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Missed Miscarriage – Signs and Symptoms 

Unlike other miscarriages, a missed miscarriage often shows no signs, and it can be hard to detect. Thus, it is unsurprising that many people seek information about this issue. This publication takes a deep dive into the common symptoms, causes, and available treatment options to help you understand a missed miscarriage, and address how long it takes for the miscarriage to become apparent. 

What is a Missed Miscarriage?

A missed miscarriage or missed abortion is an early pregnancy loss that stays undetected, and the dead foetus remains in the womb for longer than usual. This particular miscarriage is distinguishable from other miscarriages by lack of the typical symptoms of miscarriage, like cramping or vaginal bleeding.

This experience can be emotionally challenging as you remain hopeful and expectant, unaware of your loss until a medical exam or ultrasound reveals the absence of a foetal heartbeat. 

The unique nature of missed miscarriages further complicates the grieving process. The lack of physical symptoms delays and deepens the emotional impact as it takes longer for the realisation of the loss of pregnancy to sink in. As a result, you may feel confused or guilty, wondering why your body didn't show any signs.



Due to the unique challenges that accompany a miscarriage, it is crucial to join local support groups or seek professional assistance if you experience a pregnancy loss. Emotional support, guidance, and understanding can be helpful in the healing process.

Common Signs and Symptoms of a Missed Miscarriage

A missed miscarriage often shows no signs, and it can be hard to detect. However, it is essential to be conversant with potential indications. Some primary signs and symptoms that may indicate you have a missed miscarriage are listed below.

Lack of Foetal Movement

The most prevalent symptom of a missed miscarriage is the absence of foetal movement. You should be concerned if you have been experiencing regular moves from your baby and the movement decreases or stops abruptly.

Reduced Pregnancy Symptoms

Another common symptom related to this type of miscarriage is the decline in pregnancy signs, such as frequent urination, breast tenderness, fatigue, and nausea. If you notice a sudden reduction or complete disappearance of these signs, it may be an indication of a miscarriage.

Vaginal Bleeding or Spotting

While missed miscarriages do not often manifest in heavy bleeding, you may experience light bleeding or spotting. However, in some cases, vaginal bleeding occurs during normal pregnancies, and it is crucial to consult your doctor for proper assessment.

What Causes a Missed Miscarriage?

While there is no proven cause, several factors can contribute to a missed miscarriage. The most common potential causes include:

• Chromosomal abnormalities are the most prevalent cause of a missed miscarriage. An example of such abnormalities is an unusual number of chromosomes (aneuploidy), making the foetus incompatible with life.

• Hormonal imbalances, mostly inadequate progesterone levels, can also contribute to a miscarriage.
  
  
• Uterine or cervical structural issues such as septate uterus or fibroids can hinder the implantation and growth of the embryo, increasing the risk of a missed miscarriage.
  
  

It is critical to schedule an examination with your fertility healthcare provider if you experience any concerns about a miscarriage.

How Long Does it Take for a Missed Miscarriage to Become Apparent?

How long the miscarriage becomes apparent varies from woman to woman. Sometimes, you may discover it during a routine prenatal checkup or ultrasound before it shows any noticeable signs. At times, it may take several weeks or months to become apparent. The delayed realisation can heighten emotional stress.



Usually, you would recognize a missed miscarriage when an ultrasound scan shows no development in your baby. Still, you may not have felt any signs of a miscarriage, like cramping or bleeding. However, your experience may differ from another person's experience. The miscarriage may manifest differently in some women compared to others. Therefore, if you suspect anything, consulting your fertility healthcare provider for a comprehensive evaluation and support is crucial.

Physical Recovery and Treatment Options

Physical recovery following a miscarriage may vary depending on your circumstances. Various treatments can aid recovery, and your doctor will advise on the appropriate options after an evaluation. They include:

Expectant Management

This option is best if you prefer a more natural process and can comfortably wait for the body to miscarry naturally. Expectant management involves letting the body expel pregnancy tissue with no medical intervention. However, your doctor will closely monitor the process to ensure safe completion.

Medication

Your physician may prescribe certain medications to prompt uterine contractions and eject the pregnancy tissue. This option is suitable if you wish to speed up the miscarriage process and reduce physical distress. Usually, medication requires scheduling follow-up consultation for successful treatment.   

Surgical Intervention

Surgical intervention or dilation and curettage (R&C) involves the removal of the pregnancy tissue through a dilated cervix. Your doctor may recommend this option under the following circumstances:

• When there is an infection
  
  
• When there is an incomplete miscarriage (when some pregnancy tissue remains in the womb after miscarriage)
  
  
• When medication or expectant management is unsuccessful
  
  

Emotional Support

Besides physical recovery, you may require emotional support to help cope with the pregnancy loss. Joining support groups or sharing your feelings with loved ones can be helpful. Additionally, you can seek professional assistance.

Conclusion

Overall, a missed miscarriage can be a physically and emotionally distressing experience. This condition seldom shows symptoms, and you may only discover it during a routine prenatal checkup. The primary signs of this kind of miscarriage may include a lack of foetal movement and reduced pregnancy symptoms. 

Some potential causes of the miscarriage include structural issues with the uterus or cervix, chromosomal abnormalities, and hormonal imbalances. Available treatment options to help with physical recovery include expectant management, medications, and surgery.

Emotional support is vital in coping with the loss of pregnancy. Most importantly, you should schedule an evaluation with a qualified fertility specialist for a professional review and further support if you experience any of the above symptoms or suspect a miscarriage.

References

• Jurkovic, D., Ross, J. A., & Nicolaides, K. H. (1998). Expectant management of missed miscarriage. BJOG: An International Journal of Obstetrics & Gynaecology, 105(6), 670-671. Retrieved from https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/j.1471-0528.1998.tb10184.x

• Jurkovic, D., Overton, C., & Bender-Atik, R. (2013). Diagnosis and management of first trimester miscarriage. Bmj, 346. Retrieved from https://www.bmj.com/content/346/bmj.f3676.abstract

• Coomarasamy, A., Gallos, I. D., Papadopoulou, A., Dhillon-Smith, R. K., Al-Memar, M., Brewin, J., & Quenby, S. (2021). Sporadic miscarriage: evidence to provide effective care. The Lancet, 397(10285), 1668-1674. Retrieved from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00683-8/fulltext

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