Miscarriage: Key Questions for Expecting Mothers

Unsure if a miscarriage has occurred?

I'm sorry to disturb you, but I hope Dr.
Huang can answer my questions.
I previously asked a question, but the information was incomplete.
This time, I may be clearer.
My previous question is #138919.
Most of the content is in there.
My last menstrual period was from July 13 to July 17.
My cycles are very irregular, ranging from 35 to 55 days.
Recently, I have been experiencing severe abdominal pain, worse than menstrual cramps, so I took a pregnancy test, which confirmed that I am pregnant.
On September 10, between 6:00 and 7:00 AM, I had bleeding (about 2/3 the amount of a menstrual period), with a color resembling dark coffee, mixed with a bit of deep red.
At 9:00 AM on September 10, I visited an obstetrician-gynecologist, who drew blood and confirmed my pregnancy.
On September 14, I went back to see the obstetrician-gynecologist to review the blood test results, which indicated that I was pregnant.
The doctor performed an ultrasound for a considerable amount of time, examining both sides, and confidently stated that the embryo was naturally miscarrying, but it felt like there was no substantial basis for this conclusion.
However, the blood test results confirmed pregnancy, and he said I was three weeks along (in your previous response, you mentioned at least four weeks, so he was mistaken).

Q1: How does Dr.
Huang determine that the embryo is naturally miscarrying?
Q2: Is it true that if the gestational age is too small, the amount of bleeding during a miscarriage would also be minimal?
Q3: Based on today’s date, how many weeks pregnant do you estimate I am?
Q4: After September 14, the abdominal pain has decreased, but today I am experiencing some dull pain, dizziness this morning, and I feel quite cold.
Are these symptoms typical after a miscarriage?
Q5: Generally, at how many weeks can an embryo be detected?

Nìmíng, 10~19 year old female. Ask Date: 2018/09/15

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The last menstrual period was from July 13 to July 17, and my cycles have been very irregular, ranging from 35 to 55 days.
Recently, I have been experiencing severe abdominal pain, which is worse than menstrual cramps, so I took a pregnancy test and it confirmed that I am pregnant.
On September 10, between 6:00 and 7:00 AM, I had bleeding (approximately two-thirds of a normal menstrual flow) that was dark brownish-black with a bit of deep red.
At 9:00 AM on September 10, I visited an obstetrician-gynecologist, who drew blood and confirmed my pregnancy.
On September 14, I returned to the obstetrician-gynecologist to review the blood test results, which indicated that I was pregnant.
The doctor performed an ultrasound for a considerable amount of time, examining both sides, and confidently stated that the embryo had naturally been expelled, although it felt somewhat unsubstantiated.
However, the blood test results confirmed the pregnancy.
He mentioned that I was three weeks along (previously, you indicated that I should be at least four weeks, so he was mistaken).

Q1: How did Dr.
Huang determine that the embryo had naturally been expelled?
A: A natural miscarriage is defined as a natural expulsion.
Q2: Is it true that if the gestational age is small, the amount of bleeding during a miscarriage is also minimal?
A: Not necessarily.
Q3: Based on your assessment, how many weeks along do you think I am now?
A: Approximately 8 weeks.
Q4: In the days following September 14, my abdominal pain has decreased, but today I am experiencing dull abdominal pain, dizziness this morning, and I feel very cold.
Are these symptoms typical after a miscarriage?
A: They likely are.
Q5: At what gestational age can an embryo typically be detected?
A: 5 to 6 weeks.

Reply Date: 2018/09/15

More Info

I'm sorry to hear about your situation, and I appreciate your willingness to seek clarity on such an important topic. Miscarriage can be a deeply emotional and confusing experience for many expecting mothers. Let's address your questions one by one.

Q1: How does a doctor determine if an embryo has naturally aborted?
Doctors typically use a combination of methods to determine if a miscarriage has occurred. This includes ultrasound imaging, which can show whether a gestational sac or embryo is present and if there is any fetal heartbeat. Blood tests are also conducted to measure levels of human chorionic gonadotropin (hCG), a hormone produced during pregnancy. If hCG levels are falling or not rising as expected, it may indicate a miscarriage. In your case, the ultrasound likely showed that the embryo was no longer viable, which led to the conclusion of a natural miscarriage.

Q2: Is the amount of bleeding during a miscarriage related to how far along the pregnancy is?
Yes, the amount of bleeding can vary significantly depending on how far along the pregnancy is. In early pregnancies, such as in the first few weeks, the bleeding may be lighter compared to later stages. However, every woman's experience is different, and some may experience heavier bleeding even in early miscarriages. The color and consistency of the blood can also vary, with darker blood often indicating older blood.

Q3: Based on your calculations, how far along am I now?
If your last menstrual period was from July 13 to July 17, and you had a positive pregnancy test on September 10, you would likely be around 8 weeks pregnant at that time. However, since your doctor mentioned that you were only about 3 weeks along during your visit on September 14, it suggests that the pregnancy may not have progressed as expected. It's essential to follow up with your healthcare provider for the most accurate assessment.

Q4: Are the symptoms I'm experiencing normal after a miscarriage?
After a miscarriage, it's common to experience a range of symptoms, including cramping, bleeding, and changes in your physical state. The dull pain in your abdomen and feelings of dizziness and coldness could be related to the hormonal changes your body is undergoing. However, if you are experiencing severe pain, heavy bleeding, or any other concerning symptoms, it is crucial to contact your healthcare provider immediately to rule out any complications.

Q5: At what point can an embryo typically be detected?
Generally, an embryo can be detected via ultrasound around 5 to 6 weeks of gestation, which is about 1 to 2 weeks after a missed period. This is when a gestational sac is usually visible, and a fetal heartbeat can often be detected by 6 to 7 weeks. However, the exact timing can vary based on individual circumstances, including the accuracy of the dating of the pregnancy.

In conclusion, experiencing a miscarriage can be a challenging and emotional journey. It's essential to have open communication with your healthcare provider, who can provide personalized advice and support. If you have further concerns or symptoms, don't hesitate to reach out to them for assistance. Remember, you are not alone in this, and there are resources available to help you through this difficult time.

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