Signs of a miscarriage

Note: mandatory registration

In contrast to stillbirth, a miscarriage is not subject to reporting.

Signs and forms of a miscarriage

1. Imminent abortion: imminent miscarriage

In this form, the pregnancy is still intact. This means that the cervical canal (Cervical canal) including the cervix is ​​completely closed and the fetus is still alive (heart sounds present). A threat here is vaginal bleeding, which may even be accompanied by labor. This can also lead to a bruise behind the placenta, which can then be seen in the ultrasound.

Read more about this under

• Bleeding during pregnancy
• Spotting in early pregnancy

Therapy options:

The therapy here consists of bed rest, physical rest and possibly the administration of magnesium tablets to stop the process. Exist at the same time Labor pains (Please refer: birth), the pregnant woman receives medication to prevent labor from the 22nd week of pregnancy (Tocolytics). Is a Luteal insufficiency (corpus luteum insufficiency) Cause of the bleeding, progestins are prescribed up to the 14th week of pregnancy. The condition of the fetus should be monitored regularly by ultrasound and by measuring the pregnancy hormone (hCG) must be checked.

If the bleeding ends, the prognosis for the further course of the pregnancy is very good. At this stage, approx. 50% of women one Miscarriage averted become.

2. Abortus incipiens: incipient abortion

At this stage / sign is the Miscarriage already unstoppable. This condition is defined by the open cervix (Cervical canal passable for a finger!), which is usually accompanied by severe pain (Labor pains and Lower back pain) and bleeding is accompanied. Also the departure of Amniotic fluid can be a warning sign. Proof of childlike signs of life (fetal vitality signs) can be omitted with this form.

Therapy options:

Please refer: Therapy of miscarriage

3. Abortus incompletus: incomplete abortion

This is usually a sign of the beginning of an abortion (so.) that came to a standstill too soon. By definition, all abortions (Miscarriage) is considered incomplete up to the 24th week of pregnancy because the Plaster cake up to this point, due to its immaturity, it can rarely be completely expelled.

With this incomplete expulsion of the "Pregnancy material“Remnants remain, often the placenta (Plaster cake), back in the uterus and cause persistent vaginal bleeding. This material can then be detected during the gynecological examination.

Therapy options:

Since this condition can easily lead to an ascending infection and possibly even to the development of cancerous tissue (malignant degeneration) you should soon get one curettage (curettage). After this the bleeding should stop. Another possibility is the administration of the "labor hormone" Oxytocin, which physiologically also occurs during every labor activity of the mother's brain is released and causes uterine contractions so that the remaining material can be expelled.

4. Complete abortus: complete abortion

This also usually occurs as a result of an incipient Miscarriage on. Here the complete and synchronous expulsion of the entire pregnancy material takes place (Embryoyo/ Fetus, placenta and Membranes).

Therapy options:

If the bleeding ends by itself and has passed the 24th week of pregnancy, no scraping is necessary here. If this has to be done, however, an extrauterine pregnancy (see pregnancy complications) should be excluded in advance, as these signs of a miscarriage will otherwise lead to complications.

5. Missed abortion - restrained abortion

With this special form of Signs of a miscarriage the fruit has died without being expelled from the uterus.
The pregnancy seems completely intact: there is no bleeding or labor, the uterine canal and cervix are completely closed. The decisive factor here is the lack of sonographic evidence of children's vitality signs such as Heart actions and child movements. Other signs of pregnancy, such as uterine growth, nausea and breast tenderness, also tend to be absent.

This is a rare complication of these signs of abortion Dead fetus syndrome The dead fetus remains in the maternal one for several weeks after the 12th week of pregnancy uterus. This condition can cause thromboplastic material to get into the maternal bloodstream and lead to life-threatening intravascular (in the bloodstream) clotting.

Therapy options:

So-called suction curettage is used as a therapy up to the 12th week of pregnancy. This is a prostagland input (Type of hormone) ahead to the cervix to prepare for the operation by loosening and softening, thus minimizing the risk of injuries.

Beyond the 12th week of pregnancy there will be a Contraction drip With Oxytocin and prostaglandins administered to the birth initiate. Here, too, there is a subsequent curettage.
The is a rare subspecies of restrained abortion Cervical abortion in which a scarred cervix prevents expulsion of the fruit.

6. Abortus febrilis: febrile abortion

At a miscarriage it comes to one febrile infection (Pathogens mainly Streptococci, staphylococci and Clostridium perfringens). In the best case (uncomplicated course), only the uterine lining is affected. The infection can also spread to the entire uterus including the adnexa (fallopian tubes, Ovary) spread.

Further information on this topic can be found at: Fever during pregnancy

7. Septic abortion

If the infection even spreads to the pelvic organs and peritoneum and if bacterial endotoxins (poisons) are washed out into the maternal bloodstream, it is a septic form. This goes with one Blood poisoning and can lead to death via toxic shock with disseminated intravascular coagulation. Signs of miscarriage show up here in the form of a high fever over 39 ° C, chills and purulent vaginal discharge and amniotic fluid. A massive tenderness to pressure in the area of ​​the uterus is also one of the symptoms.

Therapy options:

The first therapy is one Administration of antibioticswhich is followed by scraping after the fever has subsided. In severe cases, the prophylaxis of a dangerous coagulation disorder requires heparin therapy and possibly the entire removal of the focus of inflammation (uterus) respectively.

8. Diaper

This is the deformity of a fertilized egg that is in the hollow Amniotic sac no or only malformed embryonic parts are located. This appendix rarely exceeds the size of a few centimeters, which also leads to the growth of the uterus being stunted. Furthermore are typical Pregnancy complaints or signs only very sparsely available, but can Spotting occur. This undesirable development rarely overcomes the first weeks of pregnancy and is the main cause of spontaneous abortions in the first two months of pregnancy.

Genetic defects as well as poisoning and insufficient oxygen supply to the fruit are discussed as causes.

Therapy options:

As treatment, scraping and after exceeding the 12th week of pregnancy induction of labor with subsequent curettage is necessary (see: Therapy miscarriage).

9. Abortus habitualis: habitual abortion

With these signs it occurs repeatedly in the woman (at least 3 times by definition) Miscarriages. In half of the cases affected, there is no cause.

However, if a cause is discovered, then it is abortions in the Early pregnancy often genetic (chromosomal Changes) or developmental disorders of the uterus. In the Late pregnancy anatomical and functional impairments of the female genital organs as the cause.
It is estimated that around 1% of all couples who want to have children are affected.

Symptoms of a miscarriage

Many pregnant women are particularly afraid of a miscarriage, especially in the first few months of their pregnancy. This is the reason why almost every physical change and every slight pain is interpreted as an indication of an impending miscarriage. But in most cases these are completely normal physical adaptation processes to pregnancy.
Still, there are a few signs that may be related to a miscarriage that you should be mindful of.

In principle, you should not have any during an intact pregnancy vaginal bleeding occur. If this is the case, it is recommended Contact the treating gynecologist as soon as possible record. In many cases, it's just a false alarm.
Still, miscarriages, especially in early pregnancy, are almost always associated with bleeding. The following applies here: it is better to go to the doctor once more than once too little.

Furthermore deliver unusually strong, sometimes even convulsive stomach pain an indication that something is wrong with the pregnancy. In this case, too, contact with a doctor is recommended.
Likewise, pain radiating to the back is by no means a common pregnancy symptom. However, they do not necessarily have to be related to the pregnancy.

Should pregnant women have one with them yellow, purulent discharge observe and possibly even fever develop, this also means an increased risk of miscarriage.

In more advanced pregnancies, the typical signs of a miscarriage change. Now these are more similar to the symptoms of an upcoming delivery. Of the Leakage of amniotic fluid, which can indicate a premature rupture of the amniotic sac, as well as the onset of labor before the calculated due date, can now provide indications of an impending miscarriage. However, none of the symptoms mentioned can prove a miscarriage. In any case, however, a clarifying medical examination should be carried out as soon as possible.

discharge

There are many different types of miscarriages. They differ in their causes, but all mean the loss of the unborn child. One type of miscarriage represents the so-called septic miscarriage This leads to an infection in the uterus. Frequently described symptoms are high fever, chills, severe abdominal pain, a general feeling of illness and vaginal discharge. In most cases this is purulent-yellow. Fortunately, this form of miscarriage is in Germany very rare become. Nevertheless, a doctor should be consulted immediately if these symptoms are present.

Back pain

Back pain is a very common, but also very unspecific symptom. In most cases they can be successfully treated with physiotherapy or physical exercise. Nevertheless, there is a possibility that there is a connection with an impending miscarriage.
There are several possible reasons for the occurrence of back pain during pregnancy. On the one hand, the pain may arise from the child's natural growth in the uterus. Furthermore, the pelvis is also preparing for the impending delivery of the child and can lead to radiation in the back. But an ectopic pregnancy could also produce such symptoms. If you are not sure about the cause of your back pain, it is advisable to go to a gynecologist for a pregnancy check.

a headache

Similar to back pain, headaches are also a non-specific symptom. They in no way provide a reliable indication of an impending miscarriage. In most cases, they will be through the Hormonal changes of the body at the beginning of pregnancy triggered and clearly decrease in intensity and frequency in the course of pregnancy. But stress or an unhealthy diet are also known to be triggers for headaches.
In rare cases, headaches can also pose a threat to the pregnant woman and the unborn child, namely in the case of a pre-eclampsia (also Poisoning during pregnancy called). However, there are other symptoms such as visual disturbances, abdominal pain, swelling of the legs and arms as well as a changed protein content (Protein content) in the urine. Preeclampsia represents one absolute emergency situation and should be hospitalized immediately.

Bleeding

The bleeding represents that most common symptom of a miscarriage When the body ejects the already nested embryo, menstrual-like symptoms usually occur, which are not infrequently accompanied by cramp-like abdominal pain. In quite a few women, a miscarriage that manifests itself by bleeding also goes unnoticed. Most miscarriages occur in the first few weeks of pregnancy, when most women are not yet aware of their pregnancy and therefore interpret the abortion bleeding as a normal menstrual period.
However, should bleeding occur during a secured pregnancy, this is an absolute warning signal. A doctor should be consulted as soon as possible. In very few cases the embryo can be identified in the lost blood. Usually it is just too small (in the 6th week of pregnancy it is a maximum of 1cm long). Self-diagnosis of a miscarriage is therefore usually impossible.

Signs of miscarriage in early pregnancy

The signs of a miscarriage in early pregnancy are quite different from those in late pregnancy. In most cases, one occurs in early pregnancy vaginal bleeding associated with the departure of the embryo. This is called a so-called Early abortion (up to the 12th week of pregnancy).
But not every bleeding has to mean the loss of the unborn child! In many cases it is harmless and will go away on its own. Still should any bleeding Reason enough to have one To see a doctor. However, some early abortions also remain almost symptom-free. In this case, we speak of a “restrained abortion”.

In summary, it can be said that it is almost impossible to determine a miscarriage based on symptoms. If you are unsure whether the pregnancy is still intact, an ultrasound should be performed by the gynecologist.