Early Miscarriage Signs - When You May Not Have to Worry

Common First-Trimester Concerns That Don't Always Mean Pregnancy Loss

The early stages of pregnancy can be an anxious time, especially if you have a history of miscarriage. But many of the things women worry about in early pregnancy are not conclusive signs that anything is wrong with the pregnancy.

Let's go over some of the most common first-trimester pregnancy worries and what you need to know.

I'm Worried About My Blood hCG Tests

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In early pregnancy, doctors may test levels of the hormone hCG (human chorionic gonadotropin) over a period of days to try to determine whether the levels are rising as they should.

In most normal pregnancies, the level of hCG should double every two to three days (hCG doubling time) during the early part of the first trimester.

But a single hCG level rarely tells you anything, and even two hCG levels may not be conclusive for miscarriage unless the second test showed that the level was dropping. You can learn more about hcg levels and miscarriage if you are concerned.

I Took Multiple Pregnancy Tests and the Line Is Getting Lighter

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Knowing that hCG levels are supposed to double every two days in early pregnancy, it's tempting to try to track your hCG levels at home by taking multiple home pregnancy tests to see if the color of the test line is getting darker. Then you may worry if the test line is faint.

But urine-based home pregnancy tests are not a reliable method for judging true hCG levels. The shade of the test line has more to do with how much water you drank and the type of test you're using than the actual hCG level in your blood.

If you and your doctor are concerned about your hCG levels, hCG blood levels are by far more accurate than urine in determining the actual level of hCG in your body.

I'm Spotting. Is the Pregnancy Doomed?

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It's natural to be concerned about spotting in early pregnancy and it's smart to call your doctor when you're having early pregnancy bleeding of any kind. Spotting can be a symptom of a miscarriage or even an ectopic pregnancy, but there are many causes of spotting in early pregnancy that are very normal.

The blood flow to the cervix increases during pregnancy and you may be more likely to spot after intercourse or following a vaginal exam. In younger women, cervical ectopy (a protrusion of the inner part of the cervix into the outer cervix) is a benign condition which may result in spotting. Implantation of the placenta into the uterus can also cause spotting in early pregnancy for many women, and in this case, is actually a good sign.

Keep in mind that while it is very important to talk to your doctor about spotting and she will likely wish to see you, there a significant number of women who go on to carry their babies to term despite having had spotting in early pregnancy.

Is Cramping a Bad Sign?

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As with spotting, cramping in early pregnancy can happen in normal pregnancies as well as in pregnancies that will miscarry and with ectopic pregnancies.

As the placenta implants in your uterus it is common to have mild and short-lived pain.

Pain that is accompanied by bleeding, however, increases the chance that you could be miscarrying.

If cramping is ever severe, it's wise to immediately contact doctor to rule out ectopic pregnancy. Go to the emergency room if you have severe lower abdominal or back pain in early pregnancy.

My Pregnancy Symptoms Have Disappeared

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It's quite normal for pregnancy symptoms to fluctuate from day to day in early pregnancy, and sometimes they may even disappear. The loss of pregnancy symptoms such as breast tenderness, nausea, and aversion to certain foods is not necessarily a sign of miscarriage, especially if you are nearing your 12th week of pregnancy.

I'm Not Feeling Nauseous

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If you have heard that morning sickness is a good sign for having a viable pregnancy, you might worry if you don't have any morning sickness.

But not having any nausea does not mean that your pregnancy is doomed. A lack of morning sickness is not considered a symptom of miscarriage. In fact, about a third of women never have any nausea at all.

Worries Over Ultrasound Results

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It's not uncommon that an early pregnancy ultrasound will raise concern (for example, your doctor may not see a yolksac,) without a solid verdict that anything is wrong. The ultrasound might show no fetal heartbeat, no fetal pole or simply measurements that don't match the original estimated due date. You might feel like you're being left in limbo when your doctor tells you that you'll just have to come back in a week for another scan. Again, this does not necessarily mean you're experiencing a pregnancy loss.

The Doctor Said I Have a "Threatened Miscarriage"

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It's scary to hear, but a threatened miscarriage is not the same thing as a definite miscarriage. The term refers to a pregnancy in which there is some level of bleeding, but the cervix is still closed and the ultrasound shows that the baby's heart is beating. Sometimes threatened miscarriage does go on to be an actual miscarriage, but many times, the bleeding stops and the pregnancy continues without further problems.


American College of Obstetricians and Gynecologists. Bleeding During Pregnancy. Updated July 2016. http://www.acog.org/Patients/FAQs/Bleeding-During-Pregnancy

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