Complications After a Miscarriage

Physical or Emotional Challenges After a Pregnancy Loss

If you've recently had a miscarriage, you're likely aware of the physical and emotional challenges people face. Yet sometimes women have complications after a miscarriage as well. For example, conditions such as excessive bleeding, infection, or depression may occur following a miscarriage.

Although most first-trimester miscarriages are relatively uncomplicated—at least from a health perspective—you may want to know what to look out for. Make sure to talk to your doctor if you suspect you have any of these problems so you can recover and go on to heal or become pregnant again without further concerns.

1
Incomplete Miscarriage

sad woman sitting on bed
What complications may occur after a miscarriage?. Elke Meitzel/Cultura/Getty Images

An incomplete miscarriage is relatively common. This means that you still have some tissue retained in your uterus from the pregnancy. The most common sign of an incomplete miscarriage is bleeding or cramping longer than would be expected after a complete miscarriage

If you've had a miscarriage, you doctor will tell you how soon the bleeding should stop. If you're still experiencing symptoms roughly two weeks after the miscarriage, it could be an incomplete pregnancy, and you should talk to your doctor.

Sometimes an incomplete miscarriage will resolve on its own, but other times you might need a D&C or medical treatment with Cytotec (misoprostol) to clear all of the products of conception from your womb.

2
Excessive Bleeding

Your doctor will advise you that bleeding is normal as a miscarriage progresses. Too much bleeding, however, could be dangerous for you.

A small percentage of women have hemorrhaging as a complication of miscarriage. The general rule is that you should seek medical attention immediately if you're soaking through a menstrual pad in under an hour. 

If you have symptoms of blood loss such as pale, clammy skin, lightheadedness, or an increased heart rate, it's likely that you've already lost a significant amount of blood. Don't wait. Call 911.

3
Infection After Miscarriage

About three percent of women will acquire an infection related to a miscarriage. This may be caused by retained products of conception in the uterus. Be sure to contact your doctor if you think you have symptoms of an infection such as:

  • Prolonged bleeding and cramping (longer than 2 weeks)
  • Fever (a temperature over 100.4 F)
  • Chills
  • Foul smelling vaginal discharge

A post-miscarriage infection can be dangerous but is generally easily treated with antibiotics.

4
Asherman Syndrome

Asherman syndrome is a rare complication of a D&C. (It can happen for other reasons as well, such as infection.)

In this condition, scar tissue, called adhesions, forms in the uterus. These adhesions can cause fertility problems and further miscarriages. The most common symptom is absent, light or infrequent periods.

A test called a hysteroscopy is usually used to either make or rule out the diagnosis of Asherman syndrome. Surgery can be used to remove the adhesions so you can try to get pregnant again.

5
Recurrent Miscarriages

According to the American College of Obstetricians and Gynecologists, 1 percent of women will have more than one miscarriage. This is known as recurrent miscarriage or repeated miscarriage.

If you have two or three consecutive miscarriages, talk to a doctor about testing for possible causes, such as Asherman Syndrome, uterine or hormonal abnormalities, the immune disorder antiphospholipid syndrome (APS) or a genetic problem called balanced translocation.

Unfortunately, at least 50 percent of the time, no cause can be found for recurrent miscarriage. 

6
Depression

According to the March of Dimes, if you experience the following symptoms for a long time after your miscarriage, or if you feel them very strongly and they're interfering with your life, you could be depressed: 

  • Having little interest in your usual activities or hobbies
  • Feeling tired all the time
  • Gaining or losing weight
  • Having trouble sleeping or sleeping too much
  • Having trouble concentrating or making decisions
  • Thinking about suicide or death

Grief is a normal reaction to miscarriage and pregnancy loss and there is not a magic amount of time for which this lasts. But if you start to show signs of clinical depression after miscarriage, talk to your doctor. There is some controversy over whether depression after a miscarriage is the same thing as postpartum depression, but whatever the diagnosis, depression is as serious as any of the other complications discussed here.

Mental health counseling and/or medications may help you return more quickly to your normal, healthy, self.

If you're not sure whether you are experiencing grief versus depression, don't wait. Talk to your doctor.

7
Anxiety Disorders

Some research suggests that anxiety and stress disorders after miscarriage are even more common than clinical depression, and they can become your new normal if you don't deal with them.

It may even be possible to develop symptoms of post-traumatic stress disorder (PTSD) after a pregnancy loss. Again, talking to a mental health professional and learning strategies for coping with your anxiety, can help you feel more like yourself again after a miscarriage.

Sources:

Cunningham, F. Gary., and John Whitridge Williams. Williams Obstetrics. New York: McGraw-Hill Education Medical, 2014. Print.

Daugirdaite, V., van den Akker, O., and S. Purewal. Posttraumatic Stress and Posttraumatic Stress Disorder After Termination of Pregnancy and Reproductive Loss: A Systematic Review. Journal of Pregnancy. 2015 Feb 5. (Epub ahead or print).

Hooker, A., Aydin, H., Brolmann, H., and J. Huime. Long-Term Complications and Reproductive Outcome after the Management of Retained Products of Conception: A Systematic Review. Fertility and Sterility. 2016. 105(1):156-64.e1-2.

Kim, C., Barnard, S., Neilson, J. et al. Medical Treatments for Incomplete Miscarriage. Cochrane Database of Systematic Reviews. 2017. 1:CD007223.

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