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 Dr. Peter H. R. Roberts, medical director of obstetrics and gynecology at Providence Portland Medical Center: 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 if it might have been a miscarriage unless she did a blood pregnancy test that showed that she had a very early pregnancy.
Most miscarriages can be detected with 100 percent accuracy on an ultrasound before they actually happen. The ultrasound images can show that the fetus is not developing. Typically, that diagnosis can be made with ultrasound 2 weeks to 3 weeks before the miscarriage occurs. In that case, the mother will have the option of having the tissue removed.
The risk of miscarriage drops at about 10 weeks of pregnancy. If you have an ultrasound at 10 weeks and it shows a normally developing embryo, then the risk of miscarriage drops almost to zero.
In answer to your last question, no, there is no connection between trouble conceiving and the risk of miscarriage.
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January 2002
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