Early Pregnancy Loss
What is an Early Pregnancy Loss?
Medically, an early pregnancy loss is defined as any loss before 20 weeks gestation, with most of these losses occurring before the thirteenth week. The death of a baby before the thirteenth week is called a first trimester loss and most commonly occurs because of a problem with the development of the baby or placenta. Many people consider losses early in the second trimester stillbirths since often labor needs to be induced so the baby can be delivered.
Types of Early Pregnancy Loss:
A threatened miscarriage means you have symptoms of a miscarriage, such as bleeding and/or cramping, but no miscarriage has occurred, and your cervix is closed. This does not mean you will definitely lose the baby, as half of all women who have these symptoms go on to deliver full term babies.
An inevitable miscarriage means you have symptoms such as bleeding and cramping, but you may also pass some tissue. An examination shows that your cervix is open, and this indicates that you will probably miscarry.
An incomplete miscarriage may occur if you experience severe cramping and bleeding. This suggests that there could be small parts of the placenta and/or baby still in your uterus. You may require hospitalization and a D & C (dilation and curettage) if this happens. During a D & C, the doctor will dilate your cervix and remove the tissue, baby, and blood lining your uterus. This procedure will either be done in a hospital under general anesthesia or in your doctor's office with local anesthesia.
A missed miscarriage is the discovery through ultrasound that your baby has died, but you have no symptoms of a miscarriage. You may eventually miscarry on your own, require a D & C, or be given a prescription that will cause you to miscarry. You may also be sent home to wait for a natural miscarriage with no intervention.
A complete/natural miscarriage is when all the products of conception are naturally expelled from the body. This usually occurs before 12 weeks gestation.
A blighted ovum is a common cause of early pregnancy loss. This means a placenta developed and produced the pregnancy hormones, but due to an abnormality with the fertilized egg, the fetus did not develop or failed earlier than the first six weeks. On ultrasound, there is only evidence of a gestational sac. Your body may have reabsorbed the baby early in pregnancy. If a natural miscarriage does not happen, you may need a D & C or other medical treatment.
An ectopic or tubal pregnancy occurs when, instead of attaching to your uterus, the fertilized egg attaches itself to a fallopian tube or some other place inside your abdomen. Usually, the first sign of an ectopic pregnancy is severe pain in the abdomen, with or without bleeding. If you have an ectopic or tubal pregnancy, your doctor may give you a drug called Methotrexate to dissolve the pregnancy. However, you may require surgery.
A chemical pregnancy is another special type of early pregnancy loss. Sometimes, because of infertility issues, a woman is closely monitored from the time of ovulation. HcG levels may rise, indicating conception has occurred, and then drop off, meaning the pregnancy was not viable. This may all happen before a menstrual period is even missed.
