- Women's Health
Delayed Miscarriage, That Little Known Incident that can Change Your World.
What is a Delayed Miscarriage?
A week ago, I had never heard of the term Delayed Miscarriage. I had always thought, that when a woman miscarries, the foetus and placenta are rejected by the body almost straight away. However, in some cases this does not happen.
The term Delayed Miscarriage means just that. The foetus is no longer viable yet for some reason the body still thinks the woman is pregnant. Hence the sac and the placenta keep growing and hormones are still produced. The woman feels pregnant and has all the signs of a continuing pregnancy. It is often the case that the situation is not realised until the first ultrasound scan is carried out.
One of the reasons for this occurrence is known as a blighted ovum. This is where there has been something wrong from day one. After conception, the fertilised egg implants in the womb, but for some reason a baby does not develop even though the placenta and membranes do. It is an act of nature and there is nothing you can or cannot do to prevent this from occurring.
Because the placenta is producing the pregnancy hormones the body will carry on as normal . It is not until the body "catches up" and realises what is happening that the hormone level will drop and the pregnancy will be miscarried. The length of time for this to happen varies from each individual sometimes taking weeks to occur.
The most common symptom of miscarriage is vaginal bleeding. This can vary from light spotting to bleeding or a brown discharge.
Cramps, back ache and the sudden absence of breast tenderness and lack of morning sickness can be other signs.Sometimes there are no symptoms and your miscarriage may only be discovered in a routine scan.
If you have vaginal bleeding at any time during pregnancy, all I can say is always always get it checked out.
Because of the quirks of pregnancy and dating, diagnosis of a delayed or missed miscarriage is usually carried out over a couple of scans.
During your scan, if the pregnancy sac measures more than 20mm, with no sign of an embryo, then a diagnosis of a delayed miscarriage can be made. This is confirmed by an internal vaginal scan which can get more accurate measurements. Although slightly uncomfortable this procedure does not cause any physical harm.
If the diameter of the sac is less than 20mm, then the dates could be wrong and the pregnancy may not be as far on as was originally thought. This would explain why the embryo cannot be seen. In which case a further scan will be carried out in a week or two time after which a diagnosis can be made.
Blood tests may also be carried out to measure the HCG - Human chorionic gonadotropin, amount in the blood. This hormone is produced by the placenta and can be detected approximately 10 days after fertilisation. If a pregnancy is progressing healthily the hormone level should double approximately every two to three days.
Once the diagnosis has been made. The decision of treatment can be discussed.
This is probably one of the hardest parts of the full situation.
One option is to let the body deal with the loss naturally, however this can be a lengthy process and the mental toll may soon start to show. Also the longer it goes on the bigger the chance of infection.The benefit of the natural route is that as long as there is no excessive pain or bleeding the person can be at home. There is a lot to be said about the comfort of your own home, especially with the delicacy of the situation. A further scan will be carried out to make sure everything has gone as it should.
The second option is with medication.These soften the cervix and make the womb contract so that the remainder of the pregnancy tissue is expelled. The amount of medication required varies from woman to woman and this option can be a long drawn out one. You can expect to be in hospital most of the day and sometimes an overnight stay will be necessary.However, once everything is complete you can go home. Yet again a further scan will be carried out.
The third option is a minor surgical procedure known as D&C (dilation and curettage). This is the fastest treatment available to assist the process of a miscarriage and is the most effective. A general anaesthetic will be given, and as long as there are no side effects or complications the patient can return home that day.
Sometimes the first two options do not work completely and the surgical method will also have to be used.
These options may appear clear cut to an outsider but for someone directly involved it can be a painstaking and heart wrenching choice that can take you round in circles for many many days.