Types Of Miscarriages

 

While most women who have had them, may speak of having “a miscarriage,” without any more specification, there are actually quite a few different types of miscarriages.

A “threatened miscarriage” is one we mentioned earlier, where signs of miscarriage might be mild bleeding or cramping early in a pregnancy, along with a low backache, but as long as the cervix stays closed, the threatened miscarriage does not become a reality. Most pregnancies continue on normally with a successful outcome.

Another type of miscarriage is a “missed” one. That literally means that the woman missed it because there were none of the usual signs of miscarriage, such as bleeding, cramping, backaches, and nothing is ever expelled out of the body.  The woman will stop having such indications of pregnancy as morning sickness, tender breasts, and gaining weight. These are not necessarily noticeable and the miscarriage is most often detected when the heartbeat is not found during a visit to the doctor.
 
A miscarriage is described as “inevitable,” when there is bleeding and back pain, and the cervix is open or dilated. Usually in a case like this the miscarriage is already underway and the uterine membranes have ruptured.

A septic miscarriage is one which involves infection and it can be fatal not only to the embryo but to the mother as well. It usually happens after a miscarriage, when the tissue is not expelled from the body. It can be because of a “missed” miscarriage, where the woman was not aware she had miscarried or because of an incomplete miscarriage, perhaps some but not all of the tissue was expelled from the body. Here the effects of sepsis are the same as in other kinds of cases--fever, chills, pain, exhaustion, plus added conditions--vaginal bleeding and vaginal discharge, which is usually smelly.

The related “incomplete” miscarriage is when the pregnancy has ended but not all of the tissue and fluids have been expelled from the uterus. The signs of miscarriage are usually continued pain and bleeding, and an ultrasound is done to see if something is left in the womb. Then a D&C (dilation and curettage) is performed, which is a cleaning out of the uterus, often performed as outpatient surgery.

“Complete” miscarriages are ones where the pregnancy has been terminated and all of the fetus tissue and placenta have left the body naturally. Any bleeding and pain ends quickly once everything has left the uterus. Your doctor will do an ultrasound to check and make sure, but usually everything is normal again almost immediately. After this type of miscarriage, periods will resume in a month or two and a pregnancy can be tried again in a few months.

The final type of miscarriage is known as a “recurrent” one. This is one of the most devastating types because it refers to miscarriages in women who have had three or more in the first trimester. This occurs only one-percent of the time.

Miscarriage treatments

Because of the nature of a miscarriage, both physical and emotional treatments may be needed. On the physical side of the equation, any continued loss of blood must be stopped and precautions taken so that there is no infection once the miscarriage is over. Some times your doctor might prescribe bed rest but other times you might be returned to normal activities right away. It will depend on what type of miscarriage you had and whether it was in the first trimester or later in the pregnancy.

If the miscarriage is incomplete, missed or septic, a D&C is usually performed to clean out the uterus and make sure that nothing remains such as clots or tissue. Once this has been accomplished any bleeding normally stops. If a woman is in the process of having a miscarriage, she can decide whether to let it continually naturally on its own, or have a D&C which will end it. It is not unreasonable that a woman would wait as long as she is otherwise healthy.

If a miscarriage does end naturally, an ultrasound and physical exam are usually done to double-check that all is OK in the uterus. Sometimes if the remaining tissue is slow in expelling itself from the womb, a medication can be given which will speed up the process. This usually does its job in just a couple of days.

If you are pregnant and have a miscarriage, and also have a blood type with a negative RH factor, the chances are good that you will be given an injection of RhoGAM. This is a drug that prevents any complications or damage to any fetus you might have in the future. Many times antibiotics are also given because there is either already an infection developing or the risk of one. Sometimes these infections can persist for several weeks if not treated aggressively right in the beginning.

It is not advisable to use such menstrual supplies as tampons after a miscarriage. IUDs can be used again soon after as can other forms of contraception. Usually doctors also advise waiting a few weeks before resuming an active sex life. A woman’s normal menstrual period will start again in one to two months.

As you might imagine, a miscarriage is a very emotional experience and this is something that needs to be addressed along with the physical treatments. A miscarriage is a very real loss of a child to most expectant mothers. There will often be postpartum depression which will need to be treated. Grief counseling is also an appropriate response to a miscarriage.

Many women and their spouses as well find it hard to talk about a miscarriage but often, talking about it to a friend or counselor can really help. Everyone grieves differently. It is good to just take each day as it comes and not push it to get life moving again. A support network of friends and family is wonderful in getting things on track, but if you don’t have one, try joining a community support group. Medications for depression or anxiety might also be helpful.

After experiencing signs of a miscarriage, keep your doctor advised of both your physical and mental condition. You might need a referral or a prescription, plus medical practitioners have access to a wide variety of different types of resources which might be helpful in dealing with the situation.