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Navigating the Challenges of Misdiagnosed Miscarriages

What is a miscarriage? 

A miscarriage, also called a spontaneous abortion or early pregnancy loss, is the loss of a pregnancy before 20 weeks. Losses after 20 weeks are known as stillbirths. 

One in four pregnant people will experience a miscarriage, some before they’re even aware they’re pregnant. For those who know they’re pregnant, the chance of early loss is 10 to 20%; however, frequent gestational ultrasounds can significantly reduce this risk. 

Misdiagnose miscarriage

What are the types of miscarriages?

We categorize miscarriages based on their timing and how much of the pregnancy tissue is expelled. Miscarriage categories include:

Threatened miscarriage

When bleeding is present, but the cervix is closed and there is evidence of continued fetal heart activity, there is a possibility of miscarriage. About 60% of pregnant women who experience vaginal bleeding in early pregnancy continue to have a normal pregnancy. 

Inevitable miscarriage

If you’re experiencing bleeding and cramping and the cervix has opened, a miscarriage is inevitable. 

Incomplete miscarriage

A miscarriage is incomplete when a portion of the fetus, gestational sac, or placenta has passed out of the uterus, but some remains. 

Complete miscarriage

When the fetus, placenta, and all other pregnancy tissue have been expelled and the cervix has closed, you’ve had a complete miscarriage. This is common for early miscarriages (pregnancy loss before 12 weeks). 

Missed miscarriage

A missed miscarriage is when the fetus has died (or never formed) but the pregnancy tissue has not been expelled. 

Recurrent miscarriages

Recurrent miscarriage or pregnancy loss is defined as two or more unsuccessful pregnancies.  

Blighted ovum

A blighted ovum occurs when a fertilized egg implants and forms a gestational sac, but no embryo develops. If your body doesn’t recognize the loss, you can still have the symptoms of a healthy pregnancy. 

How do I know I’m having a miscarriage?

The most common signs and symptoms of miscarriage are: 

  • Heavy bleeding with grayish tissue and/or blood clots 
  • Cramps and abdominal pain 
  • Mild to severe aches in the lower back 
  • Decreased pregnancy symptoms 

A pregnant person can experience bleeding and cramping and not miscarry—that’s why it’s so important to contact our OB/GYN immediately if you’re experiencing any of these symptoms.  

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How does my doctor know if I had a miscarriage?

Healthcare professionals have shared guidelines to establish a miscarriage diagnosis. The process of diagnosing a miscarriage may include blood tests, imaging, and physical examination.  

  • A transvaginal ultrasound lets us see the uterus and placenta. 
  • Pelvic examination determines if the cervix is dilated or thinned. 
  • Human chorionic gonadotropin (hCG) levels change during pregnancy, checking these hormone levels with a blood test can help indicate a miscarriage. 
Can miscarriage be misdiagnosed?

Can miscarriage be misdiagnosed?

As with any medical examination, there’s a chance of misdiagnosis. Misdiagnosis usually occurs during the first six weeks of pregnancy and can be due to doctor or laboratory error.

If you’re diagnosed with a miscarriage, it’s worth getting a second opinion, as there are misdiagnosed miscarriage success stories where women find out they are still pregnant.

Many things can contribute to a misdiagnosed miscarriage.

Tilted uterus 

The uterus usually sits horizontally over the bladder, but in around 20% of people, it’s rotated back toward the spine. 

During the first trimester, a pregnant person with a tilted uterus may experience back pain or difficulty urinating, causing fear that a miscarriage is imminent. However, these issues are also present in those without a tilted uterus and are not necessarily signs of miscarriage. 

Your baby’s heartbeat is usually detectable by ultrasound at six weeks of pregnancy; however, a tilted uterus may make it more challenging to find. If absent, medical guidelines suggest waiting for at least two weeks before a follow-up scan. 

Blood hCG levels

HCG is a hormone the body produces during pregnancy that supports fetal growth. We test hCG levels to confirm pregnancy. 

In the first four weeks of a viable pregnancy, hCG levels double every two to three days. After six weeks, the levels will double every 96 hours. Improperly rising levels of hCG may indicate an ectopic pregnancy or miscarriage; however, that’s not always the case. 

If you have slow-rising hCG levels, we’ll need to do further testing to rule out an impending miscarriage or other problems. 

As with any medical examination, there’s a chance of misdiagnosis. Misdiagnosis usually occurs during the first six weeks of pregnancy and can be due to doctor or laboratory error.

When hCG levels start to fall, it could indicate a miscarriage or a heterotopic pregnancy — a rare situation where an ectopic pregnancy and a viable pregnancy occur simultaneously. 

Confusion about the date of the last menstrual period

Monitoring healthy fetal growth during pregnancy requires knowing the first day of your last menstrual period (LMP). Being off by a few days in early pregnancy can make a difference in fetal measurements and whether a first-trimester ultrasound will detect a heartbeat. 

If the LMP is uncertain, most gynecologists and obstetricians avoid a miscarriage misdiagnosis and use ultrasound to check for continued development. 

  • In a viable pregnancy, the gestational sac and embryo will be considerably larger in the follow-up scans. 
  • A nonviable pregnancy will show either no growth or minimal growth. 

For a healthy pregnancy, choose Dr. Steve Rad

Dr. Rad is a world-renowned OB/GYN specializing in perinatology, high-risk pregnancies, and maternal-fetal medicine. His peers selected him as Los Angeles’ best maternal-fetal specialist in LA Magazine six years in a row and a Southern California Rising Star for the last four. 

Dr. Rad is certified by the American Board of Obstetrics and Gynecology and certified as a Nuchal Translucency Quality Review Provider for California’s Prenatal Screening Program. 

Call us at (844) 473-6100 or schedule your consultation online. We are currently accepting new patients. 

We are conveniently located for patients throughout Southern California and the Los Angeles area at locations in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Newport Beach, Irvine, and Downtown Los Angeles. We also offer in-home prenatal care and a fly-in program for out-of-town and international patients. Dr. Rad even travels to patients who need him throughout the U.S. and around the world. 

If you can’t make it to Dr. Rad, he also offers virtual consultations worldwide. 

Call (844) 473-6100 or click here to schedule online