Missed abortion: all about the restrained miscarriage

Woman sits on the bed with her legs bent

Losing the baby and not even realizing it: This is the nightmare of every pregnant woman. Read here how you can recognize a missed abortion, what happens in the body during a restrained abortion and what this means for further pregnancies. In addition, at the end of the article you will find a testimonial from a woman who has experienced a missed abortion.

In this article:

What is a missed abortion??

A Missed Abortion is also called a restrained miscarriage or restrained abortion. Derived from the English word "to miss" (= to miss), pregnant women do not notice that the embryo is no longer alive and "miss" the moment, so to speak. In miscarriages, pregnant women usually feel pain and experience heavy vaginal bleeding and cramping. In a restrained abortion, on the other hand, the embryo dies without the woman experiencing any symptoms.

Unlike typical miscarriages, the body does not reject the embryo on its own. In a missed abortion, the dead embryo remains in the uterus. Also, the placenta continues to grow and produce amniotic fluid. As a result, the pregnancy test remains positive for a short period of time, even if there is no life left.

What can be the causes of a restrained miscarriage??

Behavioral miscarriages can have various causes. The most common reason is that the embryo is attached to a genetic disorder (chromosomal abnormalities) suffers. To determine this, the rejected tissue can be examined in the laboratory.

But other risk factors also trigger a restrained miscarriage:

  • Malformation of the uterus or placenta
  • Increased blood clotting
  • Unhealthy lifestyle (nicotine, alcohol)
  • Hormonal disturbance
  • Blood group incompatibility

How often does a restrained abortion occur?

Data analysis shows: Worldwide, 15 to 20 percent of all clinically recognized pregnancies end as miscarriages. Missed abortion accounts for about 90 percent of them.

When can the missed abortion occur in pregnancy?

Approximately 50 percent of pregnancies end up before the 5th week. SSW, that is, before the ovum has implanted itself. After the 6. SSW medical risk of a missed abortion is about 10 to 15 percent.

The first twelve weeks of pregnancy are therefore considered a high-risk period, since 80 percent of all miscarriages occur during this period. This is why many couples take the first three months to announce the pregnancy.

How to notice a restrained miscarriage?

In contrast to other types of miscarriage, there is usually no vaginal bleeding or loss of tissue in a missed abortion. That is why a restrained miscarriage is so difficult to notice. Some women report that typical pregnancy symptoms, such as fatigue, nausea or breast tenderness, have decreased or disappeared altogether. However, only a visit to the doctor can provide certainty.

How does the doctor treat a missed abortion??

If you suspect an unnoticed abortion, the first thing the doctor will do is perform an Ultrasound examination through. Should it be a Missed Abortion, there will be no heartbeat detectable. Following this, the hCG level is still measured. If it is an abortion, it will have decreased.

Even if the doctor diagnoses you with a missed abortion, you should still get a second opinion. In the rare case, the embryo can actually lie against the chorionic cavity (corner stool). This site cannot be detected by the ultrasound scanner. Thus, misdiagnosis is not impossible.

In case of a restrained miscarriage, the embryo is removed taking into account the week of pregnancy. By the twelfth week of pregnancy it is removed with the help of suction or curettage. If a missed abortion occurs after the third month, birth is induced with the help of an infusion. After that the curettage takes place. Many women also choose to have a natural discharge.

Unnoticed miscarriage: natural abortion or curettage?

If you suffer a missed abortion, you will have to ask yourself whether you want a natural abortion or a curettage. After a professional consultation, you can usually decide for yourself which way to go.

How does a natural miscarriage occur?

A natural abortion happens naturally, as the name suggests. This means that the deceased embryo remains in the uterus for a while longer. The body alone decides when it is expelled and registers, due to the decreasing hCG level, that there is no pregnancy anymore. Then the process of natural abortion begins.

This can take days, but also weeks. Many women choose natural abortion for a restrained miscarriage because it gives them more time to process the missed abortion. They also want to give their body the time to come to terms with the change.

The natural removal is abdominal cramps and bleeding connected. Depending on the week of pregnancy in which the restrained miscarriage was detected, the bleeding can be heavier. Small remnants of the amniotic sac may also be discharged. If you wish to have a natural abortion, you should first discuss with your doctor whether this is the right way for you to go about it. If the pregnancy is already too advanced, complications can occur and you are advised not to have a natural miscarriage.

If the pain and bleeding continue for a long period of time and are accompanied by fever, you must see a doctor immediately. You can also have a midwife or doctor accompany you through the entire process.

What happens during a curettage?

Most women decide to have a curettage. The treatment involves removing the remaining tissue from the uterus. This includes parts of the placenta and embryo. Under general anesthesia, special instruments are used to remove the tissue.

How likely it is to have another restrained miscarriage?

How likely it is to have another recurrent miscarriage depends on many different factors. According to the WHO, this probability depends mainly on the Age of the woman from. In the guideline program of the German, Austrian and Swiss Society for Gynecology and Obstetrics, there is an overview that summarizes the risk of repeated miscarriage in tabular form:

Previous miscarriages Risk of recurrence
25 – 29 years 30 – 34 years 35 – 39 years 40 – 44 years
1 miscarriage ca. 15% ca. 16 – 18% ca. 21 – 23% ca. 40%
2 miscarriages ca. 22 – 24% ca. 23 – 26% ca. 25 – 30% ca. 40 – 44%
over 3 abortions About. 40 – 42% ca. 38 – 40% ca. 40 – 45% ca. 60 – 64%

Can you get pregnant again after a missed abortion?

In principle, after a restrained miscarriage, you can try to get pregnant again directly: as long as you feel ready and there is nothing medically wrong with it. A new pregnancy is associated with a lot of courage. Many couples are concerned that the risk of miscarriage is increased. However, this depends on the cause of the previous miscarriage. That is why you should have the tissue examined in the laboratory.

It can be said that hereditary and physical causes, as well as chronic diseases Increase the risk of another miscarriage. If a woman suffers a miscarriage more than three times, it is also called "habitual abortions". About one percent of all couples are affected.

If the miscarriage is due to a pregnancy-related illness, then parents can seek advice from a gynecologist. If hereditary diseases are the cause, you should seek human genetic counseling.

Psychological stress: How to deal with an unnoticed miscarriage?

Miscarriages of any kind are a burden. The incoming grief is often accompanied by feelings of guilt. You should not blame yourself and you should not bottle up your feelings.

Talk to friends or close relatives. You can also exchange information with other mothers in forums. A miscarriage is nothing to be ashamed of or feel guilty about.

Say goodbye to your child and give yourself time. Many hospitals offer funeral ceremonies for children born prematurely or never.

You can find more places to go here:

Interview: An honest account of a mother’s experience

The 37 year old Youtuber Nicki from the channel Nickisbeautyworld had a Missed Abortion in April 2020 and lost her baby in the 9. Week of pregnancy. She tells us how she noticed the restrained miscarriage and what happened next in this testimonial.

How you found out about the restrained miscarriage?

Already in the 6. During the first week of pregnancy, the doctor told me that she couldn’t hear the baby’s heartbeat, but that wasn’t so strange, because sometimes you can hear a heartbeat in the 6th week. SSW still no heart sound. I then went for a routine checkup, there I should already have ca. in the 8. – 9. This could have been your first week of pregnancy. She said she still can’t detect the baby’s heartbeat.

How the appointment with the doctor went?

I then had blood taken to check the hCG level. If this had gone down, the baby would not be alive. I had to wait a few days for the result, then go back for the examination. The value had not gone down, but there was still no heartbeat. That was strange, gave me hope, but still continued uncertainty. I had to give blood again and wait a few more days. It was a very bad feeling not to know whether you have been carrying a dead baby in your belly for days or even weeks.

When at the second appointment there was still no heartbeat and my hCG level had finally dropped, it was clear that the baby was no longer alive.

Why did you choose to have a curettage and not have a natural delivery?

The gynecologist told me about the normal discharge and the curettage in the hospital. After a few hours of reflection, I decided to have the curettage, because the psychological suffering was already enough. I just wanted to get it over with as quickly as possible. By the time I got the abortion appointment, the first bleeding started. It was miserable. Unfortunately, I was also very afraid of the curettage, as I had already had a traumatic experience with it in the past.

How do you deal with grief? What helped you?

It is very difficult to deal with the grief. This one will always stay. At the same time I was separated from my partner. Double grief. I gave myself a lot of strength and tried to distract myself as much as possible. But this was almost impossible, because there was the Corona pandemic, where you mainly just had to stay at home. As a keepsake, I had a tea light holder made (by other mommies with star babies who make such things themselves) with cute designs that remind me of the star baby. Every evening I lit a candle for the lost baby.

What advice would you give to mothers who have just experienced a restrained miscarriage??

I give this advice to moms: don’t give up on having a baby. Sooner or later the desired baby comes and everything works out as hoped for! By sharing my experience publicly, countless women have contacted me who have gone through the same thing. The fact that you are not alone gives you strength, as well as the hope that your dream baby will come. Just keep trying.

What would you like to see in people around you?

My family and friends have not reacted negatively to my restrained miscarriage. They gave me strength and backed me up. Just like the women who have followed my story on YouTube.

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