A missed miscarriage is when the unborn baby has died but the woman has not yet miscarried. There are no visible miscarriage signs, such as vaginal bleeding, cervical dilation or uterine contractions and the baby remains in the uterus.
Pregnancy symptoms such as morning sickness or sore breasts may cease. A missed miscarriage is not usually detected until a routine ultrasound scan is carried out, when no fetal heart beat is found. The fetus is usually several weeks younger than the woman’s dates, indicating that it died weeks prior.
This can be especially shocking as most women feel they have been carrying a healthy pregnancy and nothing is wrong. Finding out that the baby has been deceased for some time can be equally as distressing.
Causes of Missed Miscarriage
Causes include:
• Chromosomal abnormalities in the baby
• Infections in the mother
• Exposure to chemical agents, pesticides, heavy metals and radiation
• Illnesses such as diabetes or thyroid disease
• Immune disorders
• Illegal drug abuse
• Medicinal drug use, such as ibuprofen
• Hormone disorders
Sometimes the cause is not known.
Treatment
Expectant Waiting
In an observational study, 76 percent of women with missed miscarriage, eventually miscarried spontaneously without the need for surgery or medical assistance, so it is a perfectly acceptable option to wait and see if bleeding will begin. The majority of miscarriages will be complete by day 14 after diagnosis.
The researchers concluded:
"Most women who miscarry (all types of miscarriage) in the first trimester choose expectant management and about 81 percent of these complete their miscarriage without intervention."
Medical Management
This involves having prostaglandins inserted into the vagina to encourage dilation of the cervix and contraction of the uterus. This will then expel the fetus.
Surgery
A dilation and curettage (D+C) can be performed under general anaesthetic. This is when the cervix is dilated and the contents of the uterus are gently scraped out. Sometimes suction is used instead.
After a Miscarriage
You may be depressed, tearful or angry for several weeks. It is normal to grieve after the loss of a child, no matter how early the stage of gestation, so don’t be afraid to discuss it with your partner or another woman who has been through a miscarriage. You might also be tired or have headaches due to blood loss, so it’s a good idea to rest and have a couple of days off work if you can.
If you are still feeling depressed after a few months or you are having difficulty coping with your feelings, contact your doctor who will be able to refer you for counselling.
Help and Support:
Pregnancy and Infant Loss Support
The National Share Office
402 Jackson Street
St. Charles, MO 63301
Phone: 636-947-6164 or 800-821-6819
Fax: 636-947-7486
Web: http://www.nationalshare.org
Sources:
Missed Miscarriage, Our Miscarriage. Web. 12 October 2011. http://www.ourmiscarriage.com/missed_miscarriage.html
Occupational risk factors and reproductive health of women, Occupational Medicine, (2006) 56 (8): 521-531. Full Text: http://occmed.oxfordjournals.org/content/56/8/521.full
Outcome of expectant management of spontaneous first trimester miscarriage: observational study, British Medical Journal, 2002 April 13; 324(7342): 873–875. Full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC101397/
Ibuprofen 'can double the risk of miscarriage' and many expectant mothers are unaware of the dangers, Daily Mail (7th September 2011). http://www.dailymail.co.uk/health/article-2034434/Ibuprofen-double-risk-miscarriage.html
Miscarriage, Net Doctor. Web. 12 October 2011. http://www.netdoctor.co.uk/diseases/facts/miscarriage.htm
Reviewed October 12, 2011
by Michele Blacksberg RN
Edited by Jody Smith