Pregnancy

Different Types of Miscarriage

A miscarriage can take hours, days or even weeks unfold. There are many different types of miscarriage, from very early miscarriage, called a chemical pregnancy, that occurs shortly after the implantation process, often before the woman even knows she is pregnant, to late term miscarriage, which happens after 12 weeks but before 20 weeks gestation. Miscarriage is not a single event but is a process and you may hear your health care provider using many terms. Here we will attempt to explain some of those terms, and the different types and stage of miscarriage.

Types of Miscarriage

Threatened Miscarriage:

A doctor might use the term “Threatened Miscarriage” when a pregnant woman is bleeding and has some lower backache or cramping, but the cervix is still closed.  The doctor may conduct an ultrasound, and look for the baby’s heartbeat.  If a strong heartbeat is detected, the chance of miscarriage decreases.  The term threatened miscarriage does not mean a woman will miscarry, it means that she is showing some symptoms similar to miscarriage and that she could miscarry. This term is used a lot in women who have a blood clot or a broken blood vessel between the outer layer of the placenta, called the chorion, and the uterine wall, called a sub chorionic hematoma or sub chorionic hemorrhage (SCH).  Most of the time a SCH will resolve on its own and the woman will not lose the baby.  Sometimes, however, a miscarriage does occur; hence the term threatened miscarriage is used.

Incomplete Miscarriage:

Incomplete miscarriage is used to describe a miscarriage in which some of the placenta remains in the uterus.  A woman experiences all the symptoms of miscarriage, heavy bleeding, strong cramps, a dilated cervix, and loss of the fetus.  An incomplete miscarriage is suspected when a woman’s hCG hormone levels do not return to zero after the miscarriage.  The placenta produces hCG, and as long as a portion of the placenta remains in the uterus, it continues producing hormone and pregnancy tests will continue to be positive, even though the woman has experienced the loss of her baby.  For this reason, and because such tissue can easily become infected and threaten the mother’s health, a doctor will often elect to do a dilation and curettage (D&C) procedure to ensure that all of the placenta passes the cervix and leaves the body.  Ultrasound can also tell a doctor if a miscarriage was complete or incomplete, and many doctors prefer to use ultrasound to avoid unnecessarily subjecting a woman to a D&C.

Complete Miscarriage:

A complete miscarriage occurs when the placenta and the fetus leave the woman’s body completely.  Most pregnancy losses are complete miscarriages.

Missed Miscarriage:

A missed miscarriage happens when a fetus dies in the womb, but the placenta and the fetus are not expelled from the woman’s uterus.  A woman is typically unaware that she has lost the baby, and such a loss is often discovered at a routine doctor visit, when the doctor cannot find the baby’s heartbeat.

Recurrent Miscarriage (RM):

Recurrent miscarriage is defined as three consecutive miscarriages or as more than three miscarriages occurring in the first trimester.  Many women who are planning a family will have a single miscarriage, and those miscarriages are usually due to a random chromosomal abnormality in the embryo.  Doctors usually do not do any sort of testing on the embryo or the mother after a single miscarriage. Recurrent miscarriage is a cause for further examination by the doctor.

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