What Is Miscarriage?
A miscarriage, or spontaneous abortion, is defined as the loss and expulsion of the fetus and its associated tissues from the uterus before the pregnancy reaches viability. Miscarriages can occur for a variety of medical, genetic, and environmental reasons and are among the most common complications of early pregnancy.
Types of Miscarriage
- Anembryonic Pregnancy (Blighted Ovum): A condition in which the gestational sac develops but no embryo forms inside.
- Threatened Miscarriage: Vaginal bleeding before the 20th week of pregnancy, seen in approximately 30–40% of all pregnancies.
- Inevitable Miscarriage: Increasing vaginal bleeding accompanied by cervical thinning and dilation, although pregnancy tissue has not yet been expelled. Cramping pain typically intensifies during this stage.
- Incomplete Miscarriage: Partial expulsion of the products of conception from the uterus.
- Complete Miscarriage: Total expulsion of all pregnancy tissue from the uterus.
- Missed Abortion: Intrauterine fetal demise without immediate expulsion of the pregnancy tissue.
- Recurrent Miscarriage: Two or more consecutive pregnancy losses.
Causes of Miscarriage
Approximately 15–20% of clinically recognized pregnancies end in spontaneous miscarriage. In very early pregnancies—those detected only through rising β-hCG hormone levels—the actual rate of pregnancy loss may reach up to 40%.
About 80% of miscarriages occur within the first trimester, and roughly half of these are due to chromosomal abnormalities. Conditions such as trisomies (e.g., Trisomy 13, 16, 18, 21, 22) and Monosomy X (Turner Syndrome) significantly increase miscarriage risk.
Other contributing maternal and paternal factors include:
- Advanced maternal or paternal age
- Conceiving again within 3 months of a previous delivery
- Infections (e.g., urinary tract, uterine, or cervical infections)
- Uncontrolled systemic diseases such as diabetes, thyroid disorders, connective tissue diseases (lupus, scleroderma), and kidney disease
- Smoking, alcohol, drug use, or certain medications
- Excessive caffeine intake or radiation exposure
- Uterine abnormalities, intrauterine adhesions, or cervical insufficiency
In cases of recurrent miscarriage (two or more consecutive losses), underlying causes such as thrombophilia (blood clotting disorders) and immune-mediated factors are frequently identified.
Prevention and Management of Miscarriage
Close and regular prenatal monitoring is essential for maintaining a healthy pregnancy. Once pregnancy is confirmed, ongoing medical supervision should be established early.
If the cause of a prior miscarriage is known, specific preventive measures should be taken — for example:
- Tight blood sugar control in diabetic patients
- Treatment of thyroid or kidney disorders prior to conception
Although these measures do not completely eliminate miscarriage risk, they substantially reduce it.
In cases of recurrent miscarriage, both parents should undergo:
- Chromosomal (karyotype) analysis
- Thrombophilia and coagulation factor testing
- Pathological examination of previous pregnancy tissue and placenta by experienced specialists
Such detailed investigations often reveal underlying issues that are not apparent through standard clinical evaluation.
Emotional Support and Counseling
Couples—especially women—often experience profound sadness and guilt following a miscarriage or when complications arise during pregnancy. At this stage, empathetic medical communication and psychological support are crucial.
Healthcare providers should offer not only medical explanations but also reassurance regarding the couple’s future chances of achieving a healthy pregnancy. After completing the necessary tests and pathological evaluations, couples are advised to have a follow-up consultation 4–6 weeks after the miscarriage to review findings and plan next steps based on scientific evidence.
Comprehensive Clinical and Genetic Approach
In our country, the success of a healthy pregnancy is directly linked to adequate preconception counseling and prenatal care. Although many centers provide care at international standards, access disparities remain due to socioeconomic and regional factors.
At our clinic, with the collaboration of molecular biology and medical genetics specialists, we investigate numerous thrombophilic factors and specific gene regions that may contribute to recurrent miscarriage and preterm birth.
Our advanced diagnostic panels include rare tests used by only a few research centers worldwide. In coordination with research institutions in the United States, we conduct detailed pathological examinations of the placenta, enabling an exceptionally comprehensive evaluation of each case.
This integrated, science-based approach allows us to identify the root causes of miscarriage and provide personalized preventive strategies to optimize future pregnancy outcomes.
