even large blood clots may pass with the discharge. Lower-abdominal and back pain resembling menstrual pain is common. Miscarriages taking place in the first trimester are, as a rule, treated at outpatient clinics during regular office hours. However, patients experiencing heavy bleeding will need emergency care. Sometimes, the fetus may have been dead for several weeks, and the miscarriage is detected as the uterus stops growing.
An ultrasound scan is performed to confirm miscarriage. If there is no fetal tissue left in the womb and there is no heavy bleeding, the patient may be monitored to ensure the miscarriage is complete. However, if tissue needs to be removed from the womb, the alternatives are medication or surgery. In some cases, dilation and curettage (D&C) may be necessary due to heavy bleeding. D&C is performed under general anesthesia.
A late miscarriage (after the 12th week of pregnancy) often starts with the breaking of the amniotic fluid, followed by contractions and birth of the fetus. Sometimes, the fetus may die inside the uterus without initiating a miscarriage. Depending on the pregnancy weeks, a D&C may be conducted to empty the uterus, or a miscarriage is induced using medication.
Miscarriages are treated at the gynecological emergency clinics of HUS hospitals. During office hours, Gynecological Outpatient Clinic in Women's Hospital is primarily responsible for treating miscarriages in the capital area (Helsinki, Espoo, Vantaa, Kerava, Kauniainen, Kirkkonummi).
More information:
Emergency care for pregnant women