Am I having a miscarriage?

Department of Obstetrics and GynecologyNews

Department of Obstetrics and Gynecology
Understanding Early Miscarriage

Early miscarriage refers to loss of a pregnancy in the first trimester. The majority of early miscarriages occur before the pregnancy is 10 weeks gestation. Some miscarriages happen very early, even before a woman is sure she is pregnant. Still, miscarriage can be a hard and sad experience, no matter when it occurs.

Miscarriage is more common than many people realize. About 10-20% of women who learn they are pregnant will have an early miscarriage. The rates of early miscarriage are even higher when women are checking home pregnancy tests very close to the time of their period and are finding a positive test VERY early. By chance alone, 1% to 4% of women will have two miscarriages in a row. However, it is very rare to have 3 or more miscarriages in a row, which is recurrent miscarriage (*link to recurrent miscarriage page).

In medical terms, early miscarriage is called an early pregnancy failure. This means that the pregnancy failed to develop. Almost all early miscarriages are due to circumstances beyond anyone’s control, and were destined to happen before the woman even knows she is pregnant.

See a doctor who can evaluate you quickly in an office setting and do laboratory testing or ultrasound examinations that need to be done.

If you are having very heavy vaginal bleeding or are feeling very sick, you should go to the Emergency Room.

Symptoms of early miscarriage

*Bleeding – light bleeding early in pregnancy is fairly common, and does not mean you will have a miscarriage.
*Brown discharge: this may look like coffee grounds. This “discharge” is actually old blood that has been in the uterus for a while and is just coming out slowly.
*Spotting, bright red bleeding or clots
*Passage of tissue through the vagina
*A gush of clear or pink vaginal fluid
*Abdominal pain or cramping
*Pregnancy symptoms, such as breast tenderness and nausea, begin to go away
*Dizziness, lightheadedness, or feeling faint
*If you have any symptoms of a miscarriage, you should contact a doctor right away to have an evaluation. It will be important to have an ultrasound exam to look into the uterus to see if the pregnancy is normal or you are having a miscarriage. Even if you think you passed the entire pregnancy and are feeling better, you should see a doctor. Sometimes, passing tissue occurs with an ectopic pregnancy (pregnancy outside of the uterus) which can be life-threatening if not diagnosed early.

Types of early miscarriage

Early miscarriage is a non-medical term for lots of different types of events that might or might not actually result in pregnancy loss. The types of miscarriage include the following:

*Threatened Miscarriage: Spotting or bleeding in the first trimester in which the patient and the doctor are not yet sure if the pregnancy will miscarry or not. About 1/3 of all women will bleed in the first trimester, but only about half of those women will have a miscarriage.

*Complete Miscarriage: the entire pregnancy is passed from the uterus, most commonly with bleeding and cramping, and no additional treatment or observation is needed.

*Incomplete Miscarriage: the pregnancy is definitely miscarrying, but only some of the pregnancy tissue has passed. The tissue that is still in the uterus will eventually pass on its own. Some women may need emergency treatment if there is also heavy vaginal bleeding. Otherwise, women can use medicines to cause the rest of the tissue to pass or simply wait for the rest of the tissue to pass from the uterus.

*Anembryonic Gestation: with this type of miscarriage, the pregnancy implanted but the embryonic tissue (the part of the pregnancy that will develop into a fetus) never developed, or started to develop and then stopped.

*Embryonic or fetal demise: with this type of miscarriage, the early embryo (or fetus once 10 weeks pregnant) stops developing and growing.

*Missed abortion: This is an uncommon type of miscarriage today. With a missed abortion, the pregnancy stops developing but the pregnancy tissue does not pass out of the uterus for at least 4 weeks. Sometimes, dark brown spotting or bleeding occurs, but there is no heavy bleeding.

*Septic Miscarriage: some miscarriages occur with an infection in the uterus. This is a serious condition that requires urgent treatment to prevent shock and death. With septic miscarriage, the patient usually develops fever and abdominal pain and may have bleeding and discharge with a foul odor. Antibiotics and suction evacuation of the uterus are important to start as quickly as possible.