What is a Missed Miscarriage?
A missed miscarriage occurs when the fetus dies, however the woman's body continues as if the fetus is still viable. The diagnosis of a missed miscarriage is usaully considered after fetal heart tones are not heard or the size of the uterus has not grown. Then a ultrasound will be performed which will show a fetus that stopped growing several weeks prior to the ultrasound and there will be no fetal heart tones.
Signs and Symptoms of Missed Miscarriage
A missed miscarriage will usually have no signs and symptoms initially. The woman will usuall feel as if the pregnancy is going just fine. There are some women who may experience some dark brown vaginal spotting but this is not a definative sign of a missed miscarriage. Other women have stated that they have lost some of the signs and symptoms of pregnancy such as breast tenderness, nausea, and / or fatigue. With a missed miscarraige women will not have lower abdominal or pelvic pain. To learn more Go To Signs and Symptoms of Miscarriage.
Causes of Missed Miscarriage
There are several causes for a missed miscarriage and it depends on when during the pregnancy the missed miscarriage occurs. Due to the fact that most missed miscarriages occur within the first twelve weeks of gestation the cause is most commonly due to chromosomal abnormalities within the fetus. These chromosomal abnormalities can be due to several factors including poor quality sperm or egg, abnormal cell division of the fetus, and / or genetic abnormalities of either mother or father. Other causes of a missed miscarriage include infection (ie. Chlamydia, Cytomegalovirus, Genital herpes, Syphilis, Toxoplasmosis, and Rubella), abnormal uterine anatomy (ie. unicornate uterus or septate uterus), abnormal hormonal levels within the mother (ie. low progesterone), systemic illnesses (ie. untreated thyroid disease or diabetes), immune disorders, and substance abuse. To learn more about the causes Go To Cause of Miscarriage.
Treatment of Missed Miscarriage
A missed miscarriage requires medical intervention. The treatment option for a missed miscarriage are medical (medication) or surgical (D&C). The surgical treatment option for a missed miscarriage is a D&C (dilatation & curettage). A D&C entails a women going into the hospital and having anesthesia while an obstitrician dialates her cervix and curettes (scrapes) the uterine lining to ensure complete removal of all products of conception. This is done for a missed miscarriage to prevent infections, severe bleeding and other associated complications. A benefit of this type of treatment is that the products of conception are sent to a pathologist for evaluation and genetic testing can be performed if so desired. Another treatment option for a missed miscarriage is medication. A physician will place prostaglandins inside the vagina next to the cervix to allow the cervix to soften, dialate, and contract. After a certain amount of time if there are no uterine contractions then the physician can start pitocin. Once the contractions begin the woman's body will deliver the products of conception. Again this treatment option requires the woman to go into the hospital for her care. Another follow-up test that should be performed is serial hCG levels to ensure that they are decreasing.
A extremely difficult part of a missed miscarriage is the emotional aspect. A woman and the couple have to cope with the missed miscarriage. With a missed miscarriage the couple feels that their pregnanc is going just fine only to be devastated by with the news that their fetus has died. If a couple has experienced several early miscarriages (2-3) there is genetic counseling available through their physician. To learn more Go To Treatment of Miscarriage.
It is recommended that a couple wait at least one regular menstrual cycle before trying to conceive again after a missed miscarriage.
