Miscarriage

What is it?
Miscarriage is the loss of a pregnancy in the first 20 weeks. If you lose a baby after 20 weeks of pregnancy, it’s called a stillbirth.

What causes a miscarriage?
Many first trimester miscarriages are thought to be abnormalities in the fertilized egg. This typically means that the egg or sperm had the wrong number of chromosomes, and as a result, the fertilized egg is unable to develop normally. It can also be caused by problems that occur during the early process of development (i.e. an egg implanting in the wrong area).

I’ve had a miscarriage, what now?
Don’t be shocked or hurt if you see that the doctor or midwife seems rather “matter-of-fact” about it, as miscarriages are more common than you may think.  You will likely talk to them about things such as medical history, and they may even perform something called a D&C or a D&E (dilation and curettage, or extraction) to ensure the uterus is completely cleansed of the pregnancy.  If you’ve had multiple miscarriages, you may even be given tests to check your blood for antibodies as well as some other genetic testing.

Dealing with emotions.
Feelings of shock, grief, sadness, depression, fatigue, moodiness, inability to concentrate and sleep are all quite normal.  You may dread having to tell people the bad news.  The most important thing is to remember that you and your partner are not to blame.  Don’t fight off or hide from the emotions you are feeling.  Give yourself time to heal and mourn – you are dealing with a huge sense off loss after all.  Even if you feel fine, taking a day or two off of work might be helpful.  Everyone grieves differently.

Molar Pregnancy

What is it?
A molar pregnancy happens when you have an abnormality in the fertilized egg at conception. The fertilized egg either never develops into an embryo or it develops abnormally and can’t survive. In all molar pregnancies, the chromosomes from the father are duplicated.  Sometimes, the chromosomes from the mother are also present, sometimes they are not – which determines what type of molar pregnancy you are having.

How would I know if I had a molar pregnancy?
Early on you may have typical pregnancy symptoms, but at some point you’ll begin to have some spotting or heavier bleeding. From as early as six weeks into your pregnancy or as late as 12 weeks, you may notice bright red or a brownish discharge, continuous or intermittent, and light or heavy bleeding. Other things to look out for are extreme nausea and vomiting, abdominal cramping, and abdominal swelling.

Call your doctor or midwife right away if you have any spotting or bleeding during your pregnancy. It doesn’t necessarily mean signal a molar pregnancy, but your practitioner will likely order an ultrasound to find out what’s causing it and may do a blood test to measure your levels of the hormone hCG.

Ectopic Pregnancy

What is it?
The word ectopic actually means “out of place”. About one of every 50 known pregnancies is ectopic. This type of complication occurs when a fertilized egg is implanted outside the uterus, usually in one of the fallopian tubes. It may implant in another part of the abdomen, in an ovary, or in the cervix. In rare cases, an ectopic pregnancy and a normal pregnancy in the uterus occur at the same time.  If an ectopic pregnancy is not recognized and treated in time, the embryo will grow until it causes the tube to rupture, resulting in severe abdominal pain, bleeding, and sometimes death.

Symptoms of ectopic pregnancy

Abdominal / pelvic pain or tenderness, vaginal spotting or bleeding, heavy bleeding, pain that gets worse with physical activity, bowel movements, or coughing, and pain in the tip of your shoulder, especially when you lie down. If the ectopic is ruptured, you may also have signs of shock like a weak, racing pulse; pale, clammy skin; and dizziness or fainting. You need to get medical attention right away.Keep in mind that not all ectopic pregnancies register on home pregnancy tests either – so if you are experiencing any of these symptoms and are showing as negative on a home pregnancy test, it is important to visit your doctor right away.

Treatment

  • Best case scenario – you are given the drug methotrexate.  This is ideal when the embryo is small enough, and will not damage your fallopian tube.  The drug enters your bloodstream and kills the cells that are building the placenta – it would be as though you had has a miscarriage.
  • You may have laparoscopic surgery if the embryo is too large.
  • Worst case scenario – if you have extensive scar tissue in the abdomen or heavy bleeding, you will need to haveabdominal surgery where you would be given general anesthesia so that the surgeon could open your abdomen to remove the embryo and ruptured tube, if required.

Bed rest

What does this mean?
If you’ve been told to go on bed rest, it means just that: resting in bed. The goal of bed rest is to keep the baby inside you, developing in the uterus, for as long as possible.  Each woman may be given different instructions on what they can and can’t do when on bed rest.  You may be asked to spend most of your pregnancy in bed, or just the last few weeks. It depends on your particular pregnancy and doctor.

For some women bed rest means 24 hours a day in bed, getting up only to use the bathroom. No trips to the kitchen to make lunch, no sitting at the desk working on the computer. Usually, in this situation, you should be lying on your side most of the day.

For others, bed rest may be less limiting: You may have rest periods in bed, but you can make occasional outings in the car, usually to the doctor, and get up to make yourself lunch or to take a brief shower.