A missed miscarriage happens when the pregnancy stops developing before the 20th week of pregnancy.
Also known as a silent miscarriage, a missed miscarriage typically happens without many symptoms.
Your body may still feel pregnant, and you may still experience pregnancy symptoms.
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It is typically diagnosed when there is no fetal cardiac activity during a routine prenatal ultrasound.
There are several potential causes for a missed miscarriage.
Potential causes include:
Amolar pregnancyis abnormal cell growth in the fertilized egg or placental tissue.
In either instance, the pregnancy typically ends early in a miscarriage.
In some cases, an individual may experience few or no symptoms.
Around 10% of known pregnancies willend in miscarriage.
And in up to 50% of miscarriages, chromosomal or genetic abnormalities of the fetus are the cause.
The percentage of pregnancies that result in miscarriage increases with age.
What Are the Signs of a Missed Miscarriage?
In a missed miscarriage, you may not experience any signs and continue tofeel pregnant.
Sometimes, a person might have some cramping and brownish-pink or redvaginal discharge.
What Are the Odds of Having a Silent Miscarriage?
The most common time to have a miscarriage is during the first trimester and before 10 weeks.
In most cases, there are no signs that anything is wrong.
Since the majority of missed miscarriages happen early on, there are no signs such as reduced fetal movement.
Additionally, even though a silent miscarriage has occurred,pregnancy hormonesare still high.
A pregnancy test may continue to show a positive result as well.
Diagnosis
A missed miscarriage is often diagnosed during a prenatal care visit.
The ultrasound may also show an empty amniotic sac or no sac.
In this instance, the fetus stopped developing very early or was reabsorbed by the body.
Sometimes, an empty amniotic sac is referred to as an anembryonic pregnancy or a blighted ovum.
After 20 weeks, a fetus that passes away is called a fetal demise instead of a miscarriage.
The healthcare provider may also order bloodwork to look at pregnancy hormones.
If they are not increasing, then a miscarriage is more likely.
What Is the Best Way To Treat a Missed Miscarriage?
This is because molar pregnancies have the potential to cause severe bleeding and other health complications.
Expectant Management
Expectant management is often an acceptable option if an individual is in the first trimester.
Expectant management means waiting to see if the body eventually miscarries and expels the pregnancy.
This method is successful approximately 80% of the time.
Your provider may check in or have you call when you have passed the tissue.
It will feel like a heavy period withmoderate to heavy bleedingand cramping.
However, waiting can be very challenging psychologically or not a safe option if the pregnancy is farther along.
Medical or surgical management are other options to consider.
The two medications typically used aremifepristoneand misoprostol.
Both are safe and effective options, and they can be used together to more significant effect.
Mifepristone causes the pregnancy tissue to detach from the uterine wall.
This option gives the patient more control over the location and timing.
In both procedures, the cervix is dilated.
A tool called a curette is used to remove the pregnancy tissue from the sides of the uterus.
In D&E, aspiration is used to help remove the tissue from the uterus.
Both procedures are done underanesthesia.
How Long Does It Take for a Missed Miscarriage to Pass?
The length of time it takes for a missed miscarriage to pass varies depending on the method chosen.
Medical and surgical management takes much less time for the miscarriage to pass.
You may still experience somebleeding and crampingfor up to four to six weeks after the tissue passes.
The bleeding should lighten to spotting within that four- to six-week timeframe.
With surgical management, your provider inserts an instrument through your cervix to remove the tissue.
While the tissue is passed during the procedure, you may still bleed for several weeks after the procedure.
The bleeding should lighten and turn into spotting.
However, there are limited studies to provide evidence for the ideal timeframe to wait.
When you are ready, a healthcare provider can help you understand your options.
Reach out to your loved ones for support.
Support groups may also be helpful.
Summary
A missed miscarriage happens when the fetus stops developing but has not been physically miscarried yet.
If a person has a missed miscarriage, they might not have any symptoms.
The condition might only be discovered when they have an ultrasound at a prenatal visit.
If this does not occur, medications and medical procedures can be used to complete the miscarriage.
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An ob-gyn discusses the options.
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