Lily Allen hospitalized

Pop singer Lily Allen has been hospitalized in England for a blood infection. Earlier this week Allen revealed that she had miscarried the baby she had been expecting with boyfriend Sam Cooper. She was six months pregnant at the time. Now the Daily Mail reports that Allen was hospitalized Friday with septicemia. She is being treated with antibiotics and according to her spokesperson: “She is responding well to treatment and her condition continues to improve.”

A miscarriage, sometimes called pregnancy loss, is the loss of pregnancy from natural causes before the 20th week of pregnancy. Most miscarriages occur very early in the pregnancy, often before a woman even knows she is pregnant.

What causes a miscarriage?
There are many different causes for a miscarriage, some known and others unknown. In most cases, there is nothing a woman can do to prevent a miscarriage.

There are some factors that may contribute to miscarriage:

  • The most common cause of miscarriage in the first trimester is a chromosomal abnormality in the fetus. This is usually results from a problem with the sperm or egg that prevents the fetus from developing properly.
  • During the second trimester, problems with the uterus or cervix can contribute to miscarriage.
  • Women with a disorder called polycystic ovary syndrome are three times more likely to miscarry during the early months of pregnancy than women who don’t have the syndrome.

Women who have miscarriages can and often do become pregnant again, with normal pregnancy outcomes.

What are the symptoms of and treatments for miscarriage?

Signs of a miscarriage can include:

  • Vaginal spotting or bleeding
  • Cramping or abdominal pain
  • Fluid or tissue passing from the vagina

Although vaginal bleeding is a common symptom when a woman has a miscarriage, many pregnant women have spotting early in their pregnancy but do not miscarry.  But, pregnant women who have symptoms such as bleeding should contact their health care provider immediately.

Women who miscarry early in their pregnancy usually do not need any treatment.  In some cases, a woman may need a procedure called a dilatation and curettage (D&C) to remove tissue remaining in the uterus.  A D&C can be done in a health care provider’s office, an outpatient clinic, or a hospital.

If any tissue from the pregnancy remains in the uterus it can become infected. In this case,  germs can get into the bloodstream.   This is called bacteremia. If the number of bacteria is small, the body’s immune system will take care of it.  However, if the number is higher or if the organism is more virulent (likely to cause disease), then the patient has sepsis, or septicemia.  Septicemia can begin with spiking fevers, chills, rapid breathing, and rapid heart rate. The person looks very ill.

The symptoms can rapidly progress to shock with fever or decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in mental status, and blood clotting problems. Low blood pressure can lead to organ shut down, such as kidney and liver failure.

Treatment requires hospitalization, often in an intensive care unit.  Fluids and medicines are given by an IV to maintain the blood pressure.Oxygen will be given. Antibiotics are used to treat the infection. Plasma or other blood products may be given to correct any clotting abnormalities.

For more information about miscarriage, click here to go to the Resounding Health Casebook on Miscarriage.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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