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Future Pregnancies After Miscarriage
By Nancy Kennedy

Even when a pregnancy is planned and the woman is healthy, pregnancy may result in miscarriage – the loss of the pregnancy before the fetus is able to survive outside the uterus. Miscarriage is quite common; Douglas H. MacKay, M.D., a board-certified obstetrician-gynecologist who practices in McMurray and Mount Lebanon and is on the staff of St. Clair Hospital where The Family Birth Center welcomes up to 1,300 babies each year, says that 15-20% of recognized pregnancies will end in miscarriage. Despite this, it is not a topic that is openly discussed and many women feel alone with their feelings of loss.

Most miscarriages occur in the first trimester. Most often, no cause is identified. When a woman has recurrent miscarriages, defined as three or more, a work-up is recommended. This may include chromosomal analysis of expelled tissue; assessment of anatomic issues such as an abnormally shaped uterus or fibroids; karyotypes on parents to check for genetic problems; studies to rule out autoimmune or endocrine problems such as thyroid disease, diabetes or polycystic ovary syndrome; and checking for infection. Anatomic problems account for 15% of recurrent miscarriages and can usually be remedied with simple surgeries.

MacKay says, "It's important for women to understand that they have not done anything to cause the miscarriage. It's normal to feel grief, but they should not blame themselves or feel guilty. Miscarriage creates anxiety about future pregnancies, but there is reason to be hopeful. Eighty percent of women will go on to have a successful next pregnancy." Following miscarriage, couples should give themselves time to recover and to undergo any testing that their obstetrician suggests. There are support groups and web sites that many couples find helpful, including www.nationalshare.org and www.MEND.org.

For information about the Family Birth Center at St. Clair Hospital, visit www.stclair.org. To contact Dr. MacKay, call (412) 942-1866.

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