A routine prenatal appointment can become a devastating event when you're diagnosed with a missed miscarriage, an uncommon form of pregnancy loss also known as early fetal demise or a silent miscarriage. You're excited to be pregnant, and still experiencing pregnancy symptoms, but the ultrasound shows that the new life that you've been expecting is no longer developing. How is it possible that you still feel pregnant when you're no longer able to look forward to giving birth in nine months?
What is a Missed Miscarriage?
A missed miscarriage is rare, only occurring in approximately one percent of pregnancies, and thought to be caused by chromosomal abnormalities. It is called a "missed" miscarriage because it is typically undetected until a routine prenatal visit. Many women with this type of loss have no indication that there is a problem, but some experience a reduction in early-pregnancy symptoms, such as morning sickness and breast tenderness. These symptoms commonly start to abate during the end of your first trimester anyway, however, so this can be misleading. During a doctor's visit, your obstetrician may be alerted to the possibility of a silent miscarriage by the following signs:
- A lack of fundal growth during measurement
- Inability to detect a fetal heartbeat
- Ultrasound images show lack of expected growth and development
Pregnancy Symptoms and Hormone Levels
A silent loss doesn't cause the same miscarriage symptoms as a spontaneous loss, and many women continue to experience morning sickness and other symptoms until the miscarriage is complete. Despite the loss of the fetus, your placenta may continue to produce hormones such as human chorionic gonadotropin, or HCG, which causes morning sickness and other early pregnancy symptoms. Over time, however, the placenta will produce less and less of these hormones. Your doctor will order a series of blood tests to compare the levels of progesterone and HCG over the course of several days to confirm the diagnosis.
Misdiagnosed Miscarriages – Could the Doctor be Wrong?
HCG levels are expected to double every few days during the early stages of pregnancy. An initially low test result, combined with unexpectedly small measurements and other signs may be due to a miscalculation of your conception date or an irregular menstrual cycle, and may result in a misdiagnosed miscarriage. Follow-up tests, such as a second ultrasound and additional blood testing to measure the increase or decrease in hormone levels, are common methods of verifying the diagnosis. If your pregnancy is viable, subsequent blood tests may show a dramatic increase in HCG levels, and ultrasounds should show the fetus growing and developing.
Grief Over a Pregnancy Loss
If you have experienced a pregnancy loss, don't suffer alone. There are many types of support available, from local support groups and counselors to online support groups. You can turn to friends, family, your spouse or partner or your church for help as well. See your doctor if your feelings of grief are unbearable.
Sources:
American Pregnancy. Miscarriage. Accessed March, 2011.
Parenting Weekly. Missed Miscarriage, Blighted Ovum and Chemical Pregnancy. Accessed March, 2011.
Pillitteri, A. Maternal and Child Health Nursing. Lippincott Williams & Wilkins 2009.
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
Victoria Nicks - Victoria Nicks has a Master's Degree in IT, and extensive hands-on experience with various types of hardware and software.
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