Warning Signs of a Miscarriage and When To Seek Medical Help

A miscarriage is a pregnancy that ends on its own within the first 20 weeks of gestation. It is the most common type of pregnancy loss and is in general more common than most people believe it to be. According to studies, around 10- 25% of pregnancies end in a miscarriage.

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At times, a woman miscarries soon after implantation, and the bleeding occurs at around the time of her normal period. The woman might not even know she's having a miscarriage. Since miscarriages are so common, it is important to understand their warning signs and know when to contact a doctor.

Recognising the signs of a miscarriage is important because having an incomplete miscarriage can be dangerous for your life. Any leftover tissue can put you at risk of infections.

Common Warning Signs Of A Miscarriage

Vaginal bleeding

Vaginal bleeding is the most common sign of a miscarriage. This bleeding could start as light spotting, or begin like a gush of blood. The bleeding usually gets heavier as the cervix dilates to push all the tissue out. The bleeding is at its heaviest within the first 3 to 5 hours of when it starts. You may see lighter bleeding for a few weeks coming and going at intervals till it stops completely. The colour of the blood can vary as well, ranging from bright red to pink and dark brown. The fresh blood that leaves your body quickly is bright red, while brown blood has been in the uterus for a while. You might even see blood that is closer to black during a miscarriage. The amount you bleed will vary depending on your circumstances, whether the miscarriage is progressing naturally, and how far along you are in your pregnancy. It is concerning if you bleed through two sanitary pads within an hour.

Abdominal pain and cramps

Mild abdominal pain and cramps are not unheard of during pregnancy. They might even be considered normal. However, if the pain is severe to the extent that you are having trouble speaking, it could be a sign of a miscarriage. The cramps are most often accompanied by bleeding. The cramps may be similar to or much more intense than menstrual cramps. The degree of pain can vary from person to person. This cramping can last the entire duration of the miscarriage. It can also come after the miscarriage is complete. Consult your doctor if the pain persists.

Lower back pain

Some amount of pain in the lower back is normal during pregnancy, however, if the pain is severe and refuses to subside, it might be a sign of a miscarriage, especially if it is accompanied by bleeding and abdominal cramps.

Tissue or fluid discharge

If you are passing white or grey tissue in your discharge, you might be having a miscarriage. Discharge during a miscarriage can also look black, or brown or show up in the form of large blood clots.

Sudden decrease in pregnancy symptoms

If your pregnancy symptoms suddenly disappear or there is a decrease in them, you might want to consult a doctor because this is potentially a sign of a miscarriage.

Dizziness and lightheadedness

Feeling dizzy and lightheaded could be a sign of a miscarriage, however, only if it is accompanied by other symptoms like bleeding and cramps. Some amount of dizziness is common during pregnancy and should subside on its own or if you drink water or juice. If you are still concerned about your symptoms, you can consult your doctor.

Drop in hCG

A drop in human chorionic gonadotropin (hCG) can be a sign of a miscarriage. hCG levels will drop by 50% within 48 hours of a miscarriage. hCG levels dropping could also indicate that the embryo is no longer developing. After your miscarriage, you might still get a positive pregnancy test result due to some hCG being left over in your body. Symptoms of miscarriage can vary from person to person. Let us look at some less common ones. Less Common But Serious Warning Signs of a Miscarriage:
  • Fever with chills: Some women have reported having high fever with chills that do not seem to go away despite using a lot of layers and blankets.
  • Sudden weight loss: This is rare, but suddenly losing weight after steady weight gain can be a sign of an approaching miscarriage. Some women report losing weight for four to five days before miscarriage.
  • Shoulder pain: If the miscarriage is happening in the second trimester, the bleeding can sometimes trigger shoulder pain.

When To Seek Medical Help

If you have any of the above symptoms, especially heavy bleeding and cramping, you should consult your doctor. Severe bleeding requires immediate and urgent attention from a doctor. You should also call your doctor if you have mild symptoms like slight spotting or cramps. It’s always better to be safe and well-aware than to regret not noticing the signs later. While you wait for more medical advice from your doctor, you might want to monitor your symptoms, like the severity of the cramps and the bleeding. Keep track of whether they decrease or increase in intensity.

How Can a Miscarriage Be Diagnosed?

There are different tests used to determine if a miscarriage is taking place and what type of miscarriage it is.
  • Ultrasound: An ultrasound is used to check for a foetal heartbeat or to check the presence of a yolk sac.
  • Blood test: A blood test is used to determine the amount of hCG in the blood. If the levels are too low or do not seem to be increasing, it is likely a miscarriage has occurred.
  • Pelvic exam: A pelvic exam can check if your cervix has opened.
  • Tissue tests: Tissue samples are collected to determine the cause of the miscarriage and if it happened due to chromosomal abnormalities.
  • Chromosome tests: Chromosome tests can also be used to check for a miscarriage
The doctor will also assess the type of miscarriage it is, like whether it is complete, incomplete, or a threatened one. Based on this knowledge, you will be guided further.

Lifestyle Choices And Prenatal Care

Unfortunately, miscarriages cannot be avoided. However, there are some risk factors you could avoid by making some lifestyle changes like quitting smoking and drinking, taking prenatal vitamins, managing stress levels, limiting caffeine, avoiding illicit drugs, and avoiding secondhand smoke. It is extremely important for you to recognise the initial signs of a miscarriage to get the medical help you require at the right time. Once a miscarriage is completed, it is very important for you to take care of both your emotional and physical well-being. You can consider joining an online support group of women who have been through a miscarriage as well.

FAQs on Warning Signs of a Miscarriage and When To Seek Medical Help

  1. What are some clear signs of a miscarriage?If you are experiencing severe vaginal bleeding accompanied by cramps, you could be having a miscarriage. Along with this, if you have symptoms like a sudden decrease in pregnancy symptoms, and tissue or fluid discharge and feel lightheaded and dizzy, it might be best for you to call your doctor.
  2. When should I call a doctor?You should call a doctor immediately after you notice vaginal bleeding. It does not matter how severe the bleeding is, and it might not even be a miscarriage. Call a doctor if you see any unusual symptoms.
Disclaimer: Medically approved by Dr Geeta Komar, Senior Consultant, Obstetrics & Gynaecology, Kinder Hospitals, Bangalore