What are the signs of Miscarriage?

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Signs of miscarriage

The main signs of miscarriage, or that a person is about to miscarry, are pain and cramps in the pelvic area, and vaginal bleeding, which intensifies as the miscarriage progresses. In many pregnancies, miscarriages take place without the affected person perceiving any signs that they are going to miscarry: often, miscarriages are diagnosed during a routine ultrasound scan.

At the first signs of miscarriage, immediate medical attention should be sought. The doctor or midwife will be able to find out if the affected person is about to miscarry, or, if a miscarriage is already taking place, and can provide any treatment needed. It may be necessary to run diagnostic tests to see if a miscarriage is occurring, such as checking for levels of the pregnancy hormone human chorionic gonadotropin (hCG) in the blood and/or urine, and an ultrasound scan to detect the baby’s heartbeat.

Although they are possible signs of miscarriage, vaginal bleeding, and abdominal cramps are not always a cause for concern, as, in many cases, they can also be present due to processes that the body goes through during a healthy pregnancy. If a pregnant person’s symptoms do not indicate a miscarriage, the check-up will be an opportunity for the doctor or midwife to identify any other possible complications with the pregnancy and/or to offer them reassurance that the baby is developing normally.

Read more about Pregnancy »

Good to know: Miscarriages that occur in the first trimester (weeks 1-12 of pregnancy) are known as early miscarriages. Miscarriages that occur in the second trimester (weeks 13-20 of the pregnancy) are known as late miscarriages. Loss of the baby which occurs after week 20 of pregnancy is known as a stillbirth.^[1]

Symptoms of miscarriage

When present, common signs of a miscarriage, or that a person is about to miscarry, include:^[2]

• Abdominal cramps
• Abdominal pain
• Vaginal bleeding
• Discharge of fluid or tissue from the vagina
• Loss of the common early signs of pregnancy, such as nausea and breast tenderness

It is normal for the symptoms of early pregnancy, including nausea or sickness, vomiting, and implantation bleeding, to ease off towards the end of the first trimester, as most bodies adjust to their pregnancies. However, a sudden loss of pregnancy symptoms, which had previously been pronounced, may indicate a miscarriage. The adoctor can help you find the nearest doctor adoctor Algeria.

Differences between early and late miscarriage symptoms

Although the signs of a miscarriage ‒ including blood or spotting (small amounts of blood coming from the vagina), discharge, and abdominal pain ‒ are broadly the same whether the miscarriage is early or late, there are some differences in their specific characteristics.

Late miscarriages often involve:^[3][4]

A greater volume of vaginal discharge and bleeding

A person is more likely to see blood clots in their discharge in a late, rather than early, miscarriage. These are likely to be larger and thicker than those passed in the first trimester. Blood or spotting during the second trimester is more likely to be related to a miscarriage; small amounts of blood leaving the vagina are common in the first trimester and can be unrelated to miscarriage.

More severe abdominal pain

Cramping and abdominal pain are commonly present in miscarriages. However, the severity of the pain and cramps is greater in a late miscarriage and is unlikely to respond to traditional pain-relieving techniques such as taking a hot bath, lying in certain positions, or taking over-the-counter pain-relief medications suitable for pregnant people.

More severe back pain

Back pain can occur in both early and late miscarriages. It is possible to experience back pain throughout pregnancy without it relating to a miscarriage, as it is a normal side-effect of carrying a growing fetus in the womb. However, intense pain in the lower back is commonly a feature of late miscarriage. It results from the muscles in the lower back working to expel the unborn baby.

Loss of fetal movement

In many pregnancies, the movements of the developing fetus can be felt from around week 16 of pregnancy; for first-time mothers, fetal movement may be felt later than this, at around week 18-20. The unborn baby’s decreased or absent movement may indicate a miscarriage. However, it can also indicate other possible problems with the pregnancy and does not necessarily mean that the fetus has died. If the fetus is moving less than normal or appears to have stopped moving altogether, prompt medical investigation will be necessary to diagnose miscarriage or other possible problems.

After week 12 of pregnancy, the presence of symptoms like blood or bloody discharge coming from the vagina, abdominal pain, or back pain is more likely to indicate a miscarriage than to relate to other factors associated with a healthy pregnancy. Medical attention should be sought promptly if these symptoms occur, especially if they are present after week 12 of pregnancy.

Bleeding from the vagina in combination with abdominal pain and/or cramps is more likely to be indicative of a miscarriage than the presence of any of these symptoms on their own. Many people become concerned that they are having a miscarriage if any of its possible symptoms occur ‒ particularly the presence of blood ‒ so it is advisable to seek medical attention to check if there is a problem.

Other possible explanations for signs that could indicate miscarriage

A person who is miscarrying may experience some, all, or none of the common signs of miscarriage. However, their presence is not always a sign that a miscarriage is taking place.

Other causes for the symptoms of miscarriage include:^[5]

• Implantation. Light bleeding or spotting is commonly experienced by pregnant people around the time the fertilized egg implants in the uterus.
• Light vaginal bleeding, due to early pregnancy. Aside from implantation bleeding, spotting is also commonly present at intervals during the first 12 weeks of pregnancy. This does not always mean that one is having an early miscarriage.
• Blood flow to the pelvic area in pregnancy. Many people produce a greater quantity of discharge than usual during pregnancy as more blood flows to the pelvic area.
• Normal pain and cramps associated with pregnancy. Pain and cramps are features expected of a healthy pregnancy, to some extent. It is common to experience stomach aches and constipation, which may cause pain, especially back pain, and cramps. These symptoms of pregnancy will often worsen as the fetus develops.

Rather than meaning that a person is miscarrying, the loss of pregnancy symptoms could mean that their body is adapting well to the pregnancy. Many people experience bodily changes indicating their pregnancies, such as nausea, vomiting, and breast tenderness. However, these generally lessen or become absent as most pregnancies progress ‒ particularly after the first 12 weeks ‒ and so experiencing a loss of pregnancy symptoms is not always a sign of miscarriage or a cause for concern.

Other complications of pregnancy, which may also produce some of the symptoms associated with miscarriage, include:^[2]

• Ectopic pregnancy. This occurs when the embryo attaches outside the uterus (womb), for example in one of the fallopian tubes; a common subtype known as a tube pregnancy. As with a miscarriage, abdominal pain and bleeding or spotting are two principal signs of ectopic pregnancy.
• Molar pregnancy. This occurs when a lump of abnormal cells grows in the womb, instead of a healthy embryo. As with miscarriage, vaginal bleeding can be a sign of molar pregnancy.

Read more about Molar Pregnancy ».

Read more about Ectopic Pregnancy »

Good to know: A person can undergo an early pregnancy ultrasound scan if they suspect a miscarriage. This can put their mind at ease and/or detect any complications with the pregnancy. It is always worth consulting a medical professional if a person is worried about any potential problems with their pregnancy; a medical professional is unlikely to turn a person away if they perceive any cause for concern.

Types of miscarriage and their symptoms

It is possible to have a miscarriage without being aware of or experiencing any related symptoms such as bleeding, cramping or pain. Types of miscarriage in which symptoms may not be discernible by the pregnant person include:^[6][7]

Missed miscarriage

Many miscarriages are diagnosed during a routine scan in the course of pregnancy apparently progressing normally, due to detecting the absence of a fetal heartbeat. Before the scan, one possible warning sign of a missed miscarriage may be that the unborn baby or bump is smaller than it should be at this stage. No pregnancy tissue or fecal matter will pass out of the womb in a case of missed miscarriage, and the physical miscarriage may have to be medically induced.

Chemical pregnancy

Many miscarriages take place because the fertilized egg fails to fully and properly implant in the uterine lining. These miscarriages often occur before people are necessarily aware of their pregnancies. In miscarriages related to a chemical pregnancy, the lost fertilized egg and pregnancy tissue may be mistaken for a person’s next menstrual period, and they may therefore be unaware of miscarrying.

A miscarriage can be complete or incomplete, depending on whether all or part of the fetus and pregnancy tissue passes out of the body after the miscarriage begins:^[6]

Complete miscarriage

The entirety of the fecal matter and pregnancy tissue pass out of the uterus naturally and rapidly through the cervix, the lowest part of the womb, connecting it to the vagina, after the miscarriage begins. Pain, bleeding, and cramping will typically be experienced as the fetus and pregnancy tissue are passed. There is usually no need for further medical treatment, and doctors will advise on appropriate aftercare and possible psychological interventions to help a person process the experience of miscarrying.

Incomplete miscarriage

Only part of the fecal matter and pregnancy tissue exit the womb. Pain, bleeding, and cramping will typically be experienced as this is passed. Further medical treatment will be needed to identify the extent of the remaining tissue and to remove it.

Signs of miscarriage in diagnostic tests

A pregnant person should seek medical attention at the first sign(s) of a suspected miscarriage. The diagnostic tests to confirm a miscarriage and possible treatment options will depend on the type of miscarriage a person is having.

Early miscarriages are most commonly diagnosed using a combination of tests, including:^[8][9][10]

Human chorionic gonadotropin (hCG) test

To test for the presence of the pregnancy hormone in the blood and/or urine. Doctors will look out for low or diminishing levels of hCG compared to the levels of hCG expected for the person’s stage in pregnancy.

Pelvic exam

Doctors will examine whether the cervix is dilated and check for the presence of blood and/or pregnancy tissue in the cervical opening, both signs that can indicate a miscarriage.

Ultrasound scan

This is a non-invasive, safe imaging technique that uses sound waves to create images of the developing fetus and pregnancy sac. During a scan, doctors will lookout for signs of miscarriage including an empty pregnancy sac in the uterus, pregnancy tissue but no fetus in the uterus, and/or a fetus or embryo which is smaller than it should be by this stage of pregnancy. If the pregnancy is far enough advanced for the scan to detect the unborn baby’s heartbeat – after week seven of pregnancy – then doctors will also look out for the lack of a heartbeat.

Fetal heart scanning

This is a special type of scan that produces detailed images of the unborn baby’s heart. The absence of the baby’s heartbeat is a conclusive sign of miscarriage.

Diagnosing late miscarriage

In a late miscarriage, there may be no need for these tests to confirm the diagnosis, but any or all of them will be performed if necessary. However, the miscarriage may be conclusively evidenced by symptoms including:

• Abdominal pain
• Bleeding / spotting
• Passing a recognisable pregnancy sac or tissue
• Delivering the fetus

In this instance, tests such as an autopsy on the pregnancy tissue or a placental exam may be performed to help determine the possible causes of the miscarriage.

Read more about the diagnosis of miscarriage »

Treatment

There are a variety of treatment options available for miscarriage, depending on the type of miscarriage that a person is undergoing. Doctors will usually recommend or prescribe appropriate over-the-counter or prescription painkillers to help manage the pain and cramping. For people who have a complete miscarriage, where all pregnancy tissue and fecal matter pass out of the uterus naturally, no further medical treatment is typically needed, but psychological treatments such as counseling may be necessary to help a person process the experience.^[2]

For people having an incomplete miscarriage, there are a range of possible treatment options including:^{[11][12][13][14]}

Medically-induced miscarriage

This is a non-surgical treatment that involves taking a medication called misoprostol(Cytotec) in order to induce cramping in the uterus, which pushes out the remaining fecal matter and pregnancy tissue over the course of approximately 4-5 hours. One advantage of a medically-induced miscarriage is that the medication can be taken at home.

Manual vacuum aspiration

This procedure is usually recommended for early miscarriages or as a means of removing any remaining pregnancy tissue when the fetus has already passed out of the womb. A device is inserted into the cervix to empty the womb of the fetus and all pregnancy tissue using gentle suction. This procedure can be carried out under local anesthetic and takes around 10-15 minutes.

Surgery

There are two possible operations for surgically inducing miscarriage, both of which are usually performed under general anesthetic as outpatient procedures.

Dilation and curettage (D&C)

D&C is usually performed in early miscarriages and involves using an instrument called a curette to scrape the pregnancy tissue and fecal matter out of the dilated uterus.

Dilation and extraction (D&E)

D&E is usually performed in late miscarriages and involves using a grasping instrument called forceps to take the fetus out of the dilated uterus.

After a miscarriage

After a medically- or surgically-induced miscarriage, cramps and bleeding or spotting may continue for up to two weeks, and a person should avoid sexual activity until their next menstrual period at around 4-6 weeks after the miscarriage completes, in order to reduce the risk of infection. Absorbent products, such as sanitary pads, will be needed to manage spotting for 2-3 weeks after treatment; a person’s doctor or midwife will be able to make appropriate recommendations.

Post-miscarriage psychological intervention such as one-on-one or group counseling may be recommended to help a person process the experience, and to avoid developing anxiety and depression in the aftermath of miscarriage. Doctors will be able to recommend a range of available support options.

Read about post-miscarriage psychological intervention »

FAQs

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1. “Facts about stillbirth.” Centers for Disease Control and Prevention. 02 October 2017. Accessed: 24 January 2018. ↩

2. “Miscarriage: symptoms.” NHS Choices. 21 May 2015. Accessed: 24 January 2018. ↩ ↩ ↩

3. “Late miscarriage.” The Miscarriage Association. 2018. Accessed: 31 January 2018. ↩

4. “Understanding second trimester loss.” UC Davis Health, Department of Obstetrics and Gynecology. 2018. Accessed: 31 January 2018. ↩

5. “Symptoms & diagnosis.” The Miscarriage Association. 2018. Accessed: 31 January 2018. ↩

6. “Miscarriage.” Planned Parenthood. 2018. Accessed: 24 January 2018. ↩ ↩

7. “What is a chemical pregnancy?.” Made for Mums. 2018. Accessed: 24 January 2018. ↩

8. “Office Management of Early Pregnancy Loss.” American Family Physician. 01 July 2011. Accessed: 24 January 2018. ↩

9. “Ultrasound scans.” Miscarriage Association. 2018. Accessed: 24 January 2018. ↩

10. “Fetal heart scanning in the first trimester.” Prenatal Diagnosis. 30 December 2004. Accessed: 24 January 2018. ↩

11. “Medical miscarriage: information for patients.” Oxford Radcliffe Hospitals, NHS Trust. July 2010. Accessed: 24 January 2018. ↩

12. “First-trimester pregnancy termination: Uterine aspiration.” Uptodate. 21 September 2018. Accessed: 14 December 2018. ↩

13. “Dilation and Curettage (D&C).” The American College of Obstetrics and Gynecologists. February 2016. Accessed: 24 January 2018. ↩

14. “The D&E for miscarriage.” Elizabeth Petrucelli. 2018. Accessed: 24 January 2018. ↩

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**Understanding the Signs of Miscarriage**



**What is a Miscarriage?**



A miscarriage is ‍the spontaneous loss of a pregnancy before ‌the ‍fetus⁤ is viable. It typically occurs within the first 12 weeks of ‍gestation, but can happen at any⁣ point during pregnancy.



**Common⁤ Signs of Miscarriage**



* **Vaginal bleeding:**⁤ This may be light or heavy, and may ‍be⁢ accompanied by cramps.

* ⁢**Cramping:**⁢ Painful contractions in ‌the lower abdomen or back.

* **Passage of tissue or fluid:** This may include the fetus, placenta, or blood⁢ clots.

* **No longer having pregnancy symptoms:** Such⁢ as nausea, breast ​tenderness, or‍ fatigue.

* **Fetal ⁤heartbeat⁢ no⁢ longer detectable:** Typically confirmed through an ultrasound.

* **Cramps‍ and bleeding ⁤after​ a positive pregnancy test:** This may indicate a chemical pregnancy, ⁤where the⁤ fertilized egg fails to implant successfully.

* **Severe ​abdominal pain or fever:** This may be a sign of an ectopic pregnancy or other medical emergency.



**Causes of Miscarriage**



The exact cause ⁤of miscarriage is often‌ unknown, but​ common⁣ factors include:



* Chromosomal⁣ abnormalities

* Maternal health conditions ⁤(e.g., diabetes, thyroid issues)

* Infection or illness

*‌ Advanced maternal age

* Lifestyle factors‌ (e.g., smoking, excessive alcohol consumption)

* Physical trauma

* Uterine abnormalities



**When to Seek‍ Medical Attention**



Seek medical attention immediately⁣ if you ⁢experience any of the following:



* Heavy vaginal bleeding that soaks ‌through a pad per hour

* Severe abdominal pain or cramps

* ⁤Fever

* Passage of ‍large clots‌ or tissue

* No heartbeat ⁢detected⁣ on ultrasound after 6 weeks of pregnancy



**Treatment ​Options**



Treatment options for miscarriage depend on the stage of⁣ pregnancy⁢ and the‍ severity of the ‍symptoms.



* **Conservative⁢ management:** Monitoring ‌the situation⁢ and allowing the miscarriage to ⁣complete naturally.

* **Medical management:**​ Medications (e.g., misoprostil)‍ to induce a ⁢miscarriage.

* **Surgical management:** Dilation and curettage (D&C) to ⁤remove ⁤the pregnancy tissue.



**Recovery from Miscarriage**



Physically, most women recover ⁤from a miscarriage within‌ a few ⁢weeks. Emotionally, it can take longer to heal. Seeking⁢ support from loved ones, ⁣counselors, or support⁢ groups⁣ can help.



**Prevention**



While not all miscarriages can be prevented, ⁤healthy lifestyle‍ choices may reduce the risk:



* Maintain a ​healthy weight

* Quit smoking ‍and limit alcohol consumption

* ⁣Manage⁤ chronic health conditions (e.g., diabetes)

* ⁣Take prenatal vitamins containing folic acid

* Avoid ‍exposure​ to environmental toxins‌ and​ infections