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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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Antenatal Care

Miscarriage, Recurrent Miscarriage & Ectopic Pregnancy

It can be helpful to understand the symptoms and risks of miscarriage, recurrent miscarriages, and ectopic pregnancies.
Video Tutorial
In Short
Around 1 in 4 pregnancies end in miscarriage.

Recurrent miscarriage means 3 or more miscarriages in a row - a disorder that affects 1-2% of couples.

Around 1 in 80 pregnancies are ectopic - which means the pregnancy occurs outside the womb - usually in the fallopian tubes.

Miscarriage, Recurrent Miscarriage, and Ectopic Pregnancy
Miscarriage

Every miscarriage or pregnancy loss is unique and there is no right or wrong way to feel.

The loss of a baby during pregnancy can be frightening, sad and lonely. Feelings of grief, anger, and shock are not unusual.

You may be surprised to know how many women in your family, at work, and in your support network have experienced pregnancy loss. Sadly, miscarriage is extremely common, perhaps as many as one in four of all pregnancies end in pregnancy loss. It is particularly hard to be trying a long time for a pregnancy, find exultantly that you are pregnant and then have it all go away. Our society often does not acknowledge miscarriages very seriously, but for a couple, it can be devastating. Many women who have had miscarriages remember and mourn each year on the date when that loss occurred.

Here we discuss the medical aspects of pregnancy loss and miscarriage.

There are many different ways for miscarriages to occur. Some will have pain, either minor or strong. Some will have very heavy bleeding, others may have light bleeding. Others may have no symptoms at all, and the discovery of the miscarriage will only occur at a routine ultrasound scan.

The great majority of miscarriages are unexplained although research is underway around the world to better understand the causes and risks factors associated with pregnancy loss. Most miscarriages cannot be stopped once the bleeding has started to be anything other than slight. The trauma of a hospital admission for miscarriage can also be also deeply unsettling.

Recurrent miscarriage

Recurrent miscarriage means 3 or more miscarriages in a row and affects 1-2% of couples.

If you’ve had 3 or more miscarriages in a row, you should seek tests to try to find out the cause. This should happen whether or not you already have children. You should also be offered tests if your miscarriage is late (second trimester).

Risks of recurrent miscarriage increase if you are over 35 or very overweight or very underweight.

Ectopic pregnancy

Ectopic pregnancy, a pregnancy that develops outside of the womb.

Around 1 in 80 pregnancies is ectopic. Most of them are in one of the fallopian tubes. These tubes cannot stretch enough for the embryo to survive, and there is not yet any way to safely transfer the embryo to the womb. Once a woman has had one ectopic pregnancy she is more likely to have another ectopic pregnancy in the future.

The experience of ectopic pregnancy can be very frightening and upsetting. Afterwards, although you feel very relieved to be safe and out of pain you may still feel utterly sad at the loss of your baby and worried about your future health and family. Your partner might be more concerned about your health, especially if you required emergency medical treatment, as well as sadness over the loss of the baby.

Doctors don’t always know why someone has an ectopic pregnancy, but risk factors include blocked or narrow fallopian tubes, caused by infection or previous surgery, or a previous ectopic pregnancy. The risks are also higher for women over 35, or women who smoke heavily. But they can occur also in women with none of these risk factors.

Symptoms include bleeding (unlike period bleeding), nausea, dizziness, pain in the stomach, constipation.

If you are concerned you may be experiencing an ectopic pregnancy you should urgently seek medical help and immediately request a scan or laparoscopy.

The good news is if you’ve had an ectopic pregnancy, you can get pregnant again healthily, around 66% of women will get pregnant again naturally, some might need some help with fertility treatment. The overall chance of a subsequent ectopic pregnancy after a first one is around 7-10%.

The Miscarriage Association is a charity that offers support to people who have lost a baby. They have a UK helpline (01924 200 799, Monday to Friday, 9am to 4pm) and an email address (info@miscarriageassociation.org.uk), and can put you in touch with a support volunteer who can help you find the support you need. Please also see our

Most trusts have either a bereavement midwife or councellor in position to provide added support to families who suffer pregnancy or neonatal loss.

Please also see our article and video from Professor Robert Winston on miscarriage and ectopic pregnancy in our Conception section.

For further information, please visit Professor Robert Winston’s Genesis Research Trust website, www.genesisresearchtrust.com

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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.