Talk:Miscarriage

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Ratio of miscarriages seems high[edit]

Article says 15 percent - which seems way too high. -St|eve 06:08, 5 August 2005 (UTC)

No this rate is correct. 20% have bleeding in first 20weeks and in all 15% do miscarry. I'll add the BMJ referrence to the article. -David Ruben 21:06, 5 August 2005 (UTC)

this ratio is particularly bad in our specees.authers have far better statistics.our big brain and low genetic diversity is to be blamed,or something like that.--Ruber chiken 18:37, 23 May 2006 (UTC)

I would like to see something on rates of miscarriage in twin pregnancies - I don't know enough about it to do it myself but am pregnant with a (so far) surviving one of an initial twin pregnancy, and came here to see if there was anything on the survival rates if one twin miscarries.

This statement: Up to 78% of all conceptions may fail, in most cases before the woman even knows she is pregnant. references this article: [1] but I cannot find where in the article that statement is supported. Could someone help me out? Lyrl 22:48, 5 June 2006 (UTC)
A miscarriage of a fetus is very rare compared to a miscarriage of an embryo.Ferrylodge (talk) 03:40, 17 March 2009 (UTC)

Pregnancies and Their Outcomes


  • In Alaska, 14,060 of the 141,000 women of childbearing age become pregnant each year. 71% of these pregnancies result in live births, and 14% result in abortions; the remainder end in miscarriage.
  • Alaska has the 30th highest teenage pregnancy rate of any state. Of the 1,770 teenage pregnancies each year in Alaska, 66% result in live births and 19% result in abortions.
  • Alaska’s teenage pregnancy rate declined by 34% between 1992 and 2000.

source: http://www.guttmacher.org/pubs/state_data/states/alaska.html --Stefanbcn (talk) 00:15, 5 September 2008 (UTC)

Removal of "Oral sex & semen exposure" paragraph[edit]

I have deleted this paragraph for two reasons.

First, I have looked over the sources for this paragraph, neither of which makes any apparent such claim. There's a New Scientist article that I can't read in full without subscribing, but which makes no such claims in its introductory paragraphs. Then there's a survey extract which relates to protection from pre-eclampsia, not miscarriage. There is also, in the abstract, nothing to suggest that oral sex is the key means of acquiring "seminal priming": http://www.jrijournal.org/article/S0165-0378(03)00052-4/abstract

The paragraph was also listed under "causes" (rather than, for example, "prevention"). If anyone is able to find a valid source that claims lack of oral sex is an actual cause of miscarriage, then feel free to cite it. I doubt any chances of success in this task.

What could be appropriate would be to list "immunological issues" as a potential cause of miscarriage. Istara (talk) 09:52, 25 February 2011 (UTC)

Premature birth[edit]

I had originally written the premature birth section to point out why the phrase "premature birth" might be used at a point in gestation that most sources would call it a "miscarriage". Thus the specific (cited!) reference to infants crying after being born at 16 weeks of gestation; even though that falls before the 20-week "cutoff" for not being a miscarriage, I don't think anyone is going to call something that results in a crying baby a "miscarriage".

The section has now been edited to discuss survival rates of premature births, which seems outside the scope of the "miscarriage" article. I gather there was something that struck the editor as not right about my description, but I don't think this was the most appropriate way to fix it.

Any perspectives from other editors on what should be done with that section? Lyrl Talk C 02:49, 17 January 2007 (UTC)

As an obstetrician working in the UK I frequently deal with pregnancy loss. From a medical point of view, premature birth is used to describe babies delivered between 24 and 37 weeks. As for a baby crying at 16 weeks gestation, I find this completely unbelievable. The lungs at that gestation are simply not formed enough to permit breathing or air movement of any kind, lacking the cartilage and surfactant required to keep them patent. For a mid-trimester miscarriage at 16 weeks gestation the lifespan of these unfortunate babies is measured in seconds. There may be signs of life, such as heartbeat and small movements, but certainly not crying. I note the reference is from the presbytarian pro-life movement, I would have to treat anything produced by such a religious, openly biased organisation with extreme dubiaty, particularly with regard to such a sensitive issue as the viability of fetal life. The facts are that regardless of what the fetus does following it's expulsion it is called a miscarriage. If it survives the immediate delivery for several minutes then it would be classed as an early neonatal death. It doesn't matter what people's opinions are and what one person would or wouldn't call a miscarriage. Medico-legally and in terms of definition the appropriate word is miscarriage. 86.1.205.82 (talk) 11:24, 29 March 2008 (UTC)

Very sad that the Obstetrician(and we only have his word for it!) should use this talk page to make an outright religious attack on Christians.Maybe their reference is right.We need more Obstetricians who are willing to be openly identified as such to give us their views.This person goes against the so called neutrality of the Wikipedia.Rosenthalenglish (talk) 13:13, 29 March 2008 (UTC)

Not at all. This editor simply notes that the source used is biased. By noting this does not make the changes non-neutral. Gillyweed (talk) 23:45, 29 March 2008 (UTC)

Caffeine[edit]

Copied with permission from my talk page. LyrlTalk C 12:40, 26 January 2008 (UTC)

I noticed that you - de facto - removed caffeine as a considered factor in the current understanding in the genesis of miscarriages. I do not like to go into an edit war, but here is my point:

Li's recent study (it may not be the last word) (as referenced in the NYT article, ref # 19) is the among the best we currently have and should be taken very seriously. You eliminated its point by just leaving it as a subject in "correlations", a section that obviously suggests that is just a unrelated linkage and that other factors are behind it (how do you know this?). The statement that half the patients were recruited after fetal death is not supported by the reference at all. Dr. Westhoff's personal opinion in the reference does not invalidate the study.

Li demonstrated not only that 200 mg are linked to double the miscarriage rate, but that there is a dose-response association. Why would you like to censor Li's findings? It may well be, ultimately, that there are other factors involved, but would it not simply be prudent to take this information seriously (adherening to the nil nocere concept) and not withhold it from the readers? Ekem (talk) 01:03, 24 January 2008 (UTC)

I agree that Li's recent study is among the best we currently have and should be taken very seriously. I disagree that acknowledging the partially retrospective nature (and therefore potential bias) of Li's study equates to withholding information from readers.
From the New York Times article: "At the time of the interview... 102 had already miscarried... Later, 70 more women miscarried." Technically, 59% of the miscarriages had occurred before the patients were recruited.
Li did not demonstrate a dose-response association. The miscarriage rates of women with zero caffeine intake and caffeine intake of less than 200mg/day were not different enough to be statistically significant.
The New York Times article states the study group had "an overall miscarriage rate of 16 percent... a typical rate." But 16% is not typical of prospective studies. The only prospective studies I have been able to find (PMID 10362823 PMID 12620443) both found 25% miscarriage rates by the sixth week LMP. A further number (around 8%) miscarry after the sixth week, for a total rate of around 33%. So by recruiting women who were (on average) already 10 weeks pregnant, Li's study missed a huge number of very early miscarriages, about half of the total miscarriages that occurred. This could affect his results in two significant ways: First, caffeine intake may show the same relationship to very early pregnancy loss as to later pregnancy loss, meaning it is even more harmful that Li's study suggests. Second, caffeine intake may show an inverse relationship to very early pregnancy loss compared to later pregnancy loss, so "saved" very early pregnancies could cancel out the "increased" miscarriage rate later on.
Is there precedent for a drug affecting very early pregnancy loss differently than clinical pregnancy loss? Yes, tobacco smoke. From this prospective study: "the group of women whose husbands smoked >=20 cigarettes/day had the highest prevalence of early pregnancy loss in the first conception (nonsmoking: 22 percent; <20 cigarettes/day: 20 percent; and >=20 cigarettes/day: 29 percent), [and] the lowest prevalence of clinical spontaneous abortion (nonsmoking: 8 percent; <20 cigarettes/day: 10 percent; and >=20 cigarettes/day: 4 percent)."
So, again, Li's study is one of the best available and should be taken seriously. But because it was not a prospective study, I believe the potential for bias is too high to present his results as established fact rather than the strong suggestion that they are. I'm not attached to the current formatting, though, if others have suggestions for reorganization. LyrlTalk C 01:12, 25 January 2008 (UTC)


This is a complicated issue and it appears to me that the discussion is currently made without even having the primary source available, at least I have not been able to verify that the article has appeared in the January issue of the American Journal of Ob Gyn as the NYT indicated, - I have seen several press releases, a more comprehensive perhaps here: [2]. Where have you found the article itself to be in a position to critique its methodology?
Wikipedia is an encyclopedia and as such should provide verifiable information but not take personal interpretations in the scientific fray: when you place “caffeine” in the “correlation” you are making a judgment and saying this is an example of presumably spurious association. Li’s study is one of many that would caution a reader to come to that conclusion. Li' study is just lowering the bar, so the question should be how much caffeine may still be safe in pregnancy?
I do not understand your position that the study is invalid because women were studied posthoc; that is how most epidemiologic studies are conducted, just think of all the studies looking at links with cancer,
It appears to me from the data so far released that patients with > 200 mg caffeine had about a 100% increase in miscarriage rates, those with less caffeine exposure a 40 % increase, and those with no exposure were the zero controls: isn't there a dose - response?
It is my simple suggestion to place "caffeine" back into the discussion of putative causative agents, and include a reference to Li’s data which have been already discussed in the general media. I have no objection to the attachment of a qualifier attached if that appears appropriate and is referenced. Ekem (talk) 04:57, 26 January 2008 (UTC)
The New York Times article states the study "will be published on Monday": I'm assuming that's January 28th. I have critiqued the information provided by the New York Times article, on the assumption that the New York Times is correctly reporting relevant information. Should the NYT article turn out to have misrepresented the study in the areas I am concerned about, I will certainly withdraw my assessment.
I have added nausea and vomiting of pregnancy as well as exercise to the correlations section - I hope these will increase the credibility of the factors listed in that section. I certainly do not want to imply that these associations are spurious.
If an epidemiological study on cancer omitted half the patient population who died of that cancer, I think the results of the study could be questioned. Because such a large portion of miscarriages happen very early in pregnancy, unfortunately retrospective studies of miscarriage (unlike those of most other conditions) miss a significant amount of valid information.
From this Medscape article: the aHR of miscarriage for caffeine use less than 200 mg/day was 1.42, which was not statistically significant. The study was small enough that a 40% change in risk is likely to be the result of random variation. The study on exercise I've added to the article did show a statistically significant dose-response relationship, showed a much higher risk of miscarriage (up to triple the risk of non-exercisers) and the authors of that article still cautioned that their results were subject to bias because of retrospective data collection and should not be used to tell pregnant women to not exercise. I think my response to the caffeine study was biased by having read the exercise study first (here); seeing the similarities in data collection methods, my tendency is to treat their results with equal weights. LyrlTalk C 13:42, 26 January 2008 (UTC)


As you predicted, the study came out today: [3], unfortunately all I get there is the abstract. It indicates that the study was done in a prospective manner, and that increasing doses of caffeine increased the risk of miscarriage (dose - response), but we may want to look at the full article.
The inclusion of other "factors" in the "correlation" section makes it better as "caffeine" now is not singled out as the only item. It should be clear that a "correlation" in this context is a connection under serious investigation and of concern, not some spurious event. Ekem (talk) 21:58, 28 January 2008 (UTC)

Environmental Toxins?[edit]

What exactly does the article mean when it mentions environmental toxins, and how are they a risk? --24.56.163.227 (talk) 04:36, 7 March 2008 (UTC)

Terminology and timeline[edit]

Even I as a GP doctor get confused by timelines and what gets defined as what & when, so I wonder if a table might help the terminology section. Note there are different definitions worldwide for "Stillbirth" (vs the term "Perinatal mortality").

Gestational age from LMP (in weeks and 2 more than Developmental age)
Situation of fetus & pregnancy 2 6 11 20 23 37 40
(EDD)
42
Prenatal development stage Embryo Fetus
Viability ? Not viable Viable
If vaginal bleeding is observed Threatened abortion Antepartum haemorrhage
Onset of spontaneous delivery Early
pregnancy
loss
Clinical spontaneous abortion
(aka "Miscarriage")
Premature labour Term labour Overdue
... and delivered alive Premature birth Delivery
... but then dies afterwards Neonatal death
If died before delivery Clinical spontaneous abortion Stillbirth
Age of viability was 28 weeks before availability of modern medical intervention.
Definition of stillbirth varies by country. Australia 20 weeks, UK 24 weeks, US has no standard definitio and Canada uses "Fetal death" for all stages.


With the potential to confuse on this, I thought I would open for comment first, rather than just boldly adding to the article :-) David Ruben Talk 04:06, 30 March 2008 (UTC)

I think in the U.S. as early as 20 weeks is considered premature birth: from March of Dimes: "A pregnancy that ends between 20 weeks and 37 weeks is considered preterm." Ditto for the vaginal bleeding column. Is there some way to make that overlap in the table fuzzy?
Also, the viability line is not sharp it is is depicted in the diagram; there are many variables influence the death and disability risks of an individual preemie aside from gestational age at the time of birth. A few preemies as early as 21 and 22 weeks have survived, while the death rate for 24 and 25 weekers is still rather high. I don't know that viability is something that should be included in the table.
Otherwise, I really like the table. LyrlTalk C 23:50, 31 March 2008 (UTC)
(Gulp re US 20 weeks) - Thanks for points, it is not of course a diagram but a table which has hard cell boundaries, so no "fuzzy" boundaries unless I convert this (once agreed) into a picture. The viability issue is the primary medical factor in understanding the table (at least from UK position). With the fall in this from 28 to 24weeks, the previous UK abortion law on "routine" abortions upto 28 weeks became anacronistic, given that it was apparent that fetus far younger could survive (allbeit with high morbidity rates). In 1992 the UK law changed, limiting most abortions to 24 weeks and defined still birth as interuterine death from 24 weeks. Also this drop had a knock-on effect on the issuing of the UK "Mat-B1" form which is the official certificate issued by doctors/midwives and used by woman to then notify their employers of their rights to maternity, with this being issuable from 20 rather than 24 weeks (issued before viability so that necessary paperwork can be done in time and a reasonable notice period given to employers).
I entirely agree that a very few survivals have now occured before 24 weeks, but in generally that is still exceptional and so there is a split in management between under 24weeks, which is still gynaecology (ie manage the woman) and after 24weeks which is obstetrics (manage a baby and a mother). Hence in vaginal bleeding, prior to 24weeks is seen as a threatened miscarriage and if contractions start and continue then outcome will be a non-surviving fetus, and if a catestrophic bleed starts then all measures just on sorting out the women. Whereas after 24weeks the term is antepartum haemorrhage, literally meaning before birth bleeding, and as this implies if managed well will be something that preceeds a successful emergency cesarian delivery (will well baby and what is then a mother). So if I see a woman who senses reduced movements of her baby at say 19 weeks, there is no point in my referring to labour ward for a midwife to help deliver a fetus (it is not going to happen), however if the same reduced movements felt at 26 weeks then I would direct her straight to the labour ward for assessment, and if concerns raised then emergency caesarian.
Of course 15 years ago, the cut off was probably 26 weeks, if not 28, as to what pragmatically could be achieved. But realistically a fetus at 20 weeks is not going to survive and be an independantly surviving preterm baby, and this in UK would not be seen as pre-term delivery but a lost pregnancy of a miscarriage. Again I agree survival rates have improved markedly in the last 10-20 years.
Recent Irish consensus paper: Vavasseur C, Foran A, Murphy JF (2007). "Consensus statements on the borderlands of neonatal viability: from uncertainty to grey areas". Ir Med J 100 (8): 561–4. PMID 17955714. "All would provide intensive care at 26 weeks and most would not at 23 weeks. The grey area is 24 and 25 weeks gestation. This group of infants constitute 2 per 1000 births." 
Sobering (none of this is pleasant) 1995 US paper PMID 8648459, and then look at a 2006 paper:Kaempf JW, Tomlinson M, Arduza C, et al (2006). "Medical staff guidelines for periviability pregnancy counseling and medical treatment of extremely premature infants". Pediatrics 117 (1): 22–9. doi:10.1542/peds.2004-2547. PMID 16396856.  - see current survival table wherein survival 50% (value other papers suggests neonatologists consider the full rescussitation point) is still around 24-25 weeks which reflects decision whether to offer caesarian (generally not for fetal reasons until after 25 weeks) and this table of neonatologists rescussitation advice wherein level 3 is their neutral poistion whether they would or would not recommend rescussitation.
Finally this year Morgan MA, Goldenberg RL, Schulkin J (2008). "Obstetrician-gynecologists' practices regarding preterm birth at the limit of viability". J. Matern. Fetal. Neonatal. Med. 21 (2): 115–21. doi:10.1080/14767050701866971. PMID 18240080.  also concludes viability 24 weeks.
Anyway the purpose of teh table to to try and give an overview of theatended miscarriage vs APH, miscarriage expulsion vs onset labour etc, so yes will try create version with changing cut offs varying on circumstances and country. :-) David Ruben Talk 01:48, 1 April 2008 (UTC)
First stab at creating table image with "fuzzier margins for viability":David Ruben Talk 02:26, 1 April 2008 (UTC)

Miscarriage-Pregnancy timeline.png

Wow, that's lovely! I'm really impressed with how you put all that information together. I look forward to seeing it in the article. LyrlTalk C 23:57, 1 April 2008 (UTC)
Above now lost some silly extraneous words in left-hand column (I had "premature" and "term" inserted when they only belonged in relevant place to teh right), abbreviated 2nd footnote a little to get it to fit.
Only real shame over picture vs table is that can't have those nice wikilinks for teh various terms - oh, well. I'll insert into the article now. David Ruben Talk 01:12, 3 April 2008 (UTC)
There should be nothing in the "Not viable" and "....delivered alive" cell. ✏✎✍✌✉✈✇✆✃✄Ⓠ‽ (talk) 17:49, 8 June 2008 (UTC)

Beter table table in wiki:

Gestational age from LMP (in weeks and 2 more than Developmental age)
2 6 11 20 21 22 23 24 25 26 27 28 29 37 40 42
Aspect
of
fetus
and
pregnancy
Prenatal development stage Embryo Fetus
Whether fetus is viable Not viable (probably not) (probably) Viable
If vaginal bleeding is observed Threatened abortion (probable miscarriage) Antepartum haemorrhage
Onset of spontaneous delivery Early
pregnancy
loss
Clinical spontaneous abortion
(aka Miscarriage)
Premature labour Term Overdue
… and delivered alive Premature birth Delivery
… but then dies afterwards Neonatal death
If died before delivery Stillbirth
^† Age of viability was 28 weeks before availability of modern medical intervention.
^‡ Definition of stillbirth varies by country. Australia 20 weeks, UK 24 weeks, US has no standard definitio and Canada uses "Fetal death" for all stages.

--Voidvector (talk) 07:59, 30 August 2008 (UTC)

But then you lose the color shifting. I find the shaded colors to be helpful in showing the idea of viability as a continuum, rather than a sharp dividing line. LyrlTalk C 02:06, 31 August 2008 (UTC)
Problem with this as a plain table is that some boundary lines are absolute (solid lines) as form definition ages of terms (eg "Term" pregnancy is 37-41, premature is under 37) whereas others have soft definition points (like non-vible to probably not viable at 20 weeks, which in turn drifts into Limit of viability (which ius the 50% survival point) to viability (when would expect most to survive at 28) - hence Lyrl's original critique of using a plain table. Likewise still birth as a number of alternative worldwide definition points, hence the semi-bold lines. The colour gradation is very deliberate indication that there is no hard and fast guarantee of survival point between 20 weeks and the point of term deliveries (from 37 weeks). Lastly the column widths were as near as I could make out proportional to the intervals in mentioning the number of weeks (some numbers hinted at in grey to help the reader appreciate the roll of weeks but not themselves definitions of any specific stages, plus a little typesetting license for clarity as well as fitting to common monitor page widths). David Ruben Talk 03:02, 23 November 2008 (UTC)
I've converted the image to SVG, see File:Pregnancy outcome terminiology.svg. I think the text needs a little tweeking, but the XML coding always seems to get me. -Andrew c [talk] 17:26, 8 April 2009 (UTC)

Image?[edit]

This topic is sensitive, but spurred by the discussion of images at Talk:Abortion, I thought I would look for images that could illustrate this article. http://www.flickr.com/photos/merelymel/1581515048/ This is an image of a coffin intended for a miscarried fetus, which I think may be suitable. Fences and windows (talk) 00:02, 17 March 2009 (UTC)

It would be suitable in the section Psychological aspects Fences and windows (talk) 00:05, 17 March 2009 (UTC)

How about this image instead? This article isn't a flashpoint for controversy, so maybe a realistic color photo (rather than a black and white drawing) would be okay.Ferrylodge (talk) 03:42, 17 March 2009 (UTC)
Added both. Fences and windows (talk) 07:41, 18 March 2009 (UTC)
Looks okay to me. Thanks.Ferrylodge (talk) 16:02, 18 March 2009 (UTC)
I think this is a sensitive topic, even if it is not controversial. I disagree with the use of the photo because I find a realistic photo accompanying an article about death to be inappropriate for any Wikipedia article. I will be on the lookout for a replacement image. In the meantime, I am fixing the caption, which is misleading. Caption currently states the image shows a "a complete miscarriage at about 6 weeks" but the file label states is is a picture of a human embryo at about 6 weeks, not a miscarriage. Benutzer41 (talk) 20:48, 13 October 2013 (UTC)

Just when you thought it couldn't get more complicated.[edit]

So, so terms I've been trying to sort out.

  • Early pregnancy loss
  • Miscarriage
  • Spontaneous abortion (SAB)
  • Molar pregnancy
  • Ectopic pregnancy
  • Chemical pregnancy

Now, we've got some conflicting defintions here. Some, would have you believe that EPL, miscarriage and spontaneous abortion are all the same thing. This source suggests that EPL is any loss before 20th week, and that a miscarriage, AKA SAB, which is also is one type of EPL, while molar pregnancy is another. This only mentions miscarriage, as a general sort of term while this agrees and gives a number of alternative defintions. Neither source says boo about EPL. this source brings up the term "chemical pregnancy" and suggests that miscarriage proper is only one type of several types of "pregnancy loss". This says EPL is before 12 weeks. There is still more to come, too.--Tznkai (talk) 15:34, 7 April 2009 (UTC)

The ACOG pamphlet is titled "early pregnancy loss" and discusses losses that occur early in pregnancy. I don't believe they are using "early pregnancy loss" as a technical term at all. Molar pregnancy is a disease that has to be surgically removed (and occasionally treated with chemotherapy) and as such is not a type of miscarriage (i.e. it is not a spontaneous abortion).
A chemical pregnancy is one which can be detected by urine or blood chemistry only (i.e. it never progresses to the point where it can be detected by ultrasound or physical examination). The current article already has references that use the terms EPL and chemical pregnancy to refer to miscarriages prior to the 6th week LMP.
While the book Fetal medicine uses the term EPL for any first-trimester miscarriage, for purposes of this article it seems easier to just say first-trimester miscarriage. Unless there is evidence that this definition of EPL is widespread, I don't see any usefulness to including it in this article. LyrlTalk C 13:05, 11 April 2009 (UTC)

Human centric[edit]

We should cover spontaneous abortion in livestock as well- Brucellosis, Rift Valley fever, Bluetongue disease, Neospora caninum and other diseases, parasites and plant ingestion are all causes. In cattle brucellosis is also known as "contagious abortion." In pregnant livestock infected with RVF there is the abortion of virtually 100% of fetuses. (This from Wikipedia's articles.) These are serious issues for livestock, and the articles link either here or the main Abortion article. KillerChihuahua?!? 22:26, 7 April 2009 (UTC)

I'm fine with this article being human centric if we cover the topic elsewhere. Spontaneous abortion (mammals) or some such.--Tznkai (talk) 22:31, 7 April 2009 (UTC)
Before Tznkai's comment, I started a section on it. I support splitting the section off to a new article once there's enough material.Ferrylodge (talk) 22:32, 7 April 2009 (UTC)
I agree with keeping this article human centric and moving this section to spontaneous abortion (mammals) or similar but I believe it is in the best interest of this article to do so before waiting for additional content on "other animals". — Preceding unsigned comment added by Benutzer41 (talkcontribs) 20:38, 13 October 2013 (UTC)

List of diseases[edit]

FYI, I started a List of diseases that may cause miscarriage. Another editor has elsewhere objected that: "If the relevant articles are properly written, there's no need for a potentially very misleading list of this kind upon which cursory readers who encounter it might mistakenly rely to their personal detriment."[4] Is the list misleading, can it be improved, and if not should all the info in the list be incorporated into this miscarriage article? The list seems okay to me, but maybe some disclaimers need to be added.Ferrylodge (talk) 19:50, 9 April 2009 (UTC)

I think I see what they're getting at, but I think that is useful information. I'd suggest userfying you list for the meantime. I'll try to think of a middle ground.--Tznkai (talk) 20:32, 9 April 2009 (UTC)
Je ne comprend pas "userfying". Parlez vous anglais?  :-)Ferrylodge (talk) 20:46, 9 April 2009 (UTC)
Copy the contents to User:Ferrylodge/List of diseases that may cause miscarriage--Tznkai (talk) 20:47, 9 April 2009 (UTC)
Or move, and CSD the redir which results as a cross-namespace redir. That would mostly make sense if there were multiple contributors to the page; if its just you, then copy, then CSD the (blanked) article. KillerChihuahua?!? 20:53, 9 April 2009 (UTC)

(undent)Okay, the contents are now in oblivion.Ferrylodge (talk) 21:16, 9 April 2009 (UTC)

Call to change primary title of article to 'Spontaneous Abortion'[edit]

Miscarriage is a colloquial term for a spontaneous abortion. Furthermore spontaneous abortion is more descriptive and precise. From an etymological perspective the Latin origin is aboriri, which is often translated as 'miscarry.' More technically: ab- 'away, from' and -oriri 'be born' (Oxford American Dictionary). I therefore feel that it would be more appropriate to redirect 'miscarriage' to 'spontaneous abortion' rather than the other way around.

If there is no discussion in ten days I will make the change. Otherwise I hope there can be a consensus on what is most appropriate. Ibrmrn (talk) 17:50, 25 April 2009 (UTC)

The current title seems okay to me. We could certainly insert some info about etymology, just like in the fetus article.Ferrylodge (talk) 21:29, 25 April 2009 (UTC)
That may be the most appropriate action. I've been doing a little more reading and it seems that physicians try to use miscarriage over abortion to avoid the negative connotation that is often coupled with the word abortion. Still the goal here seems to be to have the most accurate article, not necessarily to reflect cultural norms. Why do you feel 'okay' with the current title Ferrylodge? Would you feel just as 'okay' with the proposed change? Are there any other opinions?Ibrmrn (talk) 22:23, 1 May 2009 (UTC)
Having done some reading here I agree that miscarriage is the term generally used. It is also the prefered nomenclature according to this document (2005) from the European Society of Human Reproduction and Embryology: [5]
"The traditional grouping of all pregnancy losses prior to 24 weeks as ‘abortion’ may have had pragmatic origins, but it is poor in terms of definition and makes little sense. The term abortion is also confusing for the patient. She may not realize that (spontaneous) abortion is not a termination of pregnancy because ‘medical abortion’ or ‘legal abortion’ is used in the same way." (see above link: Introduction - 2nd paragraph)
The title of an article should be understandable to the non-professional because an encyclopedia is for general use. The unborn baby is being carried in the womb during pregnancy and so miscarriage is the more correct term in my opinion. Early miscarriage is when the the loss is before 12 weeks, and late miscarriage after 12 weeks, according to:[[6]]. According to the ESHRE document linked to above, the term spontaneous abortion is to be avoided, and spontaneous miscarriage prefered. (see Table I) [7] In my opinion there is no need to change the redirect and we should keep the primary title as Miscarriage. User: DMSBel 62.254.133.139 (talk) 07:55, 16 February 2011 (UTC)
Moved to new section: If I may also comment from my perspective as a reader wanting to understand the topic - I find the term "spontaneous abortion" less than clear and don't think it's use helps comprehension. Are there any objections to the use of "spontaneous miscarriage" in place of "spontaneous abortion" in the article? User: DMSBel 62.254.133.139 (talk) 11:21, 16 February 2011 (UTC)

Ref for recurrent pregnancy loss[edit]

I fixed a dead link used as a ref for the rate of recurrent pregnancy loss. Reading through the guideline after I found the new url, I noticed it doesn't actually say anything about the rate of RPL. It looks like we need a new ref, if anyone is inclined to look for one. LyrlTalk C 20:57, 25 June 2009 (UTC)

The recurrent pregnancy loss uses math rather than data. According to Mayo Clinic, (http://www.mayoclinic.com/health/miscarriage/DS01105/DSECTION=risk-factors) the percentage of a chance to have a second miscarriage is the same as the first, and it increases (rather than decreases) after that. Musikcat04 (talk) 05:51, 25 February 2011 (UTC)

Autoimmune diease / miscarriage[edit]

Lyrl, nobody nows whether autoimmune disease may cause miscarriage or vice versa. You deleted my sentences (that miscarriage may cause autoimmunity) because you felt that it was not supported by "experimental evidence". Well, the former reasoning also lacks such evidence, so why did you left it there? Or can you cite any experiments supporting that view? Science is not exclusively about experiments. Empirical evidence shows that miscarriage comes first, and autoimmunity may rise only several months or a year later. Moreover, autoimmunity shows a very strong female bias, certain types occur exclusively in women -- just like spontaneous abortion. These simple facts support the view you have deleted, and contradict the opposite view, that you left there. I intend hang on. Hope you think it over. Best, User:Lajos.Rozsa 11:39, 2. December 2009. (UTC) —Preceding unsigned comment added by 193.224.72.252 (talk)

I have modified the wording in the article to better reflect the current state of knowledge - simply that there is a correlation. Indisputably, women with some autoimmune diseases have difficulty carrying a pregnancy to term - see for example PMID 19816395. I believe that is the information most readers are interested in; I hope the new wording continues to convey that information while improving the technical accuracy of the sentence.
A review of the first page of hits on PubMed gave me the impression that there is no consensus about miscarriage causing autoimmune disease. If this article needs expansion on the topic, it would be better to cite a review article such as PMID 19842070 (a secondary source) rather than a single primary source (see Wikipedia:No original research#Primary, secondary and tertiary sources). LyrlTalk C 03:01, 3 December 2009 (UTC)

=== Maternal gene defect in MTHFR possibly associated with recurring pregnancy failure A new-ish gene test can identify whether the mother has a defective form of the MTHFR gene. Methylenetetrahydrofolate Reductase (MTHFR) is necessary to convert folic acid to folate. At least 2 identified defects in the MTHFR gene, at 677 and 1298, reduce efficiency in the conversion to folate. Without sufficient folate, there is a risk to the fetus of neural tube defects like spina bifida. If a fetus begins to develop these conditions, there is a high risk of either miscarriage or birth defect. Pregnant women are told to take folic acid supplements to prevent the birth defects and miscarriage risks, but it hasn't yet become common knowledge that some women have an MTHFR defect and can't use the folic acid efficiently, so either additional folic acid or direct Methyltetrahydrofolate supplements like FolaPro (by MetaMetrix) are needed. If you or closely related women are experiencing repeated pregnancy failures (from failure to implant to stillborn), talk to your doctor about an MTHFR gene test. I'm posting this after my cousin and I have experienced a total of more than 10 failed pregnancies, and another cousin has had 3. The tragedy of all these miscarriages might have been lessened if we knew earlier that our family shares the MTHFR 1298 defect. — Preceding unsigned comment added by Cassiebabe (talkcontribs) 03:07, 23 March 2012 (UTC)

Diabetes and Miscarriage[edit]

While it is true that pre-existing diabetes does increase the risks during pregnancy, it is NOT true that gestational diabetes increases miscarriage risk. No study has ever found a correlation between the two. Pregnancy is naturally a high-glucose condition, where the level of sugars in the pregnant woman's bloodstream is elevated above those of non-pregnant people. For most people "diagnosed" with gestational diabetes, the only associated risk is birthing a larger baby. Most women can accommodate birthing large babies if they are able to move freely during labor and push in a position of their choosing. —Preceding unsigned comment added by 98.67.60.99 (talk) 19:08, 21 May 2010 (UTC)

General Risk Factors[edit]

I would like to address the part of this section on paternal tobacco use where the author says, "The husband study observed a 4% increased risk for husbands who smoke less than 20 cigarettes/day, and an 81% increased risk for husbands who smoke 20 or more cigarettes/day." After reading the referenced study "Paternal Smoking and Pregnancy Loss" regarding the research done in China, I can not determine where it says or indicates there is an "81%" increased risk [of pregnancy loss] for husbands who smoke 20 or more cigarettes / day. It struck me as rather odd for the risk factor to jump from 4% to 81% depending on whether or not a man smoked 1/2 a pack of cigarettes a day or a full pack.

http://aje.oxfordjournals.org/cgi/content/full/159/10/993

Judging from Table 2: Outcomes of prospective observation and prevalence of early pregnancy losses in Anhui, China, by husband’s smoking amount, 1996–1998, it seems as though the group of husbands who smoked over 20 cigarettes / day had 71 clinical pregnancies, of which 45 experienced zero pregnancy loss. That would mean 63% of those pregnancies were successful, correct? It's a bold statement to imply that the risk of a miscarriage increases 81% if the father smokes over 20 cigarettes / day. I just want to call attention to this statement so that maybe the author will make certain such a claim is legitimate or perhaps rephrase it. A woman's exposer to passive smoke and tea & alcohol consumption were also factors noted regarding pregnancy loss in this study. Whereas in the "Miscarriage" Wikipedia article one might easily conclude that the sole contributing factor to pregnancy loss among paternal smokers is chromosomal damage. —Preceding unsigned comment added by Atxgal (talkcontribs) 12:04, 24 June 2010 (UTC)

On the use of terms "spontaneous abortion", "missed abortion" etc.[edit]

If I may comment from my perspective as a reader wanting to understand the topic - I find the term "spontaneous abortion" somewhat less than clear and don't think it's use helps comprehension. Are there any objections to the use of "spontaneous miscarriage" in place of "spontaneous abortion" in the article? and likewise for "missed abortion" to "delayed miscarriage"(see [[8]]) User: DMSBel 62.254.133.139 (talk) 11:21, 16 February 2011 (UTC)

Looking back through the discussion in other sections, I hope my above comments will not complicate things (as I saw after posting that there had been quite a bit of discussion on the various terminology). In my view it would be good to differentiate between abortion and miscarriage by avoiding the use of the word "abortion" in primary terminology in this article (as far as possible) for purpose of clarity. Obviously it is still used as a medical term, but as the above link explains it is not always prefered. User: DMSBel 62.254.133.139 (talk) 14:00, 16 February 2011 (UTC)

It's worth bearing in mind that this article is not just about spontaneous abortion in humans, but about it generally in all viviparous animals. In non-human animals the term "miscarriage" is rarely or never used, and so too careful an avoidance of "abortion" may create confusion. Either way the term "spontaneous abortion" is actually very clear (what else could it possibly mean?). Also worth remembering that Wikipedia is not censored, and so "preference" should be a minor reason for the choice of term. Richard New Forest (talk) 14:25, 16 February 2011 (UTC)
The article is primarily about miscarriage in women and I think that is fine. There has been suggestion for a separate article on miscarriage in animals which would be fine too. I don't see why you bring up WP:NOTCENSORED? Did you read the linked to article? If you find it clear that's fine, however the clarity issue is one that has been raised by the European Society for Human Reproduction and Embryology. And I don't think that can be ignored. Perhaps unless there is a consensus it would be best to leave it as it is for now. I'll add a footnote though. The term "missed abortion" is less clear (ie. more liable to be misunderstood). 62.254.133.139 (talk) 14:51, 16 February 2011 (UTC)
No, I don't think that's right. An article "primarily about miscarriage in women" would be called Miscarriage in humans or some such. The range of this article is not restricted in that way – it just happens to have more material about humans than other animals. On the other hand if we do want to keep the range of the article to humans, it needs to be moved to a new title. Richard New Forest (talk) 22:35, 23 February 2011 (UTC)
DMSBel asked for my opinion because I commented about this previously. My opinion is that we would be most consistent with reliable sources if we use the word "abortion" in the first sentence, and then nowhere else except the sections titled "terminology" and "in other animals". This doesn't seem like a hugely important thing, even though it would be best if everyone agrees with me.  :-)Anythingyouwant (talk) 16:18, 16 February 2011 (UTC)
I have been thinking a lot about this. You're right it is not hugely important, and I'd rather not change it if it likely to create problems, though I am agreeance with your suggestion about where to keep it in and where to change it. I have added a sentence to the terminology section to indicate that an updated nomenclature has been proposed from within the medical profession. I am not sure how widely the updated terminology has been adopted, but I think it is fair to say that the "spontaneous abortion" term is still in use. Since that is the case it would be best to use it in the lead. Is it necessary to explain that it is synonymous with "spontaneous miscarriage"?. I know there has been discussion here previously and an attempt to differentiate terminology, which is important, but it seems to have got bogged down in trying to differentiate what (to my mind at least) seems to be at times almost synonymous phrases as though they have widely differing meaning. DMSBel (talk) 18:14, 16 February 2011 (UTC)
This article does not presently use the term "spontaneous miscarriage" and that's fine with me, because it's not a common term, and also it's redundant (all miscarriages are spontaneous).Anythingyouwant (talk) 18:44, 16 February 2011 (UTC)
Well yes, they are all spontaneous, it's just a matter of consistency. Should we just use "miscarriage" then instead of "spontaneous abortion"? There is also "threatened abortion". I think it would make more sense to use miscarriage in each instance that abortion is used, since miscarriage is already used in the article fairly heavily.DMSBel (talk) 19:02, 16 February 2011 (UTC)
Sorry, should have read the article more closely - I see that "delayed miscarriage" is mentioned as the alternative for "missed abortion". On second thoughts it seems better to leave things as they are.DMSBel (talk) 19:22, 16 February 2011 (UTC)

I have no problems with keeping the title miscarriage. Ibrmrn (talk) 16:18, 23 February 2011 (UTC)

The article says "In the recent past, health professionals used the phrase “spontaneous abortion” interchangeably with “miscarriage”. However, many women who have had miscarriages object to the term "abortion" in connection with their experience, because in everyday English the word is strongly associated with induced abortions. Use of inappropriate terminology may cause women to feel that their experiences are not being recognised or appropriately acknowledged." however there is no citation for this. Can this be cited please?108.15.50.162 (talk) 11:04, 5 June 2013 (UTC)

Rename to Spontaneous abortion[edit]

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the move request was: not moved. No support at all, and the common name is not disputed, reflecting the previous consensus. It seems likely that some or all of this edit should be reverted in the light of this. Andrewa (talk) 09:50, 25 May 2012 (UTC)


MiscarriageSpontaneous abortion

Rename to Spontaneous abortion.

  • Support I think it is ridiculous that the whole article uses the term "spontaneous abortion", but the title of the article is "miscarriage". Either the article is renamed "spontaneous abortion", or if it stays with the current title of "miscarriage", than the text is changed back to "miscarriage" everywhere it currently uses "spontaneous abortion". 5.12.65.248 (talk) 23:46, 17 May 2012 (UTC)
  • Oppose I disagree with your assertion. I do not find it unreasonable that the article is titled miscarriage but uses the term spontaneous abortion. — Preceding unsigned comment added by Triacylglyceride (talkcontribs) 02:53, 18 May 2012 (UTC)
Whoops, didn't realize it was that formal a motion... never seen one put up without the putter-upper indicating their support or opposition.
  • Oppose per WP:UCN (use common names) and User:DMSBel's comments in a previous discussion of the title above. —  AjaxSmack  05:43, 19 May 2012 (UTC)
  • Oppose The problem is not with the name but with the text of the article. It looks like someone has spent some time folding their idiosyncratic displeasure with use of the vastly more common name into the article text. Imagine if every article topic that had a scientific name began this way. Our article on sheep would begin thusly: "Sheep the unscientific name for Ovis aries..." and then Ovis aries would be used throughout instead of just plain sheep. The first sentence is absurd and it continues from there. This common name issue is not close here, e.g. this versus this.--Fuhghettaboutit (talk) 23:30, 24 May 2012 (UTC)
The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

Changes to lede and terminology in the article[edit]

I did some small changes to the lede, as suggested above - a partial revert of the edit of user:83d40m - but the article may still need changes in regard to terminology. I believe the use of "miscarriage" vs. "spontaneous abortion" should be consistent throughout the article. — Preceding unsigned comment added by 5.12.77.206 (talk) 17:33, 25 May 2012 (UTC)

This is a great improvement. I realise that most people don't see a lot of difference between miscarriage, which is an event, and "miscarriage", which is a term describing the event, but semantically there is a very significant difference, and failure to observe this distinction is often a warning of other problems with an article. On the other hand if we make the lead clear and logical, other problems often disappear. Andrewa (talk) 12:38, 26 May 2012 (UTC)
There were still inaccuracies and imprecision in the terminology section (eg not being clear on time of death and time of birth), and it was very UK-specific for something that differs so much in the English-speaking world and beyond. There were claims about women's views that aren't supported by the literature (as someone's inline comment queried), and some of the phrasing about women's reports of their miscarriages would be offensive to many (in relation to ultrasound). I think the table has too many inaccuracies to be kept in that form, and given the major international differences here, I wonder at it's desirability. Perhaps a more vague illustration would be better, or don't even try to bring precision into something that isn't precise. Really, people needed to be guided by the profession or relevant authority in their own country. Perhaps a collection of those would be better? I added some as in-line citations.Hildabast (talk) 20:51, 4 July 2013 (UTC)

Baby vs. fetus[edit]

I notice that the lede sentence of this article uses the split noun phrase "a baby... in the early stages of its development as a fetus prior to fetal viability (the stage of potential independent survival)."

This seems unnecessarily awkward and imprecise to me. Why not simply say "an embryo or fetus... prior to fetal viability (the stage of potential independent survival)."

Seems like it would cut down on unnecessary rephrasing ("a baby, when it was a fetus" is a bit like saying "a chicken, when it was an egg," or at best "a cat, when it was a kitten" -- in either case, you could just skip to the egg/kitten), be more precise (the current phrasing does not include "embryo"), and avoid POV.

Proposal: A miscarriage is the natural death of an embryo or fetus while it is still in the womb, prior to fetal viability (the stage of potential independent survival).

PS: I also replaced "its mother's" with "the," mostly because it looked more natural to me. Copy-editing grounds alone; I'm not pushing POV by removing it. Please consider the two edits separately in your feedback.

Triacylglyceride (talk) 19:22, 10 November 2013 (UTC)

Point taken--I split the sentences. Red Slash 00:46, 19 November 2013 (UTC)