Vaginal bleeding and pelvic pain are the hallmark symptoms of
miscarriage. All vaginal bleeding during pregnancy should be
investigated, although not all instances of bleeding result from a
miscarriage.
The pain tends to be dull and cramping, and it may come and go or be
present constantly. Sometimes, there is passage of fetal or placental
tissue.
Blood clots may also be present in the vaginal bleeding.
Brown or bright red bleeding with or without cramps 20-30% of all
pregnancies can experience some bleeding in early pregnancy, with
(about 50% of those resulting in normal pregnancies)
Tissue with clot like material passing from the vagina Sudden decrease
in signs of pregnancy.
Mild to severe back pain often worse than normal menstrual cramps
Types of miscarriage
Threatened Miscarriage:
Some degree of early pregnancy uterine bleeding accompanied by cramping or
lower backache. The cervix remains closed.
Incomplete miscarriage: -
Sometimes not all the products of conception are passed from the womb.
Usually, when the woman is admitted to hospital an ultrasound scan will be
carried out. If there are remains of tissue present then the woman will usually
be taken to theatre for an evacuation.
An inevitable miscarriage
When the cervix starts to dilate and open up.
Once this occurs it is unlikely that the pregnancy will be preserved. Bleeding
and pain are common symptoms of this. The pain is due to contraction of the
womb as it tries to evacuate the pregnancy.
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The woman may notice large pieces of tissue, which appear like blood clots,
being passed from the vagina. An inevitable miscarriage will either progress to
an incomplete or a complete miscarriage
Complete Miscarriage:
A completed miscarriage is when the embryo or products of conception have
emptied out of the uterus. Bleeding should subside quickly, as should any pain
or cramping. A completed miscarriage can be confirmed by an ultrasound.
Missed Miscarriage:
Women can experience a miscarriage without knowing it. A missed miscarriage
is when embryonic death has occurred but there is not any expulsion of the
embryo. Signs of this would be a loss of pregnancy symptoms and the
absence of fetal heart tones found on an ultrasound.
Recurrent Miscarriage:
Defined as 2 or more consecutive miscarriages. This can affect 1% of couples
trying to conceive
Septic miscarriage:
A miscarriage in which there is infection in the fetal and pregnancy material
before or after a miscarriage
Blighted Ovum:
Also called an anembryonic pregnancy. A fertilized egg implants into the
uterine wall, but fetal development never begins. Often there is a gestational
sac with or without a yolk sac, but there is an absence of fetal growth.
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Diagnosis
An ultrasound examination is typically performed if a woman has symptoms of
a miscarriage. The ultrasound can determine if a fetal heartbeat is present.
Ultrasound examination can also reveal whether the pregnancy is an ectopic
pregnancy (located outside of the uterus). Other tests include blood tests for
pregnancy hormones, blood counts to determine the degree of blood loss or to
see whether infection is present, and a pelvic examination.
The mother’s blood type will also be checked at the time of a miscarriage, so
that Rh-negative women can receive an injection of anti-D immune globulin to
prevent problems in future pregnancies.
Inevitable Blighted ovum Normal threatend
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