Missed miscarriage

Missed miscarriage is also known as missed abortion. Others call it by the descriptive term Silent Miscarriage. Missed miscarriage refers to a situation where the fetus or embryo ceases to be viable (dies) in the course of early pregnancy, but is retained in the womb. In the majority of these cases, there is little or no immediate warning. Sometimes, the warning may come in the sudden disappearance of pregnancy symptoms but this is by no means always the case.

If the pregnancy is advanced into the second trimester, some women may experience some light leakage of breast milk.

Causes of missed miscarriage

This pregnancy complication remains clouded in mystery. It is generally accepted that some of these babies might have chromosomal or genetic abnormalities which are lethal. However, this is clearly not always the case.

Management of missed miscarriage

Management largely depends on the stage of the pregnancy. If it is early in the first trimester, evacuation of the uterus in theatre under a general anesthetic is usually recommended.

Again there is the option of medical management in the form of orally administered tablets and/or vaginal tablets (pessaries). With this, there is an inevitable time lag of up to three days, occasionally longer.

Another alternative is to await spontaneous miscarriage to take place. This is not popular with gynecologists because it carries with it a small inherent risk of causing clotting abnormalities, especially if the non-viable pregnancy is retained for several weeks (which is possible). Moreover, spontaneous miscarriage may take place and surgical evacuation of the uterus may still be necessary. This is, if some products are retained and/or there is serious bleeding.

Effect of missed miscarriage on future fertility

A woman who has experienced a missed miscarriage will be traumatized by the experience. A small consolation will be the knowledge that that event will have no influence whatsoever on her future fertility.

Molar pregnancy

Molar pregnancy or hydatidform mole is an abnormal form of pregnancy where, instead of a fetus, a mass of grape-like vesicles form and proliferate in the womb. There is no baby.

The woman will feel pregnant as usual and pregnancy symptoms such as nausea and vomiting may be greatly exaggerated. The size of the womb may also be bigger than suggested by the dates. An ultrasound scan will immediately confirm the diagnosis.

This condition is discussed in much more detail in another section. It is included here as it is legitimately classified as another form of early pregnancy loss.

Next Page: Spontaneous miscarriage