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| Inevitable Miscarriage | Inevitable miscarriage is the condition when bleeding and pain are accompanied by the breaking of membranes and the widening of the cervix. Uterine contractions to drive out the fetus typically start almost immediately after these symptoms develop.
An inevitable miscarriage happens in two different situations:
1) An inevitable miscarriage occurs is when the fetus has not changed size over a two week period, the hCG levels are decreasing, and the physician is unable to hear or see fetal heart tones.
2) An inevitable miscarriage occurs is when the cervical os (cervical opening) is open and there is heavy vaginal bleeding.
If one of these two situations happens previous to the 20th week of gestation then it is measured as an inevitable miscarriage.
Signs and Symptoms
An incomplete miscarriage will have heavy vaginal bleeding which is the most common symptom. Moreover, majority will experience significant abdominal / pelvic pain. Other symptoms of an inevitable miscarriage include abdominal cramping, a large amount of fluid that is discharged from the vagina, and pain or pressure in the lower back or pelvis. Blood clots and fragments of products of conception are usually expelled through the vagina as well. With an inevitable miscarriage an ultrasound will show no fetal heart tones, no growth of the fetus within two weeks or the loss of amniotic fluid. Also with an inevitable miscarriage the hCG level will be decreasing with serial blood draws.
Causes
Several causes for an inevitable miscarriage exist and it depends on when during the pregnancy the miscarriage occurs. For the reason that most inevitable miscarriages happen within the first twelve weeks of gestation the cause is most commonly because of chromosomal abnormalities within the fetus. These chromosomal abnormalities can be caused by several factors including poor quality sperm or egg, abnormal cell division of the fetus, and genetic abnormalities of either mother or father.
Other causes of an inevitable miscarriage include:
 infection (ie. Chlamydia, Cytomegalovirus, Genital herpes, Syphilis, Toxoplasmosis, and Rubella);
abnormal uterine anatomy (ie. unicornate uterus or septate uterus);
abnormal hormonal levels within the mother (ie. low progesterone);
systemic illnesses (ie. untreated thyroid disease or diabetes);
immune disorders;
substance abuse.
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