Definition An incomplete miscarriage occurs when the body expels only part of the products of conception.
What is going on in the body? 1 in 5 pregnanacies will miscarry. Often, miscarriages occur when the foetus dies due to a chromosomal abnormality, or genetic defect, that affects health and development.
As the foetus and placenta stop growing, pregnancy hormone levels fall. Symptoms of pregnancy, such as breast tenderness, nausea and fatigue, may disappear.
In most cases, the uterus starts to contract, causing cramping, discomfort and vaginal spotting or bleeding until the contents of the uterus are expelled. If any tissue remains in the uterus there is a risk of increased bleeding and infection.
What are the signs and symptoms of the condition? A pregnant woman may:
experience vaginal bleeding or spotting
feel pelvic or abdominal cramping
pass some tissue or clots from her vagina
A woman who has had three or more miscarriages without a live baby is considered to have recurrent miscarriage. This may require evaluation.
How is the condition diagnosed? A blood or urine pregnancy test will be done to confirm that a pregnancy exists. The level of the pregnancy hormone HCG may be checked repeatedly and should double every 2 days. Rising levels suggest that the foetus is growing. Levels that fall or stay steady suggest a failing pregnancy or possible pregnancy of the fallopian tube (ectopic).
a progesterone level. This falls early in a failing pregnancy
an ultrasound to check for any foetal movement and heartbeat and to rule out ectopic pregnancy, which occurs when the egg implants outside of, instead of within the uterus
a pelvic examination to see if the cervix is open and whether or not there is any foetal tissue in the vagina or within the cervix
What are the long-term effects of the condition? The long-term effects of an incomplete miscarriage vary. There are many myths about what causes miscarriage. A woman may feel anxiety, fear and guilt if she believes she has "hurt her baby" by lifting heavy furniture, exercising too much, having sex or doing anything else to cause the miscarriage. A healthy pregnancy cannot be harmed by any of these activities. A woman should discuss any feelings or worries like these with her doctor. Delaying diagnosis and treatment of an incomplete miscarriage may increase a woman's risk of:
What are the risks to others? There are no risks to others.
What are the treatments for the condition?
A suction curette, or D and C, must be done to remove any foetal tissue remaining in the uterus.
Antibiotics and drugs to help the uterus contract so that bleeding stops may be used for 24 to 48 hours in individual cases.
If the mother is Rh-negative, she should be given a Injection of Rh immune globulin (anti-D). Otherwise, Rh sensitivity could affect later pregnancies and cause blood incompatibilities between the mother and foetus.
What are the side effects of the treatments? Side effects caused by anaesthesia may include:
drowsiness
fatigue
nausea
vomiting
Antibiotics and drugs to help the uterus contract may cause:
rash
diarrhoea
drug allergy
upset stomach
abdominal cramps
These side effects are usually short-term.
What happens after treatment for the condition? Within hours of having a D & C, a woman is usually sent home to recuperate. She should rest for 1 to 2 days. A woman should call her doctor if she:
has a fever
feels worsening cramps or lasting pain
continues to bleed heavily
A birth control method should be used if the woman does not wish to get pregnant. Birth control pills may be started 2 weeks after the miscarriage. If a future pregnancy is desired, conception may be attempted after the next period. An individual miscarriage does not affect the chances of a successful pregnancy in the future.
How is the condition monitored? Monitoring the level of HCG may help the doctor rule out the possibility of retained foetal tissue or ectopic pregnancy if bleeding or cramping continue. A repeat ultrasound is useful in these situations.
Author: Eva Martin, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
