Types of Miscarriages
From its use in social issue and public policy debates, the word abortion is often assumed to mean elective termination, but the word technically refers to any interruption of a pregnancy, including spontaneous miscarriages. Under the heading of abortion, there are several designations that are clinically important.
Threatened Abortion—Threatened Miscarriage
It is most frightening for a woman to experience bleeding in the first part of her pregnancy. First trimester bleeding is any bleeding noted during the first 12 weeks, and it is one of the most common symptoms that sends a woman to her obstetrician. And rightly so, because until a non-threatening cause is identified, all first trimester bleeding is labeled “threatened miscarriage,” or “threatened AB.”
Serial hCG levels can determine well-being or danger. Ultrasound is also important following such a condition.
This refers to a pregnancy that is no longer viable but hasn’t passed or caused any bleeding yet. In a missed abortion, either waiting to see if a complete miscarriage occurs or jumping right to dilation and curettage (D&C) are all acceptable options. If you wait, however, there has to be a time limit, as infection or clotting disorders may complicate matters.
Inevitable Abortion—Inevitable Miscarriage
When the cervix begins to dilate (a sure sign of impending expulsion of the fetus from the uterus) but before actual expulsion has begun. Sometimes this is the result of an incompetent cervix.
Complete Abortion—Complete Miscarriage
A miscarriage is considered “complete” when the entire gestational sac, placental tissue, and fetus are expelled. No further treatment is necessary. Yet, when in doubt, doctors usually lean to doing the D&C. It can be done at any time that it’s felt there’s been incomplete emptying, and sometimes this diagnosis takes time to make. Following hCG levels until they fall to a certain level is common.
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