When it comes to miscarrying, the majority of women experiencing one will have identifiable symptoms such as cramping, nausea, and bleeding, which is often heavy. The medical term for a miscarriage, spontaneous abortion is a miscarriage that occurs before 20 weeks gestation. Unfortunately, about 10 to 25% of pregnancies are lost to a miscarriage, and a small percentage of these result in missed miscarriages.

A missed miscarriage typically happens within the first 12 weeks of pregnancy, most often occurring soon after the fetus has been implanted in the rich lining of the uterus. With a missed miscarriage, the woman has no exterior symptoms of losing the pregnancy because the body fails to "notice" the loss of the baby. As a result, the fetal tissue is not immediately expelled by the uterus. This type of miscarriage differs from what is called a chemical pregnancy, where a woman miscarries early on, and bleeds around the same time of her usual period — most women who experience this never even knew they were pregnant.

Although there may be no typical signs of a miscarriage, for a woman suffering a missed miscarriage, she may stop feeling the symptoms of pregnancy, such as nausea, tender breasts, etc. Many missed miscarriages are discovered at the doctor's office during a regularly scheduled prenatal checkup. During a typical exam after 10 weeks gestation, the doctor will try to locate the fetal heartbeat using a Doppler instrument. In a missed miscarriage, the doctor will not be able to detect the heartbeat, and may resort to an ultrasound to confirm that the fetus is still healthy and developing as it should be. It is usually by ultrasound that a missed miscarriage is confirmed.

The number one cause of a missed miscarriage is an abnormality in the chromosomal makeup of the fetus, or a chromosomal abnormality. This is the usual cause of most miscarriages as well. Lifestyle choices, such as drug use and smoking are also causes of miscarriage, as well as incorrect implantation and trauma to the mother.
With most any other miscarriage, the body will take care of expelling the fetal tissue on its own, but with a missed miscarriage, you may have to resort to medical intervention to ensure that you do not retain the fetal tissue, which can eventually result in infection. If the pregnancy is earlier than 8 weeks, your doctor may give you misoprostol to encourage the uterus to expel the tissue. After 8 weeks, your doctor may take a wait and see approach to allow the body to eventually react to the miscarriage naturally. For some women, the waiting is too traumatic, and they will want to have a dilation and curettage, or D&C. This is a medical procedure by which the doctor will remove the tissue. This ensures that the woman does not retain any tissue, reducing her risk of infection.

The vast majority of women will be able to go on and have healthy subsequent pregnancies. Follow your doctor's advice on when to start trying to get pregnant again, and don't hesitate to get support for any symptoms of grief you may be experiencing as a result of a missed miscarriage.