From the Research
Yes, a miscarriage can occur with no visible bleeding when there is an ongoing infection, known as a "missed miscarriage" or "silent miscarriage". This condition arises when the embryo or fetus has stopped developing but has not been expelled from the uterus. Infections such as bacterial vaginosis, chlamydia, gonorrhea, or other reproductive tract infections can cause inflammation that interferes with pregnancy development without immediately triggering bleeding 1. Women experiencing a missed miscarriage might notice other symptoms like diminishing pregnancy symptoms, abdominal pain, or discharge with an unusual odor, though some women have no symptoms at all. The infection can cause the pregnancy to fail by creating an inflammatory environment hostile to embryo development, disrupting placental function, or directly infecting the developing embryo. Key points to consider include:
- The role of infections in miscarriage, as highlighted in studies focusing on the management of miscarriage and the use of antibiotics 2, 1.
- The importance of addressing the underlying infection with appropriate antibiotics and potentially requiring a procedure such as dilation and curettage (D&C) to remove the pregnancy tissue, preventing further complications like sepsis.
- The use of misoprostol as a medical approach for managing spontaneous abortion, which can be effective in avoiding surgery in a significant proportion of women with spontaneous abortion 3. If you suspect a missed miscarriage, it is crucial to seek immediate medical attention for an ultrasound evaluation. Treatment should prioritize addressing the infection and may involve a combination of antibiotics and surgical intervention to ensure the best outcomes in terms of morbidity, mortality, and quality of life. Given the potential for serious complications, including sepsis, prompt medical evaluation and treatment are essential 4, 5.