How long does it take for a missed miscarriage to pass

Treating miscarriage | The Royal Women's Hospital

If a miscarriage has begun, there is nothing that can be done to stop it. Any treatment you have will be aimed at avoiding heavy bleeding and infection. 

A discussion with the doctor or nurse will help you to work out which treatment options are best and safest for you.

On this page:

• No treatment (expectant management)
• Treatment with medicine
• Surgical treatment (curette)
• Waiting for treatment
• After a miscarriage

No treatment (expectant management)

You can choose to wait and see what will happen. This is called 'expectant management'. If nothing is done, sooner or later the pregnancy tissue will pass naturally. If it is an incomplete miscarriage (where some but not all pregnancy tissue has passed) it will often happen within days, but for a missed miscarriage (where the fetus or embryo has stopped growing but no tissue has passed) it might take as long as three to four weeks.

While you are waiting you may have some spotting or bleeding, much like a period. When the pregnancy tissue passes, you are likely to have heavier bleeding with crampy, period-like pains. You can use sanitary pads and take pain relieving tablets, such as paracetamol.

If your miscarriage is incomplete, with just a small amount of pregnancy tissue remaining, it’s probably best to take a wait and see approach. But if there is heavy bleeding or signs of infection you will need treatment. 

If the tissue does not pass naturally or you have signs of infection, the doctor will recommend a dilatation and curettage (D&C). You and the doctor can discuss and decide the preferred option for you. 

Things to know

• There are many reasons why some women prefer to wait and see. It may feel more natural, it may help with the grieving process or it may give you more of a sense of control.
• Some women become worried or frightened when the bleeding gets heavier, especially if blood clots, tissue or even a recognisable embryo is passed.
• Usually, the wait and see approach takes longer than any other approaches such as surgery or medication. Sometimes bleeding can last for up to four weeks.
• Although excessive bleeding and blood transfusion are very rare, they are slightly more common with expectant management than with surgery.
• A few women still need to have surgery – sometimes urgently – if they develop infection, bleed heavily or if the tissue does not pass naturally.
• The waiting time can be emotionally draining for some women. 

Treatment with medicine 

Medicine is available that can speed up the process of passing the pregnancy tissue. For an incomplete miscarriage, the medicine will usually encourage the pregnancy tissue to pass within a few hours. At most it will happen within a day or two. For a missed miscarriage, it may happen quickly, but it can take up to two weeks and, occasionally, longer.

• Medication is not suitable if there is very heavy bleeding or signs of infection. It is usually not recommended for pregnancies that are older than about nine weeks.
• If the tissue does not pass naturally, eventually your doctor will recommend a dilatation and curettage (D&C).

Things to know

• The pregnancy tissue will pass between four to six hours after taking the medicine, during which time you may be in hospital.  After a few hours, if the pregnancy hasn’t passed, you may be sent home to wait. This will depend on where you are and which hospital you are in. 
• The medicine has side effects which usually pass in a few hours but can be unpleasant, such as nausea, vomiting, diarrhoea, fever and chills. The tablets can be swallowed or dissolved under the tongue, or inserted in the vagina.
• After receiving the medication there may be some spotting or bleeding like a period. When the pregnancy tissue passes, you are likely to notice heavier bleeding and clots with strong cramping, period-like pains. You can use sanitary pads and take pain relieving tablets such as paracetamol.
• Some women may need stronger pain killers or a pain relieving injection.
• A few women still need to have surgery, sometimes urgently, if they develop infection, bleed heavily or if the tissue does not pass. 

Surgical treatment (curette)

A D&C (or ‘curette’) is a minor operation. The full name is dilatation and curettage. It is done in an operating theatre, usually under general anaesthetic. There is no cutting involved because the surgery happens through the vagina. The cervix (neck of the uterus) is gently opened and the remaining pregnancy tissue is removed so that the uterus is empty. Usually the doctor is not able to see a recognisable embryo.

The actual procedure usually only takes five to ten minutes, but you will usually need to be in the hospital for around four to five hours. Most of this time will be spent waiting and recovering.

You may have to wait a day or two to have a curette and sometimes, while you are waiting, the pregnancy tissue will pass on its own.   If this happens and all of the tissue is passed you may not need to have a curette.

A curette is done in the following circumstances:

• You have heavy or persistent bleeding and/or pain.
• The medical staff advise that this is a better option for you; this may be because of the amount of tissue present, especially with a missed miscarriage.
• This is an option you prefer.

Things to know

The risks of a D&C are very low, but include:

• some pregnancy tissue remains in uterus. This can cause prolonged or heavy bleeding and the operation may need to be repeated
• infection needing antibiotics
• damage to the cervix or uterus. This is very rare (around 1 in 1000) and, when it does happen, it is usually a small hole or tear which will heal itself
• excessive bleeding (very rare)
• anaesthetic risks. These are very low for healthy women, but no anaesthetic or operation is without risk. 

Waiting for treatment

If you have heavy bleeding with clots and crampy pain, it is likely that you are passing the pregnancy tissue. The bleeding, clots and pain will usually settle when most of the pregnancy tissue has been passed. Sometimes the bleeding will continue to be heavy and you may need further treatment. 

You should go to your nearest emergency department if you have:

• increased bleeding, for instance soaking two pads per hour and/or passing golf ball sized clots
• severe abdominal pain or shoulder pain
• fever or chills
• dizziness or fainting
• vaginal discharge that smells unpleasant
• diarrhoea or pain when you open your bowels.

What to do while you are waiting

• You can try to rest and relax at home.
• Usual activity that is not too strenuous will not be harmful. You can go to work if you feel up to it.
• If you have pain you can take paracetamol.
• If there is bleeding, use sanitary pads rather than tampons. 

After a miscarriage

• It is usual to have pain and bleeding after a miscarriage. It will feel similar to a period and will usually stop within two weeks. You can take ordinary painkillers for the pain. Your next period will usually come in four to six weeks after a miscarriage.
• See a doctor or attend a hospital emergency department if you have strong pain and bleeding (stronger than period pain), abnormal discharge, (especially if it is smelly), or fever. These symptoms may mean that you have an infection or that tissue has been left behind.
• Try and avoid vaginal sex until the bleeding stops and you feel comfortable.
• Use sanitary pads until the bleeding stops (do not use tampons).
• All contraceptive methods are safe after a miscarriage 
• See a GP (local doctor) in four to six weeks for a check-up.

Anti-D injection after a miscarriage 

It is important to have your blood group checked. If you’re RhD negative and the fetus is RhD positive this can cause problems for future pregnancies. This is because the fetus’s blood cells have RhD antigen attached to them, whereas yours do not. If small amounts of the fetus’s blood mixes with your blood, your immune system may perceive this difference in blood cells as a threat and produce antibodies to fight against the fetus’s blood. Once your body has made these antibodies they can’t be removed. This is unlikely to have caused your miscarriage and is more likely to affect future pregnancies. Women with a negative blood type usually need an Anti-D injection, which will stop the antibodies forming. 

Future pregnancies after a miscarriage

One of the most common concerns following a miscarriage is that it might happen again. However, if you have had one miscarriage the next pregnancy will usually be normal.

If you do try for another pregnancy, try and avoid smoking, alcohol and excess caffeine as they increase the risk of miscarriage. It is recommended that all women take folic acid while trying to conceive, and continue until three months of pregnancy. In your next pregnancy you are encouraged to see your GP and have an ultrasound at about seven weeks. If ultrasound is done too early in pregnancy the findings are often uncertain and cause unnecessary worry.

Feelings and reactions

There is no ‘right’ way to feel following a miscarriage. Some degree of grief is very common, even if the pregnancy wasn’t planned. Partners may react quite differently, just as people can respond differently to a continuing pregnancy. Feelings of loss may persist for some time and you may have mixed feelings about becoming pregnant again. Some friends and family may not understand the depth of emotion that can be attached to a pregnancy and may unreasonably expect for you to move on before you are ready.

Some couples decide that they want to try for a pregnancy straight away, while others need time to adjust to their loss. If you feel anxious about a possible loss in future pregnancies, you may find it helpful to talk to someone about this. If it’s difficult to speak with your friends and family about these issues, your doctor, community support group and counsellors can provide information and assistance.  

Related Health Topics

• Treatment for miscarriage

  Treatment for miscarriage is aimed at avoiding heavy bleeding and infection. It is also aimed at looking after you, physically and emotionally.

  • (English) PDF (302 KB)

The Women’s does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided on the Website or incorporated into it by reference. The Women’s provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.

Missed miscarriage - The Miscarriage Association

A missed (or silent) miscarriage is one where the baby has died or not developed, but has not been physically miscarried.  In many cases, there has been no sign that anything was wrong, so the news can come as a complete shock.

Why does it happen?

It’s not at all clear why some miscarriages happen within days of a baby dying and others take much longer before the pregnancy hormone levels drop and the physical miscarriage begins.  Sometimes that delay may be a matter of days, but it might take several weeks.

While many miscarriages begin with symptoms of pain and bleeding, there are often no such signs with a missed miscarriage.  Pregnancy hormones may continue to be high for some time after the baby has died, so you may continue to feel pregnant and a pregnancy test may well still show positive.

In the first few weeks of the second trimester, it may be too early to feel the baby kick so without any bleeding or pain, you are likely to assume all is well.

There often is no way you could know, except by having an ultrasound scan.

Nurses told me the baby probably died around seven weeks, four weeks before I realised anything was wrong. Four weeks in which I was marching around with a big smile on my face.

A missed miscarriage is often diagnosed at a routine ultrasound scan, whether around 12 weeks or at the 20 week ‘anomaly’ scan.  However it might also be seen at a non-routine scan, NHS or private, whether or not there are any symptoms.

With a missed miscarriage, the scan picture usually shows a pregnancy sac with a baby (or fetus or embryo) inside, but there is no heartbeat and the pregnancy looks smaller than it should be at this stage.

After taking lots of pictures I was told ‘I’m sorry there is no heartbeat, the baby died at 9. 5 weeks’, so it was a missed miscarriage and my body thought I was still pregnant.  It hit me hard.

In some cases, the scan shows an empty pregnancy sac or no clear sac at all.  The embryo has either not developed or it stopped developing at a very early stage and been reabsorbed by the body. You might hear that called ‘early embryonic demise’ or the old-fashioned term ‘blighted ovum’.

The diagnosis of a missed miscarriage can be very shocking, especially if you had no indication at all that anything was wrong.

You might have been full of excitement about seeing your baby and looking forward to sharing your news, as Tina was:

As we got to the 12 week scan, I was looking forward to it.  I wanted that to be the benchmark when I could tell everybody.

Perhaps you had an early or additional scan because of spotting, pain or bleeding, or just a sense that something wasn’t right.  The diagnosis might have confirmed your worst fears but it might still have come as a real shock, perhaps especially if it was some time since the baby had died.

On the other hand, you may have had several scans before the miscarriage was confirmed, and this can be a very stressful time.

The scan showed the “baby” was only the size of a 5 week pregnancy and there was no heartbeat. We were told we would have to wait a week to see if there was any growth and if there had been, then the baby might be big enough to have a detectable heartbeat.  That was one of the longest weeks of my life.

This period of waiting can feel like you’re ‘in limbo’, whether you try to be positive, as in this story, or you prepare for the worst.  You might move between the two.

At the same time as dealing with the news that you have a missed miscarriage, you may also be asked to make some difficult decisions about how to manage the miscarriage process.  (We write about this here.)

You might feel ready to make that decision very quickly, or you might need a few days to take everything in before making a decision.   You are very welcome to contact us if you’d like to talk things through.

What about work?

Work may be the last thing on your mind right now. But if you need more information about your rights and support for you and your employer, our Miscarriage and the Workplace hub has more information for everyone.

You might also find it helpful to read some of the following stories:

• Jennifer’s story
• Hayley’s story
• Little sesame
• Never thought it would happen to me
• Amy Abrahams writes about her experience (originally published by The Pool), ‘Breaking the silence of a missed miscarriage’

Our animation ‘Helping people through’ shares one couple’s experience of a missed miscarriage:

You might also want to talk with others who have been through something similar:

• by phone (contact us for details of a support volunteer)
• in a support group, or
• through our online forum.

You don’t need to go through this alone.

Miscarriage: causes, symptoms, diagnosis, prevention

Article content

1. Symptoms and signs of miscarriage
2. Causes of development
3. Risk factors
nine0005 Complications
4. When to see a doctor
5. Preparing for a visit to a gynecologist
6. Diagnosis of missed pregnancy
nine0005 Treatment
7. Home remedies
8. Prophylaxis
9. How to make an appointment with an obstetrician-gynecologist?

A frozen pregnancy at an early stage is the death of the fetus in the womb. It stops its development and dies for up to 28 weeks. Symptoms may be mild, which increases the risk of maternal toxicity. If during pregnancy the fetus froze and stopped its development, an urgent visit to an obstetrician-gynecologist is necessary. nine0003

Symptoms and signs of missed pregnancy

A frozen pregnancy at an early stage proceeds absolutely imperceptibly, it can last for 1-2 weeks. This is the danger of the situation.

After 10-12 days, a woman has the first symptoms of a missed pregnancy:

• discharge with blood;
• severe pain in lower abdomen;
• after 18 weeks, you can track the cessation of fetal movement. nine0006

There are no symptoms of a missed pregnancy in the first trimester. Sometimes there are spotting spotting, there is a pulling feeling below the navel.

The second frozen pregnancy indicates the presence of a pathology that requires careful study.

Causes of development

Unfortunately, the first missed pregnancy is more common. This is due to the lack of preparation of one's own body. This can happen to any woman. nine0003

Main reasons:

• genetic and chromosomal abnormalities cause the development of anomalies that are incompatible with the life of the fetus;
• the fetus was infected with sexually transmitted infections and viruses - even before pregnancy, the risk of the presence or development of such diseases must be excluded;
• hormonal failure increases the risk of miscarriage, progesterone levels should be monitored during gestation;
• a clotting problem causes blood clots to form, preventing them from delivering enough oxygen to the baby; nine0006
• Rh conflict causes the production of antibodies that provoke oxygen starvation of the fetus.

Risk factors

Accurately answer the question "Why does pregnancy freeze?" pretty hard.

Consider the most common factors:

• viral diseases can affect the development of the fetus;
• the main reason is hormonal imbalance; nine0006
• non-compliance with doctor's recommendations;
• severe stress;
• overheating or severe freezing is prohibited during childbearing;
• smoking and alcohol;
• very tight clothing may harm pregnancy;
• should abandon self-medication and taking drugs not prescribed by a doctor, the body's chemical processes are closely interconnected with each other, the effect can be unpredictable. nine0006

Complications

Signs of a missed pregnancy cause the following complications:

• depression. Requires medical treatment, visits to a psychiatrist;
• mummification of the fetus occurs with prolonged missed pregnancy, mummification occurs due to calcium salts, requires surgical intervention;
• infection of the mother's body. Toxins, which are formed due to the decomposition of the fetus, quickly enter the woman's blood. There is sepsis, intoxication, the correct blood clotting is disturbed; nine0006
• Lithopedion is a fossilized fetus that has undergone calcification in the body. A woman may not feel any painful symptoms.

When to see a doctor

The gynecologist should observe his patients throughout the entire period of pregnancy. If there is a risk of a missed pregnancy, the terms of which do not exceed 12 weeks, you should immediately consult a doctor. He will determine the condition of the fetus and prescribe further examinations and treatment. nine0003

Preparing for a Gynecological Visit

• Shower before visiting a doctor.
• It is better to visit a doctor with an empty bladder, so as not to interfere with palpation.
• Do not take drugs that can affect the microflora or the general condition of the body, this will prevent the doctor from taking an accurate anamnesis.

Symptoms of a missed pregnancy may not appear at all. To avoid intoxication of the body, you should regularly visit a gynecologist. nine0003

Diagnosis of missed pregnancy

Diagnosis is carried out in 2 ways: a blood test and ultrasound. If fetal cardiac arrest is detected on ultrasound, the patient is referred to a gynecologist for further procedures.

The patient can make an appointment and get a consultation at a convenient time for him. The pregnancy management program fully complies with clinical guidelines and the latest standards. nine0003

JSC "Medicine" (clinic of Academician Roitberg) is located in the Central Administrative District of Moscow, not far from Mayakovskaya, Belorusskaya, Novoslobodskaya, Tverskaya, Chekhovskaya metro stations. Address: 2nd Tverskoy-Yamskoy lane, building 10.

Treatment

Treatment occurs in 3 ways:

• curettage;
• aspiration;
• artificial childbirth.

Curettage - curettage of the uterine cavity. Cleaning after a frozen pregnancy is carried out for a period of 5 weeks. nine0003

Aspiration - pumping out the remains of the fetal egg. Carried out in the early stages up to 5 weeks.

Curettage and aspiration are performed under anesthesia. The procedure takes about 30 minutes. After the operation, a course of antibiotics is prescribed. The patient then visits the doctor every week. If complications do not appear, and the causes of a missed pregnancy are eliminated, a woman can continue life in her usual rhythm.

After the loss of an embryo, many women are depressed, they begin to blame themselves for doing something wrong. This is an absolute mistake that can lead to depression. To alleviate your condition, you should contact a psychologist, as well as a gynecologist and other specialists who will help prepare the body for pregnancy. nine0003

After treatment, a woman can plan a pregnancy after a missed pregnancy in six months.

Home remedies

Treatment of a missed pregnancy, the terms of which exceeded 12 weeks, involves surgery. At home, the restoration of the body is impossible. Successful recovery requires a large number of tests and a long recovery, associated with the use of antibiotics. At home, it is possible to raise the overall tone of the body. nine0003

Important! During gestation, any drugs should be taken as prescribed by a doctor. Many decoctions and herbs have a negative effect on the fetus and can even provoke early labor or miscarriage.

To raise your progesterone levels, you need to:

• include fermented milk products, cheeses, cottage cheese, milk, cream in the diet;
• eat fatty fish;
• do not forget about nuts, berries, fruits and vegetables; nine0006
• drink a decoction of plantain seeds, hogweed, raspberry leaves.

It is better to use decoctions in the second half of the cycle. Drink a drink in a volume of 200 ml, no more than 2 times a day.

Important! Decoctions that increase progesterone should not be drunk simultaneously with hormonal drugs.

To prepare for pregnancy, you need:

• replace coffee with tea with chamomile, mint, rosehip and oregano; nine0006
• replace sugar and sweeteners with natural honey;
• drink more pure water;
• be treated for sexual infections and maintain health with a decoction of the red brush, hog uterus, coltsfoot.

Prevention

Prevention is a thorough preparation for a new bearing of the fetus. To do this, it is necessary to study the problem of a previous stop in the development of the embryo. nine0003

To exclude signs of a frozen pregnancy, you need:

• visit a geneticist who will consult a man and a woman. He will calculate the probability of a missed pregnancy;
• Both partners should be screened for sexually transmitted infections. If they are present, do not start conception until the body is fully restored;
• before conception, you need to find out the Rh factor and blood type. If the Rh is negative, the woman should be observed by a doctor who will control the dynamic observation and will control the antibody titer; nine0006
• control of the hormone progesterone will reduce the risk of miscarriage and developmental arrest. If its level is too low, a woman is prescribed special drugs.

It also makes sense to stop smoking and drinking pleasure drinks. It is necessary to do this not only for a woman, but also for a man.

How to make an appointment with an obstetrician-gynecologist?

You can make an appointment with a doctor by filling out a simple form on the website or by calling +7 (495) 775-73-60. You can call around the clock. The causes of a missed pregnancy cannot be detected on their own, consultation of several specialists is required.

We are located near Mayakovskaya metro station and Belorusskaya metro station.

signs, symptoms and causes. How to determine a frozen pregnancy. Clinic Ak. Grishchenko

03/15/2021

Not always long-awaited and such a desired pregnancy ends with the birth of a baby. Sometimes women find out that the pregnancy has stopped. Unfortunately, this problem is not rare. According to statistics, in about 15% of cases, the planned babies "freeze" in the womb for one reason or another. nine0003

CONTENT:

• What is it?
• Dangerous timing: when can it happen?
• Why is this happening?
• How do doctors determine missed pregnancy?
• Signs and symptoms
• How to recover from a frozen pregnancy?
• What tests to pass after?
• Answers from experts on whether ST cleanup is required.
• Frequently asked questions for which go to the forum.

What is it?

A missed pregnancy is a pregnancy that initially met all medical standards, but suddenly stopped developing in a certain period. The cessation of progress in the development of the fetus leads to its death, but it remains in the uterine cavity. For this reason, such a pathology is called a failed miscarriage.

In fact, at the very beginning, everything happens, as in a normal pregnancy - the egg is fertilized, enters the uterus and is implanted for further development, but it stops at one moment. This pathology also includes the syndrome of "empty fetal egg". It is the development of fetal membranes in which there is no embryo. With this syndrome, a pregnancy test is positive, as well as an analysis for hCG. nine0003

Dangerous timing: when can it happen?

Fetal development can stop at any time up to 28 weeks (in rare cases, development can stop later), but the greatest probability of such a pathology occurs in the first trimester. There are also several periods with the highest risk of miscarriage, these include the following periods:

• 3-4 weeks;
• 8-10 weeks;
• 16-18 weeks.

It is these terms that most often become critical for pregnancy.

Causes of miscarriage?

Even doctors are not always able to find out exactly why a miscarriage happened. In modern medicine, there are a number of reasons that can cause such a pathology. All of them are divided into several large groups:

• Genetic pathologies . It is these reasons that most often provoke a halt in fetal development. Pathological genes or the presence of an extra chromosome in the embryo can cause the development of many defects that are incompatible with life, leading to termination of pregnancy. Often, genetic pathologies cause a stop in the development of pregnancy in the eighth to tenth week. nine0006
• Infections . A missed pregnancy can also often happen due to the presence of infectious diseases, since during the period of bearing a child, a woman experiences a rather serious decline in immune defenses. Especially dangerous for this period are TORCH infections, which include rubella, cytomegalovirus, herpes and toxoplasmosis. The greatest danger to the fetus is the first "meeting" of the mother with the infection in an already pregnant state. Therefore, when registering, pregnant women are strongly recommended to be screened for these types of infections. Even seemingly simple and familiar diseases such as influenza or SARS can cause pathology, especially in the early stages, when vital organs are formed in the fetus. The infection can affect the fetus directly, causing various types of anomalies, or on the membranes, resulting in a significant lack of oxygen or nutrients to the fetus. nine0006
• Hormonal disorders . Hormonal balance is extremely important for the normal bearing of a child. Therefore, with a lack of progesterone or an excess of male hormones (androgens), the likelihood of miscarriage significantly increases. Any hormonal disruptions are recommended to be treated before pregnancy.
• Antiphospholipid syndrome . Because of them, the formation of placental vessels or their blockage may also decrease, which leads to a violation of the fetus receiving the necessary nutrition. nine0006
• Teratozoospermia . This cause of a missed pregnancy is associated with pathologies in the seminal fluid of a man. With teratozoospermia, spermatozoa have an irregular structure, so fertilization with such a cell leads to abnormalities in the development of the embryo.
• Lifestyle . The presence of bad habits, as well as lifestyle during childbearing (and the planning period) can also adversely affect the development of the embryo, causing it to freeze. The use of alcoholic beverages, smoking, stress, occupational hazards, daily routine, sedentary lifestyle, unbalanced diet - all this is considered negative factors for pregnancy. nine0006
• Other factors. Pregnancy fading can also occur due to a sharp change in climate, a history of abortions (especially if there were several).

In some cases, several causes can be found at once, which could lead to a pregnancy fading.

How do doctors determine missed pregnancy?

At each examination of a pregnant woman, the gynecologist determines the size of the uterus, so if they do not correspond to the current period, the specialist may suspect the fetal fading. But such a diagnosis is made only after an ultrasound examination. In rare cases, ultrasound is not performed - if the woman turned to the doctor late and intoxication of the body has already occurred due to the death of the fetus. nine0003

Signs and symptoms

The symptoms of miscarriage in any trimester are the same. The main signs that may indicate such a pathology are:

• vaginal discharge with blood impurities;
• general weakness, chills, fever;
• drawing pains in the lower part of the abdomen;
• cessation of swelling and soreness of the mammary glands;
• abrupt disappearance of manifestations of toxicosis;
• absence of fetal movements (with pathology in the second trimester). nine0006

Despite the presence of characteristic symptoms of pathology, often the cessation of fetal development goes unnoticed, since the basal temperature can remain within 37 degrees, and the hCG level remains high for several more weeks. In this case, the woman learns about the problem only at the next appointment with the doctor or a planned ultrasound.

How to recover from a missed pregnancy?

If this pathology occurs, it is imperative to remove the dead embryo from the uterine cavity, if this did not happen naturally. For this, a cleaning is carried out, with the help of which all particles of the fetal membranes are removed from the uterus. Both scraping and vacuum can be used. If the fading occurred at a very early date, doctors may suggest a medical abortion, which is somewhat more gentle for the woman, including psychologically. nine0003

Doctors recommend to refrain from the next pregnancy for six months (according to the recommendation of the World Health Organization). This time is enough for the body to recover after what happened. Therefore, during this time, women are advised to take oral contraceptives, which minimize the likelihood of conception, and also allow you to normalize hormonal levels.

During recovery, it is also recommended to lead the most healthy and active lifestyle, take care of a balanced diet and take vitamin complexes. A woman definitely needs psychological support, and if she endured the incident especially hard, she may need the help of specialists - a psychologist or psychiatrist. This will help you get back to normal and prepare for your next pregnancy. nine0003

What tests to take after?

Before becoming pregnant after a missed pregnancy, it is necessary to exclude the possibility of a recurrence of what happened. Treatment should be appropriate to the problem that caused the pathology. Therefore, it is extremely important to undergo a complete examination, which will help determine the cause of the fetal development fading. According to the results of the examination, doctors prescribe treatment in accordance with the detected diseases.

It is recommended to undergo an examination after the restoration of the woman's menstrual cycle (usually it takes about 30 days after cleansing). But both spouses should be tested. The full examination includes:

• genetic testing of spouses;
• tests for TORCH infections;
• study of hormonal levels;
• blood coagulogram;
• Gynecological ultrasound;
• spermogram;
• immunogram.

This examination is usually sufficient to determine the causes of miscarriage, both early and late. The attending physician may prescribe additional studies if necessary. All these examinations can be done at the IVF and infertility treatment clinic of Academician V.I. Grishchenko. nine0003

Frozen pregnancy is not a verdict - in 90% of cases, after the occurrence of such a pathology, spouses become happy parents of healthy babies in the near future. The main thing is to undergo a complete examination and eliminate the cause of the pathology. And if necessary, you can go through the procedure of artificial insemination (IVF).

Answers from specialists in the field of reproduction, fertility, women's health about whether cleaning is mandatory during a missed pregnancy.

On the Internet, the question is often asked: “Is it necessary to do curettage during a missed pregnancy (ZB)?” nine0003

We asked this question to our doctors:

Parashchuk Valentin Yuryevich

Chief physician of the Academician Grishchenko Clinic, obstetrician-gynecologist, reproductologist.

Good afternoon. If the pregnancy froze at an early stage and there are no signs that it is going to resolve itself, that is, there is no bleeding, then it is advisable to evacuate the contents of the uterine cavity, that is, to do curettage. If the pregnancy seeks to resolve itself, then it can come out on its own. nine0216 And then curettage is not required, you can just look at the ultrasound as soon as the discharge ends, that there are no inclusions in the uterine cavity, that there are no elements of the ovum left in the uterine cavity.

Hello. Today I will try to answer the most frequently asked questions regarding non-developing pregnancy. Perhaps I’ll start with such a rink: “Is it necessary to do vacuum aspiration of the contents of the uterine cavity, that is, the evacuation of a missed pregnancy, if a non-developing pregnancy is diagnosed?” And so let's deal with the concept. nine0215 Non-developing pregnancy is a pathological condition in which the pregnancy fades, but spontaneous expulsion from the uterine cavity does not occur. At the same time, the woman herself does not immediately understand what happened to her. The first signs of a missed pregnancy can appear 2-3 weeks after the incident. The fetal egg, which is located in the uterine cavity, undergoes various pathological changes, adversely affecting the endometrium, thereby causing an inflammatory process called "endometritis". nine0003

If a woman decides to wait for the spontaneous expulsion of a missed pregnancy from the uterine cavity, what happens? The endometrium tries to reject the frozen fetal egg, but the inflammatory processes taking place in this endometrium slow down this process, and the process can last from several days to several weeks. Which absolutely negatively affects the endometrium and contributes to the development of the inflammatory process further. There is an act that the fetal egg from the uterine cavity, as it were, came out, but not completely. There is a part of him left. From this part, often, a placental polyp is formed. The presence of a placental polyp in the uterine cavity contributes to the prevention of a subsequent pregnancy. Before the onset, planning a subsequent pregnancy, such a pali must be removed. In addition, the presence of a fetal egg in the uterine cavity for four weeks or more significantly increases the risk of bleeding. Therefore, the best solution to such an issue, in the presence of a missed pregnancy in a patient, is vacuum aspiration of the contents of the uterine cavity with the appointment of subsequent anti-inflammatory therapy. nine0003

The second issue is errors in the diagnosis of non-developing pregnancy. For example, at 5-6 weeks, an ultrasound examination, in order to avoid such errors, is carried out by at least two specialists. If there are no clear criteria for non-developing pregnancy, it is recommended for the patient to repeat this study after 3-7 days. Again, to avoid mistakes. In addition, in parallel, the task of such an analysis as an analysis of human chorionic gonadotropin in the blood is mandatory. If the pregnancy develops, the hCG will increase accordingly, if the pregnancy is still frozen, then the hCG will either fall or not grow at all. If the gestational age is 7-8 weeks, then according to the ultrasound examination, the heart rate of the embryo will be absent. In addition, there will be a discrepancy between the size of the fetal egg and the gestational age. At gestational age 9-12 weeks, in addition to the lack of heart rate and the discrepancy between the gestational age and the size of the fetal egg, there will also be no movement of the embryo. It should always be remembered that every woman has the right to take a closer look at the ultrasound in a few days for an accurate diagnosis, to control the human chorionic gonadotropin, in fact, in order to avoid errors in the diagnosis of "non-developing pregnancy".

Answers to frequently asked and discussed questions on the forums:

✅ Can an ultrasound erroneously show a miscarriage?

Misdiagnosis of non-developing pregnancy occurs in the early stages. In our clinic, in order to avoid such errors, ultrasound at 5-6 weeks is performed by at least two specialists. If there are no clear criteria for non-developing pregnancy, then the patient is recommended to do a second study after 3-7 days. And on re-examination, it may turn out that the frozen pregnancy turned out to be normal.

✅ With a missed pregnancy, is it possible to do without cleaning?

If, however, a frozen pregnancy tends to resolve itself, then it can come out on its own, and then curettage (cleansing) is not required. As soon as the discharge ends, it is necessary to check on an ultrasound scan that there are no elements of the ovum left in the uterine cavity. If the pregnancy froze at an early stage and there are no signs that it is going to resolve itself, that is, there is no bleeding, then it is advisable to do a curettage. nine0003

✅ Frozen pregnancy - cleaning or pills?

Medical termination of pregnancy is indicated for women who have had pregnancies in the past and had natural childbirth. But it is more correct to do a scraping, or a vacuum, if the time permits. Because, sometimes, after medical abortions, you also have to do scraping, but already in fact of complications. Because the contents of the uterine cavity do not always come out completely, and inflammation is added, and this is a big trauma for the uterus and it is better not to allow this. Therefore, it is better to do a moderate, without severe injury and without complications, curettage on time than to do it as a necessary measure. And most importantly, scraping products can be sent for genetic testing to identify the causes of fetal development fading. nine0003

✅ Can there be a miscarriage without symptoms?

It happens that the pregnancy stops, and the patient knows absolutely nothing about it, and this is discovered at a later date, when she is told that the fetal egg does not correspond in size, that the pregnancy stopped earlier, but this, unfortunately, it is impossible to suspect in advance. The first signs of a non-developing pregnancy can appear 2-3 weeks after the incident. These are spotting or pulling pains in the lower abdomen. With these symptoms, you should definitely consult a doctor.

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