Late Miscarriage

Definition - What does Late Miscarriage mean?

A late miscarriage occurs when a fetus dies during the second trimester of pregnancy, after the 14th week, but before the 20th. Late miscarriage can be caused by problems with the fetus’ growth or health problems of the mother. One in five pregnancies end in late miscarriage.

Late miscarriage may also be called second trimester miscarriage, a late term miscarriage, or a second trimester loss.

FertilitySmarts explains Late Miscarriage

There are two primary types of miscarriage: first trimester miscarriage, which occurs prior to the 14th week of pregnancy, and late miscarriage. Pregnancy loss that occurs after the 20th week of pregnancy is considered a stillbirth. Other conditions may also cause pregnancy loss, including an ectopic pregnancy, a molar pregnancy, or a preterm delivery due to health conditions.

Several factors may cause a late miscarriage, many of which involve a complication with the development of the fetus. Genetic conditions, such as a chromosomal abnormality, heart defect, or growth disorder may be the cause. Trauma, such as an accident or blunt force to the mother’s body may also cause miscarriage. Medical conditions of the mother, including chronic health issues, disease, or other disorders can induce pregnancy loss. Finally, physical problems with the mother’s body may be the cause.

Some of the most common issues include:

  • Thyroid disorders
  • Lupus or immune conditions
  • Preeclampsia
  • Genetic disorders
  • Infection
  • Hypertension
  • Diabetes
  • Incompetent cervix

Signs of a late miscarriage include:

  • Vaginal bleeding
  • Passing tissue matter
  • Cramping
  • Lower back pain
  • Not feeling movement of the fetus
  • Fever

In order to diagnose a late miscarriage, an ultrasound and blood tests are completed. If the uterus is empty and the fetal matter has been expelled through the vagina, the miscarriage is complete. However, in some cases a dilation and curettage (D&C) may be performed to remove any remaining tissues.

Testing may be completed to determine if illness or infection caused the loss. If a late miscarriage occurs after a previous miscarriage, more advanced testing is performed. A physical exam will check for issues with the woman’s body, including an incompetent cervix, Rh negative blood, or uterine issues. Genetic testing, pelvic ultrasounds, hysterosalpingogram, or a hysteroscopy may be advised.

Certain conditions or circumstances may create a higher risk for a late miscarriage. These include:

  • Having had prior miscarriages
  • Being over the age of 35
  • Abnormal uterine shape
  • Over or under weight
  • Chronic health issues
  • Invasive prenatal testing
  • Drinking or drug use

However, it is still possible for women with many of these conditions to carry a pregnancy to term.

Recovery from a late miscarriage depends on the age of the fetus at the time of loss. Women who experience labor and delivery will have a more extensive healing process. For many women, the process of a late miscarriage is similar to a period, with cramping, back pain, and exhaustion. Many women who experience a late miscarriage may struggle emotionally. Women, and their partners, should be encouraged to seek emotional support during their recovery.

85% of all women who experience a miscarriage are able to conceive again and carry a healthy pregnancy to term. However, a doctor should advise on the best time to begin trying, as it may be important to give the body several months to heal. Any present medical issues should also be addressed before another attempt is made. Additionally, some women and couples may need time to grieve the loss before being emotionally ready to undergo another pregnancy.
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