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Causes for Miscarriage within the Second Trimester

A miscarriage within the second trimester is a being pregnant loss that occurs particularly between 13 weeks 0 days and 20 weeks 0 days of gestation. The incidence of second trimester loss as much as 20 weeks is lower than 1%. (After this time, the loss is extra precisely labeled as a stillbirth or neonatal dying.) Regardless of the timing, it is solely pure to need solutions when such an occasion happens.

Causes of second-trimester miscarriage differ, however, typically, the being pregnant loss is not as a result of anybody’s actions. Oftentimes, even your physician will not be capable to clarify why it occurred.

Chromosomal Abnormalities

Chromosomal abnormalities, akin to trisomies, are a serious trigger of virtually all types of being pregnant loss. Second-trimester miscarriages are attributable to these abnormalities about one-quarter of the time. Prenatal testing could have made you conscious of the potential for this, however that’s not at all times the case.

In contrast to a first-trimester being pregnant loss, second-trimester miscarriages are much less prone to be attributable to a chromosomal abnormality. All advised, round a 3rd of second-trimester losses are a results of genetic aberration.

Congenital Defects

Congenital start defects are these which can be typically inherited however may additionally be attributable to an an infection throughout being pregnant or publicity to sure teratogenic (defect-causing) medicines, chemical substances, or toxins. Beginning defects akin to coronary heart or mind malformations in your growing child could make your being pregnant a nonviable one.

Relying on the sort and severity of the start defect, your physician might be able to diagnose any potential issues by way of ultrasound. Others could also be detected throughout routine prenatal screenings.

Placental Issues 

One such downside known as a placental abruption. In case your placenta—the construction that is hooked up to the wall of the uterus and offers vitamins to your child by way of the umbilical wire—out of the blue peels off the wall of the uterus earlier than you are prepared to present start, this may forestall your growing child from getting mandatory vitamins and oxygen.

Signs of placental abruption embody vaginal bleeding, stomach ache, uterine contractions, cramping, and again ache over the last 12 weeks of being pregnant.

Cervical Insufficiency

Cervical insufficiency, also referred to as an incompetent cervix, means your cervix is weak and begins dilating and opening too quickly.

Some ladies expertise cervical insufficiency after having a difficult start or after having a cervical process akin to loop electrosurgical excision process (LEEP), laser ablation, or chilly knife conization. Others develop the situation as a result of congenital uterine malformations.

Signs of cervical insufficiency embody backache, vaginal bleeding, stomach cramps, pelvic stress, and vaginal discharge, normally between 14 and 20 weeks of being pregnant. Some are fully asymptomatic.

Infections That Trigger Miscarriages

Uterine an infection is one other doable reason behind miscarriage, though it’s a extra frequent trigger in growing international locations than in the US. Nonetheless, any untreated or extreme uterine an infection could set off the spontaneous lack of a being pregnant, together with:

  • Bacterial vaginosis
  • Chlamydia
  • Gonorrhea
  • Trichomoniasis
  • Viral vaginitis

Poorly Managed Continual Situations

Continual ailments within the mom may also enhance the chance for being pregnant loss. In lots of instances, the chance will increase if the illness is poorly managed with medicines or life-style. Different persistent circumstances carry an inherent danger of being pregnant loss relying on their severity. Examples embody:

  • Autoimmune ailments like scleroderma and antiphospholipid syndrome
  • Diabetes
  • Hypertension (hypertension)
  • Polycystic ovary syndrome (PCOS)
  • Thyroid illness

The chance could be additional elevated in ladies who smoke, are overweight, or have hormone issues.

Thrombophilia Throughout Being pregnant

Thrombophilia is an elevated danger of forming blood clots in blood vessels like veins and arteries which may be as a result of a genetic abnormality or an issue together with your immune system, akin to in lupus. This may trigger issues involving your placenta and your umbilical wire. Thrombophilia is usually handled throughout being pregnant with blood-thinning medication or with low-dose aspirin.

Signs of thrombophilia embody ache, swelling, and tenderness in your leg, normally in your calf, in addition to pink or heat pores and skin (notably behind your leg under the knee).

Belly Trauma 

Any trauma akin to an car accident, fall, or being hit within the stomach can damage each you and your growing child and probably trigger a miscarriage.

In a automobile, at all times put on a seat belt, putting the lap belt underneath the uterus and placing the shoulder strap between your breasts. Keep away from high-impact bodily actions which may trigger you to lose your steadiness. Attempt to not let your children roughhouse with you, should you can keep away from it.

In case you are a sufferer of home violence, name 1-800-799-SAFE, the Nationwide Home Violence Hotline.

Drug and Alcohol Use

Cocaine and methamphetamine are particularly linked to miscarriage. Research have proven that the usage of unlawful medication has been related to low start weight, untimely labor, placental abruption, and fetal dying. Alcohol has additionally been cited as a reason behind being pregnant loss throughout not solely the primary trimester however the second trimester as properly.

In keeping with analysis from the College of Copenhagen, gentle consuming (outlined as one to 2 drinks per week) will increase the percentages of an early second-trimester miscarriage by 70%.

Unknown Causes of Miscarriage

Generally a being pregnant loss happens for no obvious cause and, regardless of how a lot a health care provider investigates, no trigger could be discovered. As distressing as this can be, it does occur and extra regularly that one would possibly assume.

Furthermore, having had a previous second-trimester miscarriage in and of itself is a danger issue for subsequent second-trimester miscarriages. Whereas the trigger could also be recognized in some ladies (like cervical inadequate or uterine defects), others will stay a thriller.

In keeping with analysis from the College of Pennsylvania, ladies with a prior second-trimester miscarriage have been 10.8 occasions extra prone to have recurrent second-trimester losses in contrast with ladies who beforehand delivered at time period.

A Phrase From Verywell

When you’ve had second-trimester being pregnant loss and are pregnant once more, seek the advice of your physician early in your being pregnant in case further monitoring could also be wanted. A miscarriage of a previous being pregnant would not essentially imply {that a} girl is at excessive danger, as most girls go on to have wholesome pregnancies.

Verywell Household makes use of solely high-quality sources, together with peer-reviewed research, to help the info inside our articles. Learn our editorial course of to study extra about how we fact-check and maintain our content material correct, dependable, and reliable.
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  2. Edlow AG, Srinivas SK, Elovitz MA. Second-trimester loss and subsequent being pregnant outcomes: What’s the actual danger? Am J Obstet Gynecol. 2007;197(6):581.e1-6. doi:10.1016/j.ajog.2007.09.016

  3. World Well being Group. Congenital anomalies.

  4. ACOG Apply Bulletin No.142: Cerclage for the administration of cervical insufficiency. Obstet Gynecol. 2014;123(2 Pt 1):372-379. doi:10.1097/01.AOG.0000443276.68274.cc

  5. Allanson B, Jennings B, Jacques A, Charles A, Keil A, Dickinson J. An infection and Fetal Loss within the Mid-Second Trimester of Being pregnant. Obstet Gynecol Surv. 2010;65(10):613-614. doi:10.1097/ogx.0b013e3182021f22

  6. Eunice Kennedy Shriver Nationwide Institute of Baby Well being and Human Growth. What Are the Causes of and Dangers for Being pregnant Loss (Earlier than 20 Weeks of Being pregnant)?

  7. Ormesher L, Simcox L, Tower C, Greer IA. Administration of inherited thrombophilia in being pregnant. Womens Well being (Lond). 2016;12(4):433-441. doi:10.1177/1745505716653702

  8. Andersen AM, Andersen PK, Olsen J, Grønbæk M, Strandberg-Larsen Okay. Average alcohol consumption throughout being pregnant and danger of fetal dying. Int J Epidemiol. 2012;41(2):405-413. doi:10.1093/ije/dyr189


Further Studying

  • Hawkins Bressler L, Correia KF, Srouji SS, Hornstein MD, Missmer SA. Elements related to second-trimester being pregnant loss in ladies with regular uterine anatomy present process in vitro fertilization. Obstet Gynecol. 2015;125(3):621-7. doi:10.1097/AOG.0000000000000667

By Krissi Danielsson

Krissi Danielsson, MD is a health care provider of household drugs and an advocate for many who have skilled miscarriage. 

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