Pregnancy Loss
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Pregnancy Loss
Pregnancy loss is the death of an embryo or fetus. It may include any of the following: ;Unintentional pregnancy loss: * Miscarriage ** Blighted ovum ** Ectopic pregnancy * Stillbirth * Toxic abortion, caused by pollution or chemical exposures ;Pregnancy loss through intentional termination: * Abortion * Selective reduction to reduce the number of fetuses in a multiple pregnancy * Hysterotomy abortion, a surgical abortion of a non-viable fetus performed similar to a cesarean section * Late-term abortion * Self-induced abortion * Sex-selective abortion Sex-selective abortion is the practice of terminating a pregnancy based upon the predicted sex of the infant. The selective abortion of female fetuses is most common where male children are valued over female children, especially in parts of Eas ...
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Miscarriage
Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the death of an embryo or fetus before it is able to survive independently. Miscarriage before 6 weeks of gestation is defined by ESHRE as biochemical loss. Once ultrasound or histological evidence shows that a pregnancy has existed, the used term is clinical miscarriage, which can be ''early'' before 12 weeks and ''late'' between 12-21 weeks. Fetal death after 20 weeks of gestation is also known as a stillbirth. The most common symptom of a miscarriage is vaginal bleeding with or without pain. Sadness, anxiety, and guilt may occur afterwards. Tissue and clot-like material may leave the uterus and pass through and out of the vagina. Recurrent miscarriage (also referred to medically as Recurrent Spontaneous Abortion or RSA) may also be considered a form of infertility. Risk factors for miscarriage include being an older parent, previous miscarriage, exposure to tobacco smoke, obesity, dia ...
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Blighted Ovum
A blighted ovum is a pregnancy in which the embryo never develops or develops and is reabsorbed. In a normal pregnancy, an embryo would be visible on an ultrasound by six weeks after the woman's last menstrual period. Anembryonic gestation is one of the causes of miscarriage of a pregnancy. A blighted ovum or anembryonic gestation is characterized by a normal-appearing gestational sac, but the absence of an embryo. It likely occurs as a result of early embryonic death with continued development of the trophoblast. When small, the sac cannot be distinguished from the early normal pregnancy, as there may be a yolk sac, though a fetal pole is not seen. For diagnosis, the sac must be of sufficient size that the absence of normal embryonic elements is established. The criteria depends on the type of ultrasound exam performed. A pregnancy is anembryonic if a transvaginal ultrasound reveals a sac with a mean gestational sac diameter (MGD) greater than 25 mm and no yolk sac, or an ...
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Ectopic Pregnancy
Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. The pain may be described as sharp, dull, or crampy. Pain may also spread to the shoulder if bleeding into the abdomen has occurred. Severe bleeding may result in a fast heart rate, fainting, or shock. With very rare exceptions the fetus is unable to survive. Overall, ectopic pregnancies are very rare, annually affecting less than 2% of pregnancies worldwide. Risk factors for ectopic pregnancy include pelvic inflammatory disease, often due to chlamydia infection; tobacco smoking; prior tubal surgery; a history of infertility; and the use of assisted reproductive technology. Those who have previously had an ectopic pregnancy are at much higher risk of having another one. Most ectopic pregnancies (90%) occur in the fallopian tube, whic ...
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Stillbirth
Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can result in the feeling of guilt or grief in the mother. The term is in contrast to miscarriage, which is an early pregnancy loss, and Sudden Infant Death Syndrome, where the baby dies a short time after being born alive. Often the cause is unknown. Causes may include pregnancy complications such as pre-eclampsia and birth complications, problems with the placenta or umbilical cord, birth defects, infections such as malaria and syphilis, and poor health in the mother. Risk factors include a mother's age over 35, smoking, drug use, use of assisted reproductive technology, and first pregnancy. Stillbirth may be suspected when no fetal movement is felt. Confirmation is by ultrasound. Worldwide prevention of most stillbirths is possible with improved health systems. Around half of stillbirths occur durin ...
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Toxic Abortion
Toxic abortion is a medical phenomenon of spontaneous abortion, miscarriage, or stillbirth caused by toxins in the environment of the mother during pregnancy, especially as caused by toxic environmental pollutants, though sometimes reported as caused by naturally occurring plant toxins In humans The term "toxic abortion" was first used to identify this phenomenon in humans in the earliest studies of the effects of pollutants on pregnancy in 1928, ''An Experimental Investigation Concerning Toxic Abortion Produced by Chemical Agents'' by Morris M. Datnow M.D. Toxic abortion chemicals studied at that time were: Petrochemicals, Heavy metals, Organic solvents, Tetrachloroethylene, Glycol ethers, 2-Bromopropane, Ethylene oxide, Anesthetic gases, and Antineoplastic drugs. In 1932, the ''Journal of State Medicine'' reported on a natural variation, with the occurrence of "a considerable number of cases of toxic abortion" being caused by untreated dental caries. Study of pollution-caused ...
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Abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word ''abortion'' generally refers to an induced abortion. The reasons why women have abortions are diverse and vary across the world. Reasons include maternal health, an inability to afford a child, domestic violence, lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest. When properly done, induced abortion is one of the safest procedures in medicine. In the United States, the risk of maternal mortality is 14 times lower after induced abortion than after chi ...
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Selective Reduction
Selective reduction is the practice of reducing the number of fetuses in a multiple pregnancy, such as quadruplets, to a twin or singleton pregnancy. The procedure is also called multifetal pregnancy reduction. The procedure is most commonly done to reduce the number of fetuses in a multiple pregnancy to a safe number, when the multiple pregnancy is the result of use of assisted reproductive technology; outcomes for both the mother and the babies are generally worse the higher the number of fetuses. The procedure is also used in multiple pregnancies when one of the fetuses has a serious and incurable disease, or in the case where one of the fetuses is outside the uterus, in which case it is called selective termination. The procedure generally takes two days; the first day for testing in order to select which fetuses to reduce, and the second day for the procedure itself, in which potassium chloride is injected into the heart of each selected fetus under the guidance of ultraso ...
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Hysterotomy Abortion
Hysterotomy abortion is a surgical procedure that removes an intact fetus from the uterus in a process similar to a cesarean section. The procedure is generally used after another method of termination has failed, or when such a procedure would be medically inadvisable, such as in the case of placenta accreta.Roche, Natalie E. (June 16, 2006)Surgical Management of Abortion Retrieved July 1, 2007. In 2016, this method made up less than 0.01% of all abortions in the United States, with the CDC reporting only 51 having occurred due to the invasive and complex nature of the procedure, and the availability of much simpler and safer methods. In 2022, scholars reported that in the aftermath of the overturning of ''Roe v. Wade'' and the subsequent limitations on elective induced abortion in Texas, providers were performing hysterotomy abortions again, under the view that it may not be technically considered an abortion under existing law. Indications As with other abortion procedures, ...
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Late-term Abortion
Late termination of pregnancy, also referred to as late-term abortion, describes the termination of pregnancy by induced abortion during a late stage of gestation. In this context, ''late'' is not precisely defined, and different medical publications use varying gestational age thresholds. In 2015, about 1.3% of abortions in the United States took place after the 21st week, and less than 1% occur after 24 weeks. Reasons for late terminations of pregnancy include circumstances where a pregnant woman's health is at risk or when birth defects, such as lethal fetal abnormalities, have been detected. Later abortion is not associated with any negative physical or mental health outcomes, and the risk of death following a surgical abortion after 20 weeks is less than that of typical full-term childbirth in the United States. Late termination of pregnancy is more controversial than abortion in general. Most countries in Europe only permit abortion in later stages of pregnancy if specifi ...
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Self-induced Abortion
A self-induced abortion (also called a self-managed abortion, or sometimes a self-induced miscarriage) is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women. Self-induced (or self-managed) abortion is often attempted during the beginning of pregnancy (the first eight weeks from the last menstruation, menstrual period). In recent years, significant reductions in maternal death and injury resulting from self-induced abortions have been attributed to the increasing availability of misoprostol (known commercially as "Cytotec"). This medication is a synthetic prostaglandin E1 that is inexpensive, widely available, and has multiple uses, includin ...
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