From the Guidelines
Miscarriage signs and symptoms typically include vaginal bleeding, which may range from light spotting to heavy flow, often accompanied by abdominal or pelvic pain resembling menstrual cramps. You might also experience the passage of tissue or clot-like material from the vagina. Other symptoms can include a sudden decrease in pregnancy symptoms such as morning sickness or breast tenderness. Back pain, fever, and unusual vaginal discharge may also occur in some cases. The severity and combination of symptoms can vary widely between individuals. If you experience any of these symptoms during pregnancy, especially bleeding with pain, you should contact your healthcare provider immediately or go to an emergency room, as prompt medical attention is essential. While not all bleeding during pregnancy indicates miscarriage (some women experience spotting and continue with normal pregnancies), only a medical professional can properly evaluate your condition. Miscarriages typically occur due to chromosomal abnormalities in the developing embryo, and most happen in the first trimester of pregnancy. They are unfortunately common, affecting about 10-20% of known pregnancies, as noted in the most recent study 1.
Some key points to consider when evaluating a potential miscarriage include:
- Vaginal bleeding, which can range from light to heavy
- Abdominal or pelvic pain
- Passage of tissue or clot-like material from the vagina
- Sudden decrease in pregnancy symptoms
- Back pain, fever, and unusual vaginal discharge It's essential to seek medical attention if you experience any of these symptoms, especially bleeding with pain, as prompt evaluation and treatment can help prevent complications and improve outcomes, as discussed in 1 and 1.
In terms of diagnosis, ultrasound is a crucial tool for evaluating a potential miscarriage, as it can help confirm the presence of a pregnancy and determine its location and viability, as noted in 1, 1, and 1. The Society of Radiologists in Ultrasound has developed a lexicon for first-trimester ultrasound, which provides guidelines for the evaluation and diagnosis of early pregnancy loss, including the use of terms such as "concerning for EPL," "diagnostic of EPL," and "completed EPL" 1, 1, and 1.
Overall, while miscarriage can be a devastating experience, it's essential to prioritize your health and seek medical attention if you experience any symptoms or concerns during pregnancy. By working with a healthcare provider and following established guidelines and recommendations, you can receive the care and support you need to navigate this challenging situation, as emphasized in the most recent and highest-quality study 1.
From the Research
Signs and Symptoms of Miscarriage
The signs and symptoms of a miscarriage can vary from woman to woman, but common indicators include:
- Vaginal bleeding, which can range from light to heavy [(2,3)]
- Abdominal pain 3
- Passing of blood clots 2
- Symptoms may worsen or persist beyond 14 days 2
Risk Factors and Assessment
Risk factors for miscarriage include:
- Advancing maternal and paternal age [(2,4)]
- Being underweight or overweight 2
- Smoking and high alcohol consumption [(2,4)]
- Previous miscarriages [(4,5)]
- Low serum levels of progesterone or human chorionic gonadotrophin (hCG) 5
- Heavy bleeding, early gestational age, and an empty gestational sac of >15-17 mm diameter 5
Assessment of the amount of vaginal bleeding experienced is best made in the context of time taken to saturate a sanitary pad, with changing a pad soaked with blood and clots more than once an hour indicating heavy bleeding that requires immediate referral 2. Transvaginal ultrasound scan should be considered the standard test to assess viability of the pregnancy 2.