When is a Miscarriage More Likely to Occur?

Miscarriage can happen very early or a bit later during the pregnancy period. Clinical guidelines define miscarriage as loss of a fetus aged 20 weeks to 22 weeks, weighing about 500 g or less. Most miscarriages, however, occur at the first trimester before the 13th week. An estimated 50% of pregnancies result in miscarriages due to a wide range of causes but only about 15% to 20% are detected as such.
Miscarriage is a life-and-death event, yet it is not a simple yes-or-no occurrence. It can manifest in many different forms. It does not happen in a single instant but consists of a series of events that culminate in the loss of the fetus and termination of the pregnancy.

Most miscarriages occur at a very early stage, sometimes even before a woman even realizes she is pregnant, and the embryo hasn’t even had the chance to implant in the uterus aka chemical pregnancy. About 15% of pregnancies result in early miscarriage during week 1 or 2. In such cases, the woman is blissfully unaware of what happened.

What’s an Embryonic Pregnancy?

A blighted ovum aka embryonic pregnancy will inevitably end up in a miscarriage which occurs a bit later, when the woman is usually aware of her condition. What she is not aware of is that although there is a sac in her uterus, there is no embryo inside. The body eventually passes the empty sac, usually before the 8th week of pregnancy.

As the fetus grows older, the chances of miscarriage decrease. However, the emotional pain that comes with miscarriage increases with increasing fetal age.

A threatened miscarriage is actually a potential tragedy thwarted. The most common sign of a threatened miscarriage is vaginal bleeding or commonly known as “spotting”. In such cases, the doctor usually prescribes bed rest as well as medications that can prevent contractions. Many threatened miscarriages have a happy ending, resulting in a healthy baby.

What Are the Signs of Miscarriage?

• Vaginal bleeding, which may be mild or profuse. The bleeding is due to the passing of the embryonic/fetal and placental tissue out of the body, the so-called conception products. Miscarriage is complete if all products are expelled, characterized by profuse bleeding. Miscarriage is incomplete if the body cannot get rid of all products. In such cases, bleeding may be mild. Take note, however, that vaginal bleeding or spotting does not necessarily mean miscarriage. Some women with viable pregnancy can occasionally have some light spotting.

• Pain in the lower back, which has been described as a persistent, dull but also sharp pain.

• Abdominal cramps and pain, which can be mild or severe. Some women describe the sensation as being similar to menstrual cramps. The cramps may actually be real contractions wherein the body is trying to expel the conception products.

The intensity, timing, and duration of the symptoms vary from woman to woman.

In the doctor’s clinic, impending, threatened, or complete miscarriage is confirmed by several tests that include manual examination, pelvic ultrasound, and blood test to check for levels of human chorionic gonadotrophin (HCG) hormone.

Manual examination checks the state of the cervix (dilation is a bad sign) and presence of other structural abnormalities such as tenderness and pain.

An ultrasound can check the status of the fetus, usually in terms of its size and heartbeat. The ultrasound can also detect abnormalities such as ectopic pregnancy.

The levels of HCG in the blood can indicate whether the pregnancy is proceeding normally or not.

More significant than how they deliver the information, though, is the test’s sensitivity.  A home pregnancy test’s sensitivity affects how early it can accurately deliver the good news.

How soon can I take a home pregnancy test?

Sensitivity is based on the lowest amount of the pregnancy hormone hCG the home pregnancy test can detect. The less hCG your home pregnancy tests needs, the earlier the test will be able to detect  pregnancy.  Some home pregnancy tests can be taken as early as five days before your missed period.

There is a greater chance of false positives and chemical pregnancies with early home pregnancy tests.

A chemical pregnancy is a very early miscarriage, in which the fetus is spontaneously aborted before a heartbeat could even be detected. In the case of a chemical pregnancy, you will get your period as scheduled, or perhaps a little bit later. It may be heavier or more painful than usual, with more intense cramps, or it may simply come as scheduled without incident, your positive pregnancy test is the only indication you had ever been pregnant at all.

Before choosing the most sensitive home pregnancy test on the market, weigh the risks of knowing as soon as possible about your pregnancy with the potential disappointment if the pregnancy does not stick. Women who experience multiple chemical pregnancies should see their doctor about possible treatment.

In the past several years, pregnancy tests have advanced. Most tests now have a sensitivity level where they can detect 25 mIU of hGc and can be used as early as five days before your missed period. AimStrip tests and BabyHopes tests can detect hCG levels as low as 20 mIU.

For best results, be sure to use your first morning urine.

If you are farther along in pregnancy, a test later in the day – as long as it’s been at least two hours since you last urinated – may still give a positive result.

If your test does not work, your urine may be too diluted from drinking too much water. Wait two hours without drinking anything and try again.

Author: Dawn Allcot

In the medical world, hCG is short for Human chorionic gonadotropin which is a hormone that a woman makes when she is pregnant. It can be detected in a urine sample or a blood sample as early as 10 days before your period should start. However, it can take until several days after you miss your period for these levels to be high enough that they can be detected.

The hCG hormone helps sustain a woman’s pregnancy until the second trimester when the placenta starts functioning fully and takes over. It also helps create the testes, secretes estrogen, and helps develop the placenta.

For women who have faced infertility issues, or who have had problems with miscarriages, doctors will routinely draw blood to check the hCG levels 2-3 times a week in early pregnancy. This is because hCG is supposed to at least double in a 48 hour period until it reaches a certain level, when it starts to decline. If the levels are doubling, it is often a sign that the pregnancy is viable and progressing as normal. If there is only a small rise in the number, no rise in the number, or a drop, it can be the first sign to a doctor or midwife that this pregnancy may not last through the first trimester.

There is no “norm” in the range for hCG levels in a pregnancy. They generally fall into this range.

If hCG levels are taken and they not only double, but triple, quadruple or more, this is often a sign that there is more than one baby in the uterus. When a woman is pregnant with multiples, her hormones will rise much faster than they do when it is just a single pregnancy.

If you have questions about your hCG levels, be sure to ask your doctor or midwife. They are the only ones who can correctly test, judge, and give you answers regarding the health of your pregnancy.