AskMeDoctor! Ep10 - What are the Common Causes of Miscarriage?

Early pregnancy loss can be heartbreaking and affect the woman both emotionally and physically. A miscarriage happens for a variety of medical reasons - many of which are not within a person's control. For this episode of AskMeDoctor!, we have invited Dr Tan Cheng, an obstetrician and gynaecologist at Tung Shin Hospital to answer our questions about miscarriage and abortion. Q1: What is a miscarriage? Dr Tan Cheng: A miscarriage (pregnancy loss) is defined as the spontaneous demise of a pregnancy before the fetus reaches viability. Q2: Does a man or woman’s age affect miscarriage? Dr Tan Cheng: Woman’s age is particularly associated with the risk of pregnancy loss. Risk of pregnancy loss is lowest among aged 20-35; it rapidly increases after age 40. Prevalence of pregnancy loss is 10-15%. Q3: Will cooling food cause miscarriage? (acidic food such as pineapple, etc.) Dr Tan Cheng: If you are new to this here are some background info: Since ancient times, traditional Chinese medicine practitioners have used the warming and cooling nature of foods to balance the body’s yin and yang – to prevent and treat disease. It is believed that pineapple is a cooling food and that you should avoid during pregnancy. It is a common myth that pineapple causes miscarriage. This is due to the content of bromelain, an enzyme that breaks down protein, that is found in pineapple. It is unlikely normal consumption of pineapple will cause any issues to the pregnancy. One author suggests that a pregnant woman would probably need to eat about 10 whole pineapples in one sitting to accumulate enough amount of bromelain to be problematic. We normally advise pregnant women to eat clean, cooked food at a normal amount as we all know excessive consumption of any particular one type of food is not healthy. Q4: What are the main cause of miscarriage? Dr Tan Cheng: Age is the main risk factor for pregnancy loss. Other conditions such as antiphospholipid syndrome, hypothyroidism, abnormal uterine anatomy are associated with recurrent pregnancy loss. Q5: Will I go through a miscarriage as well if my mum/sister has been through it? Dr Tan Cheng: This will depend on the underlying cause of the miscarriage. If there is a genetic component that causes recurrent miscarriage, then it is possible. Parental karyotyping may be offered if there is a strong family history of miscarriage in the family. Q6: What is the chance for my baby to be defected if I experienced a miscarriage in the past? Dr Tan Cheng: As mentioned previously, the prevalence of pregnancy loss is 10-15%. Majority of the cases the subsequent pregnancy will be normal. If there are recurrent pregnancy losses, then further investigation is indicated. Q7: How to overcome overwhelming emotion after a miscarriage? Dr Tan Cheng: Feeling sad is part of the grieving process. There are various support groups available. It helps to talk to others with similar experiences before. Some ladies may subsequently suffer from depression and it is crucial to seek help from healthcare professionals if the emotion is too overwhelming. Q8: What treatments are available to avoid miscarriage occurring? Dr Tan Cheng: Treatment depends on the underlying causes of the miscarriage and different causes will have different treatment. Indicated Tests Q9: Can the baby survive if the mother has an ectopic pregnancy? Photo Credit: emra.org Dr Tan Cheng: Ectopic pregnancy means the baby is not in the womb. The baby will not survive. Commonplace for ectopic pregnancy is in the fallopian tube. Ectopic pregnancy is an emergency as when the baby starts to grow, eventually, the tube will start to bleed. If it is diagnosed early, it may be treated with injection (methotrexate) to shrink the pregnancy tissues. If it is diagnosed later, surgical treatment is indicated. Q10: What are the risks of recurrent miscarriage? Dr Tan Cheng: Assuming we have excluded the possible causes as mentioned previously. There are risk factors that are associated with recurrent miscarriage: Q11: Does abortion hurt during and after the process? Dr Tan Cheng: Tummy cramps, pain, vaginal bleeding are commonly associated with spontaneous pregnancy loss. If the pregnancy loss is complete, the symptoms will improve. If the bleeding and pain persist, it is likely the miscarriage is incomplete. Please seek medical attention if you experience any vaginal bleeding or abdominal pain when you are pregnant. https://youtu.be/Jb03Z3CaPlQ Stay tuned with our AskMeDoctor series at Motherhood Story and our Facebook page.

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