What are the signs and symptoms of miscarriage?
A sign is something you can objectively see or measure, like vomiting or a fever.
A symptom is something only you feel and report.
If you are pregnant and develop any of these signs and symptoms, go to the nearest Emergency Room immediately. These are possible symptoms of miscarriage.
- Bright red or brownish bleeding from the vagina, which may be painless
- Passing clots or tissue
- Painful contractions every 5 to 20 minutes apart
- Leaking clear fluid from the vagina (not urine from the bladder)
If you are pregnant and develop any of these signs and symptoms, phone your doctor as soon as possible. Your baby could be at risk:
- Back pain
- Abdominal cramps
- White or blood-tinged mucous from the vagina
- Loss of pregnancy signs, like abdominal and breast swelling
- Fever over 101 ÂºF or 38.33 ÂºC, especially if accompanied by chills (rigors)
If your doctor is unavailable, ask for the obstetrician on call (locum tenens) or go to the nearest hospital Emergency Room immediately.
If you have aÂ high fever, take acetaminophen/paracetamol (TylenolÂ®/PanadolÂ®) to reduce it, because prolonged high fever damages the fetus. The ER doctor can update your obstetrician when your condition has stabilized.
AnÂ ectopic pregnancyÂ occurs in the fallopian tubes instead of the uterus. Often, the affected womanâ€™s first pregnancy test will be positive, and then repeat tests will be negative, although the woman still has otherÂ pregnancy symptoms.
If you have an ectopic pregnancy (tubal pregnancy), then your symptoms will be more dramatic than most:
- Bright red, spotty vaginal bleeding
- Abdominal pain that increases in severity as the tube nears rupture
- Referred shoulder pain
- Mass on the sides of the uterus (adnexal mass) instead of within the uterus
- Uterus that is smaller than expected for the stage of pregnancy
- Urge to move the bowels
Go to the nearest Emergency Room immediately. Ectopic pregnancy is life-threatening for the mother. You must have surgery performed on the ruptured fallopian tube to stanch the bleeding.
If you haveÂ painless, bright red bleeding in your second or third trimesterÂ that stops and recurs again days or weeks later, you may have placenta previa. The placenta partly or completely grew over the opening to the birth canal.
On rare occasions, you may be unable to get medical attention immediately. If bleeding occurs and you cannot get to your doctorâ€™s office right away, try these easy steps to control bleeding:
1. Bed rest.
2. Drink several salty liquids, like V8, tomato juice, or bouillon soup. Good fluid balance will help keep you from getting dizzy.
3. Take one or two 200 mg tablets of ibuprofen every 4 to 6 hours. Avoid taking aspirin, because it is an anticoagulant and could worsen your bleeding. Ibuprofen will lessen your cramps by decreasing prostaglandins and reduce the blood flow 25% to 30%.
4. Take one 300 mg tablet of ferrous gluconate or iron equivalent per day to prevent anemia.
The paramedics, triage nurse, ER doctor and obstetrician must all askÂ you how much blood you have lost. Try to be patient with their repetitive questions, as they are tracking your progress over time.
An overnightÂ pad or super tampon holds around 10 ml of blood. To calculate the approximate amount of blood you have lost, multiply the number of sanitary products you saturated by 10. For example:Â 5 extra-absorbent pads x 10 = 50 ml blood lost.
If you are losing aÂ blighted ovum, then your blood flow will be slow and brown.
If you are losing aÂ molar pregnancyÂ (hydatidiform mole), you will bleed during Week 12, your HCG levels will be too high, and your uterus will be larger than normal for a 12-week pregnancy. Remember that you are only losing some poor genetic material, not a fully-formed child in either of these situations. Only 1 in every 1,000 pregnancies is molar.
How is miscarriage classified?
A fetus is not necessarily present in every miscarriage. Blighted ovum and molar pregnancy are two conditions where there is no fetus,Â only the supporting tissues or abnormal growths. These are the different stages of a true miscarriage:
1. If you are only spotting, and your cervix is still closed, it is called a threatened abortion. Your doctor will advise bed rest and abstaining from any activity that could aggravate your condition. This includes sexual intercourse until the problem resolves.
2. If you are actively bleeding, have back or abdominal pain, and your cervix is open, then you have an incomplete miscarriage.
3. If your cervix is dilated or effaced, or if your membranes have burst, you have an inevitable miscarriage.
4. If you have expelled the contents of your uterus, you have a complete miscarriage.
5. If the embryo is dead but remains in the uterus, you have a missed miscarriage.
6. If you have three or more first trimester miscarriages in a row, you have recurrent miscarriage (RM).
Understand more on Miscarriage:
The information in this article has been taken with permission from the official Lawley booklet onÂ UnderstandingÂ Miscarriage.Â