How to recognize a miscarriage: the symptoms

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How to recognize a miscarriage

The first three months of pregnancy are the most delicate and worry future mothers the most, especially because of the risk of spontaneous abortion, which is higher in the first weeks. In fact, the probabilities of interruption have entered the fourth month of gestation how to recognize a miscarriage? And what are the causes and symptoms?

In this article

  • What is spontaneous abortion
  • What are the causes?
  • Symptoms of miscarriage
  • Internal abortion symptoms
  • What to do?


What is spontaneous abortion

Abortion is defined as stillbirth of a fetus within the twentieth week. Spontaneous termination of pregnancy is more common than thought and occurs in approx one third of pregnancies.

What are the causes?

In about half of the cases of miscarriage in the first few weeks the pregnancy is terminated due to one chromosomal abnormality which prevents the fetus from developing. Chromosomes are structures found in cells that carry genes within them: most cells contain 23 pairs of chromosomes for a total of 46 chromosomes. The sperm and the oocyte each yield 23 chromosomes to the new human being, which then give rise to a new human being. It is evident, however, that if the egg or the spermatozoon have an abnormal number of chromosomes, during the union of the two cells the new cell will also have this anomaly. In some cases the baby grows and develops equally, in other cases the pregnancy is interrupted.

Other causes include:

  • An anatomical abnormality of the uterus that is capable of causing repeated miscarriages (10-15% of cases);
  • Luteal phase deficiency;
  • Anomalies of the thyroid function;
  • bacterial or viral infections.

Symptoms of miscarriage

Vaginal bleeding and cramps are the most common symptoms of miscarriage in the first weeks of pregnancy. However, it is not always easy to distinguish an interruption of pregnancy: right at the beginning, among the most common symptoms of pregnancy, it is quite common to notice small losses (which may be the so-called implantation losses, that is, they are caused by the nesting of the embryo in the uterine walls), and have small cramps in the lower abdomen.

We can suspect that everything is going well even if the classic symptoms of pregnancy persist for a few weeks, such as:

  • breast pain and tension;
  • early morning nausea;
  • frequent urination;
  • tiredness and sleepiness;

Many women do not notice anything because pregnancy ends at its inception, when the pregnancy test has not even been taken, and the losses are mistaken for normal menstruation.

Certainly the way to know if a pregnancy has been interrupted is with an ultrasound: the first ultrasound, which is usually performed around the tenth, eleventh week, will reveal to us that everything is going well, if there is heart activity and if the embryo is implanted correctly.

Read also: Tubal abortion

Internal abortion symptoms

It is called "internal abortion " or "deemed abortion" a spontaneous termination of pregnancy that does not give any symptoms or manifest itself in an obvious way. It is usually discovered at the first ultrasound, when the operator highlights the heartbeat assignment and the arrested growth of the embryo. 

An internal abortion, therefore, at the beginning it does not manifest itself with actual symptoms: only after a few days, or even weeks, can discharge and uterine contractions occur.

What to do?

Of course, if we already know that we are pregnant and we notice particularly strange symptoms, it is always good to call your doctor: in particular, rather severe pains in the lower abdomen and blood loss, even mild ones, should never be underestimated.

As we have said abortion clearly manifests itself with a hemorrhage which feels like a period but is thicker and lasts longer than usual. Bleeding is accompanied by abdominal crams and uterine contractions which are aimed at promoting the expulsion of tissues. It is normal to notice gods blood clots.

After a few days the doctor will prescribe a Beta Hcg test and an ultrasound to check if the uterus has been completely cleaned: if not, a small surgery called curettage will be necessary.

In conclusion, in the event of spontaneous termination of pregnancy in the first weeks, there are essentially two options:

  1. you wait a few days to see if the material is spontaneously expelled;
  2. we proceed with a curettage that cleans the entire uterine cavity.


  • ACOG
  • Merck Manual
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