5 Symptoms of Miscarriage

It's important to recognize the symptoms of miscarriage in order to see a physician for diagnosis and appropriate treatment. Learn more.

Written and verified by the doctor Sandra Golfetto Miskiewicz.

Last update: 21 September, 2022

Miscarriages are one of the most frequent complications of pregnancy, affecting up to 20% of pregnancies. But how do you know if you’re facing an imminent or consummated loss? Today, we’re going to tell you the most suggestive symptoms of miscarriage. Keep reading!

General information about miscarriages

First of all, we have to clarify what we mean when we talk about miscarriage. According to the European Society of Human Reproduction and Embryology (ESHRE), it’s the natural termination of pregnancy (not induced) within the first 20 weeks after conception.

The causes of miscarriage are varied, and when they occur sporadically, are attributed to a failure in the development of the embryo. On the other hand, recurrent miscarriages (3 or more) can be linked to maternal factors, such as immune dysfunction or hormonal alterations.

Symptoms that suggest a miscarriage

It’s important to clarify that miscarriages can occur symptomatically or go completely unnoticed by the pregnant woman. The following are the most common manifestations that accompany the termination of pregnancy:

1. Abdomino-pelvic contractions or cramping.
2. Bleeding dark vaginal bleeding.
3. Expulsion of embryonic tissues (sometimes seen as gelatinous clots).
4. Hypotension and fainting sensation (especially if the bleeding is very abundant).

Warning signs

If in addition to the manifestations mentioned above, the expectant mother experiences any of the following signs or symptoms, she could be facing a septic (or infected) miscarriage:

• Fever
• Purulent vaginal discharge
• Tachycardia
• Paleness of the skin and mucous membranes

If you suspect a septic miscarriage, it’s best to seek medical help immediately.

Symptomatic miscarriages

As we’ve already mentioned, there are some cases in which miscarriages occur without any clinical manifestations. On other occasions, the most striking symptom is the disappearance of the typical discomforts of pregnancy, due to the normalization of hormone levels.

Vaginal bleeding doesn’t always indicate a miscarriage

Not all vaginal bleeding that occurs during pregnancy implies the loss of the embryo. There are also other health conditions that condition the appearance of this symptom and should also be evaluated:

• Ectopic pregnancy.
• Sub-chorionic hematoma: This is a frequent cause of bleeding in the first half of gestation (occurs in up to 11% of normal pregnancies). The blood loss is mild and is often detected as a finding in a routine ultrasound.
• Cervical diseases (infectious cervicitis, cervical polyps, ectropion, and dysplasia). All of them may appear along with vaginal bleeding, especially after sexual intercourse.
• Gestational trophoblastic disease: This is uncommon, but should be suspected in the case of older women or women with a history of previous miscarriages.
• Maternal trauma.

Complications of a miscarriage

During a miscarriage, the embryonic remains aren’t always completely eliminated. In this context, the situation can become complicated and have potentially serious consequences for the mother:

• Sepsis. It may happen that an intrauterine infection is the cause of the miscarriage (which we call septic miscarriage) or it may happen that the retained embryonic remains become colonized with germs. In both cases, a systemic infection may occur in the mother, capable of affecting her vital organs.
• Disseminated intravascular disease (DIC). This involves the excessive and abnormal production of thrombin and fibrin in the blood, which favors the development of clots and thrombi. But if the disease progresses rapidly, it predisposes to mother to severe bleeding.
• Cervical lacerations, especially when the miscarriage is instrumented.
• Hematometra, this is the accumulation of blood in the uterus that can’t be eliminated through the cervix.

What to do when a miscarriage is suspected and what to expect afterward

If a woman has symptoms suggestive of a miscarriage, she should immediately see an obstetrician-gynecologist for monitoring. In this context, the professional will probably request complementary examinations, such as an ultrasound and a blood test, to corroborate and determine the necessary treatment.

The therapeutic management of the miscarriage will depend on the type and general condition of the pregnant woman. There are two possible alternatives:

• Medical management: This consists of the administration of a medication known as Misoprostol, which produces uterine contractions and cervical dilatation so that the embryonic remains are expelled naturally.
• Surgical management (curettage): This consists of the instrumental elimination of the gestational remains. Although it’s quick and safe, it’s not free of complications.

Despite what has been described above, some women develop the post-abortion triad, which consists of low-grade fever, pelvic pain, and bleeding.

The use of contraceptive methods can be restarted immediately after the miscarriage, with the exception of the intrauterine device (IUD) in cases of septic abortion.

The search for a new conception can also be resumed, and studies have even shown that there’s a higher success rate in the first 3 months after the miscarriage.

Family and professional support are very important

It’s important to take into account the psychological impact that a miscarriage can have on the parents. They may experience various feelings, such as sadness, frustration, and guilt. For this reason, the best thing to do is to seek adequate professional support and to encourage the support of close family and friends.