Signs of a Spontaneous Abortion

I am 9 weeks pregnant and have had some bleeding with clots, and spotting for the last 6 days. Only minor cramping occurred, most blood is dark, with a very small amount of fresh blood. Have I miscarried?

Up until the 20th week of a pregnancy when the fetus is viable, any loss of pregnancy is called a spontaneous abortion rather than a miscarriage. The distinction is not really important when it comes to the loss a woman might feel, but it is a medical distinction that is important when talking about the likelihood that a woman would experience a spontaneous abortion and the possible reasons for her loss. For instance, it is estimated that approximately one third of all pregnancies will spontaneously abort, whereas the figure is much lower for miscarriage. Miscarriages are usually the result of an anatomical problem with the mother, whereas spontaneous abortions are usually caused by problems with the development of the fetus.

The major symptoms of a spontaneous abortion are abdominal cramps and bleeding from the vagina, sometimes with clots and/or bits of tissue. Early warning signs can also include pain in the lower back. Fevers, chills and/or blurred vision that is accompanied by headaches and high blood pressure can all be signs and symptoms of an infection and should be checked out by a doctor. Any woman who experiences bleeding along with any lower torso pain (front, pelvic, back, or groin areas) early in her pregnancy should contact a doctor, and go the emergency room if she doesn't have one or hers is not available. Any bleeding or spotting, without any pain (including back pain) or other symptoms should warrant a call to the doctor. Although these are not sure signs of a spontaneous abortion, they can be indications of problems that might complicate the pregnancy and lead to pregnancy loss down the road. Approximately 25% or so of women have some first trimester bleeding. Some underestimate the length of their pregnancies because they think they are having their period. While women who bleed have a higher rate of spontaneous abortion, the majority go on to deliver normally.

Little can be done to stop or prevent a spontaneous abortion. Still, a visit to the doctor at the beginning of the process will confirm the diagnosis, give her some pain relief, and alert her to warning signs of more serious complications. The fastest way for a pregnant woman to confirm that she has aborted is to have an ultrasound. If a woman knows or suspects that she already had a spontaneous abortion or a "miscarriage" she should follow up with her doctor to make sure that all of the developing fetus has been expelled. Tissue left behind in the uterus can lead to problems, such as infection or clotting in the woman (see our article on missed abortion or "missed miscarriage"). This will also provide her with an opportunity to talk about any concerns she might have about future pregnancies.

REFERENCES
a listing of scientific articles and texts used.