Miscarriage clots size

Miscarriage - Atlanta Gynecology and Obstetrics

Loss of pregnancy before 20 weeks is called a miscarriage. Spontaneous miscarriage is the most common complication of early pregnancy and the rate decreases as the pregnancy progresses.

Miscarriages occur in 8-20% of clinically-recognized pregnancies:

• 80% of these happen in the first 12 weeks of pregnancy
• The rate of loss for unrecognized or “chemical pregnancies” is 13-26%
• The overall risk of loss after 15 weeks is relatively low

Causes of miscarriage

Though it is difficult to identify what causes all miscarriages, most pregnancy losses are thought to be due to chromosomal defects.

• Chromosomal Abnormalities > 60%
• Maternal: Structural Abnormalities
• Uterine Fibroids, Septums, and Adhesions
• Trauma
• Acute Infections
• Blood Disorders (Thrombophilia)
• Unexplained

Loss of viability of the pregnancy usually occurs between 6-12 weeks. Recognition may not occur until weeks later. The course of treatment that you take will depend on your current condition, your desires, the size of your pregnancy, and your provider recommendations.

Factors associated with miscarriage

There can be many factors that affect the probability of having a miscarriage. In many cases, there is more than one factor that comes into play. If you know what these factors are, you can be more cautious.

• Age: Miscarriage risk increases with age. The risk can be as high as 40% at 40 years old and 80% after 45 years old
• Previous miscarriage: The rate of miscarriage increases with the number of previous miscarriages: 20% after one, 28% after two consecutive, and 43% after three or more consecutive losses
• Smoking: Increases the risk of loss
• Alcohol use: Studies have been inconsistent in proving that alcohol can cause an increased rate of pregnancy loss. One study indicated that there was an increase in miscarriages among women who drank more than 3 drinks a day
• Cocaine use
• Non-steroid anti-inflammatories (NSAIDs: Ibuprofen, Advil, Motrin): May be associated with an increased risk of miscarriage if used around the time of conception. The prostaglandin in NSAIDs may interfere with proper implantation
• Caffeine: The risks of miscarriage increase with high levels of consumption (>300mg /day)

Miscarriage at home

You may first note mild vaginal spotting and/or cramping. This bleeding and cramping will increase, at which point you may expel the tissue of the pregnancy. During the miscarriage, you may bleed heavily with large clots, soaking a pad every 10-20 minutes. The cramping may be significant. Tylenol and a heating pad are okay to use at this time. You should call the office or the on-call doctor if the heavy bleeding does not improve after two hours.

Once you have passed the pregnancy tissue, you will notice a decrease in bleeding and cramping. You may collect the passed tissue and store it in a clean and dry container and bring it to the office so that it may be sent out for pathological identification. You may call the office or the on-call doctor at any time for direction and advice.

Office Number: 404-299-9724 | After Hours Number: 404-487-2450

D&C at the hospital

A D&C is a surgical procedure performed under anesthesia to remove tissue from the uterus that has not started to or that has not entirely come out.

A D&C is an outpatient procedure that lasts for about 15-20 minutes. You usually go home about 1-2 hours after the procedure is completed. Most women return to light duties and activity the next day. Cramping and bleeding are common after a D&C. You may have bleeding for up to 2 weeks after your procedure.

Alternatively, we offer appropriate candidates a procedure called a Mechanical Vacuum Aspiration (MVA). This procedure is similar to the D&C, but it can be done in the office under local anesthesia. Recovery and warning signs are similar to those of the D&C procedure.

With either of these procedures, we recommend that you do not put anything in the vagina (no tampons, douching, or intercourse) until you are seen again in the office.

Warning signs after a miscarriage or D&C

Call the office if you have:

• Temperature > 100.4
• Nausea and vomiting for > 12 hours
• Increasing pain or bleeding
• Foul-smelling vaginal discharge

Coping with the loss of pregnancy

Emotional healing can take longer than physical healing. Grief after a pregnancy loss is a normal response. In the days and weeks after your pregnancy loss, you may experience a loss of appetite, emotional changes, irritability, sleep disturbances, and inability to focus on daily tasks. This is all normal and should resolve in a few weeks or months. If you find that these symptoms are severe or that you are unable to cope with these feelings, please call and make an appointment to talk to a provider in our practice. We will be able to help you and make any other referrals you may need.

The next pregnancy

Your next period should come within 4-6 weeks after your miscarriage. We recommend that you use contraception until after you have had a normal period. You may continue prenatal vitamins during and after this time. You may also discuss birth control at your post-miscarriage visit if you do not desire to become pregnant again.

Miscarriage - what you might actually see and feel

7-minute read

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WARNING — This article contains some graphic descriptions of what you might see during a miscarriage.

A miscarriage requires prompt medical care. If you think you are having a miscarriage, call your doctor or midwife for advice and support. Go to the Emergency Department if:

• you are bleeding very heavily (soaking more than 2 pads per hour or passing clots larger than golf balls)
• you have severe pain in your tummy or shoulder
• you have a fever (a temperature above 38 degrees C)
• you are dizzy, fainting or feel like fainting
• you notice fluid coming from your vagina that smells bad
• you have diarrhoea or pain when you have a bowel motion (do a poo)

Miscarriage is a very unfortunate and sad outcome of pregnancy that takes a significant emotional and physical toll on a woman. It also happens more frequently than many people think. It's important to recognise that there's no right or wrong way to feel about a miscarriage.

Despite close to one in 5 pregnancies ending in miscarriage, what actually happens and what a woman needs to know and do when faced with a possible miscarriage are subjects that rarely get discussed.

This article aims to give you an idea of what happens and what a woman needs to know and do at different stages in her pregnancy.

Please call Pregnancy, Birth and Baby on 1800 882 436 if you have any concerns or wish to discuss the topic further.

What might I feel during a miscarriage?

Many women have a miscarriage early in their pregnancy without even realising it. They may just think they are having a heavy period. If this happens to you, you might have cramping, heavier bleeding than normal, pain in the tummy, pelvis or back, and feel weak. If you have started spotting, remember that this is normal in many pregnancies — but talk to your doctor or midwife to be safe and for your own peace of mind.

Later in your pregnancy, you might notice signs like cramping pain, bleeding or passing fluid and blood clots from your vagina. Depending on how many weeks pregnant you are, you may pass tissue that looks more like a fetus, or a fully-formed baby.

In some types of miscarriage, you might not have any symptoms at all — the miscarriage might not be discovered until your next ultrasound. Or you might just notice your morning sickness and breast tenderness have gone.

It is normal to feel very emotional and upset when you realise you’re having a miscarriage. It can take a while to process what is happening. Make sure you have someone with you, for support, and try to be kind to yourself.

What happens during a miscarriage?

Unfortunately, nothing can be done to stop a miscarriage once it has started. Any treatment is to prevent heavy bleeding or an infection.

Your doctor might advise you that no treatment is necessary. This is called 'expectant management', and you just wait to see what will happen. Eventually, the pregnancy tissue (the fetus or baby, pregnancy sac and placenta) will pass naturally. This can take a few days or as long as 3 to 4 weeks.

It can be very hard emotionally to wait for the miscarriage because you don’t know when it will happen. When it starts, you will notice spotting and cramping and then, fairly quickly, you will start bleeding heavily. The cramps will get worse until they feel like contractions, and you will pass the pregnancy tissue.

Some women opt to have medicine to speed up the process. In this case, the pregnancy tissue is likely to pass within a few hours.

If not all the tissue passes naturally or you have signs of infection, you may need to have a small operation called a ‘dilatation and curettage’ (D&C). You may need to wait some time for your hospital appointment. The operation only takes 5 to 10 minutes under general anaesthetic, and you will be able to go home the same day.

While you are waiting for a miscarriage to finish, it’s best to rest at home — but you can go to work if you feel up to it. Do what feels right for you. You can use paracetamol for any pain. If you are bleeding, use sanitary pads rather than tampons.

What might I see during a miscarriage?

In the first month of pregnancy, the developing embryo is the size of a grain of rice so it is very hard to see. You may pass a blood clot or several clots from your vagina, and there may be some white or grey tissue in the clots. The bleeding will settle down in a few days, although it can take up to 2 weeks.

At 6 weeks

Most women can’t see anything recognisable when they have a miscarriage at this time. During the bleeding, you may see clots with a small sac filled with fluid. The embryo, which is about the size of the fingernail on your little finger, and a placenta might be seen inside the sac. You might also notice something that looks like an umbilical cord.

At 8 weeks

The tissue you pass may look dark red and shiny — some women describe it as looking like liver. You might find a sac with an embryo inside, about the size of a small bean. If you look closely, you might be able to see where the eyes, arms and legs were forming.

At 10 weeks

The clots that are passed are dark red and look like jelly. They might have what looks like a membrane inside, which is part of the placenta. The sac will be inside one of the clots. At this time, the developing baby is usually fully formed but still tiny and difficult to see.

At 12 to 16 weeks

If you miscarry now, you might notice water coming out of your vagina first, followed by some bleeding and clots. The fetus will be tiny and fully formed. If you see the baby it might be outside the sac by now. It might also be attached to the umbilical cord and the placenta.

From 16 to 20 weeks

This is often called a 'late miscarriage'. You might pass large shiny red clots that look like liver as well as other pieces of tissue that look and feel like membrane. It might be painful and feel just like labour, and you might need pain relief in hospital. Your baby will be fully formed and can fit on the palm of your hand.

After the miscarriage

You will have some cramping pain and bleeding after the miscarriage, similar to a period. It will gradually get lighter and will usually stop within 2 weeks.

The signs of your pregnancy, such as nausea and tender breasts, will fade in the days after the miscarriage. If you had a late miscarriage, your breasts might produce some milk. You will probably have your next period in 4 to 6 weeks.

Remember, it’ll be normal to feel very emotional and upset at this time.

More information

Read more about miscarriage:

• What is a miscarriage?
• What happens after a miscarriage
• Emotional support after miscarriage
• Fathers and miscarriage
• Experiencing a pregnancy loss

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:

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Last reviewed: March 2022

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Related pages

• Fathers and miscarriage
• Emotional support after miscarriage
• What happens after miscarriage
• Miscarriage
• Experiencing a pregnancy loss

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