Missed Miscarriage (Silent Pregnancy)



Missed miscarriage is an intriguing & devastating phenomenon wherein despite fetal death, gestation would continue as normal and body not expelling constituents of an aborted pregnancy for several weeks. Due to ambiguity in missed miscarriage signs & symptoms, several females are not aware of the reality that pregnancy termination has occurred. Such women might even be mistaking signs & symptoms of missed miscarriage to be that of pregnancy.

Around 4/5th of miscarriage cases arise in the initial 12 weeks of gestation, though they could take place past this time known as late missed miscarriage.

Causes

The precise reason for missed miscarriage is still not known, but around fifty percent of all early miscarriage cases develop from a heritable issue related to sperms or eggs. Prevalent reason is fetal chromosomal aberrations arising from many factors like pitiable quality of sperms or eggs, irregular fetal cell-division, &/or inherent irregularities of maternal or father’s side.

Additionally other aspects like immune system conditions, presence of infections (like STDs, CMV, rubella, toxoplasmosis), abnormality in the anatomical structure of the uterine (septate, unicornate), irregular maternal hormone levels (lesser levels of progesterone), drug abuse, systemic illness (like unmanaged thyroid condition or being diabetic).

Signs & Symptoms

Many pregnant females would be feeling nothing off-beam while others might notice some darkish brown spotting from the vagina that then turns deep red in colour, non-existent heart beat of the fetus during ultrasound scanning and reduced or lost gestational signs & symptoms like weariness, feeling nauseous & tender breasts.

Missed miscarriage signs can be baffling with women continuing to sense exhaustion & feeling nauseous since the tissue of placenta are continually releasing pregnancy hormones despite miscarriage having taken place. Due to this, such women could even get an affirmative pregnancy test outcome. Moreover, vaginal discharge doesn’t at all times arise instantaneously which makes it harder in discerning if or not pregnancy termination has occurred. Even pains in the lower abdomen or pelvis are not experienced among females undergoing missed miscarriage.

Diagnosis

Ultrasound scan could ascertain if or not miscarriage has occurred. Absences of fetal heartbeats mostly signify pregnancy termination.

Treatment

Missed miscarriage needs medical intercession and therapy choices are medications or operative dilation & curettage (D&C). The operative therapy choice involves hospitalization of the woman and after anesthetizing; a gynaecologist would be dilating her cervical area & curetting or scraping cell lining of the uterus for ensuring total exclusion of any remnants of lost pregnancy. This is conducted to avert any infection, acute blood loss & other related complication. A plus point about undergoing D&C is that the removed pregnancy matter is then forwarded to pathologists for examination & genetic testing done in case needed.

Medicines could be administered as another choice of therapy wherein prostaglandins are placed within the vaginal area in close proximity to the cervix for causing softening, dilating & contracting. Subsequent to some period of time, when there aren’t any contractions in the uterus then the doctor would commence with pitocin for stimulating them. Doing so helps the female’s body is expelling pregnancy constituents. A follow up testing would be done for ensuring if hCG levels are dipping.

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