Miscarriage Symptoms, Causes, Diagnosis, And Treatment Options

Miscarriage is a devastating experience, and no mother should have to go through it. Unfortunately, it is a common occurrence, with an estimated 23 million miscarriages happening worldwide each year.¹ A miscarriage is defined as the loss of a pregnancy before 20 weeks of gestation. If a pregnancy loss occurs after 20 weeks, it is called a stillbirth.² It is a deeply upsetting experience for expectant parents as  it can be prevented in some cases.³ In this blog, we will discuss miscarriage symptoms and some proactive practices that can help expectant couples to avoid miscarriage.

What Is Miscarriage?

As discussed above, miscarriage is a form of pregnancy loss that occurs before 20 weeks of gestation. Miscarriages can occur naturally for several reasons including genetic factors, maternal health issues, existing illness or disease. ² 

Types of Miscarriage

Here are a few types of miscarriages pregnant women might be diagnosed with ⁹:

• Complete Miscarriage: In this case, the pregnancy is lost, and your uterus is empty. You may have experienced bleeding and passed fetal tissue, which can be confirmed through an ultrasound.
• Recurrent Miscarriage: This is defined as three consecutive pregnancy losses and affects roughly 1% of couples.
• Missed Miscarriage: This occurs when the pregnancy is lost, but you may not realise it because there are no noticeable symptoms. An ultrasound will show that the fetus no longer has a heartbeat.
• Threatened Miscarriage: You may have bleeding and pelvic cramps, but your cervix remains closed. Most pregnancies continue without further problems, though your healthcare provider may monitor you more closely.
• Inevitable Miscarriage: Bleeding and cramping occur, and your cervix begins to open (dilate). Amniotic fluid may leak, and the pregnancy is unlikely to continue.

Miscarriage Symptoms

It’s important to understand that not all pregnant women will experience symptoms of miscarriage right away. That is why regular doctor’s visits are of utmost importance during this delicate phase to determine the health of your growing baby.²  

How Do I Know If I’m Having A Miscarriage?

Women who experience miscarriage may notice :

• Unusual vaginal discharge
• Sharp-acute pain in lower back or abdomen
• Vaginal bleeding or spotting
• Bleeding that gets heavier, with possible clots or gray tissue.
• Reduced pregnancy symptoms.

Miscarriage Causes

Did you know that the reason behind almost 50% of miscarriages is the presence of an extra or missing chromosome? Apart from this, miscarriages occur as the fetus’ development doesn’t take place as expected.⁴ Though there have been some rare cases, where a miscarriage happened due to either mother’s or father’s genetics.² 

If you take a look at the following, you’ll find that the cause for miscarriages can be broadly divided into 3: chromosome-related, maternal health and other factors. Let’s take a closer look at all of them.

i. Chromosome-Related

Since chromosome plays an important role in the development of an embryo, any error caused by them can lead to-⁴

• Blighted Ovum: When a fertilized egg implants to the uterus but fails to further develop. ⁵
• Intrauterine Fetal Demise: When the embryo develops but abruptly stops to grow and eventually dies.
• Molar Pregnancy: A condition in which the fertilized egg has both sets of chromosomes from father, this often results in abnormal placenta.
• Partial Molar Pregnancy: A condition where the egg receives two sets of chromosomes from the father but only one set from the mother.

ii.  Maternal-Health

Pregnancy is a delicate time for both the mother and the baby. The mother’s health plays an important role in the healthy development and growth of the baby. That’s why it is important for mothers to take care of their health during pregnancy. 

There are some health conditions that can affect pregnancy and lead to miscarriage. These conditions include-^{4 6} 

• High diabetes
• Pregnency in Hypertension (PIH)
• Hormonal conditions like PCOS
• Sexually transmitted infections (chlamydia, gonorrhea, syphilis)
• Issues with uterus or cervix
• Thyroid condition

iii. Other Factors 

Now, below-mentioned factors may not directly be associated with pregnancy. However, their impact can cause serious outcomes. ^{2 6 7}

• Blood clotting disorder (refers to a condition where the body forms blood clots more often than usual)
• Drug or alcohol abuse
• Excess maternal weight
• Exposure to environmental toxins
• Immune disorders such as lupus where the immune system attacks the healthy body parts)

What Risk Factors Increase The Likelihood Of A Miscarriage?

A risk factor is something that can make you more likely to develop a condition or disease. When it comes to miscarriage, here are some factors that can increase the risk:

• Age: Studies show that the risk of miscarriage is about 12-15% for those in their 20s, but it rises to roughly 25% for those over 40. Age-related miscarriages are often due to chromosomal abnormalities in the fetus.
• Past miscarriage: If you've had a miscarriage before, your chances of having another increase to around 25%. However, this is only a slight increase compared to those who haven't had a miscarriage.
• Health issues: Certain health conditions, such as uncontrolled diabetes, infections, or problems with the uterus or cervix, can increase the likelihood of miscarriage.

It’s a good idea to speak with your doctor about your individual risk factors. They can assess your medical history and help you understand your personal chances of experiencing a miscarriage. 

How Intense Is The Pain During A Miscarriage?

The experience of a miscarriage varies widely from person to person. Some may feel mild, period-like cramps, while others endure intense, labor-like contractions. Pain levels can also depend on the type of miscarriage. For instance, a complete miscarriage at home may cause more discomfort than a missed miscarriage managed with a medical procedure. Factors like how far along the pregnancy is and individual pain tolerance further influence the intensity. If the pain becomes severe, it’s essential to reach out to your healthcare provider.⁹

What Usually Happens At The Start Of A Miscarriage?

Miscarriage symptoms vary greatly, making it difficult to pinpoint what happens first. Some individuals have no warning signs and learn about the loss during a prenatal ultrasound. For most, cramping and bleeding occur to some degree, though the order can differ. Often, it starts with spotting or light bleeding that gradually becomes heavier, accompanied by cramping. These symptoms suggest the pregnancy tissue is beginning to pass from the uterus.⁹

How Long Does A Miscarriage Typically Last?

The process can vary depending on the individual. In many cases, a miscarriage completes within a few hours to a couple of days. However, some symptoms like light bleeding or spotting may continue for up to 4-6 weeks. ⁹ 

What Are Common Symptoms After Experiencing A Miscarriage?

After a miscarriage, some women may experience:

• Light bleeding or spotting.
• Mild cramping.
• Emotional effects like sadness, anxiety, or grief.

If symptoms like heavy bleeding, fever, or severe pain occur, medical attention is essential.⁹

Miscarriage Diagnosis

Diagnosis is a significant step which can help pregnant mothers from avoiding miscarriage. However, a diagnosis can be effective in preventing pregnancy loss only if it’s done before the to-be mom experiences miscarriage symptoms. Thus, to accurately diagnose a miscarriage, the doctor may conduct a series of screening and tests, such as pelvic exams, ultrasound scans, blood and tissue tests.^2,4 

Miscarriage Complication

When a miscarriage occurs, it can sometimes lead to complications. One such complication is septic abortion. This occurs when a part of the placenta or fetus remains in the uterus even after the miscarriage.²  This retained placental/ fetal tissue also leads to uncontrolled bleeding after the abortion. 

Miscarriage Treatment

The treatment for miscarriage typically involves post-pregnancy loss procedures. This means that doctors will make sure that the patient’s uterus is empty to prevent infection or other complications.

In cases where the fetus has not been expelled from the uterus, the doctor may recommend surgical or non-surgical treatments. Surgical treatments, such as dilation and curettage (D&C), involve removing the remaining tissue from the uterus.⁸ Non-surgical treatments, such as medication, may be used to help the body expel the tissue naturally.⁸

Moreover, the type of treatment that is best for the patient will depend on the circumstances of the miscarriage. The doctor will discuss the options with the patient and make a recommendation based on their individual needs.

When Can You Try To Conceive After A Miscarriage?

If you’re someone who has recently experienced miscarriage, then it’s recommended to wait until after your next normal menstrual cycle.⁸ However, it’s crucial to recognize and acknowledge that you’re mentally and physically prepared to conceive. 

What Can I Do To Reduce The Risk Of Another Miscarriage?

Consistent prenatal care is one way to avoid pregnancy-related complications, even miscarriage. Since miscarriage can occur due to a number of factors, preventing it completely is not possible.^2,8 However, there are some things you may consider to avoid any pregnancy-related complications:

• Maintaining healthy weight
• Avoiding risk factors such as consumption of alcohol, smoking, etc.
• Consuming prescribed prenatal vitamins
• Maintaining a healthy lifestyle
• Strictly following medications as prescribed by your gynecologist

Moreover, many times, during pregnancy, some women may experience symptoms that are similar to miscarriage symptoms, such as vaginal bleeding. However, this does not necessarily mean that a pregnancy loss will occur.² 

FAQs

Q1. Is Miscarriage Painful?

Miscarriage symptoms vary depending on how far along the pregnancy is. In the early weeks of gestation, a miscarriage may cause menstrual cramps or pain similar to that of a period. However, if a miscarriage happens in the second trimester, the woman may experience labor-like contractions, which may require hospital care.⁹

Q2. Can Stress Cause Miscarriage?

Studies have shown a link between high stress and an increased risk of miscarriage. However, more research is still needed to understand the exact reason.¹⁰ It is, therefore, recommended that expectant mothers find ways to manage stress, as this is not only good for their mental health, but also for the health of their unborn baby.¹¹ 

Q3. How Long Does A Miscarriage Last?

After a miscarriage, most of the tissue passes out of the body within 2-4 hours of cramping and bleeding. However, some women may experience light bleeding for up to 4-6 weeks. A follow-up ultrasound scan with a gynecologist can help to confirm that all of the tissue has passed and that there are no complications.¹²

Q4. Which Week Has The Highest Risk Of Miscarriage?

About 8 out of 10 miscarriages happen in the first trimester, before the 12th week of pregnancy. And about 1 to 5 in 100 pregnancies may result in miscarriage in the second trimester, between the 13th and 19th weeks.¹³ This means that the risk of miscarriage is highest in the first trimester, but it can still happen in the second trimester. 

Q5. What Not To Do After A Miscarriage?

It’s recommended not to engage in sexual intercourse, use tampons or perform douching for at least next 2 weeks. Moreover, it’s best to wait for 2 menstrual cycles minimum before trying to conceive again.¹⁴ 

Parting Thoughts!

We really hope this blog has helped you gain a better understanding of miscarriage and how to identify its symptoms. Miscarriage is a common experience, but it can be devastating. It is important to know the signs and symptoms so that you can get the help you need. The best way to prevent miscarriage is to have active prenatal care. This means seeing your doctor regularly and following their recommendations. Prenatal care can help identify and address any potential problems that could lead to miscarriage.

If you are pregnant and experience any miscarriage symptoms, it is important to see your doctor right away. Early diagnosis and treatment can help to prevent further complications. Remember, a healthy you means a healthy pregnancy. Take care of yourself physically and emotionally, and be sure to get the support you need.