Incomplete Miscarriage – Causes, Symptoms and Treatment

Pregnancy can be full of good as well as worrisome surprises. While mothers-to-be try to take good care of themselves and their babies, for some, it could be difficult to have a healthy term due to health conditions and pregnancy-related complications. One such complication is a miscarriage or spontaneous abortion, which refers to the loss of the baby before the pregnancy reaches 20 weeks. As per recent studies, every one out of five pregnancies results in miscarriage. In this article, we shall discuss a few facts about incomplete miscarriage, its causes and treatment.

What Is an Incomplete Miscarriage?

As per the definition, incomplete miscarriage is when the cervix has dilated, and the bleeding has begun, but the tissue is still embedded in the uterus. Sometimes the tissue gets dispelled from the body naturally. Some women, however, require medical intervention to treat the miscarriage.

Causes of Incomplete Miscarriage

Miscarriages, though painful, are quite common during pregnancy. Some of the miscarriages pass on their own while some of them need medical treatment. The most common reasons for incomplete miscarriages are:

1. Chromosomal Abnormalities

This is an indicator that the chromosomes the baby is carrying might be defective. The damaged egg or sperm cell cause most of these chromosomal abnormalities. A problem during the division process of the zygote could also cause chromosomal abnormalities.

2. Hormonal Problems

An insufficiently developed uterine lining can cause miscarriage. Hormonal imbalance in women with adrenal and thyroid gland problems have been the two most significant reasons for miscarriage.

3. Structural Problems

Problems with the shape/structure of the uterus can also cause miscarriage in women. They typically interfere with the implantation of the fertilised egg. Uterine fibroid can also affect the uterine lining resulting in an incomplete miscarriage if the tissue is not expelled from the body.

4. Cervical Issues

The weakening of the cervical muscle causes the cervix to open up as the weight of the foetus increases during the pregnancy and puts pressure on the cervical opening. This condition can also cause incomplete miscarriage.

5. Infections

Some infections like Toxoplasmosis, Syphilis, Varicella-Zoster, Parvovirus B19, Rubella, Cytomegalovirus (CMV), and Herpes Infections can hamper foetal development and may result in miscarriage.

6. Environmental Factors

Being exposed to toxins in the air for a considerable period during pregnancy can cause miscarriage in some women. Smoking, alcohol, and drugs can also cause miscarriage during pregnancy.

7. Immunological Causes

Antiphospholipid Antibodies, a group of immune proteins produced by the body as an autoimmune response to phospholipids, can cause miscarriage in women. Blood tests help in detecting the presence of these antibodies.

8. Subchorionic Hematoma

This is a condition where blood accumulates between the uterine wall and the chorion (the outer fetal membrane) during pregnancy. In some cases, a subchorionic hematoma can lead to a miscarriage. If the hematoma is not fully expelled, it can result in an incomplete miscarriage.

Signs & Symptoms of an Incomplete Miscarriage

Listed below are some of the signs and symptoms of an incomplete miscarriage:

1. Heavy Bleeding

You might start bleeding suddenly, and it increases with every passing hour. If you are experiencing this, then you should see a doctor immediately.

2. Passing Clots

During your pregnancy, if you suddenly start passing big clots, you must seek medical help immediately as this could be a sign of an undergoing incomplete miscarriage.

3. Contractions

You might experience excruciating pain which is similar to contractions of the uterus.

4. Missed Miscarriage

A missed miscarriage, as the name suggests, refers to the situation when the body fails to recognise that the pregnancy is no longer viable. In an incomplete miscarriage, no bleeding is noticed until the hormone levels of the woman decrease, which triggers the uterine lining to shed.

Incomplete Miscarriage Complications

Though most of the miscarriages in early pregnancy are relatively uncomplicated from the health perspective, you should be cautious and see a doctor immediately if you observe some or all of the below-mentioned symptoms:

1. Prolonged Bleeding

Most of the incomplete miscarriages have longer cramping or bleeding period than the normal miscarriages. If you experience fatigue, lightheartedness or an increased heartbeat rate, you should seek medical help immediately. A small percentage of women face the risk of haemorrhaging during their incomplete miscarriage.

2. Infection Risk

An incomplete miscarriage comes with the risk of an infection which can be dangerous if not treated immediately. Fever, chills and a foul-smelling discharge from the vagina are usually the symptoms that indicate you have developed an infection.

3. Asherman Syndrome

In Asherman syndrome, scar tissues, called adhesion’s, form in the uterus, causing fertility problems and further miscarriages. This is a rare complication of a D&C procedure. It is usually corrected by surgically removing the adhesion’s to facilitate pregnancy again.

Post analysing the signs and symptoms of incomplete miscarriage, the medical practitioner will suggest treatment. Read on to know what the treatment options could be.

Diagnosis of Incomplete Miscarriage

To confirm an incomplete miscarriage, your healthcare provider will employ a range of assessments, which involve:

• Fetal heart monitoring
• Examination of the pelvic area
• Quantitative hCG blood analysis
• Incomplete miscarriage ultrasound

Treatment Options for an Incomplete Miscarriage

Incomplete miscarriage management can be both invasive and non-invasive, depending on the requirement of the patient.

1. D&C Surgery

This surgery is usually done under general anaesthesia in which the doctor dilates the cervix to access the uterus. Using a curette, the physician scrapes the sides of the uterus to clean off the remains of conception tissues.

2. Cytotec

Cytotec/Misoprostol can be administered by mouth, or inserted vaginally. It has a higher success rate for pregnancies of the gestational age of 13 weeks or below. But, they can’t be taken without a doctor’s prescription.

Tips to Cope Up With Incomplete Miscarriage

In addition to tending to your physical well-being, it’s crucial to prioritize your emotional health during this period. Here are some coping strategies to consider:

1. Allow Yourself the Space to Grieve

Experiencing a miscarriage is a profound loss, and like any other loss, you may navigate through the various stages of grief, which can include denial, isolation, anger, bargaining, depression, and, ultimately, acceptance.

2. Include Your Partner in the Process

If you’re experiencing the grief of miscarriage with a partner, involve them in your decision-making and discussions. Research indicates that both partners experience grief after a miscarriage, though they may express it differently. This time can be an opportunity for you both to draw closer rather than drift apart.

3. Seek External Support

Beyond professional mental health assistance, there are numerous non-profit organizations dedicated to raising awareness about pregnancy and infant loss. These organizations also provide valuable support services.

When to Consult the Doctor?

If you experience any of the following, it’s crucial to contact your healthcare provider immediately:

• Heavy Bleeding: This is defined as saturating a new pad every hour for three consecutive hours.
• Foul-Smelling Vaginal Discharge
• Fever of 100.4°F (38°C) or Higher: Or as advised by your healthcare provider.
• Increasing Lower Abdominal Pain: Particularly if the pain worsens over time.
• Feelings of Weakness or Dizziness

An incomplete miscarriage is very traumatic and can fill your mind with anxiety, doubt, and a feeling of loss. You should get plenty of rest and concentrate on eating healthy. Pursue your hobbies or anything that brings joy to your mind. Try meditation to calm your mind and lower your stress levels. If you still feel distressed, seek professional help such as counselling. This will also give your body adequate time to heal so that you can plan for your next pregnancy.

References/Resources:

1. Miscarriage, Incomplete; mountnittany.org; https://mountnittany.org/wellness-article/miscarriage-incomplete

2. Treating miscarriage; thewomens.org.au; https://www.thewomens.org.au/health-information/pregnancy-and-birth/pregnancy-problems/early-pregnancy-problems/treating-miscarriage

3. Incomplete miscarriage; tommys.org; https://www.tommys.org/baby-loss-support/miscarriage-information-and-support/types-of-miscarriage/incomplete-miscarriage

4. Incomplete Miscarriage: Care Instructions; healthy.kaiserpermanente.org; https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.incomplete-miscarriage-care-instructions.uh2809

5. Miscarriage; mayoclinic.org; https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/diagnosis-treatment/drc-20354304

6. Miscarriage; pregnancybirthbaby.org.au; https://www.pregnancybirthbaby.org.au/miscarriage

7. Miscarriage: Should I Have Treatment to Complete a Miscarriage?; peacehealth.org; https://www.peacehealth.org/medical-topics/id/tn7433

8. Incomplete miscarriage; radiopaedia.org; https://radiopaedia.org/articles/incomplete-miscarriage

Also Read:

Early Miscarriage
How to Heal After a Miscarriage?
Best Ways to Have Natural Miscarriage
Types of Miscarriage That You Should Know About