Any kind of pregnancy loss can be devastating. A missed miscarriage can be especially painful since it can happen without warning. But how common is missed miscarriage at 12-week scan?
Understanding what a missed miscarriage is and what you can expect during and after can help you navigate your way through this difficult time.
What is a Missed Miscarriage?
A miscarriage is the spontaneous loss of a baby prior to 20 weeks of gestation. A missed miscarriage, sometimes referred to as a silent miscarriage, occurs when the baby has died but remains in the womb. The embryo may have begun to grow, but stopped developing somewhere along the way.
How Common is a Missed Miscarriage at 12 week scan?
Miscarriages happen in roughly 10-25% of confirmed pregnancies. Missed miscarriages only occur in about 1-5% of pregnancies, so they are not exceptionally common.
In the case of most miscarriages, the pregnancy began exactly as it should. The fertilised eggs implant in the uterus, signaling your body to produce hormones to prepare you to carry a baby to term.
So how common is a missed miscarriage at 12 week scan?
A missed miscarriage is often detected during the first-trimester exam, usually between 11 and 14 weeks. After a heartbeat has been detected at the eight-week scan, the chance of a miscarriage drops to only 2%. The chance falls to below 1% after 10 weeks.
Though a missed miscarriage can be detected after a 12-week scan, the chances are much lower at that stage of pregnancy.
How is a Missed Miscarriage Detected?
The majority of missed miscarriages are detected at a routine prenatal exam. Since it is important to correctly diagnose a miscarriage, your doctor will go through a few steps before making the final call.
When there is no audible fetal heartbeat from a handheld doppler by 12 weeks or no heartbeat detected at a 12-week scan, there is a possibility of miscarriage. The doctor will take a few extra precautionary steps to make absolutely sure.
Pregnancy timing is based on a 28-day cycle with ovulation occurring on day 14. This is simply not the case with every pregnancy. The dating of the pregnancy could be off, so it is necessary to conduct additional scans and other tests to confirm the loss.
The placenta produces the hCG (human chorionic gonadotropin) hormone during pregnancy. During the early days of your pregnancy, these numbers will double every 48-72 hours. Your doctor will likely conduct a series of blood tests to make sure these levels continue to rise.
If subsequent blood tests show that the hCG levels have failed to rise or are beginning to fall, the doctor will likely schedule one last sonogram. If there is no heartbeat detected on that sonogram, a miscarriage has occurred.
Causes of Miscarriage
For the vast majority of miscarriages, some chromosomal abnormality has occurred to make the embryo unviable. These abnormalities are random in nature and can occur without notice.
The egg and the sperm each contribute one set of chromosomes. If the correct amount of genetic material is not present, the embryo will stop growing and the heartbeat stops.
In the case of a blighted ovum, implantation occurs, but the embryo never develops. An ultrasound in this case will reveal an empty gestational sac.
It is important to note that, outside of extreme behaviours like smoking or excessive drug and alcohol use, the loss of a pregnancy is nothing the mother could have caused.
Other factors that can contribute to increased risk of miscarriage are maternal age, structural abnormalities in the uterus, and poorly managed health disorders such as thyroid issues and type 1 diabetes.
Signs and Symptoms of Missed Miscarriage
Unfortunately, with a missed miscarriage, there may be no symptoms at all. For a normal miscarriage, you may feel abdominal cramping, back pain, nausea, vomiting, or see some vaginal bleeding. These miscarriages are “missed” because there are often no signs that would signify that something has gone wrong with the pregnancy.
Since your body is producing a high level of hormones, you may still be feeling pregnancy symptoms. This can mask any other signs that a loss has occurred.
While there are typically no signs of a missed miscarriage, some women say they feel the symptoms of pregnancy lessen or fade.
What to Expect
Once you’ve been diagnosed with a missed miscarriage, your doctor will offer you a few options. You can wait to let the tissue pass on its own, take medications to speed up the process, or undergo a procedure to have the pregnancy tissue removed.
Your first option is to simply wait for your body to pass the tissue on its own. Some women simply want the process to be over and find it too painful to wait for the process to begin on its own. This is something you should discuss with your doctor, so you can choose the best option for your physical and emotional well-being.
Your doctor may also offer the option of using a medication called misoprostol. This medication dilates the cervix and causes the uterus to contract and the lining to shed. This will feel like a heavy period.
Another option is to perform a D&C. This procedure removes the tissue from inside your uterus and is performed while you are sedated or under anaesthesia. Your doctor will use small tools to open your cervix and gently remove any tissue with suction tubing.
For a naturally occurring miscarriage, you will experience heavy bleeding for one to two days. After that, you may see more bleeding for another one to two weeks.
Whether you’ve had a procedure or if you’ve waited for the miscarriage to occur on its own, your doctor may have you wait a week or two before resuming normal activities like regular exercise or sex.
One question many women who have experienced a miscarriage asks is, “How soon can I get pregnant again?” If your body has gone through a natural miscarriage or the process began with medication, you can try again with your next menstrual cycle. After a D&C, your doctor may want you to wait a little longer if there is any scar tissue in the uterus.
Your cycle should return somewhere between 4 to 6 weeks after a miscarriage. Some studies show that getting pregnant again within six months of a loss improves your chances for a healthy, full-term pregnancy.
The most important factor to consider when trying to get pregnant again is whether you are emotionally as well as physically ready. Give yourself time to heal and grieve. Also, discuss with your partner and your health care provider the best path forward.
No doubt any pregnancy after a miscarriage will be filled with anxiety and stress. It is important to share feelings of joy, as well as fear, with your partner, friends, and loved ones.
Often there is no clear explanation as to why a pregnancy has ended and there is no way to prevent a loss from happening. However, you can take some steps to have a healthy pregnancy.
Studies show that taking 400 micrograms (mcg) of folic acid every day can help prevent certain abnormalities that can lead to miscarriage and birth defects. You can add more folic acid to your diet by eating fortified foods, like bread and cereals, or by taking a supplement.
You should also live a healthy lifestyle while pregnant or trying to become pregnant. This means avoiding unhealthy practices such as smoking, drug use, and excessive alcohol consumption. You can also improve your overall health by getting regular exercise, adequate sleep, and eating a balanced diet.
Coping with Loss
The grief process is different for everyone. Some may want to memorialise the pregnancy in some way and some may want to grieve in a more internal and private way. The important thing is the grieve in the way that suits you best.
After you’ve experienced a loss, take it a day at a time and don’t push yourself to do too much too soon—physically or emotionally. Take care of yourself by getting plenty of rest and eating a healthy diet.
Declining pregnancy hormones can leave you with feelings of depression and this is completely normal. If you feel like the depression is getting worse or keeping you from doing normal everyday activities, seek advice from a mental healthcare professional.
Final Thoughts about Missed Miscarriages
An unexpected pregnancy loss can be devastating to both you and your partner. A missed miscarriage can be particularly painful since it can seem to come without warning. Even though this type of miscarriage is uncommon,
It is important to remember that many who experience a miscarriage go on to have healthy pregnancies. When you and your partner are ready to try again, keep in mind that the chances of having a second miscarriage are very low. Though a pregnancy after a loss may cause a bit of anxiety, there is also joy.
For any pregnancy, you’ll want to make sure you are in the hands of professionals who are not only qualified and capable but will also ensure your peace of mind. The staff and facilities of Imaginatal are there to offer you a range of services to provide a safe and healthy pregnancy. Our state-of-the-art private baby scanning clinics provide you with the opportunity for early viability scans and most importantly the opportunity to check up on your little one.