Early Miscarriage

Definition - What does Early Miscarriage mean?

An early miscarriage typically refers to the loss of a pregnancy in the first 10 weeks. This type of miscarriage is very common, accounting for about 80% of all miscarriages and affecting 5-15% of pregnancies. Most of the early miscarriages are spontaneous, i.e. they occur in the absence of a known cause. However, in some cases, chromosomal defects may be responsible. These miscarriages can be threatened, inevitable, incomplete, complete, or missed.

FertilitySmarts explains Early Miscarriage

A woman undergoing an early miscarriage may experience vaginal bleeding with or without the passage of blood clots and severe abdominal cramps. The future course of the miscarriage may vary. If vaginal bleeding and abdominal/pelvic pain subside while the cervix is still closed, the pregnancy will continue. This type of early miscarriage is called a threatened miscarriage.

At other times, the symptoms of pregnancy loss are present and cervix is dilated but the products of pregnancy are still in the uterus. This is known as an inevitable miscarriage. These products may eventually start to expel. If all the products are not expelled naturally, an incomplete miscarriage ensues, whereas complete expulsion of the products signals a complete miscarriage. In the latter case, an ultrasound would reveal an empty uterus.

Some early pregnancy losses do not show any signs and symptoms but are identified only during a routine ultrasound scan as an empty gestational sac without the embryo. This is referred to as a missed miscarriage.

If the products of conception fail to expel naturally through the vagina, a doctor will remove them by performing a dilation and curettage (D&C) or dilation and evacuation (D&E). If the miscarriage is inevitable or incomplete, a “watch and wait” approach of expectant management may be used. Women who cannot wait for the spontaneous complete expulsion but also want to avoid surgical evacuation, treatment with medications like misoprostol may be considered.

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