Bleeding during pregnancy loss occurs when the uterus empties. In some cases, the fetus dies but the womb does not empty, and a woman will experience no bleeding. Some doctors refer to this type of pregnancy loss as a missed miscarriage.
The loss may go unnoticed for many weeks, and some women do not seek treatment. According to the American Pregnancy Association , most losses occur within the first 13 weeks of pregnancy.
While an estimated 10—25 percent of all recognized pregnancies end in a pregnancy loss, a loss in the second trimester is very rare. Some women have no external symptoms of pregnancy loss. When the loss occurs early on, a woman may have few signs of pregnancy, which can make identifying the loss more difficult. It is normal to experience changes in pregnancy signs over time, particularly in the transition from the first to the second trimester.
These changes do not usually indicate the loss of the pregnancy. Most women seek treatment for a pregnancy loss when they experience bleeding. When there is no bleeding, a doctor may only diagnose a loss during a routine scan. A doctor may also suspect a loss because of other indications, such as a drop in the levels of pregnancy hormones or an unusual decrease in other pregnancy signs.
Blood tests can determine the levels of hormones, which can help to assess the likelihood of a pregnancy loss. To conclusively diagnose a loss, a doctor must perform an ultrasound to check for a heartbeat.
The heartbeat does not develop until 6. To determine the reason for a loss, a doctor may also recommend genetic testing, further ultrasound scans, or blood testing. The goal of treatment is to remove the fetus and tissue from the uterus and to prevent complications, such as a uterine infection. There is a variety of treatment options available, and a doctor or midwife will be able to advise on the best option.
When pregnancy loss occurs without bleeding, it is often safe to wait for a few weeks before seeking treatment, because the uterus may empty on its own. When this occurs, a woman can expect bleeding that involves passing the tissue. Sometimes, miscarriages happen because the pregnancy develops outside the womb. This is known as an ectopic pregnancy. Ectopic pregnancies are potentially serious as there's a risk you could experience internal bleeding.
Symptoms of an ectopic pregnancy usually appear between weeks 5 and 14 of the pregnancy. Almost nothing you can do will cause an early miscarriage. Avoiding sex or heavy work will not impact an early pregnancy. There are a lot of changes that need to occur with the cells and genes in a developing pregnancy, and sometimes those changes do not happen perfectly.
There are some health conditions or habits that can increase the chance that an early miscarriage will occur, including:.
Our specialists can evaluate you quickly in an office setting. Any laboratory testing or ultrasound examinations that need to be done can be performed easily and conveniently. We perform our own ultrasound examination in the office and can share the results with you immediately.
If we do confirm you have a miscarriage, we can discuss expectant management or treatment options with you immediately. Should you need blood testing to evaluate the pregnancy, the laboratory is in the same building as our office. If you are having very heavy vaginal bleeding or are feeling very sick, you should go to the Emergency Room to see our physicians.
The choice of whether to wait for the pregnancy to completely pass without any treatment is up to you. Our doctors are committed to providing options for all patients, including the pros and cons of all available options when miscarriage is diagnosed. All patients with Rh-negative blood, regardless of which option they choose, need treatment with Rh-immune globulin, an injection that prevents a woman from forming substances in her blood that may attack the baby during a future pregnancy.
You may choose to have the procedure in the office or operating room based on your preferences -- different women have different needs. Office procedure:. Bleeding may continue for several weeks after a miscarriage but tends to be much lighter with a suction aspiration. Any bleeding may change in color from bright red to pink or brown. Lower abdominal cramping in the few days after treatment is also common.
You should contact a doctor right away if the bleeding gets heavier after the miscarriage instead of lighter, if a fever develops, or if vaginal discharge or a strange or unpleasant vaginal odor occurs. Avoid intercourse, douching, or using tampons for one week.
Regular activities can be resumed right away, based on how you feel. Importantly, if you want to delay getting pregnant after the miscarriage, it will be very important to start an effective method of contraception. Q: Does having a miscarriage mean I'm more likely to have another one? A: Having one miscarriage does not increase your chances of having another.
Medication is not suitable if there is very heavy bleeding or signs of infection. It is usually not recommended for pregnancies that are older than about nine weeks. Things to know The pregnancy tissue will pass between four to six hours after taking the medicine, during which time you may be in hospital. This will depend on where you are and which hospital you are in. The medicine has side effects which usually pass in a few hours but can be unpleasant, such as nausea, vomiting, diarrhoea, fever and chills.
The tablets can be swallowed or dissolved under the tongue, or inserted in the vagina. After receiving the medication there may be some spotting or bleeding like a period. When the pregnancy tissue passes, you are likely to notice heavier bleeding and clots with strong cramping, period-like pains. You can use sanitary pads and take pain relieving tablets such as paracetamol. Some women may need stronger pain killers or a pain relieving injection.
A few women still need to have surgery, sometimes urgently, if they develop infection, bleed heavily or if the tissue does not pass. The medical staff advise that this is a better option for you; this may be because of the amount of tissue present, especially with a missed miscarriage. This is an option you prefer. This can cause prolonged or heavy bleeding and the operation may need to be repeated infection needing antibiotics damage to the cervix or uterus.
This is very rare around 1 in and, when it does happen, it is usually a small hole or tear which will heal itself excessive bleeding very rare anaesthetic risks. These are very low for healthy women, but no anaesthetic or operation is without risk.
Waiting for treatment If you have heavy bleeding with clots and crampy pain, it is likely that you are passing the pregnancy tissue. What to do while you are waiting You can try to rest and relax at home. Usual activity that is not too strenuous will not be harmful. You can go to work if you feel up to it. If you have pain you can take paracetamol. If there is bleeding, use sanitary pads rather than tampons.
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