Missed Abortion (Missed Miscarriage): Causes, Symptoms, Complications And Treatments

Wednesday, July 29, 2020, 14:59

Missed abortion or missed miscarriage refers to a confusing situation in which the foetus has died, but the body is unable to recognise the loss, causing the placenta and embryonic tissues to continue releasing hormones. This causes women to experience symptoms of pregnancy such as nausea and breast tenderness while the embryo is already dead.

Missed abortion is also known as silent abortion as it does not occur like a normal miscarriage with bleeding and cramping. Only in a routine checkup or ultrasound the undeveloped or dead foetus can be diagnosed. This makes the condition more painful for women as they come to know about their pregnancy loss much later after the actual loss. [1]

Around 10-20 per cent of known pregnancies result in miscarriage during the first trimester (first 3 months of pregnancy). Take a look into the details of the missed abortion.

Causes Of Missed Abortion

The exact cause of missed abortion is not completely known. However, medical experts suggest that a large percentage of such abortions happen due to chromosomal abnormalities that cause the death of the foetus or early pregnancy failure. [2] Other factors that are responsible for missed abortion include:

Uterine scarring
Smoking habit of the mother
Maternal autoimmune disease [3]
Placental problems
Physical trauma
Embryonic anomalies
Blighted ovum

Missed abortion cause a lot of emotional impact on women. Possibilities of stress and anxiety increases as most of the women tend to blame themselves for what had happened. At this situation, it is important to understand that missed abortion can happen to any woman and there's no clear explanation for the cause of the condition.

Also, exercise, travel, sex and stress won't cause miscarriage, therefore self-blaming is meaningless.

Symptoms Of Missed Abortion

As missed miscarriage is different from a normal miscarriage, no symptoms such as abdominal cramping or vaginal bleeding can be noticed. Other symptoms like breast tenderness, fatigue and nausea will also vanish (they usually vanish in normal pregnancy). Some women may get a brownish discharge occasionally. [4]

Complications Of Missed Abortion

Prolonged holding of the dead foetus in the uterus can cause complications such as:

Infections
Disseminated intravascular coagulation syndrome (rare), abnormal blood clotting in the blood vessels
Pain and mild fever
Uterine perforation, hole in the uterus [5]
Bladder or bowel injury
Hematometra, collection of blood in the uterus

Diagnosis Of Missed Abortion

The best way to diagnose missed abortion is by never missing out on your routine checkups. It helps you diagnose any problem or difficulty during the pregnancy period and let you take early effective measures to deal with those problems. [6]

If you were feeling nauseated or fatigued and suddenly those signs vanish, consult a doctor. Also, look out for signs of brownish vaginal discharge.

Missed abortion is mainly diagnosed through ultrasound before 20 weeks of pregnancy when the heartbeat of the baby is not found. To identify missed miscarriage in 10 weeks or less, hCG levels (pregnancy hormones) are checked. If the level does not rise and stays the same for around two days, it is a sign of silent abortion.

Treatment Of Missed Abortion

Wait-and-see approach: In around 65 per cent of women, the dead foetus or embryonic tissues naturally comes out of the vagina. It is also known as expectant management. If not passed, medical or surgical treatments are required to bring out the placenta. [7]
Medications: It helps in uterus contraction to expel embryonic tissues.
Surgery: This method is known as dilation and curettage surgery. It is recommended for women who had missed abortion during the 12 weeks of pregnancy. As the size of the foetus is large, surgery is considered the best option. [8]

To Conclude:

Physical recovery after a missed abortion usually takes a few weeks or a month, depending on the condition. However, emotional recovery may take time. Talk to your partner, friends and family. Consider talking to a counsellor as it helps a lot. Also, if you had miscarriages many times, consult a fertility doctor to understand the issue well.

Common FAQs

1. What causes missed abortion?

Chromosomal abnormalities are considered the main cause of missed abortion. However, the exact cause of the condition is still unknown.

2. How long does it take for a missed miscarriage to pass?

The embryonic tissues of the dead foetus usually take around 4-6 weeks to pass. Until the time a woman comes to know about pregnancy loss, it has already happened.

3. How can we avoid missed abortion?

Missed abortion can happen to any women without any exact cause. Some factors that can decrease the risk of missed abortion includes eating healthy, strictly avoiding smoking and alcohol consumption, exercising regularly and including more folic acid in the diet.