The majority of miscarriages occur in the first trimester (first 12 weeks) of pregnancy, and beyond that, most women feel, quite rightly, that they are 'out of the woods'. However, occasionally, the tragedy of miscarriage can occur after this time. This is termed as a 'late miscarriage'.
What is 'late miscarriage'
This is when a miscarriage occurs after the 12th week and before the 20th week.
Beyond this time (though some argue it should be regarded as the 24th week), it is considered a premature birth (stillborn) due to the size of the fetus.
It is very rare indeed, if there are no medical reasons for the pregnancy to be regarded as risky in any way. Even including risk groups, late miscarriage only accounts for about a quarter or all miscarriages.
Why does a late miscarriage happen?
Miscarriages later in pregnancy are usually associated either with the placenta or with the health of the mother.
These days, with monitoring of pregnant women (blood tests, urine samples, better care and advice on necessarily lifestyle changes), a woman's health is less of a threat to the unborn baby. When there is an ongoing medical condition which gives cause for concern, the doctor or consultant should have discussed this with the mother in the early weeks of pregnancy.
Despite costume dramas which have ladies falling downstairs and losing their unborn child, accidents do not tend to bring on miscarriage in healthy pregnancies. However, serious infection, existing tumours and other serious illnesses contracted during pregnancy do need to be treated with urgent care to protect the fetus.
Placental problems are also a worry, uncommon as they are.
The placenta feeds the baby thoughout pregnancy and should remain intact until the birth at full-term. One danger is that it can become detached from the fetus too early. However, more common worries are placenta praevia, placental insufficiency, or an incompetent cervix.
What are the symptoms of late or 'threatened' miscarriage
The most common symptoms are a pink discharge for a few days, or a brown discharge for several weeks. These tend to signal only a 'threatened miscarriage' and your baby may well be fine. It is important to raise this with your doctor, midwife or consultant to be on the safe side.
Some discharges are nothing to worry about, but if you start to bleed, even if you are not in pain, do call your doctor or seek emergency hospital attention.
Treatment for 'threatened miscarriage'
If you have just experienced some discharge, it is quite likely you have not miscarried.
However, your doctor will insist on bed rest. If examination suggests the cervix may have started to open too soon, some treatment is possible to close it back up.
Treatment and assessment of late miscarriage
Once a miscarriage has happened it is not possible to save the baby, but medical treatment is urgently needed to make sure the mother is well, and to ensure that no longterm damage has been done which may affect another pregnancy.
It is good practice to examine the possible or certain causes for the late miscarriage so that preventative measures can hopefully bring about a safe and healthy full-term pregnancy next time.
