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Recurrent Pregnancy Loss Association Awareness. Advocacy. Answers.
Fast Facts
- Up to 1 in 5 pregnancies ends in loss; however, with time most couples go on to have healthy pregnancies after loss
- 1-2% of couples experience recurrent miscarriage, or the loss of multiple, clinical pregnancies before the 20th week
- For 50% of couples who experience multiple miscarriages the cause is "idiopathic," meaning the underlying reason remains unexplained.
- Known causes of recurrent miscarriage include anatomic abnormalities of the uterus; autoimmune, endocrine or other medical conditions; chromosomal abnormalities; and lifestyle or environmental factors.
Definitions
Recurrent Pregnancy Loss
"Recurrent pregnancy loss (RPL)", sometimes referred to as recurrent miscarriage, is defined as the loss of two or more clinical pregnancies at any stage of gestation. The losses need not be consecutive.
Pregnancy Loss
Pregnancy loss means the unwanted ending of a pregnancy at any gestational age. It may include, but is not limited to, miscarriage, ectopic pregnancy, molar pregnancy, stillbirth, or termination for medical reasons.
- Miscarriage, or early pregnancy loss, is a pregnancy loss that happens before 20 weeks. It is estimated that up to 20% of known pregnancies end in miscarriage. About 80% of miscarriages happen before the 12th week of pregnancy.
- Ectopic pregnancies occur in about 12 in 1000 pregnancies and happen when an embryo develops outside of the womb in the fallopian tube, ovary, cervix, or abdomen. Ectopic pregnancies almost always result in a pregnancy loss because the embryo does not have enough room to develop. Ectopic pregnancies can cause serious complications including death of the mother.
- Molar pregnancies occur in about 1 in 1000 pregnancies and are caused when extra chromosomes come from the sperm of the father. A complete molar pregnancy happens when the mother’s chromosomes are not present in the egg and the chromosomes of the father are copied. A partial molar pregnancy occurs when the mother’s chromosomes are present in the egg but the father’s chromosomes are copied, resulting in 69 chromosomes instead of 46. Molar pregnancies always result in pregnancy loss and may cause serious health problems.
- Stillbirths occur in about 1 in 175 pregnancies per year and refers to loss after 20 weeks of pregnancy. (It is important to note that 20 weeks is the US definition of stillbirth. The WHO defines stillbirth as the death of a baby after 28 weeks gestation.)
- Termination for medical reasons (TFMR), is when a desired pregnancy is terminated due to a chromosomal, genetic or structural fetal abnormality, or where continuing the pregnancy would risk the health or life of the mother.
Early Pregnancy Loss
A pregnancy loss is a significant event no matter when it occurs. Grief is not dependent on the length of gestation. However, definitions matter in medicine. Below are some other terms you may hear related to early pregnancy losses or miscarriages.
- A "clinical pregnancy" is one which has been confirmed by both an ultrasound and blood test. If a loss occurs after a positive urine or blood test, but before an ultrasound, it will sometimes be referred to as a "chemical pregnancy" or "biochemical."
- An "embryonic loss" is a loss which occurs before 9 weeks gestation.
- A "fetal loss" is a loss which occurs after 9 weeks but before 20 weeks.
- A "blighted ovum", also called an "anembryonic pregnancy", happens when an egg implants in the uterus but does not develop into an embryo, leaving an empty gestational sac.
- A "missed miscarriage," sometimes called a "silent miscarriage," happens when the pregnancy has stopped progressing - the baby has died - but there have been no physical symptoms such as bleeding or pain to indicate anything is wrong.
Sources
- Rev Obstet Gynecol. 2009 Spring; 2(2): 76–83.
- Fact Sheet: What is Recurrent Pregnancy Loss? 2016 Revision. American Society for Reproductive Medicine. www.reproductivefacts.org
- Arias-Sosa, Luis Alejandro, et al. “Genetic and Epigenetic Variations Associated with Idiopathic Recurrent Pregnancy Loss.” Journal of Assisted Reproduction and Genetics, Springer US, 2018, www.ncbi.nlm.nih.gov/pubmed/29313278
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