Miscarriage - Diagnosis and tests

Miscarriage is defined as the loss of an embryo before the 20th week of pregnancy as it is incapable of surviving independently. In medical terminology, miscarriage is a type of abortion, as it refers to the pregnancy ends with the death and removal or expulsion of the fetus, regardless of whether it is spontaneous or medically induced abortion. In US alone, over 15% of pregnancy ends in miscarriage.
Diagnosis and tests
Vaginal bleeding can be caused by the rupture of a small vein on the outer rim of the placenta, ectopic pregnancy or it is a sign of miscarriage. In fact, Bleeding in early pregnancy may be a sign of a threatened or early miscarriage.
1. Physical exams
If you have vaginal bleeding, your doctor after recording the family history, a physical exam includes the examine your cervix to determine the cause of bleeding if he/she can such as is the cervix is dilated? is uterus enlarged abnormally?

2. Blood test
a. Human chorionic gonadotrophin
The hCG blood tests are done over two days apart. In early pregnancy, If the hCG doubling time is slower or if the level decreases over time, It may be an early indication of miscarriage or ectopic pregnancy.
b. Antinuclear antibody
The normal titer of ANA is 1:40 or less. Any higher titers may be an indication of autoimmune disease which may cause miscarriage if it attaches the fetus tissue or organs.

3. Hysterosalpingography (HSG)
It is a radiologic test such as radiography, to look into the image of the shape of the uterine cavity and the fallopian tubes for any abnormality which can affect the progression of the pregnancy or may be an early sign of miscarriage.

4. Pelvic ultrasound
Pelvic ultrasound is an image test by using high frequency sound waves to generate the the image which will be sent to your doctor to examine for any abnormality in the pelvic.

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