OBSTETRIC CONDITIONS
Miscarriage
Miscarriages occur approximately in 1 in 5 pregnancies . The vast majority occur prior to 14 weeks of pregnancy . The medical term for miscarriage is “ missed abortion .” In most circumstances , a miscarriage is nature ’ s way of ending a pregnancy that was not normally progressing . Approximately one-half of miscarriages are caused by problems with the baby ’ s chromosomes . In most cases , this genetic problem happens by chance and the parent ’ s chromosomes are normal .
There is no evidence that trauma , emotional distress , working , exercise , or sex increases the risk of miscarriage . Please remember that most miscarriages are predestined at conception and that there is nothing that you or your physician could do to change this fact .
A “ threatened miscarriage ” occurs anytime a woman has vaginal bleeding during early pregnancy . Most of these pregnancies will result in a normal pregnancy . If you have persistent bleeding in early pregnancy , especially when it is associated with increasing pain , you should be evaluated for a possible miscarriage .
Emotional support is very important following a miscarriage . You should always be mindful that a miscarriage is not your fault . Sharing your feelings with your partner , health care provider , or a friend will help . We recommend postponing your next pregnancy for at least two or three months following a miscarriage . This time will allow you to heal emotionally and physically . Some women will need more formal counseling through a clergy member or psychiatric services to recover emotionally .
Ectopic Pregnancy
An ectopic pregnancy is defined as a pregnancy that develops outside of the uterus . About 95 % of all ectopic pregnancies are located in the fallopian tube . An ectopic pregnancy can be life threatening since it may lead to heavy internal bleeding .
An ectopic pregnancy occurs in about 1 in every 100 pregnancies . Signs of a tubal pregnancy include abdominal pain and vaginal bleeding . Severe abdominal pain accompanied by dizziness or fainting may indicate rupture of the ectopic pregnancy , requiring emergency evaluation .
The diagnosis of ectopic pregnancy is frequently difficult . Early in the evaluation , it may be impossible to differentiate an ectopic pregnancy from a very early normal pregnancy . A proper diagnosis may call for ultrasound , repeated measurements of the pregnancy hormone ( B-hCG ), and pelvic examinations over several days .
If you had an ectopic pregnancy , your risk of having another in your next pregnancy is 15-25 %. Therefore , it is important that you see your obstetrician very early in any subsequent pregnancies .
70 My Prenatal Care Book