What is Incomplete Miscarriage

A miscarriage is the loss of an unborn baby (fetus) before the 20th week of pregnancy.

In an incomplete miscarriage, parts of the fetus or placenta (afterbirth) remain in the body. Most miscarriages happen in the first 3 months of pregnancy. Sometimes, it happens before a woman even knows she is pregnant.

Having a miscarriage can be an emotional experience. If you have had a miscarriage, talk with your health care provider about any questions you may have about miscarrying, the grieving process, and your future pregnancy plans.

What are the causes?

This condition may be caused by:

• Problems with the genes or chromosomes that make it impossible for the baby to develop normally. These problems are most often the result of random errors that occur early in development, and are not passed from parent to child (not inherited).
• Infection of the cervix or uterus.
• Conditions that affect hormone balance in the body.
• Problems with the cervix, such as the cervix opening and thinning before pregnancy is at term (cervical insufficiency).
• Problems with the uterus, such as a uterus with an abnormal shape, fibroids in the uterus, or problems that were present from birth (congenital abnormalities).
• Certain medical conditions.
• Smoking, drinking alcohol, or using drugs.
• Injury (trauma).

Many times, the cause of a miscarriage is not known.

What are the signs or symptoms?

Symptoms of this condition include:

• Vaginal bleeding or spotting, with or without cramps or pain.
• Pain or cramping in the abdomen or lower back.
• Passing fluid, tissue, or blood clots from the vagina.

How is this diagnosed?

This condition may be diagnosed based on:

• A physical exam.
• Ultrasound.
• Blood tests.
• Urine tests.

How is this treated?

An incomplete miscarriage may be treated with:

• Dilation and curettage (D&C). This is a procedure in which the cervix is stretched open and the lining of the uterus (endometrium) is scraped to remove any remaining tissue from the pregnancy.
• Medicines, such as:
  • Antibiotic medicine to treat infection.
  • Medicine to help any remaining tissue pass out of your uterus.
  • Medicine to reduce (contract) the size of the uterus. These medicines may be given if you have a lot of bleeding.

If you have Rh negative blood and your baby was Rh positive, you will need a shot of medicine called Rh immunoglobulinto protect future babies from Rh blood problems. “Rh-negative” and “Rh-positive” refer to whether or not the blood has a specific protein found on the surface of red blood cells (Rh factor).

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed antibiotic medicine, take your antibiotic as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Do not take NSAIDs, such as aspirin and ibuprofen, unless approved by your doctor. These medicines can cause bleeding.

Activity

• Rest as directed. Ask your health care provider what activities are safe for you.
• Have someone help with home and family responsibilities during this time.

General instructions

• Keep track of the number of sanitary pads you use each day and how soaked (saturated) they are. Write down this information.
• Monitor the amount of tissue or blood clots that you pass from your vagina. Save any large amounts of tissue for your health care provider to examine.
• Do not use tampons, douche, or have sex until your health care provider approves.
• To help you and your partner with the process of grieving, talk with your health care provider or seek counseling to help cope with the pregnancy loss.
• When you are ready, meet with your health care provider to discuss important steps you should take for your health, as well as steps to take in order to have a healthy pregnancy in the future.
• Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

• The American Congress of Obstetricians and Gynecologists: www.acog.org  
• U.S. Department of Health and Human Services Office of Women’s Health: www.womenshealth.gov  

Contact a health care provider if:

• You have a fever or chills.
• You have a foul smelling vaginal discharge.

Get help right away if:

• You have severe cramps or pain in your back or abdomen.
• You pass walnut-sized (or larger) blood clots or tissue from your vagina.
• You have heavy bleeding, soaking more than 1 regular sanitary pad in an hour.
• You become lightheaded or weak.
• You pass out.
• You have feelings of sadness that take over your thoughts, or you have thoughts of hurting yourself.

Summary

• In an incomplete miscarriage, parts of the fetus or placenta (afterbirth) remain in the body.
• There are multiple treatment options for an incomplete miscarriage, talk to your health care provider about the best option for you.
• Follow your health care provider’s instructions for follow-up care.
• To help you and your partner with the process of grieving, talk with your health care provider or seek counseling to help cope with the pregnancy loss.