What Are the Features of a Missed Miscarriage?
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Missed Miscarriage - An Overview

Published on Mar 21, 2023   -  4 min read


Sometimes a miscarriage occurs without knowledge, as typical signs may be absent. This is called a missed miscarriage. Learn more from the article below.


A miscarriage can be defined as the spontaneous loss of a pregnancy before the completion of the 20th week of the gestation period. It could be a shocking and emotional experience for expectant mothers and all the family members waiting and planning to welcome a baby. It is more likely to occur within the first trimester of the pregnancy. It is not always due to the actions or activities of the expectant mother while carrying the pregnancy; more often than not, it is due to factors beyond one’s control.

What Are the Types of Miscarriages?

  • Missed Miscarriage: This type catches an individual unaware since it exhibits no symptoms, and one assumes that all is well until it is diagnosed during a routine ultrasound scan days or weeks after it has occurred.

  • Complete Miscarriage: In this type, the uterus appears empty on an ultrasound scan, and fetal tissue is entirely lost through bleeding.

  • Recurrent Miscarriage: Three repeated miscarriages constitute a recurrent miscarriage. It is very rare, affecting only 1 % of couples.

  • Threatened Miscarriage: This type is not an actual miscarriage; one experiences bleeding and pelvic cramps, but the cervix remains closed. It requires close monitoring for the remaining period of pregnancy.

  • Inevitable Miscarriage: It is characterized by bleeding and cramps; the cervix is dilated, ultimately progressing to a complete miscarriage.

The reason why some miscarriages show overt symptoms and some do is not clearly understood.

How Common Is Miscarriage?

Miscarriage is relatively common, occurring in about 10 % to 20% of pregnancies. However, the actual prevalence cannot be known since it can occur at very early stages before a pregnancy is even detected.

What Are the Causes of Miscarriage?

The majority of miscarriages occur due to problems with chromosomes. It is rarely genetic and is more commonly due to some error by chance during the division or growth of the embryo (the baby is referred to as an embryo from conception until the 8th week of development, after which it is called a fetus). Chromosomal abnormalities can lead to the following.

  • Blighted Ovum - Failure to form an embryo.

  • The Demise of the Fetus Within the Uterus - A formed embryo might stop developing and die.

  • Molar Pregnancy - Molar pregnancies occur when both sets of chromosomes are inherited from the father. The fetus does not develop in such cases and is associated with abnormal placental growth. A partial molar pregnancy occurs when the mother’s chromosomes are present in addition to two sets of chromosomes from the father. This results in an abnormal fetus. Both these types of pregnancies are not viable.

Sometimes a miscarriage can be attributed to the mother’s health condition. Such factors include:

  • Infections.

  • Diabetes that is not controlled.

  • Hormonal issues.

  • Severe malnutrition.

  • Radiation exposure.

  • Maternal age.

  • Lifestyle factors like tobacco and alcohol consumption.

  • Certain drugs.

  • Thyroid disorders.

  • Abnormalities in the uterus or cervix.

No scientific evidence suggests exercise, sexual intercourse during pregnancy, or stress play a role in miscarriage.

What Are the Features of a Missed Miscarriage?

It is otherwise known as a silent miscarriage or silent abortion. Two reasons why one does not realize they are no longer pregnant are - pregnancy hormones continue to remain high even after the baby dies and pregnancy tests come out positive. When the miscarriage occurs, it is usually too early to feel the baby kick and all are assumed to be well. Occasionally one may experience decreasing pregnancy symptoms or a brownish discharge. An ultrasound scan is the only way to detect a missed miscarriage due to the absence of any other symptoms like cramps or increased bleeding. An ultrasound scan can reveal:

  • Whether there is an absence of heartbeat. However, if the miscarriage occurs even before a heartbeat can be detected, then pregnancy hormone levels human chorionic gonadotropin (HCG) are monitored. If there is a rise to expected levels in the coming days or a follow-up scan is prescribed after about one week to check for a heartbeat.

  • Whether the baby is much smaller in size than it is expected to be at the given gestational stage.

  • When there is an empty sac or no clear sac at all. This occurs if the baby dies during the initial stages of development and the body reabsorbs the embryonic tissue or if the embryo has not formed.

How Is a Silent Miscarriage Treated?

There are three treatment approaches for the management of a silent miscarriage.

  1. One may wait for the miscarriage to occur naturally. The fetal tissue is passed out of the body within two weeks. Sometimes it may take much longer. It is a wait-and-watch approach that works in a large number of cases. Should this approach fail, one can go with alternative treatment options.

  2. Medical management involves taking medications that trigger the body to expel fetal tissue. It takes about four to five hours to pass the pregnancy tissue and can cause bleeding and cramping. Medicine is taken at the doctor’s office, and one can return home.

These treatment options are typically chosen when the pregnancy is lost within the 10th week. Sometimes the doctor recommends surgical management after the diagnosis when waiting to pass the fetal tissue is unsafe and must be removed immediately. This procedure involves dilation and curettage. The cervix is dilated, and pregnancy tissue is removed by scraping or suctioning it out of the uterus under anesthesia.

What Does Recovery From a Miscarriage Look Like?

Physical recovery from a missed miscarriage can take up to a month or sometimes longer. Menstruation is resumed within three to six weeks. Emotional recovery is essential in addition to physical recovery before trying to conceive again. It is common for mothers to blame themselves, but it is a fact that most miscarriages occur due to unknown reasons. Three months is advised to prepare one’s body to welcome pregnancy after a miscarriage. One miscarriage is not a cause for worry regarding future pregnancies. One can have a successful pregnancy after a missed miscarriage. Two or more consecutive miscarriages must be investigated to identify the underlying cause.


A silent or missed miscarriage involves spontaneous abortion of the baby in utero without exhibiting any symptoms. It usually occurs during the first trimester. Due to the lack of symptoms, one has a false sense of well-being until diagnosed on a prenatal ultrasonogram. It can be mentally and emotionally challenging; looking after one’s emotional health is critical, as taking enough time to grieve the loss with family and friends. Treatment options include waiting for a natural miscarriage and medical or surgical management.

Frequently Asked Questions


What Are the Initial Indications of a Missed Miscarriage?

The initial indications of a missed miscarriage may include a sudden cessation of pregnancy symptoms, such as morning sickness and breast tenderness. Additionally, there might be a lack of fetal movement or a reduction in the uterus size. If any of these signs arise, it's essential to consult a healthcare provider promptly for further evaluation and care.


Describe the Occurrences During a Missed Miscarriage.

During a missed miscarriage, the fetus may have stopped developing, but the body does not immediately expel the pregnancy. Often, there are no noticeable symptoms, and the woman may continue to feel pregnant. The diagnosis typically occurs during a routine ultrasound when no fetal heartbeat is detected, indicating the loss of the pregnancy. Medical attention and appropriate care are crucial in such situations.


How Much Time Does It Usually Take to Identify a Missed Miscarriage?

The time it takes to identify a missed miscarriage can vary. It may be detected during a routine prenatal check-up when the doctor can't find a fetal heartbeat or the growth is not as expected. However, in other situations, a woman may not realize she has experienced a missed miscarriage until a follow-up ultrasound confirms the absence of fetal development.


Will a Missed Miscarriage Result in a Positive Pregnancy Test?

Yes, a missed miscarriage can still result in a positive pregnancy test. This can be confusing for some women, as the body may continue to produce the pregnancy hormone hCG (human chorionic gonadotropin) even after the fetus has stopped developing. Consequently, a positive pregnancy test does not always guarantee a viable pregnancy, and further medical evaluation is necessary to confirm the status of the pregnancy.


What Are the Reasons Behind Missed Miscarriages?

The reasons behind missed miscarriages are often not clear and can vary. They may be attributed to genetic abnormalities in the fetus, developmental issues, or problems with the placenta. Hormonal imbalances, chronic health conditions, maternal age, and lifestyle factors may also contribute to missed miscarriages. It's essential to remember that most missed miscarriages are not caused by anything the mother did or didn't do, as they are usually the result of natural biological processes.


Can Anything Be Done to Prevent a Missed Miscarriage from Progressing?

While there's no guaranteed way to prevent a missed miscarriage, certain steps can be taken to promote a healthy pregnancy and reduce the risk. These include maintaining a balanced diet, avoiding harmful substances like alcohol and tobacco, managing chronic health conditions, getting regular prenatal care, and promptly addressing any concerns or symptoms with a healthcare provider. However, not all miscarriages can be prevented, as they can sometimes occur due to factors beyond anyone's control.


What Are the Treatment Options for a Missed Miscarriage?

The treatment options for a missed miscarriage typically depend on the woman's health, gestational age, and personal preferences. Sometimes, a healthcare provider may recommend a wait-and-see approach to allow the body to expel the pregnancy tissue naturally. Alternatively, if the miscarriage doesn't occur on its own, medical or surgical interventions like dilation and curettage (D&C) or medication may be considered to remove the remaining tissue from the uterus. Emotional support and counseling are crucial aspects of the treatment process to help the woman cope with the loss.


Does the Abdomen Size Increase in the Case of a Missed Miscarriage?

During a missed miscarriage, the size of the abdomen may not significantly increase or may even appear to decrease. This is because the body may not immediately recognize the loss of pregnancy, and the uterus may continue to grow for a period despite the absence of fetal development. As the pregnancy hormones gradually decrease, the abdomen may return to its pre-pregnancy size.


What Are the Post-Miscarriage Guidelines to Follow?

After a miscarriage:
- Rest and follow medical advice.
- Avoid strenuous activities.
- Seek emotional support.
- Monitor for any unusual symptoms.
- Delay pregnancy attempts until you've recovered.
- Consult with your healthcare provider for guidance.


Is a Missed Miscarriage a Painful Experience?

A missed miscarriage, even without an immediate physical indication of loss, can still be a painful emotional experience for many women. The grief and sadness associated with the loss of a pregnancy can vary from person to person. It's essential for those going through this difficult time to seek emotional support from loved ones, counselors, or support groups to help navigate the grieving process and find healing.


Is There a Connection Between Stress and Miscarriages?

While stress can impact a person's overall well-being, there is limited evidence to suggest that stress alone directly causes miscarriages. Miscarriages typically occur due to genetic abnormalities or other biological factors beyond an individual's control. However, managing stress and adopting a healthy lifestyle during pregnancy can positively contribute to maternal health and well-being. Discussing any concerns or stress-related issues with a healthcare provider is always a good idea to ensure proper support and care during pregnancy.


Is Sperm Implicated in Miscarriages?

Miscarriages are generally not caused by healthy sperm. Most miscarriages occur due to genetic abnormalities or issues with the developing embryo. However, certain lifestyle factors, health conditions, or exposure to harmful substances can potentially affect sperm quality, which may indirectly influence pregnancy outcomes. Both partners need to maintain a healthy lifestyle and seek appropriate medical care when planning to conceive or if experiencing recurrent miscarriages to address any potential factors that might affect fertility and pregnancy.


Can Bed Rest Help Prevent Miscarriages?

There is no conclusive evidence to suggest that bed rest can prevent miscarriages. While bed rest might be recommended in high-risk pregnancy situations, such as threatened preterm labor or certain pregnancy complications, it has not been proven to prevent miscarriages. Prolonged bed rest may have risks, such as blood clots, muscle atrophy, and emotional distress.


Is There Any Link Between Late-Night Sleep and Miscarriages?

One study found that Women who had worked two or more night shifts in the previous week after reaching the 8-week mark of pregnancy faced a 32% higher risk of miscarriage than those who did not.


How Can You Determine If the Baby Has No Heartbeat?

A doctor will conduct an ultrasound to confirm a pregnancy loss to check for a heartbeat. However, it's important to note that a fetal heartbeat typically develops around 6.5–7 weeks of gestation. Before this time, the absence of a heartbeat may not necessarily indicate a loss. To ensure accuracy, the doctor might perform multiple scans on different days to confirm the diagnosis of a pregnancy loss.

Last reviewed at:
21 Mar 2023  -  4 min read




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