Missed Abortion (Silent Miscarriage): Causes, Symptoms, Diagnosis and Treatment Guide

 Missed Abortion (Silent Miscarriage): Causes, Symptoms, Diagnosis and Treatment Guide:

Updated: March 16, 2026

Disclaimer :

The information in this article is shared for education and general awareness only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment.

For any concerns about pregnancy or reproductive health, please consult a qualified healthcare professional. Avoid using this information for self-diagnosis or making medical decisions without medical guidance.

What is Missed Abortion:

Missed abortion, also referred to as silent miscarriage, meanwhile refers to the inability to continue developing the embryo or fetus after the loss of fetal heart activity, despite the pregnancy being retained within the uterus and the absence of pain or bleeding. 

Most women will not be aware of an impending missed abortion until an ultrasound has been performed on them.  

      The diagnosis is usually made when there have been no signs and symptoms during the gestational period that the pregnancy has failed and at the same time there are no fetal heart tones or normal embryonic growth can be seen on ultrasound.

The majority of the time, missed abortions result from the chromosomal abnormality of the developing baby; however, there can be other causes such as:

• Protein level to carry a baby
• Malformations within the mother’s reproductive meatus and anatomy
• Existing medical issues such as hypertension, diabetes, etc.

Management of a missed abortion can vary depending on each individual case with regards to how the case is handled. It may include observation for a natural miscarriage, use of medication to assist in the process, or a very minor surgical procedure.

Table of Contents:

1. Missed Abortion Definition
2. How Often Does Missed Abortion Occur?
3. Reasons for Missed Abortion
4. Missed Abortion Risk Factors
5. Missed Abortion Symptoms
6. How Is Missed Abortion Diagnosed?
7. Options for Treating Missed Abortion
8. Possible Complications Resulting from Missed Abortion
9. Missed Abortion Recovery and Support
10. Chances of Future Pregnancy with Missed Abortion
11. Missed Abortion Prevention
12. When You Should Contact Your Healthcare Provider If You Think You Are Experiencing a Missed Abortion
13. Common Questions New Mums Have about Missed Abortions

1.Missed Abortion Definition and Explanation:

A missed abortion is the loss of a fetus or your unborn child early in your pregnancy (the first 10 to 12 weeks), but your body does not expel the pregnancy tissue from your body.

 In many cases, a missed abortion will occur without any signs of bleeding or pain. After your pregnancy stops developing, the embryo will still be in the uterus for some time before your body recognizes that you are no longer pregnant. 

Because there is little or no bleeding and/or pain, many women experience what is known as a “silent miscarriage” because they have not had any signs of bleeding or pain before receiving an ultrasound or pregnancy examination that shows

•  No fetal heartbeat.
•  No growth of the embryo.
•  Empty pregnancy sac. 

Pregnant women often have a missed abortion and don’t even know that they are having one. This can lead to a woman having her miscarriage at a later date because she had no indication that anything was wrong with her pregnancy.

2. Missed Abortions Are Common.

The first trimester has a high frequency of early pregnancy loss. It's possible to lose a pregnancy before you know that you were even pregnant.

It is estimated that 10-20% of recognized pregnancies will end in miscarriage according to medical studies. Missed miscarriages would be a subset of the above numbers.

Genetic abnormalities in the embryo often account for the loss of pregnancy. Generally this occurs naturally during fertilization and is not the result of anything the mother has done.

Knowing this can prevent the unnecessary feelings of guilt and/or stress associated with these losses for many women.

3.Causes of Missed Abortion:

There are several medical factors that may lead to a missed abortion and the cause may not always be known.

When a doctor evaluates a missed abortion, they will often try to determine the underlying cause(s) in order to help guide their patient in planning for future pregnancies.

1. Chromosomal Abnormalities:

Chromosomal abnormalities are one of the most common causes of early pregnancy loss. When an egg and sperm fertilize, the genetic material combines to form chromosomes, and sometimes there is an error in this process which can result in abnormalities in the development of an embryo. Consequently, embryos with chromosomal errors can exhibit abnormal development and may not produce a viable pregnancy.

It is estimated that approximately 50% of all early miscarriages are due to chromosomal abnormalities.

2. Hormonal Imbalance:

Hormones play an important role in sustaining a pregnancy. One of the primary hormones is progesterone which helps maintain the lining of the uterus. If progesterone levels are low, the uterus may not be able to properly maintain an early pregnancy.

Additional hormonal issues that pose increased risk to the possibility of miscarriage are:

• Thyroid Disorders
• Polycystic Ovary Syndrome
• Luteal Phase Defects

Establishment of a proper hormone balance is necessary for the successful development of a pregnancy.

3. Maternal Health Conditions:

There are Maternal Health Conditions that increase a mother's risk of pregnancy loss due to uncontrolled chronic illnesses, but treatment of these medical problems will be beneficial in improving positive pregnancy outcomes. 

Common reasons that women have a greater chance of having missed abortions are due to maternal age (over 35 years), previous miscarriage(s), chronic health issues, hormonal problems, uterine problems, and problems found in one or both parents.

4: Uterine Structural Abnormalities:

Factors such as Uterine Structural Abnormalities also affect implantation and blood flow to embryos, and in many cases these conditions could be treated to improve fertility outcomes.

5: Lifestyle Factors:

 Lifestyle factors such as 

• Smoking.
• Drinking Alcohol.
• Excessive Caffeine use, and
• Exposure to Environmental Toxins.

 There are several things that can lead to a woman losing her pregnancy. Although the following conditions are common, they do not guarantee that your pregnancy will end in miscarriage. 

4.Missed Abortion Risk Factors:

Many women have experienced healthy pregnancies while dealing with some of these risk factors:

1.Maternal age over 35 

2.History of a previous miscarriage 

3.Pre-existing health problems 

4.Hormonal balance problems 

5.Uterine abnormalities 

6.Genetic abnormalities in either parent

While the above list show common risk factors to missed abortions, they will not always result in a pregnancy getting lost.

All put individuals at risk of complications during pregnancy; however, adjusting one’s Lifestyle Habits can improve reproductive health overall.

Although these risk factors can affect having a missed abortion, not all women who have these risk factors will experience a missed abortion. There are many women with these risk factors who have had healthy pregnancies.

5.Symptoms to Look Out For:

One of the challenges in diagnosing a missed abortion (defined as a pregnancy that has ended, but a woman does not have vaginal bleeding or the normal signs of terminating a pregnancy) is that some women may experience only minor changes in symptoms or be totally asymptomatic.

In addition, many women continue to have the same normal signs of pregnancy after experiencing a missed abortion.

Some potential signs and symptoms include:

• Decreased pregnancy signs, including nausea
• Brownish or pinkish vaginal spotting
• Mild cramping or discomfort in the lower abdomen
• Lack of fetal movement during the third trimester of pregnancy

Some women do not have any symptoms associated with a missed abortion. Because there may not be any obvious symptoms of a missed abortion, regular prenatal checkups are always very important during a pregnancy.

6.How Are Missed Abortions Diagnosed by a Doctor?

A doctor can determine whether a patient has experienced a missed abortion through a few different diagnostic tests.

The most two common diagnostic tests to confirm a missed abortion are:

1. Ultrasound:

Ultrasound examination is the most accurate way to determine if a patient has experienced a missed abortion. While performing the ultrasound, the doctor may look for the following:

1.No heart beat present

2.Lack of developmental growth of embryo

3.Gestational sac without an embryo

The above findings are confirmations that the pregnancy has stopped growing.

2. Measurement of the Human Chorionic Gonadotropin Hormone (hCG):

Performing a blood serum test to measure the level of hCG in a patient’s blood is the second way to evaluate if a patient has experienced a missed abortion. Normally, the level of hCG in a healthy pregnancy will increase throughout the entire pregnancy. If the pregnancy ceases to develop, the hCG levels may no longer continue to increase and may even begin to decrease. The level of hCG in the blood helps to determine if the pregnancy is continuing to develop normally.

Patients' health status, how far along the pregnancy is, and the person's preferences will all be taken into account when making any decisions regarding treatment choices.

7.Options for Treatment Of Missed Abortion:

When deciding on which treatment option to pursue, physicians will discuss the various treatment options in detail, and they will help the patient determine the best option.

1: Expectant Management:

One option is to wait for a natural spontaneous miscarriage. This may occur over some time as the body spontaneously expels the pregnancy tissue through a process known as spontaneous abortion.

Expectant Management typically requires close monitoring, and additional medical monitoring is also required during this time.

Monitoring includes:

• Camera examination (if necessary)
• The monitoring period can take a few days or several weeks.

2: Medical Treatment

Another type of treatment that can be prescribed to assist with the natural expulsion of pregnancy tissue is a medical procedure.

Medications can be used to help the uterus contract and support the natural process of expelling pregnancy tissue.

The medical procedure will primarily be performed at home. A physician will provide clear instructions on how to perform the medical procedure, and a follow-up visit will be made to ensure that the medical procedure is complete.

3: Surgical Treatment:

If an individual does not successfully miscarry through the above-mentioned options, there is another option available to assist in the removal of pregnancy tissue: surgical intervention.

Surgical options generally fall into the category of being outpatient surgeries.

 One form of outpatient surgery is D & C (Dilation and Curettage). This surgical procedure involves:

1.The cervix being gently opened.

2.The pregnancy tissue being removed from the uterus.

D &C procedure(s) are typically completed in a short amount of time and are performed in an outpatient facility.

8.Complications That May Occur:

Most women will recover completely and experience no long term health issues from a forgotten pregnancy.

There are rare instances where complications may occur.

In rare cases, complications can include:

1. Infection

2. Severe bleeding

3. Trapped tissue from the pregnancy

The doctor will perform regular assessments to try and help decrease the risk of complications such as these. 

9. Emotional recovery:

Emotional health can also be affected by a missed pregnancy as much as physical health.

Women may experience sadness, stress, and confusion.

Emotional support from family and friends as well as healthcare professionals can be beneficial to women.

Ways to obtain additional emotional assistance may include:

1. Making sure to get enough rest

2. Talking about your feelings with supportive people

3. Seeking professional help may be warranted

4. Part of the recovery process will include emotional recovery.

10.Future Pregnancy Possibilities:

Many women who have had a failed pregnancy will have healthy pregnancies afterwards.

Medical studies indicate that the majority of women who have had a failed pregnancy will likely have straightforward future pregnancies.

Doctors may advise patients to wait until:

1. The patient's physical recovery has reached its end

2. Menstruation resumes

3. Maintaining a healthy lifestyle and appropriate prenatal care will help support the success of the next pregnancy. 

11.How You Can Reduce Your Risk Of Having A Miscarriage:

There are no certain ways to prevent a miscarriage. However, there are some healthy choices that can support a successful pregnancy.

Ways that may help include:

1. Regularly scheduled prenatal visits

2. Healthy eating

3. Taking supplements containing folate (folic acid)

4. Controlling any chronic medical conditions

5. Not using tobacco or alcohol

6. Maintaining a healthy body weight

These actions can help to ensure a mother has good health during her pregnancy.

12. When to Get Medical Attention:

If you have any of the following symptoms during pregnancy, please contact your doctor immediately.

1. Heavy bleeding from the vagina.

2. Severe abdominal discomfort or pain.

3. Chills or fever.

4. Abnormal vaginal discharge.

5. If you do not get checked early there may be complications with your care.

13.Commonly Asked Questions:

Q(1).Can I have a missed abortion without bleeding?

Yes, many women do not exhibit signs of a pregnancy loss prior to the finding of a missed miscarriage via ultrasound.

Q(2).If I had a missed miscarriage, can I get pregnant again?

Yes, many women are able to restore normal function to the body and have a healthy pregnancy after having had a missed miscarriage.

Q(3).How long can a missed miscarriage stay in the uterus?

Hormonal changes can prolong the retention of tissue for weeks if left untreated. Most doctors will offer monitoring or treatment to prevent complications.

Author Note:

Dr. Humaira Latif

Registered Medical Practitioner 

Obstetrician/Gynaecologist 

over 14 years of experience in pregnancy care and reproductive health education, and specializes in providing patients with accurate health information that will allow them to better understand their bodies and make informed health care choices.

14. Related Articles May Helpful:

1.Polycystic Ovary Syndrome Causes Symptoms and Treatment

2.Early Pregnancy Bleeding Causes and When to Seek Medical Help

3.Intrauterine Growth Restriction Pregnancy Guide

4.Pregnancy Care Checklist and Warning Signs

15.References and Medical Sources:

1.American College of Obstetricians and Gynecologists (ACOG)

Early Pregnancy Loss Practice Bulletin

Updated 2024

https://www.acog.org

2.World Health Organization (WHO)

Pregnancy and Maternal Health Guidelines

Updated 2023

https://www.who.int

3.Mayo Clinic

Miscarriage: Symptoms and Causes

Updated 2024

https://www.mayoclinic.org/diseases-conditions/miscarriage

4.National Health Service (NHS), United Kingdom

Miscarriage Overview

Updated July 2024

https://www.nhs.uk/conditions/miscarriage

5.Healthline

Missed Miscarriage: Causes, Symptoms and Treatment

Updated 2024

https://www.healthline.com/health/pregnancy/missed-abortion.