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Miscarriages

Learn when miscarriages typically occur, as well as why they happen in the first place. Plus, get warning signs.

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-Hi, everybody. About 15 to 20 percent of all pregnancies end in miscarriage. And this can really be a devastating and confusing time for Moms and Dads. Often, parents are left with a lot of questions about why it happened. Well, joining me in the studio is Ob/Gyn, Dr. Shiva Gufrani with some answers for us today. It's great to have you here. -Thank you for having me. -Can you tell us for starters, when miscarriages typically happened? -Well, majority of them are gonna happen in the first trimester, so that means, somewhere between zero and 14 weeks. And often, we, you know, in general, we tell patients not to come to the office until about 8 weeks, because many of those miscarriage will actually have occurred before that 8-week period, and so patients aren't necessarily getting, as emotionally invested really before they've come in. -Right, right. Still difficult at any time-- that is-- -Still difficult at any time. But certainly, I think once you've seen the baby's heartbeat, it makes it-- that much more emotional. -Exactly. Now, I understand why you wait to have us come in. -That's why. -We never knew that. Okay, so why do miscarriages happen? I know there are lots of different reasons. -Typically-- just something that occurred between the egg and the sperm. They didn't really mean in the right way and the majority of all miscarriages are still gonna occur because the chromosomes are abnormal. So, something with the genetics wasn't the way it should be. In the vast majority are genetic problems. -So, what are the chances of having a miscarriage? And does your chance increases as you get older? -Well, unfortunately, each year we get older our risk of chromosome abnormalities like down-syndrome gets higher. So, that's why you hear people say, oh, we wanna get-- you know, you wanna have a baby by the time you're 35, which is actually very untrue. But that was the old fashion way of thinking about it because each year, as you get older, your chance of chromosomes being abnormal is higher and, therefore, your chance of miscarriage is higher. We still say overall, the likelihood is 15 to 20 percent, but it does again increase as you get older. -So, there are a lot of things going on with your body when you're pregnant. -Absolutely, uh-hmm. -That you're not used to different feelings and pains but, are there any signs of a miscarriage that women should be looking out for? -Well, the clearest sign would be bleeding. -Okay. -And that would be a sign that you absolutely have to call your doctor and get checked out. A less worrisome sign is actually cramping, because many women think if I'm cramping, I must be having a miscarriage. But cramping is actually a very common feeling in the early part of pregnancy. -I remember. -Yeah. And many patients calling, I think there's something wrong, I'm cramping. Cramping without bleeding is very normal. Cramping and bleeding is a sign again that you should really get checked out, though, even the cramping and bleeding can often be a normal sign. -Is there something or anything that women can do during pregnancy that can be putting them at higher risk? -Well-- -And is there a way to prevent having [unk]. -Well, there are certainly things you can do to put yourself at higher risk-- I mean, smoking absolutely has been shown to increase risk of miscarriage. They think high dosage of caffeine might do that, so we should really keep our caffeine levels at 200mg or less a day. And certainly, other obviously toxic habits like doing drugs like cocaine. If you have health problems like diabetes or high blood pressure, it's good to kind of get those and checked before you get pregnant. So, those are the obvious things. To be fair-- the most majority of miscarriages again they'll occurred just because something was wrong with the genetics. And not really means you can't prevent it. And your second question was about-- is there anything-- -If you can prevent it. -Yeah, I mean, again the things to do are just make sure you're in your best health. Genetic problems are often not preventable. They're rare circumstances where we can find those problems in Mom and Dad, and then go through infertility treatment to prevent it. But that's very rare. So, in general you have to assume that it's in your control to be in good health and the other things you kinda have to live up to something, you know, something in nature. -Why is it that some women has-- I mean, I spoke to a woman yesterday who said, I had 10 miscarriages in between having children. -Uh-hmm. -I mean, why is it that some women will have so many and some might not experience one at all? -Well-- and again, sometimes it's just has to do with the chromosomes. -Uh-hmm. -So when that egg comes about. That egg might not have had the appropriate number of chromosomes when it met the sperm. When someone has 10 miscarriages-- that's typically something more. So another, as we said the most likely reason is genetic abnormalities. But there can be-- anti-body type problems for patients. There can be other issues that can lead to difficulty carrying a pregnancy. Patients, sometimes, have the ability to create little blood clots, so that can be an issue. They can have problems with the shape of their uterus. So, again, multiple miscarriages makes you think there's something more going on. -Once you have the miscarriage, what happens then? Is there a type of treatment? -Well, if you have one or two miscarriages, believe it or not, the recommendations are not to do anything differently. Not to look for reason and not to be too concern because it's very common. So, the kind of old fashion guidelines say, we don't look for causes until someone have three miscarriages. I think that, obviously, we all tailored to that. Sometimes two miscarriages prompt us to do something. So, if we find a reason, we can treat it. -And we're just about out of time here, but I just wanna know how long you need to wait after a miscarriage before you try again? -And again, the hard part is there's no good studies, but we usually say about 2 to 3 normal periods after you had a miscarriage before just to let your lining kind of thicken up again and become healthy. -Doctor, it's so great to have you in the studio. -Thanks for having me. -Thank you for clearing up a lot of misconceptions for us. We appreciate it. -Thank you. -And if you like more information about pregnancy, you can check out our website at youtube.com/parentstv. If you have questions or comments, you can tweet with me at twitter.com/parentstvjuli. Thanks for joining.