Missed Abortion
Missed Abortion: Signs, Symptoms, and Treatment
A missed abortion, also known as a silent or incomplete abortion, is a pregnancy loss that occurs without any symptoms. It typically occurs earlier in a pregnancy, often during the first trimester. The term “missed abortion” is a misnomer since the fetus may be dead but still present in the uterus.
A missed abortion is caused by a chromosomal abnormality, usually due to an incorrect number of chromosomes or a structural abnormality. It is estimated to occur in approximately one in forty-five pregnancies. In some cases, the cause of the missed abortion can be identified while in other cases, the cause may be unknown.
Signs and Symptoms
A missed abortion may not cause any signs or symptoms until it is later in the pregnancy. By this time, the fetal heartbeat may no longer be detected, and normal biological changes may not be occurring. Signs and symptoms can include:
- No fetal movement or heartbeat
- No growth of the uterus
- No increase in hCG levels
- No ultrasound heartbeat
- Absent fetal pole on ultrasound
- No pregnancy-associated nausea or other symptoms
Diagnosis
A missed abortion is typically diagnosed by examining the uterus and performing an ultrasound. The absence of a fetal heartbeat, either through Doppler or ultrasound, is a tell-tale sign of a missed abortion.
Your doctor may also perform blood tests to detect changes in certain hormones, such as hCG. Low levels of hCG can indicate pregnancy loss. After the diagnosis, your doctor may suggest a dilation and curettage (D&C) to ensure that all products of conception have been removed from the uterus.
Treatment
If a missed abortion is confirmed, medical or surgical management is required. Medical management utilizes medications such as misoprostol to help the uterus contract and expel the fetal tissue. If a D&C is necessary, it may be done either in the operating room or in the doctor's office, depending on the patient’s condition.
After the misscalculated abortion, your doctor may recommend follow-up care. This may include blood tests to monitor hCG levels or an ultrasound to make sure the uterus is empty.
It is important to remember that a missed abortion is not the fault of the woman. It can be a difficult time but it is important to seek support from family and friends. Emotional counseling is also available if needed.