Questions in the Maternal and Child Health Forum have been answered by doctors from Henry Ford Health System.

Question Title: Miscarriage

Forum: The Maternal and Child Health Forum
Topic: Pregnancy - Abnormal

Posted by hfhs.md.db on April 15, 1999 at 21:34:46

Topic Area: Pregnancy - Abnormal


What are the medical criteria/steps for determing if you have had a miscarriage? When is an embryo visible on a sonogram and does it correspond to a beta level? When does the uterus feel pregnant and does this correspond to one's beta level?


There are several different ways to determine if miscarriage has occurred. An incomplete/complete miscarriage presents with typical symptoms/signs of bleeding, cramping, and passage of tissue. If an ultrasonographic evaluation is performed, the uterus will have irregular hemorrhagic material (i.e. blood clot) within the cavity. In the past, miscarriages were associated with clinical symptoms and the diagnosis was straightforward.

Currently, with the advent of sensitive hCG assays, and transvaginal U/S, miscarriages can often be detected (predicted) prior to clinical bleeding, cramping, or passage of tissue. In general, a fetal pole (early embryo) is visible by 6-7 weeks after the last menstrual period. Although there is a rough correlation between the quantitative hCG level and the sonographic appearance of the pregnancy, it is important to stress that there can be a significant amount of variability in early pregancy events. A falling hCG level is indicative of an impending miscarriage, as is a fetal pole that fails to show heart motion seen on a previous exam. Other characteristic U/S signs include an irregular gestational sac, failure to develop a fetal pole, and discrepancy between the size of the yolk sac (an early embryonic structure) and the embryo. As the resolution of U/S equipment improves, we are gaining significant insight into early pregnancy events.




 

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