Miscarriage,Pregnancy Loss, and Blighted Ovum
Spontaneous Abortion and First Trimester Miscarriage Symptoms
Nov 4, 2009
Many early pregnancies end even before the first period is missed, before a pregnancy test is positive. Miscarriages that occur very early, about the time of a missed period, are called chemical pregnancies. Many women with chemical pregnancies never know they were pregnant, although they may have a heavier than normal period.
Pregnancy Loss Statistics From Spontaneous Abortion in the First Trimester
Around one in four women will have a miscarriage at some point in their lives; most go on to have normal pregnancies, although 2% of women have recurrent miscarriages, which means three or more miscarriages. Most miscarriages occur in the first 12 weeks of pregnancy, known as the first trimester.
At least half of all miscarriages, and probably more, occur because of chromosomal abnormalities in the embryo. The most common chromosomal defect seen in early pregnancy loss is a blighted ovum. In miscarriage from blighted ovum, only the placenta and amniotic sac grow and release pregnancy hormones; the embryo doesn’t grow.
Other causes of early pregnancy loss can be abnormalities in the uterus, infection, or low progesterone levels. Progesterone is a hormone that helps embryos implant; checking levels is done through blood tests, and progesterone supplements can be given if levels are low.
Symptoms of Spontaneous Abortion, Threatened Miscarriage, Missed Abortion
Women who have first trimester miscarriages may have normal pregnancy symptoms, although symptoms may be less severe because the hormone levels aren’t as high as they would be in a normal pregnancy. The first sign of impending pregnancy loss is usually cramping and spotting, but since one in five pregnant women have some spotting, spotting isn’t a sign that miscarriage is definitely going to occur. Doctors may call spotting a threatened miscarriage or threatened abortion.
Some doctors suggest bed rest at this point, although there’s little evidence to suggest this helps maintain the pregnancy. Since most pregnancy loss is related to chromosomal abnormalities, nothing a woman does can prevent the loss. An ultrasound can be done to see if there’s a fetus with a heartbeat around six weeks; there should definitely be a heartbeat by seven weeks in a normal fetus.
In a spontaneous abortion, bleeding becomes heavier, and the cervix is dilated when the doctor does an internal exam. At this point, pregnancy loss is inevitable. Women who suffer pregnancy loss at this point should save any tissue that’s passed to test for chromosomal abnormalities.
Sometimes pregnancy symptoms stop and the fetus stops growing, but there are no symptoms of miscarriage. This is called a missed abortion.
Dilation and Curettage (D&C ) After First Trimester Miscarriage
A D&C is a scraping of the uterus to remove tissue that isn’t passed after a miscarriage, because tissue left in the uterus can cause infection. A D&C is usually done as an outpatient procedure; it takes very little time; light sedation is usually given. No stitches are required for a D&C.
Instructions for the patient after a D&C usually include:
- No sex for a week or two
- No tub baths for a week
- No douching for several weeks
- Wait a month before trying to get pregnant again
Pregnancy Loss From Spontaneous Abortion is Common but Still Heartbreaking
The loss of a wanted pregnancy is heartbreaking. Depression after miscarriage is common. There are many online support groups for women who have had miscarriages and pregnancy loss. Hospitals often have groups that meet monthly to help with pregnancy loss also. The good news is that for most women, a single spontaneous abortion doesn’t mean they’ll never have a baby; the next pregnancy will very likely go well.
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