Missed Abortion (Missed Miscarriage): Symptoms, Causes, Diagnosis & Treatment

A missed abortion results when a pregnancy fails to progress, but the body does not expel the pregnancy tissue immediately, which is also known as a missed miscarriage or silent miscarriage. When a woman is looking for missed abortion means it is a pregnancy that has stopped growing, but the symptoms of miscarriage may not be immediately present. In some cases, a person may not experience any symptoms or cramping or bleeding. It is only discovered by many women during a routine ultrasound appointment.

This can be an overwhelming experience and symptoms of pregnancy can last for days or even weeks. Knowing what signs and symptoms of a missed abortion are, as well as some of the causes, diagnostic and treatment options, can help the person make informed medical decisions and find the support they need.

What is a "Missed Abortion"?

A missed abortion happens when the fetus or embryo dies but is not expelled. Medical definitions of “abortion” are pregnancy loss and do not apply to an elective abortion.

If you're wondering what is meant by missed abortion, it can be a silent miscarriage as the body doesn't recognize the lost pregnancy at once.

It is typically identified in the first trimester, before 20 weeks of pregnancy. But, in many cases, there are no obvious signs of a miscarriage, so it is sometimes referred to as a “silent miscarriage.”

Common Missed Abortion Symptoms

Some women don't have any symptoms. Others might see the changes more clearly and not notice them.

Symptoms of a possible abortion may include:

• Abrupt disappearance of pregnancy symptoms like nausea or tenderness of the breast
• Light brown spotting or discharge
• Mild pelvic discomfort
• If the fetal heartbeat is not detected by ultrasound
• If the symptoms of pregnancy suddenly disappear

Heavy bleeding and intense cramping are not always experienced right away, as they are in a normal miscarriage. Unfortunately, many women only find out about the condition when they are having a prenatal scan, as there are no symptoms to warn them.

Causes of Missed Miscarriage

The most common cause is chromosomal abnormalities in the embryo. These genetic problems prevent a normal development of the fetus and typically occur randomly.

Other possible causes are:

• Hormonal imbalances
• A defect of the uterus or scarring of the uterus
• Autoimmune disorders
• Thyroid disease
• Uncontrolled diabetes
• Using drugs or smoking
• Advanced maternal age
• Certain infections

Studies indicate that approximately 50% of the early miscarriages are associated with an issue with the chromosomes.

Which of the Following is NOT Usually Associated with a Missed Abortion?

Medical experts say there are no regular activities that are usually responsible for miscarriage. These include:

• Moderate exercise
• Stress
• Sexual intercourse
• Traveling
• Working during pregnancy

How Missed Abortion is Diagnosed?

A missed miscarriage typically is detected during a prenatal ultrasound when the doctor is unable to hear a fetal heartbeat, or when the embryo has ceased growing.

The diagnosis can be made using the following techniques:

• Transvaginal ultrasound
• Blood tests to test blood levels of the hCG hormone
• Repeat scans after a few days if pregnancy is very early

Decreased hCG levels might mean pregnancy loss.

The early signs of a missed abortion can easily be missed and prompt medical evaluation can help avoid complications.

Treatment Options Available for Miscarriage

Missed abortion treatment varies according to the stage of pregnancy, symptoms, medical history and personal preference. There are three options recommended by doctors.

1. Expectant Management (Natural Miscarriage)

This helps the body get rid of the pregnancy without a medical procedure.

Advantages:

• No operation or drug required
• For some patients can feel emotionally natural

Risks:

• Unpredictable timing
• There may be a risk of incomplete miscarriage
• Stress during pregnancy and waiting for birth

Research indicates that the natural process of completion is successful in many instances, but there is some variation in success rates.

2. Medical Management Using Misoprostol

One of the most common abortive procedures used for a missed abortion is with drugs such as misoprostol. It can be given by doctors to help the uterus get rid of the remaining tissue. This drug causes the person to contract and bleed like during a miscarriage.

Common side effects:

• Cramping
• Heavy bleeding
• Nausea
• Fever or chills
• Fatigue

Studies have shown that vaginal or sublingual use of higher doses of misoprostol may be more effective than lower doses.

3. Surgical Treatment (D&C Procedure)

Dilation and curettage (D&C): This is a relatively small surgical process which involves scraping tissue from the uterus.

Surgery is recommended when:

• Heavy bleeding occurs
• Infection is suspected
• Medical treatment fails
• The patient wants to be done with it immediately

Surgical management is the best option and might be more rapid for certain women who wish to receive immediate treatment for a missed abortion.

Recovery After a Missed Miscarriage

The healing from a missed miscarriage is unique and can take a variety of forms.

The recovery from a physical injury is typically over in a few weeks while emotional is often a different story. By 4–6 weeks, most periods will resume.

During recovery:

• Do not use tampons or any sexual activity for at least one week or as directed by your doctor
• Get plenty of rest and fluids
• See a doctor if there is fever, severe pain or heavy bleeding
• Get emotional support if required

Losing a pregnancy can be a normal experience and can have a different impact on each person in the relationship.

What Happens If I Miss a Period and Miss a Baby?

A missed miscarriage is not a reason for the woman to not be able to have a healthy pregnancy later on. A single miscarriage does not raise the odds of subsequent miscarriage.

If recurrent miscarriages occur, further tests may be recommended to find out if there are underlying problems.

Knowing about the nature of a missed abortion and appropriate medical treatment can help them feel better prepared for future pregnancies.

When to Seek Immediate Medical Help

If any of the following signs occur, the patient needs to see a doctor immediately:

• Heavy bleeding - more than 2 pads soaked with blood every hour
• Severe abdominal pain
• Fever above 100.4°F (38°C)
• Foul-smelling discharge
• Dizziness or fainting

These signs could be a sign of infection or complications which require urgent treatment for miscarriage.