Missed miscarriages are a type of pregnancy loss without the expected bleeding and cramping. Most are detected at routine prenatal visits when there is no embryonic growth or heartbeat. They can feel unexpected and devastating.
Why do they happen?
The majority of missed miscarriages occur in the first 12 weeks of pregnancy. This type of pregnancy loss often happens as a result of chromosomal abnormalities with the embryo, for example if the embryo has too many or too few chromosomes. In other cases, a missed miscarriage occurs for unknown reasons.
What are the symptoms?
Women who experience a missed miscarriage usually don’t have typical miscarriage symptoms like bleeding or pain. In most cases, the miscarriage goes undetected until a woman’s next appointment. Some women still experience pregnancy symptoms, which can cause even more heartbreak and confusion.
How is a missed miscarriage diagnosed?
An ultrasound will confirm a missed miscarriage. The provider will also probably take a blood test to measure hCG levels (the hormone that is produced during pregnancy). If these are low and there’s no heartbeat to be found in the ultrasound, the provider will diagnose a missed miscarriage.
How is a missed miscarriage treated?
With a missed miscarriage, the body still has to expel pregnancy tissue, so after a diagnosis the next step is determining a way to remove this tissue. A provider might recommend any of the following for treatment depending on how far along the pregnancy was and your unique health history and risk factors Your feelings and preferences are also very important when making a decision about how to proceed.
- Wait and let the tissue expel naturally: Women may choose this option if they want to let the pregnancy end on its own, or if they don’t yet want to take medical or surgical action.
- Medical treatment: Both mifepristone and misoprostol or misoprostol alone are the medications used in helping the body expel the tissue. Different institutions have varying policies on which medications are administered and limits for when this can be done. .
- Surgical treatment: A provider might recommend a dilation and curettage (D&C) or manual vacuum aspiration if a surgical option is desired. For the procedures, anesthesia is given, either locally to the cervix or systemically, the cervix is dilated and the contents inside the uterus are removed.
What comes after treatment?
Many providers may recommend waiting one menstrual cycle before trying again to conceive after being treated for a missed miscarriage. .. However, whether one wants to try immediately after a missed miscarriage is completely up to the person as some may want to take time to recover emotionally and physically. It takes some women a long time to recover from the loss, although the healing process is different for everyone. Those who experience a missed miscarriage are at higher risk for postpartum depression, so it’s important to find a way to process the feelings from the miscarriage or reach out to a support person..
Reviewed by the Ovia Health Clinical Team
Read more
Sources
- Linda W. Prine, Honor Macnaughton. “Office Management of Early Pregnancy Loss.” Am Fam Physician. 84(1):75-82. Web. Jul 2011.
- “Miscarriages.” KidsHealth. Nemours Foundation, Jun 2015. Web.
- https://pubmed.ncbi.nlm.nih.gov/34696822/
