Missed miscarriage is a type of early pregnancy loss that can be particularly challenging due to its often silent nature. This experience is more common than many people realize. Understanding its definition, prevalence, and contributing factors can help individuals navigate this difficult time and access appropriate support.
Defining Missed Miscarriage
A missed miscarriage, also known as a silent miscarriage, occurs when an embryo or fetus stops developing, but the body does not naturally expel the pregnancy tissue. Unlike other types of miscarriage that often present with overt symptoms like bleeding or cramping, a missed miscarriage frequently has no obvious signs. Pregnancy hormones may remain elevated, leading the individual to still feel pregnant, and a pregnancy test might still show a positive result.
The discovery of a missed miscarriage typically happens during a routine prenatal ultrasound scan. During this examination, a healthcare provider may find no fetal heartbeat, or the embryo or fetus may appear smaller than expected for the gestational age. In some instances, the ultrasound might reveal an empty gestational sac, indicating an embryo either never developed or stopped developing early and was reabsorbed. This lack of physical symptoms often makes the diagnosis unexpected.
Understanding Its Prevalence
Missed miscarriage is not a rare occurrence, affecting a notable percentage of pregnancies. While overall miscarriages occur in approximately 10% to 20% of clinically recognized pregnancies, the exact proportion that are missed miscarriages varies. Some estimates suggest approximately 3% of all pregnancies result in a missed miscarriage. Another study found early pregnancy failure, which includes missed miscarriages, had a prevalence of 2.8% in ultrasound screenings between 10-13 weeks of gestation.
The increasing use of early and routine ultrasound technology contributes to higher detection rates, identifying non-viable pregnancies before symptoms develop. For instance, one study indicated missed miscarriages constituted 38.8% of all miscarriages among participants. This shows a substantial portion occurs without the individual being immediately aware.
Factors Contributing to Missed Miscarriage
The most common reason for a missed miscarriage is chromosomal abnormalities in the developing embryo or fetus. These random errors during conception account for 50% to 70% of early pregnancy losses. In most cases, the miscarriage is not due to any action or inaction by the pregnant individual. The embryo simply did not develop properly.
Beyond chromosomal issues, other less frequent factors can contribute. These include structural problems with the uterus or cervix, or underlying medical conditions such as uncontrolled diabetes, thyroid disorders, or blood-clotting disorders. While maternal age can influence miscarriage risk due to increased chromosomal abnormalities, a missed miscarriage is generally an unpredictable event outside of personal control.
Navigating the Aftermath and Support
Once diagnosed, healthcare providers typically discuss options for managing the physical process of expelling the pregnancy tissue. These options include expectant management (allowing natural passage), medical management (using medication to induce the process), or surgical management (such as a dilation and curettage (D&C) procedure). The choice is made in consultation with a healthcare provider, considering the individual’s health and preferences.
The emotional impact can involve feelings of shock, grief, and confusion. Individuals should acknowledge these feelings and seek appropriate emotional support. Support can come from healthcare providers, support groups, or mental health professionals specializing in reproductive loss. Understanding that this experience is not a reflection of personal fault and that support is available can aid in the healing process.