Signs and Symptoms of Incomplete Miscarriage

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A miscarriage is labeled "incomplete" if the bleeding has begun and the cervix is dilated, but tissue from the pregnancy still remains in the uterus.

Most of the time, a miscarriage that is "incomplete" at the time of diagnosis will run its course without further intervention, but sometimes the body has trouble passing the tissue from the pregnancy, and the miscarriage remains incomplete until the woman seeks treatment.

An incomplete miscarriage diagnosis is not the same as a missed miscarriage, a nonviable pregnancy in which the baby is no longer developing but the cervix remains closed and no bleeding has begun.

Symptoms of Incomplete Miscarriage

The main signs of incomplete miscarriage are bleeding and cramping. A woman with these symptoms should see a physician to determine whether the bleeding and cramping are due to miscarriage or some other factor. If the physician diagnoses a miscarriage, the woman may have a D & C or choose to wait for the miscarriage to complete naturally.

About 90% of the time, a miscarriage that is incomplete at the time of the initial miscarriage diagnosis will complete without intervention should the woman wish to avoid a D & C. Sometimes, however, tissue remains in the uterus without the body passing it naturally. If bleeding and cramping continue for longer than two weeks, the woman may have retained tissue in the uterus that can pose a risk of infection if not treated.

Occasionally, even a D & C may fail to remove all the tissue from the uterus and need to be repeated. So women who have continued bleeding and cramping for more than two weeks following a D & C should also follow up with their physician to determine whether or not additional treatment is needed.

Treatment of Incomplete Miscarriage

For women who have retained tissue for more than two weeks after a miscarriage diagnosis, the usual treatment would be D & C.

Some physicians may also offer medication such as misoprostol (Cytotec) to boost the odds that the body will pass the remaining tissue without surgery.

D&C Further Explained

Dilation and curettage or D&C is performed to clear the uterus of products of conception after either miscarriage or abortion. A D&C can also be performed to diagnose and treat heavy bleeding.

With D&C, an OB-GYN uses small instruments or medications to open up the cervix and access the uterus. Once inside the uterus, the physician will use a curette to scrape the sides of the uterus and gather retained products of conception. Curettes can either be sharp or use suction.

Risks of D&C

Although D&C is, for the most part, a safe procedure and the vast majority of OB-GYNs who perform this procedure are capable and well trained, sometimes bad things can happen after D&C.

Here are some possible complications of D&C:

  • scar tissue or adhesions on the uterine wall, which can result in Asherman's syndrome;
  • cervical damage;
  • perforation of the uterus;
  • infection.

Women who continue to bleed days after D&C or notice foul discharge should notify their physician immediately. Other worrisome signs after D&C include persistent pain and cramping.

Sources:

American Pregnancy Association, "Miscarriage." Jul 2007. Accessed 10 Jun 2008.

Blum, J., B. Winikoff, K. Gemzell-Danielsson, P. Ho, R. Schiavon, and A. Weeks, "Treatment of incomplete abortion and miscarriage with misoprostol." International Journal of Gynecology & Obstetrics Dec 2007. Accessed 10 Jun 2008.

Luise, C., K. Jermy, W.P. Collins, and T.H. Bourne, "Expectant management of incomplete, spontaneous first-trimester miscarriage: outcome according to initial ultrasound criteria and value of follow-up visits." Ultrasound in Obstetrics and Gynecology Jun 2002. Accessed 10 Jun 2008.

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