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Robert Winston
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Fertility expert and one of the world's pioneers of IVF and Fertility Medicine. BAFTA award-winning television presenter and Member of The House of Lords in the UK.
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Fertility in Women

Ectopic pregnancy and miscarriage

An ectopic pregnancy is one that develops outside the womb, usually in one of the fallopian tubes. Miscarriage is extremely common. As many as one in four pregnancies end in miscarriage. Most occur in the first 12 weeks. It's important to recognise the signs of these conditions and to understand the subsequent steps.
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In Short

If you know you are pregnant and experience any of the following symptoms, call an ambulance or go straight to your local hospital accident and emergency department, as you may need urgent medical attention.

Severe pain in the lower abdomen.

Feeling dizzy and faint.

Nausea or constipation.

How common is a miscarriage?

Miscarriage or the loss of a pregnancy within the first 23 weeks is extremely common. As many as one in four pregnancies end in miscarriage; most occur in the first 12 weeks. For a couple hoping for a baby, it can be devastating.

Why do miscarriages occur and what is done to help?

The great majority of miscarriages are unexplained and the medical profession probably does not always do enough to find out why they happen. There is usually very little treatment possible once a miscarriage is underway. Most of them cannot be stopped once the bleeding has started to be anything other than slight. Some women let the womb naturally expel the ‘miscarriage’ and there is also a ‘medical management of miscarriage’ that uses tablets and vaginal pessaries to encourage the uterus to contract and expel the tissue inside the uterus. Your obstetrician may do an ultrasound scan to make sure that no tissue remains in the uterus. If it does, then he or she will recommend a hysteroscopy to remove it. This will be done under general anaesthetic, but only as a day case. Most women only need a day to recuperate before returning to work. There is a small risk that the procedure will perforate the uterus and also a small risk that not all the tissue will be removed. If you are in any pain or bleeding continues, call your doctor straight away.

What does recurrent miscarriage mean?

Recurrent miscarriage is the term used if you have had three or more miscarriages in a row. This happens to around one in 100 women. If this happens to you, you will be referred to an obstetrician/gynaecologist (ask to see one with a specialism in recurrent miscarriage) who will try to determine the reason for this happening. Miscarriage can be the result of an abnormality, genetic problem, immunity problem, blood problem, hormone issue, your age, disease or injury, or it can just be a chance. Many women go on to have babies after several miscarriages.

What are the signs of miscarriage and when should I see my doctor?

There are many different ways for miscarriages to occur. Some women will experience pain slight or severe, others will have very heavy bleeding. In some cases, there are no symptoms at all, and it’s only discovered when the woman attends a routine ultrasound scan and no heartbeat can be found.

See your doctor immediately if you have bleeding or any of the following:

  • Vaginal bleeding. This is the most common sign, but it does not necessarily mean you are having a miscarriage. The bleeding may be brown or red, light to heavy, and may go on over a few days.
  • Cramping pains in your lower abdomen.
  • Swelling or “tingling” sensation in the breasts has stopped.
  • Discharge of fluid or tissue from your vagina.
  • The disappearance of morning sickness.
What is an ectopic pregnancy?

An ectopic pregnancy is one that develops outside the womb, mostly in one of the fallopian tubes. It can potentially be life threatening as the tubes cannot stretch enough for the embryo to grow and if left untreated the tube can burst. Emergency surgery is needed. Around one in 80 pregnancies is ectopic and once a woman has had one ectopic pregnancy she is much more likely to have another. If you’ve had an ectopic pregnancy, you can still have a normal pregnancy even if you have lost one fallopian tube. Around 66 percent of women who have had an ectopic pregnancy will become pregnant again naturally, others some may need treatment. What causes

What causes an ectopic pregnancy?

Like miscarriage, doctors don’t always know why someone has an ectopic pregnancy, but risk factors include blocked or narrowed fallopian tubes. The risks are also higher for women over 35 or heavy smokers. But ectopic pregnancy can occur also in women with none of these risk factors.

What are the signs of an ectopic pregnancy?

The signs of an ectopic pregnancy usually start appearing by around week five. If you know you are pregnant and experience any of the following symptoms, call an ambulance or go straight to your local hospital accident and emergency department, as you need urgent medical attention:

  • Severe pain in the lower abdomen.
  • Feeling dizzy and faint.
  • Possible nausea or constipation.
  • Bleeding from your vagina that is heavier or lighter and often darker in colour than a period.
  • Pain in your shoulders (referred pain).

The Genesis Research Trust

Despite countless breakthroughs in medical science, we still do not understand why some pregnancies will end in tragedy. For most of us, having a child of our own is the most fulfilling experience of our lives. All of us can imagine the desperation and sadness of parents who lose a baby, and the life-shattering impact that a disabled or seriously ill child has on a family.

Professor Robert Winston’s Genesis Research Trust raises money for the largest UK-based collection of scientists and clinicians who are researching the causes and cures for conditions that affect the health of women and babies.

Essential Parent is proud to support their wonderful work. You can learn more about them here.

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DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.