Ask an Expert: Miscarriage risk

Q: “Is the risk of miscarriage higher during first pregnancies? Is the risk the same throughout pregnancy, or is there a time when I can start to breathe easier? And finally, is there any link between fertility problems and a higher risk for miscarrying?”

Answer from Karen Kronman, M.D., obstetrics and gynecology, Providence Medical Group-OB/GYN Health Center (Medford):
The risk of miscarriage is not any higher for first pregnancies. Barring any known risk factors, such as advanced maternal age (above age 40) or a history of three or more consecutive miscarriages, the risk is about 15 percent for any pregnancy.

However, it’s important to realize that a number of the miscarriages that are included in that 15 percent occur so early in pregnancy that they are more like a chemical miscarriage. A woman who has such an early miscarriage probably will simply think her period has come late. There’s no way to know whether it might have been a miscarriage unless she has had a blood pregnancy test that showed that she had a very early pregnancy.

Many miscarriages can be detected with 100 percent accuracy on an ultrasound before they actually happen. Repeated ultrasound imaging is often needed to verify that it is a miscarriage situation. The ultrasound images will show that the fetus is not developing. In that case, the mother can have the option of having the tissue removed surgically or using a medicine to help empty the uterus.

The risk of miscarriage drops after the first trimester, at about 12 weeks of pregnancy. If ultrasound at 10 to 12 weeks shows a normally developing embryo, then the risk of miscarriage is very low.

In answer to your last question, no, there is no connection between trouble conceiving and the risk of miscarriage. 
                                                                                                                               Updated March 2011

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