Missed miscarriage: Symptoms, causes and when you can get pregnant again

One of the reasons why couples prefer to wait with their pregnancy announcement is the risk of a missed miscarriage; this is when the foetus stops developing and dies. However, unlike in a spontaneous miscarriage, the foetus remains in the woman's body, and because the placenta continues to secrete hormones, the mother often only hears this painful news from her doctor.

Symptoms of missed miscarriage

The other name for a missed miscarriage – a silent miscarriage – shows just how hard it is to detect. Unlike a normal miscarriage, there are usually no symptoms signalling the miscarriage – women may have mild spotting, discharge or mild lower abdominal cramping – this is why it is often missed. And not even the placenta notices – it continues to function as if the foetus was alive, which is why missed miscarriages are often only discovered when the doctor cannot detect a heartbeat.

When are women at risk of a missed miscarriage?

It most often happens during the first trimester, which is why it is recommended to wait until after the first trimester screening before announcing a pregnancy. In rare cases, women may experience a missed miscarriage in the early second trimester.

Causes of missed miscarriage

It is not entirely clear why the foetus suddenly stops developing, but research to date lists chromosomal abnormalities (the embryo has the wrong number of chromosomes) as the most common cause of missed miscarriages. Other (rare) causes include serious viral or bacterial infections, poor blood clotting, immune system disorders, hormonal disorders or thyroid problems. However, these ‘hidden’ causes are usually only discovered after a couple experiences multiple missed miscarriages and visits a reproductive specialist.

Uterine revision after a missed miscarriage

Doctors often recommend a uterine revision in which the contents of the uterine cavity are removed by a curette after a missed miscarriage. Today this is a simple routine procedure that takes several minutes, usually on an outpatient basis and under general anaesthesia. In some cases uterine revision is not necessary and the tissue will come out on its own. There is also medication that helps separate and expel the tissue. Both cases require the same regime as after childbirth: strict hygiene, rest, avoidance of sexual activity and avoidance of all places where you are at risk of infection (public swimming pools, saunas and bathtubs) for 6 weeks after the procedure.

Getting pregnant after a missed miscarriage

A missed miscarriage is a big blow to a couple – the joy of preparing to welcome a baby is quickly replaced by sadness and fear of what comes next. In addition to the emotional burden associated with such a great loss, parents also begin to worry that there may be something wrong them and that they may lose their baby again. However, doctors reassure patients that one or two silent pregnancies may not indicate anything serious – it does not increase the probability of another miscarriage. A woman can get pregnant after her next menstruation following the uterine revision, but doctors recommend waiting at least two to three months before trying again – this will give the woman’s body and mind enough time to heal and gain strength for the next time.

Missed miscarriage after IVF and a woman’s mental health

Unfortunately, even patients who get pregnant with the help of IVF experience missed miscarriages.

After this difficult experience, a woman’s mental health is very fragile – it is similar to the postpartum period because of the hormones that are released, but let’s not forget that this mother lost her baby. This is why her partner and those closest to her should support her and give her space to share all her emotions and pain, and offer help so that she can rest.