Missed Miscarriage: A Complete Guide
This article explores a complete guide to missed miscarriage, including what it is, why it happens, how it is found, and what your management options are. We cover what you need to know in plain language.
Table of Contents
What Is a Missed Miscarriage?
A missed miscarriage, sometimes called a silent miscarriage, occurs when an embryo or fetus has died or failed to develop, but the body has not yet recognised the loss and no bleeding or cramping has begun. The pregnancy sac may continue to grow, and pregnancy hormones can remain elevated, so you may still feel pregnant and have a positive test. This is why a missed miscarriage is often discovered only at a routine scan, which can be deeply shocking. Like other first trimester losses, most missed miscarriages are caused by random chromosomal problems and are not preventable. The experience is emotionally difficult because there is no warning: you arrive at a scan expecting reassurance and instead receive devastating news.Your Management Options
After a missed miscarriage is confirmed, you usually have three options: expectant management, medical management, and surgical management. Expectant management means waiting for the body to pass the pregnancy naturally, which can take one to three weeks and involves bleeding and cramping when it begins. Medical management uses tablets, usually mifepristone followed by misoprostol, to start the process and is suitable for many women. Surgical management, often called ERPC or suction aspiration, is a short procedure under anaesthetic to remove the pregnancy tissue and may be recommended if there is heavy bleeding or retained tissue. Each option has risks and benefits, and the right choice depends on your circumstances and preferences. You should have time to decide, and your clinical team should support whatever you choose. Follow-up scans confirm the miscarriage is complete.FAQ
### Why do pregnancy symptoms continue in a missed miscarriage?Pregnancy hormones can remain elevated for days or weeks after the embryo has died, so nausea, breast tenderness, and positive tests can persist. This is why missed miscarriage is often found at a scan.
How long can a missed miscarriage take to pass naturally?
It can take one to three weeks for bleeding to begin after a missed miscarriage. If it takes longer or you develop a temperature, seek medical advice.
Is surgical management safe?
Yes. ERPC is a common, short procedure with low complication rates. It may be recommended if bleeding is heavy, tissue is retained, or you prefer not to wait.
This article is for informational purposes only and does not constitute medical advice.
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