Miscarriage is the spontaneous loss of a pregnancy before the 20th week. While bleeding is a common symptom associated with a miscarriage, not all bleeding indicates a severe complication. Heavy bleeding, known as a hemorrhage, can occur during a miscarriage, but it is not always the case.
Bleeding Patterns During Miscarriage
Bleeding is a frequent sign of miscarriage, and its characteristics vary significantly. This bleeding might range from light spotting, which may appear brownish, pink, or red, to heavy flows with bright red blood and clots. The intensity and duration of bleeding are not uniform; it can begin lightly and then become heavier, or vice versa, over several hours to up to two weeks.
The amount of blood and tissue expelled during a miscarriage depends on how far along the pregnancy was. Heavier bleeding is generally expected for several hours as the body expels pregnancy tissue. While bleeding is a common symptom, light bleeding in early pregnancy does not always signify a miscarriage, as many pregnant individuals experience spotting and go on to have successful pregnancies.
Identifying a Hemorrhage
Recognizing the signs of a hemorrhage during a miscarriage is important for seeking prompt medical attention. Key indicators include soaking through more than one sanitary pad per hour for several consecutive hours. Passing very large blood clots, sometimes described as being larger than a golf ball, is another concerning sign.
Individuals experiencing a hemorrhage may also feel lightheaded, dizzy, or faint due to significant blood loss. Other symptoms can include a rapid heart rate or severe abdominal pain that is not alleviated by usual pain management. These signs indicate a need for immediate medical evaluation.
Understanding Why Hemorrhage Occurs
Hemorrhage during a miscarriage can happen for several physiological reasons. One common cause is the incomplete expulsion of pregnancy tissue, also known as retained products of conception. If parts of the placenta or fetal tissue remain in the uterus, the uterus cannot contract effectively, leading to continued bleeding. The presence of this tissue prevents the blood vessels from closing off properly.
Another reason for excessive bleeding is uterine atony, where the uterus does not contract sufficiently after the miscarriage. Strong uterine contractions are necessary to compress blood vessels and prevent excessive bleeding. If the uterus remains relaxed or “atonic,” blood flow from the placental site can continue unchecked. Less commonly, a uterine rupture, a tear in the uterine wall, can lead to severe hemorrhage, though this is a rare complication.
Medical Response to Hemorrhage
If a hemorrhage is suspected during a miscarriage, immediate medical intervention is necessary. Individuals should contact emergency services or go to the nearest emergency department without delay.
Medical interventions aim to stop the bleeding and prevent further complications. Healthcare providers may administer medications, such as oxytocin, to help the uterus contract and reduce blood loss. If retained tissue is contributing to the hemorrhage, a procedure like dilation and curettage (D&C) might be performed to surgically remove any remaining pregnancy material from the uterus. In some cases, manual removal of retained tissue may also be considered. The specific approach depends on the individual’s condition and the cause of the hemorrhage.