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Pregnancy loss before 20 weeks gestation is termed miscarriage. When we think of miscarriage, images of cramping, bleeding and pain come into our heads, and indeed these miscarriage symptoms happen in the majority of pregnancy losses, which completely spontaneously without the need for medical intervention. A missed miscarriage refers to a situation in which a fetus passes away, but the body does not follow up by expelling the fetus.

Miscarriages can occur for a variety of reasons and at any point up to 20 weeks, although miscarriages in the first trimester of pregnancy are most frequent. Causes of miscarriage include chromosomal abnormalities in the fetus, improper implantation into the uterus, maternal age, maternal trauma and injury, lifestyle factors (like smoking in pregnancy) and hormonal problems. In the majority of cases, the exact cause of a particular miscarriage will remain unknown. It is not clear why a missed miscarriage occurs in some women. Although women who have suffered embryonic death and a missed miscarriage will not have bleeding (the single most obvious miscarriage symptom), clues that they have miscarried may include a decrease in pregnancy symptoms, sudden weight loss, and of course a lack of fetal heartbeat when this is examined by medical professionals.

If you have been diagnosed with a missed miscarriage, you may have several options open to you. Many healthcare providers will recommend a D&C, especially if, for instance, you are officially ten weeks along but the fetal size is appropriate for a gestation six weeks in length. That situation shows your body has had plenty of time to start a miscarriage, but this did not happen. In some cases, monitoring and waiting for the miscarriage to complete naturally may also be an option. Keep in mind that D&C procedures can, in some cases, cause unwanted side effects.

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