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Trying to ask a scientific question about missed miscarriage...

(24 Posts)
ohthegoats Fri 14-Mar-14 18:24:55

... I don't want this to be an insensitive post, but it has the potential to offend or upset someone, so I apologise in advance.

Two relatives and a friend have had missed miscarriages in the last year, discovered at the 12 week scan. Now that I'm pregnant, it's been one of my main concerns, just because for ME, it seems to be pretty common. Before I was pregnant I always assumed miscarriages involved blood, and were really obvious. That would make sense to me. But I'm a scientist, and I get cross about unexplained 'things', even if sometimes I should just accept it as a fact.

I've been thinking about missed miscarriage quite a bit, and I am really struggling to get my head around how traitorous it makes 'our' bodies. How massively unfair it seems to make a person sick etc for weeks for no reason. I mean, what is the evolutionary reason for us to hang on to non viable pregnancies? Especially for up to 6 or 7 weeks? And especially if they are involving us being not very useful to a tribe (I'm thinking back to the stone age now!), because we're ill, or allowing us to remain essentially infertile for longer when we 'should' be breeding as much as possible?

Has anyone ever read anything that would help explain? Or is it another one of those things that I have to deal with as 'just happens'?

I don't know the answer but I think it's a good question. (And I don't think it's offensive to ask!)

Luckystar1 Fri 14-Mar-14 18:46:27

Good question, I thought about this to a degree (not quite so in depth!) after mine.

The only thing I could think of is that, while it is crap of our bodies not to realise, the actual 'knowing' has only happened since scans. Now that we can date things it is possible, previously it was 'just' another miscarriage iyswim.

This doesn't answer your question at all though!!

Very best of luck with your pregnancy! Remember, you're statically more likely to take home your baby!

LavenderFox Fri 14-Mar-14 18:47:39

I would explain a missed miscarriage as in that the body works perfectly to maintain the pregnancy, releasing the right hormones to grow the womb, prevent miscarriage and causing the symptoms of pregnancy as a side effect. Unfortunately the embryo is not genetically able to develop past a certain point, and dies. Basically there are two key factors to pregnancy, one being the 'perfect' viable baby and the other the body's ability to maintain the pregnancy and to a point these systems are independent of one another. Women with fertility problems suffer with the opposite, the pregnancy either fails to implant on the womb properly or the hormones fail to maintain the pregnancy and placenta, and she miscarries early in the classical style with cramps and bleeding.

I have had a mmc which was a hard experience but then again the fact that my body resisted the drugs and it took forever to work was reassuring to me that my body knew how to be pregnant, I just needed a healthy embryo to succeed. Both me and my husband are older and I am a midwife so I knew to expect things not necessarily going to plan but at least I knew my body produced enough progesterone to maintain a oregnancy which had been one of my fears because of multiple gynae problems and almost non-exiatent menstrual cycle.

That's a really interesting response Lavendar.

er!

I was just told after mine that a missed miscarriage means the body takes a while to respond and hasn't yet realised what has happened.

healthyhippo Fri 14-Mar-14 19:08:54

I also have a science background and have thought about this since having two mmcs. What I found really odd was that with both of mine I started bleeding just before a scan appointment (we had booked private scan just to check everything was ok so we could tell the inlaws and literally two hours before the appointment I started bleeding). It's like your body is good at being pregnant but somehow the subconscious knows there is a problem?

Wonder if this thread would be better on the miscarriage board though? Maybe a bit worrying to all the pregnant people on this board?

Tomkat79 Fri 14-Mar-14 19:18:34

Interesting thread.
I don't think there is any explanation to explain how I just knew things wouldn't go to plan when I got a BFP almost a year ago. For 4 weeks I had this niggle that something was so wrong but couldn't explain it and however hard i tried to silence these thoughts in my head they wouldn't leave. However, it didn't make me any more prepared for the MC that occurred at 8 weeks and I continued to feel extremely cheated by my body and only just began to forgive it when I got pregnant again 3 months later.
Look at the different cancers...many patients get a little warning, ie lumps/bumps etc and go on to have treatment. Other cancers don't give you any symptoms until it's so far advanced it's untreatable. I'm a nurse and I work with the elderly....they have an uncanny way of knowing when they're about to die. It's bizarre. Not sure everything can be answered scientifically sometimes.
And tell me....wtf has my body deemed it necessary to lay down at least a stone in fat reserves on each hip?! Have I ever starved it before?! Doesn't it know it's 2014 with a 24 he supermarket a short walk away? wink
Good luck with your pregnancy x

LondonJen Fri 14-Mar-14 19:43:06

After my mmc the midwife at the hospital described it as my body really wanting to hold onto and nurture the pregnancy as it should, so as someone else has said, if it were the 'right' embryo with no 'faults', this would be usual.

I can't be certain but I think I read something or maybe the mw said it (things are a bit hazy) about your hormone level starts to drop informing your body to let the pregnancy go but then your body detects the low level and goes 'aha I'm pregnant I should increase the hormone level and prepare for a baby' and tries to do that, it doesn't work and gets the message again to drop the hormones and again once it gets to a crtain low level the body thinks 'aha I'm pregnant' almost like it gets stuck in a circular hormone loop for a while before it finally concedes reality.

Certainly my hormones were very low by the time I started to actually bleed.

Mmc is cruel but I did eventually take some comfort from the thought that my body was super keen to progress any embryo that came it's way.

inmybelly Fri 14-Mar-14 19:48:12

I didn't realise that you can continue to have symptoms despite a MMC...I assumed this nausea was a good sign and must admit was getting my hopes up (a 7 weeks) and even considering telling a few people.

This has given me a bit of a reality check... Will hold on till the 12 week scan now!!

I think Lavender's explanation is a good one. From a reproduction point of view, MMC's don't make a lot of sense. I wonder what would happen if we didn't detect them with scans? Would we start bleeding at some point?? What happened before scans existed?

In my opinion there's quite a lot about the human body that doesn't make a great deal of sense, or that could be 'designed' better!!

inmybelly Fri 14-Mar-14 19:50:08

I think London just answered my question with the hormone loop thingy smile

Inmybelly - yes you would bleed and lose the baby at some point. I think it takes anything up to 6-8 weeks but of course most often happens sooner. Some women choose going home and 'waiting it out' rather than an ERPC.

However, sometimes not everything leaves and can cause infection or pain so in this case women have to have an ERPC anyway - very rare !

bakingtins Fri 14-Mar-14 19:58:07

Yes, you would start bleeding at some point. Expectant management (waiting for a natural Mc) is offered as an option for dealing with MMC, though most women opt to have surgery or medical management as the limbo is hard to live with.
The sac and placenta have often kept growing so HCG and progesterone renaming high even though the embryo has stopped growing.
From an evolutionary point of view there is a lot of wastefulness built into our reproduction - infertility, high failure rate of fertilised embryos, miscarriage....compared to other species. Not sure if there's a good reason or if it's a flaw. I try to be positive and think that every baby that makes it to being born is a bona fide miracle.

ohthegoats Fri 14-Mar-14 20:06:19

Ace answers, thanks.

Sorry to whoever said it would be better on the miscarriage board - I deliberately didn't post it there because I thought it might sound a bit 'trite' to talk about the science rather than the emotions.

ohthegoats Fri 14-Mar-14 20:07:29

think that every baby that makes it to being born is a bona fide miracle

Abso-bloody-lutely!

squizita Fri 14-Mar-14 20:30:32

Seconding all things said above.

Another possibility (very very rare), with a genetically abnormal embryo (such as partial molar) is that elements do keep growing, just not into an embryo. So the sac grows and a ball of cells within- but it never starts to turn into anything more. This is a slightly more complex situation because cruelly the cells are determined to keep alive - even after a bleed/erpc retained placental cells can regrow and there is a risk of cancer. In the UK we are very good at detecting and sorting these though, 100% cure rate for the after effects. Even so VERY rare though.

2 really good books:
-Miscarriage - What every woman should know (Lesley Regan)
-Coming to term - Jon Cohen
...all the science in a tasteful and emotionally sensitive style.

CrispyFB Fri 14-Mar-14 22:29:09

I second those books. They both helped me a LOT after my losses.

I'm quite sure both of mine would have only been spotted at the 12 week scan had I not gone for earlier scans - there was no sign of my body "letting go" and symptoms were still full on when I had my ERPCs at 8w2d and 9w2d. Early pregnancy absolutely terrifies me.

Can you buy these books anywhere I may take a trip to water stones today if so!

squizita Sat 15-Mar-14 11:15:49

I got them off Amazon.

jimijack Sat 15-Mar-14 11:29:52

Sometimes you really do just have to accept that there is no logical scientific reason that shit happens.

It's possibly the only thing that kept me sane throughout each and every one of my 7 miscarriages.

I was told, when I asked the very same question at the reoccurring miscarriage clinic, that although expert on all things to do with miscarriage, they do not know why 70% of miscarriages occur.
What they did know without question, was that I had done nothing to cause them.
That for me was an adequate enough answer and allowed me to move on.

I always knew, just knew that I would not be taking home a baby, despite feeling nauseous, sore tingly boobs, exhaustion from the moment I got a +tive test.

I suppose that it depends on your outlook.

willitbe Sun 16-Mar-14 07:53:57

I think also the mind has a powerful part to play too. Like phantom pregnancies.

With my losses at 11 weeks I had increased nausea at the time of the losses (this happened with all my earlier losses too) at 8 weeks or so, but I had no other clues. But within a couple of days of the scan confirming the loss each time, the spotting and bleeding started. I know it is not scientific but I truly believe that the mind has an influence too.

(In case you are wondering 3 children , 13 miscarriages, 4 of them missed miscarriages.)

squizita Sun 16-Mar-14 09:46:58

Willit the problem is many of us have the opposite. Weeks in limbo. Or (as in my case) symptoms even after the ERPC + bleed.

I think I fear them far more than 'normal' losses.

willitbe Sun 16-Mar-14 13:01:25

Squitzita - I too have the symptoms after the ERPCs and with my other losses. And believe me I have had weeks in limbo too, I will not go into details here. Sorry, I was not trying to imply that people can have any control over when their miscarriages start by thinking about it or any such thing, if that was what you thought I meant. All losses are different, and all different in the way they effect people. That is the reason why different options for miscarriage are right for different people.

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