Physiological Reactions After Miscarriage: Key Questions Answered

Physiological responses to miscarriage?

Hello Doctor: I had an embryo transfer on December 1st, and my blood test on December 14th showed a level of 41.5, but by December 22nd, it had dropped to 2.
The doctor mentioned that since the gestational age was small, it would naturally clear out, so no uterine contraction medication was prescribed.
On December 23rd, I experienced intense abdominal pain and passed about three blood clots, after which the pain slightly subsided.
I would like to ask: 1.
I still feel that my uterus has not returned to its original size; it feels distended when pressed, and although the menstrual flow is not heavy, I occasionally experience dull pain.
My basal body temperature is still around 36.87, similar to when I was pregnant, and sometimes my heart rate is still elevated.
Is it possible that I have not completely cleared out? 2.
If it is indeed a miscarriage, does the basal body temperature drop immediately like during menstruation, or does it remain elevated for a while before dropping? 3.
If it is an ectopic pregnancy with a degenerated embryo, will it still naturally expel? Thank you!

Niming, 30~39 year old female. Ask Date: 2015/12/25

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
Due to the blood test results, the embryo should be very small, so it should be easy to expel completely.

2.
The basal body temperature may take some time to decrease.

3.
If it is an ectopic pregnancy with embryo degeneration, it can be reabsorbed by the body.

Respectfully, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/12/25

More Info

I'm sorry to hear about your recent experience. Miscarriage can be a physically and emotionally challenging time, and it's important to understand the physiological reactions that can occur afterward. Let's address your questions one by one.

1. Uterine Recovery and Symptoms: After a miscarriage, it is common for the uterus to take some time to return to its pre-pregnancy size. The process of involution, where the uterus contracts and shrinks back to its normal size, can vary from person to person. The presence of abdominal pain and the feeling of fullness in the uterus could indicate that the uterus is still in the process of contracting. It's also possible that some retained tissue could be causing discomfort. If you continue to experience significant pain or if the bleeding resumes or increases, it would be advisable to consult your healthcare provider. They may consider performing an ultrasound to check for any retained products of conception.

2. Basal Body Temperature (BBT) Changes: After a miscarriage, the basal body temperature may not drop immediately to pre-pregnancy levels. It can take several days to weeks for hormone levels, including hCG (human chorionic gonadotropin), to return to baseline. Typically, if a pregnancy has ended, you would expect your BBT to gradually decrease as your body adjusts and hormone levels normalize. However, if your temperature remains elevated for an extended period, it could be a sign of retained tissue or infection, and you should reach out to your healthcare provider for further evaluation.

3. Ectopic Pregnancy and Tissue Expulsion: In the case of an ectopic pregnancy, where the embryo implants outside the uterus (often in a fallopian tube), the situation is more complex. If the embryo is not viable and the body recognizes this, it may eventually lead to the expulsion of the tissue. However, ectopic pregnancies can be dangerous and may require medical intervention, such as medication or surgery, to prevent complications. If you suspect an ectopic pregnancy or have symptoms such as severe pain, dizziness, or shoulder pain, it's crucial to seek immediate medical attention.

In summary, your body is going through a significant transition following a miscarriage, and it's normal to have lingering symptoms. However, if you have concerns about incomplete miscarriage, persistent pain, or other unusual symptoms, it's essential to follow up with your healthcare provider. They can provide personalized guidance and ensure that your recovery is progressing as it should. Remember to take care of your emotional health during this time as well, as miscarriages can be very distressing. Support from friends, family, or a counselor can be beneficial.

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