Well over 2 million women lose pregnancies every year. Some of these losses are inevitable. Others were preventable. You can take steps to prevent unnecessary loss.

Prevention After Loss: Get Testing.

When a first loss developed beyond six weeks, less than half are caused by chromosome abnormalities. And any second or subsequent loss should be considered suspicious. Don’t accept mere assumptions about your loss. Demand real answers.

Standard ACOG guidelines say that doctors should not look for a cause of early loss until two or more miscarriages. This guideline is ineffective. Doctors are free to apply the rule differently, with some offering testing at the second loss, and others never considering any testing. It also doesn’t consider the mother’s age or the gestational age of the pregnancy, two factors that greatly influence the likelihood of chromosome abnormalities. Patients need to get more involved in health care decisions after loss, and if you believe you need testing, ask for it.

Prevention During Pregnancy: Screen for Preterm Labor

img_testing2Obstetricians regularly screen for common disorders that could jeopardize a pregnancy, such as high blood pressure, and glucose levels. Other factors can also cause pregnancy loss or preterm labor, but are not routinely checked.

Know the Signs of Preterm Labor

Nearly 13% of all births in the U.S. are preterm. Women at increased risk for preterm birth include those who:

  • had a prior preterm birth
  • are pregnant with multiple babies
  • have uterine or cervical abnormalities

However, half of the women who experience preterm labor don’t fall into any of these risk categories.

Your best defense against preterm labor is to seek screening if signs of preterm labor occur. The signs of preterm labor include:

  • cramping or contractions
  • bleeding
  • unusual vaginal discharge
  • low back pain
  • pelvic pressure

If you have these symptoms during pregnancy, seek immediate medical care. A medical professional should perform a preterm labor evaluation which includes a pelvic exam and contraction monitoring. When preterm labor is diagnosed, medical treatments can usually halt or delay labor, but treatments are most effective when administered as soon as possible.

Consider Cervical Measurements

Cervical incompetence is believed the leading cause of second trimester loss. The condition can often be detected with cervical measurements before loss happens.

Some hospitals routinely take a cervical measurement as part of any Level II ultrasound but not all. If you are already having a Level II ultrasound, consider asking the technician to measure cervical length.

When early labor is suspected, a cervical measurement can detect internal signs of dilation. Obstetricians routinely do an external pelvic exam to assess dilation, but the cervix can be internally shortened with no visible external signs. Patients should discuss this screening tool with their doctor.

Any woman who has suffered a second or third trimester loss should ask her doctor about serial cervical measurements during subsequent pregnancies. ACOG guidelines do not recommend these measurements until two or more late losses that are considered unexplained, but some doctors do take cervical measurements before two late losses.16

Fetal Fibronectin Can Screen for Preterm Labor

img_baby-sleepingFetal fibronectin is a protein produced during pregnancy that helps attach the fetal sac to the uterine lining. This protein is normally found in vaginal and cervical fluids before 22 weeks gestation, and in the few weeks prior to birth. When fetal fibronectin is detected after 22 weeks, it means a higher risk of preterm delivery.

If you have symptoms of preterm labor, ask your physicians about testing for this protein. If the test comes back negative, meaning no signs of fetal fibronectin, it’s less likely that labor is imminent.  When the test is positive, meaning fetal fibronectin is present, your risk of preterm birth is greater, but it does not necessarily mean that labor is imminent. In this case, negative test results are more reliable than positive results.

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