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Miscarriage

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Types of Miscarriages

Because it is often a process and not a single event, there are many different stages or types of miscarriage that can occur.

  • Threatened Miscarriage - When a woman shows physical signs that she may be experiencing a miscarriage, it is called a threatened miscarriage. This is characterized by some degree of uterine bleeding and either cramping or lower back pains. It is often hard to tell if these signs are the beginning of an inevitable miscarriage in which the bleeding continues and the pregnancy is lost, or if this bleeding simply early pregnancy spotting as a result of implantation. During a threatened miscarriage, the cervix remains closed. If it opens, the miscarriage becomes inevitable.

  • Inevitable Miscarriage - An inevitable miscarriage occurs when the loss of a pregnancy is imminent. This could happen soon after a threatened miscarriage or suddenly, without warning. Symptoms of an inevitable miscarriage include bleeding, abdominal or back pain, a dilated cervix and rupture of membranes. Uterine contractions to expel the fetus usually begin soon after these symptoms develop. If the miscarriage is not complete, bleeding and cramping may continue.

  • Missed Miscarriage - It is possible for a woman to have a miscarriage without knowing it. Sometimes after a fetus has died, the cervix stays closed and there is no bleeding at first, and the body does not naturally discharge of it or any other physical elements of the pregnancy for several weeks. This is called a missed miscarriage. Signs of this include a loss of pregnancy symptoms and the absence of a fetal heartbeat during an ultrasound. Sometimes a woman is unaware that she's miscarried for days or weeks. A woman who has had a missed miscarriage may choose to wait and see if her pregnancy miscarries naturally, or have an operation to empty her uterus. While any kind of miscarriage can be emotionally devastating, missed miscarriages may be the hardest for a woman to understand and accept.

  • Chemical Pregnancy - A chemical pregnancy occurs when the egg is fertilized, but dies shortly after implantation. This is usually due to a chromosomal defect in the embryo. In most cases, a pregnancy test will give a positive result before a period has been missed, but it will come a few days later. The bleeding is similar to a heavy menstrual period. Very early miscarriages like these are thought to be quite common. An estimated 50 to 60 percent of first pregnancies end this way. If a home pregnancy test isn't taken, most women never know they were pregnant.

  • Blighted Ovum - A blighted ovum is another common type of miscarriage that occurs when the fertilized egg implants itself into the uterus, but the cells do not continue to divide or develop to create a baby. As with a chemical pregnancy, a woman will receive a positive result from a pregnancy test and may experience pregnancy symptoms, but will usually miscarry anywhere from 7 to 12 weeks later. Similar to a missed miscarriage, a blighted ovum may not be discovered for several weeks, but can be detected with an early ultrasound. In this case, the woman will have the option to have an operation to empty the uterus, or wait for her miscarriage to happen naturally.

  • Ectopic Pregnancy - When a fertilized egg implants itself outside the uterus, it is called an ectopic pregnancy. About 98 percent of ectopic pregnancies occur in the fallopian tube and are discovered at about six or seven weeks. About 1 percent of pregnancies are ectopic, but up to 50 percent of these are estimated to spontaneously miscarry and appear like early, inevitable miscarriages. The other 50 percent of women with ectopic pregnancies will experience symptoms, such as vaginal spotting, pain the lower abdomen, a bloated belly and dizziness or fainting. An ultrasound or vaginal exam can confirm an ectopic pregnancy. Depending on the size and location of the embryo, a doctor will determine the best form of treatment for an ectopic pregnancy, either an injection or surgery.

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