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Signs, Symptoms, and Types of Miscarriage

By CNY Fertility Updated on — Medically Reviewed and Certified by Dr. Edward Ditkoff Dr. Edward Ditkoff

Our mothers and grandmothers didn’t discuss it, but losing a pregnancy within the first 20 weeks is incredibly common, with most losses occurring before the 13th week.  As many as 10-25% of all recognized pregnancies will end in miscarriage. Of these, nearly 50-75% will be chemical pregnancies or a pregnancy that ends just after implantation so that any bleeding coincides with an expected period and often goes unrecognized as a miscarriage.

SYMPTOMS OF MISCARRIAGE

Symptoms of miscarriage can vary, be vague, or be completely absent. Some of the signs that could indicate that there is a miscarriage include:

  • decreased pregnancy symptoms
  • spotting or bleeding
  • unusual persistent cramping. 

WHAT TO DO IF YOU THINK YOU’RE HAVING MISCARRIAGE?

If you’re pregnant and experiencing any of the above symptoms, please contact your doctor or medical provider immediately. He or she can advise you as to the next steps.  But keep in mind that many women experience some vaginal spotting in the first trimester of pregnancy that does not result in a miscarriage. 

DIAGNOSING A MISCARRIAGE

A doctor can diagnose a miscarriage in several ways:

  • Bloodwork:  Your doctor can check to see if your levels of hCG (human chorionic gonadotropin) and progesterone are normal. Levels of both rise quickly in early pregnancy. Depending on how far along you are, your doctor may order several sets of blood tests several days apart to compare results.
  • Ultrasound:  To check for a fetal sac and heartbeat, your doctor can use a transvaginal or abdominal ultrasound.
  • Pelvic Exam:  By conducting a pelvic exam, your provider can determine whether your cervix has thinned or opened.

WHY DO MISCARRIAGES HAPPEN?

Most first trimester miscarriages are the result of chromosomal abnormalities; there is very little a mom can do to prevent one from happening outside of IVF with Genetic Testing. Having chromosomal abnormalities means something was wrong with the baby’s genetic structure—likely an extra chromosome or missing chromosome—the result of damaged egg or sperm or a problem during cell division.  Other causes can include:

  •   Womb structure abnormality the restricts development of the fetus
  •   Placental problem that interrupts blood supply
  •   Polycystic Ovary Syndrome (PCOS) which causes a hormonal imbalance
  •   Weakened cervix
  •   Infection
  •   Rubella
  •   Improper implantation
  •   Lifestyle factors:  malnutrition, exposure to toxic substances, smoking, drinking alcohol, and use of drugs can increase the risk of miscarriage
  •   Maternal age
  •   Underlying health problems: certain pre-existing health conditions have been known to contribute to miscarriage—high blood pressure, diabetes, lupus, thyroid problems, HIV, and other sexually transmitted diseases
  •       Being at an unhealthy weight – either over or underweight
  • immune disorders
  • clotting disorders

TYPES OF MISCARRIAGE

Depending on where you are in the process, you may hear your doctor use a variety of different medical terms to describe what you’re experiencing.

Threatened Miscarriage

  • Some degree of bleeding in early pregnancy with backache and cramping. Often a result of implantation and the cervix remains closed. In this case, pregnancy continues.
  • Inevitable or Incomplete Miscarriage

  • Abdominal or back pain, bleeding, with dilation or effacement of the cervix or rupture of the membranes. If the cervix is open, the miscarriage is considered inevitable. Bleeding and cramps may continue If the miscarriage isn’t complete.
  • Complete Miscarriage

  • When the embryo and all products of conception have emptied from the uterus, a miscarriage is termed complete. With this, bleeding and cramping usually subside quickly. An ultrasound can confirm that all tissue has been expelled. If some remains, your doctor may recommend you have a dilation and curettage (D&C) performed.
  • Missed Miscarriage

  • There are no other symptoms, such as bleeding or pain. In this, the fetus didn’t form or has died but is not expelled.  We don’t know why this occurs, but a mother typically experiences a loss of pregnancy symptoms with no fetal heartbeat detected on ultrasound. 
  • Blighted Ovum

  • When a fertilized egg implants into the uterine wall but fetal development never begins. A gestational sac is seen on ultrasound, but no fetal growth occurs.
  • Recurrent Miscarriage

  • Defined as three or more consecutive first trimester miscarriages of clinical pregnancies.  Recurrent Pregnancy loss affects about 1% of couples trying to conceive. The good news is that nearly two-thirds of women who have recurrent miscarriages will eventually carry a healthy pregnancy to full-term often without any treatment.  Pregnant women older than 35 have a higher risk of recurrent miscarriage. Those with recurrent pregnancy loss may need the assistance of reproductive immunology in order to bring a child safely into the world.

Preventing Miscarriage

Once a miscarriage starts to take place, there is nothing that can be done to prevent that miscarriage.

There are however many dietary, lifestyle, and pharmacological approaches that may help reduce the odds of having a miscarriage in the future.

  • Diet: It is recommended that those in pregnancy eat a high fat low carbohydrate diet, which helps reduce inflammation and quiet the immune system, which is thought to play a role in recurrent pregnancy loss. It is also important to take prenatal vitamins.
  • Lifestyle: Mild exercise like yoga, tai chi, walking are recommended, while high-intensity exercise should be avoided. Similarly, acupuncture can help manage stress and improve pregnancy outcomes. It is also imperative one stays away from tobacco, alcohol, and other drugs.
  • Medications: Numerous pharmacological drugs can help maintain a healthy pregnancy like low dose aspirin, Lovenox, Intralipids, LDN, and more.

MISCARRIAGE MYTHS

There’s a lot of misinformation about miscarriages, but thankfully also a large body of research to separate fact from fiction. Here is a list of things that are NOT known to cause a miscarriage:

  •   Working outside the home (unless in a harmful environment)
  •   Sex
  •   Moderate exercise

DEALING WITH THE LOSS

Even though your chances of miscarrying during your reproductive years are quite high, that doesn’t make the loss any easier to bear.  Suffering a miscarriage at any stage can be quite traumatic. A sense of guilt often follows it: was there anything I could have done to prevent it?  Was it the glass of wine I had before I knew I was pregnant? In most cases, there was nothing a mother could have or should have done differently to prevent the loss.

Miscarriage takes both a physical and emotional toll, and it affects both parents. You go from the high of rejoicing your awaited baby to the low of mourning the loss of a child and all the hopes you had for them. A full range of emotions can be expected:  sadness, anger, guilt, anxiety, resentment, despair, withdrawal, and acceptance. In many ways, it can feel like things are simply beyond your control. There’s no right or wrong reaction.

The grief you feel is real, and it’s important to reach out to your partner, friends, support group, clergy, or mental health counselor to find the support you need for as long as you need it. Many women find that once they work up the courage to discuss the topic of miscarriage with friends, they are surprised by the number of women close to them who have shared the same heart-breaking experience.

As time passes, you should begin to feel better. If you don’t, seek professional counseling so you can start to heal.

Similarly, it can be a good idea to reach out to a fertility specialist, particularly if you have experienced two, three, or more miscarriages to reduce the risk and discover the cause of your recurrent pregnancy loss.

If you’re ready to build your family, CNY Fertility is prepared to help no matter where you are in your journey.  Schedule your consultation today, or give us a call 1-844-315-BABY. We’re here for you every step of the way!

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