It’s the moment every pregnant woman dreads I guess. You go to the check-up, looking forward to finally seeing your baby again on the ultrasound, and then comes the sentence that changes everything: "I no longer see a heartbeat." You were actually feeling well and did not notice any signs. This is unfortunately not that rare and is called a missed abortion or also restrained miscarriage. What it is, how to detect it and what happens after diagnosis:
Content of this article
1. What is a missed abortion?
A missed abortion is also known as a restrained miscarriage. This means that there is no signs of miscarriage gives. In contrast to a "normal" miscarriage, the pregnant woman thus has No pain and no bleeding. In some cases, however, the Typical pregnancy symptoms like nausea or breast tenderness return.
This is because the Embryo is no longer alive, but still remains in the uterus. In most cases, the gynecologist does not notice that the embryo’s heart is no longer beating until the next ultrasound check-up.
2. How is a restrained miscarriage detected?
As already written, the pregnant woman herself does not notice the restrained miscarriage in most cases. Therefore, it is often only noticed during the ultrasound that the embryo in the abdomen is no longer alive. The doctor no longer sees a heartbeat or find out that although Amniotic cavity has continued to grow but the embryo itself has not.
He will then hCG level in the pregnant woman’s blood, which normally increases during pregnancy but decreases when the embryo is no longer alive. After the diagnosis is made, it is nevertheless advisable to a second opinion to catch up.
3. What are the symptoms of a missed abortion?
The treacherous thing about a missed abortion is, that the typical symptoms of a normal miscarriage are absent – hence the name restrained miscarriage. The pregnant woman has neither pain nor bleeding. Nevertheless, for some women, the physical symptoms that accompany early pregnancy recede. The Nausea disappears, breasts are no longer tense, some do not feel pregnant anymore.
Important: If you notice that the pregnancy signs disappear again, it does not automatically mean that it is a missed abortion! Your embryo can still develop completely normally.
4. How often does a restrained miscarriage occur??
The risk of a miscarriage cannot be determined exactly, because it depends on many different factors. However, it is about 90% of all miscarriages are due to a missed abortion. This is also because Miscarriages most common in the first weeks of pregnancy take place. And often so early that the woman does not even know she is pregnant yet. According to the Kinderwunsch Uniklinik Bonn up to 50% of all pregnancies end by the 4th week of pregnancy. or 5. Week.
In the first 12 weeks, abortion occurs in about 30% of all pregnancies. Therefore, this period is often considered a particularly critical phase. This is also the reason why many expectant parents do not tell their environment about the pregnancy until after this limit has been reached.
5. What are the causes of a missed abortion?
A restrained miscarriage can have many different causes. In the In most cases, the embryo suffers from a genetic disorder chromosomes and is therefore not viable. In 50 to 60 % of all miscarriages up to the 14. week, this is the cause. However, there are many other factors that can lead to or promote a missed abortion:
- malformation of the placenta or uterus
- Hormonal disturbance of the mother
- Blood groups of mother and embryo are not compatible
- Infections in early pregnancy
- Chronic illness of the mother (z.B. of the thyroid gland)
- Diabetes mellitus, which is not properly adjusted
- Higher age of the mother: from 45 years the risk of miscarriage is 75%
- Excessive coffee consumption (caffeine)
- Smoking and alcohol consumption during pregnancy
If a woman has suffered a missed abortion and would like to know what caused it, there is the possibility of having the examine the rejected tissue in the laboratory to let. For example, chromosomal abnormalities can be reliably detected.
In most cases, a missed abortion or restrained miscarriage is not discovered until the routine examination.
6. In which SSW is a restrained miscarriage most frequent??
As already mentioned, most miscarriages occur in early pregnancy up to 5. week instead of. Between the 6. and the 8. Week the Risk still about 18 %. From the 17. Week it sinks to 2 to 3. Or in other words: In the first 12 weeks of pregnancy about 80% of all miscarriages occur. In this period the risk of a missed abortion is also the highest.
7. How to treat a restrained miscarriage?
If the doctor has diagnosed a restrained miscarriage, there are two possibilities, how the dead embryo comes out of the body. Either with the help of a Cervical curettage, or the pregnant woman can wait until her Body rejects the tissue on its own. This is then called a small birth.
However, in most cases there is no need to decide immediately or particularly quickly. Therefore, if there are no medical reasons not to do so, the woman can calmly consider which way is right for her.
Scraping (curettage) / aspiration
One way to remove the embryo after a missed abortion is to perform a Abortion or also curretage. It is usually under General anesthesia performed and lasts only a few minutes. The doctor performs Speculum into the vagina and dilates the cervix. Then removed he with a so-called Curette, a kind of spoon with a sharp edge, which has Uterine mucosa and the remaining tissue including the embryo. Afterwards, he checks by ultrasound whether there are really no remnants left in the uterus.
In some cases the tissue also not scraped out with a curette, but rather aspirated.
small birth – natural abortion
If there is no medical need to immediately remove the embryo from the uterus after the restrained miscarriage, the woman has the option of, wait for a natural miscarriage. This means that the body eventually determines that the pregnancy is no longer intact, and the embryo together with the amniotic cavity and the uterine mucous cavity itself repels.
However, it can take a while for this to happen: according to a 2005 study, there was in at least 80% of pregnant women about 2 to 6 weeks after the missed abortion to a natural miscarriage. For many women this so-called small birth The opportunity to better process the early departure and say goodbye to her child. However, it also causes heavy bleeding and also pain in the. And afterwards, in any case, a doctor checks that there are no remnants in the uterus have remained.
8. Prevent missed abortion – is it possible?
In most cases of restrained miscarriage, the Embryo not viable due to genetic disorder. The mother has no influence on it and could not have prevented it.
Nevertheless, there are some things you can do, to prevent a restrained miscarriage if your embryo is healthy:
- Refrain from alcohol, nicotine and too much coffee
- Be sure to eat a healthy diet and talk to your doctor about additional pregnancy vitamins to meet increased nutrient needs.
- Take all the preventive examinations. How to detect and treat possible infections early on.
- Discuss possible pre-existing conditions such as diabetes or thyroid problems with your doctor early on.
- Do light sports.
- avoid too much stress.
9. When hCG levels drop after a restrained miscarriage?
As soon as the body realizes that the pregnancy is no longer intact, the hCG level in your blood starts to decrease. If the woman decides to Scraping decides, the Immediately after surgery Be the case because the embryo and amniotic sac are removed from their bodies. After one to two weeks the value should already have dropped significantly.
In the case of a natural departure after a restrained miscarriage it takes usually a little longer. The body must first determine for itself that the embryo is no longer alive before rejecting it. Only then will the hCG level slowly begin to decrease.
Generally After a missed abortion, it can even take two to three months for the value to drop so low that a pregnancy test no longer shows positive.
10. When can I get pregnant again after a missed abortion?
If you have had a restrained miscarriage, you can purely physically theoretically already from the next ovulation get pregnant again. However, you should keep in mind that your uterine lining to recover first must. That is why Recommendation, after a missed abortion at least three months to wait before you get pregnant again.
A miscarriage is also a great strain on the soul. Therefore, you should definitely process them first, so that you can fully concentrate on the new pregnancy.
11. What is the risk of another restrained miscarriage??
If a woman suffers a restrained miscarriage Increase the risk of another miscarriage in the next pregnancy. After the first missed abortion, the risk is 15%. If the second pregnancy has also terminated, it increases to 35. At the latest after the third miscarriage, a doctor should try to find the cause.
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