Experiencing a late miscarriage? Learn about the indications, medical interventions, and post-treatment guidance
Late pregnancy loss, also known as a second-trimester loss, occurs between weeks 14 and 20 of gestation. This article aims to provide a clear understanding of the causes, symptoms, and treatments associated with this complex issue.
Causes
Second trimester pregnancy loss can be caused by various factors, including:
- Chromosomal abnormalities in the fetus.
- Infections affecting the mother or fetus.
- Maternal health conditions such as uncontrolled diabetes, high blood pressure, or thyroid disorders.
- Structural problems with the uterus (like uterine anomalies or cervical insufficiency).
- Placental issues such as placental abruption or insufficiency.
- Lifestyle factors including smoking, alcohol use, or trauma.
In some cases, the cause remains unexplained despite investigation.
Symptoms
Typical symptoms signaling a second trimester miscarriage include:
- Vaginal bleeding (which may be mild or heavy).
- Uterine cramping or abdominal pain.
- Passage of tissue or fluid from the vagina.
- Reduced or absent fetal movement, which is more specific in the second trimester.
- Other signs might include a sudden cessation of pregnancy symptoms.
Medical Treatments
Treatment for second trimester pregnancy loss depends on the situation and may include:
- Medical management: Use of medications (pills or vaginal tablets) to induce uterine contractions and expel remaining pregnancy tissue. This method can avoid surgery and anesthesia, but it does carry risks such as infection, hemorrhage, and retained tissue. Commonly preferred for missed or incomplete miscarriage.
- Surgical management: Procedures like dilation and evacuation (D&E) to remove fetal and placental tissue from the uterus. This method usually requires anesthesia and carries surgical risks, but it is often necessary if bleeding is heavy or infection is present.
- Expectant management: Allowing miscarriage to proceed naturally without medical intervention. This method may take longer and involve more bleeding or discomfort, but some women prefer it as it can feel more natural.
Aftercare typically involves monitoring for complications such as infection or heavy bleeding, and emotional support and counseling are also crucial given the significant psychological impact of a late pregnancy loss.
For suspected second trimester pregnancy loss, immediate medical evaluation is essential to confirm diagnosis, manage complications, and provide supportive care. A doctor can identify a late miscarriage when an ultrasound scan shows no fetal heartbeat.
A range of mental health services and other forms of support are available for emotional recovery after a late pregnancy loss. It is essential to remember that talking to a trained counselor, healthcare provider, and people in support groups who have had similar experiences can help navigate the emotional aspect of recovery.
[1] NHS. (2021). Miscarriage. Retrieved from https://www.nhs.uk/conditions/miscarriage/ [2] American College of Obstetricians and Gynecologists. (2021). Miscarriage: What Every Woman Needs to Know. Retrieved from https://www.acog.org/womens-health/faqs/miscarriage [3] Mayo Clinic. (2021). Miscarriage. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/miscarriage/art-20048147 [4] Royal College of Obstetricians and Gynaecologists. (2020). Early miscarriage: Information for you. Retrieved from https://www.rcog.org.uk/en/patients/patient-leaflets/early-miscarriage-information-for-you/ [5] American Pregnancy Association. (2021). Second Trimester Miscarriage. Retrieved from https://americanpregnancy.org/pregnancy-complications/second-trimester-miscarriage/
- During a review of various health-and-wellness topics, it was discovered that second trimester pregnancy loss, while rare, can be caused by mental health conditions, such as stress or anxiety, which might affect the mother's overall health and potentially contribute to the blockage of a successful pregnancy.
- In a study focusing on women's health, it was found that Pfizer, a leading pharmaceutical company, is currently researching potential new treatments for second trimester miscarriages, with a focus on addressing chromosomal abnormalities and placental issues—factors commonly associated with such losses.
- To better support mental health during and after pregnancy, it is crucial to understand the potential psychological impact of second trimester miscarriages on women's wellbeing. Science has demonstrated that blocked emotional expression and inadequate support during this critical period can exacerbate stress, leading to negative long-term mental health outcomes.
