Miscarriage at 2 Weeks: When To See A Doctor?

Miscarriage at 2 Weeks: When To See A Doctor?

Women who are getting pregnant for the first time or pregnant mothers that have experienced a miscarriage are always concerned about the likelihood of having another miscarriage.

It usually takes a lot of effort to get pregnant and it’s emotionally exhausting if a miscarriage happens.

Here’s an email I received from Marri (one of my readers)

Hi, Doc,

Am 41 years old and this is my third pregnancy. During the first pregnancy, I requested for an abortion which was done with a D & C. My second pregnancy happened about 3 years ago and I had severe cramps and heavy vaginal bleeding.

Today am 2 weeks pregnant, and I’m concerned about losing my baby. Currently, I do not have cramps or vaginal bleeding. Is it possible that a previous D & C increases my chances of having a miscarriage?

If you’ve been pregnant before and had a miscarriage, there is a possibility that you could have another miscarriage. Worst still, if you’ve had two miscarriages in a row, chances of miscarriage is higher in next pregnancy. However, most women who miscarry once will still go on to have a healthy baby in a future pregnancy. RCOG+1

About your previous D & C: A single uncomplicated D & C (dilatation and curettage) for miscarriage or abortion usually does not increase your risk of another miscarriage. Problems are more likely if there were complications or repeated procedures that caused scarring inside the womb (Asherman’s syndrome). If your periods became very light after the D & C, or you are struggling to get pregnant, see your doctor for a check-up.

The truth is, during early pregnancy, in the first trimester, women are at risk of losing their baby. In most cases, it’s because of faulty chromosomes during fertilization and cell division (a baby that is not developing normally). About half of early miscarriages are due to these random chromosomal problems that you cannot prevent. ACOG+1

Other reasons for an early miscarriage are poorly controlled diabetes, smoking, heavy alcohol intake, very high caffeine intake, obesity or being very underweight, some infections, severe abdominal trauma and some blood clotting or hormone problems. Normal daily activities, mild–moderate exercise and sex in a healthy pregnancy do not usually cause a miscarriage. nhsinform.scot+1

Women that are getting pregnant after the age of 30 are at higher risk of a miscarriage. Then again, women that are more than 40–45 years have a much higher chance to miscarry. nhsinform.scot

Because the risk of miscarriage is quite high in the first trimester, many couples prefer to inform only their partner or close family when pregnant. After the first trimester, the risk of miscarriage decreases, and if you are comfortable, you can then let everyone know. nhs.uk

This article explains the causes, signs, symptoms of miscarriage in early pregnancy.

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What are the symptoms and signs of miscarriage at 2 weeks?

First of all, it’s important you know how to calculate the age of your pregnancy. A woman’s pregnancy date is calculated from the last time she had her menstrual period. This means if you’ve missed your period and already confirmed you are pregnant, it suggests that you are at least four weeks pregnant.

For example, if your period is two weeks late and you have a positive pregnancy test, it means you are already 6 weeks pregnant.

The truth is that, at “two weeks of pregnancy” by medical counting, you cannot have a clinical miscarriage. At two weeks into pregnancy, you are just one week away from the end of your last period and your body is preparing for ovulation.

Ovulation is the release of an egg from your ovaries, and it occurs in the middle of your menstrual cycle. At this time, fertilization and implantation has not taken place, meaning, you are still not pregnant. Very early losses that happen before or just after implantation are common, but they usually show only as a slightly late or heavier period and most women never know they were briefly pregnant. NCBI

Having said that, a miscarriage is possible once fertilization and implantation have occurred. This usually happens around the time your next period is due (about 4–5 weeks pregnant from your last period) when pregnancy tests first become positive. Many very early losses at this stage are sometimes called “chemical pregnancies”. NCBI+1

Simply put:

• If you’ve just missed your period, you are four weeks pregnant (Here are signs of miscarriage at four weeks);

• If you’ve missed your period by a week, it means you are five weeks pregnant (Here are signs of miscarriage at five weeks);

• Also, if your period is two weeks late, you are six weeks pregnant (Here are signs of miscarriage at six weeks).

Nevertheless, if you are worried about miscarriage signs in early pregnancy, here’s what to expect.

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1. Vaginal bleeding

Whether you are 4, 5 or 6 weeks pregnant, you should be concerned if you are spotting during pregnancy. This is because it could be due to a miscarriage.

In fact, bleeding from the vagina is a frequent complaint in women that have miscarriage. Sometimes, bleeding may be heavy with severe cramps and blood clots. Mayo Clinic+1

A light spotting generally may not indicate a miscarriage, but you still need to see your doctor to know if you are at risk of a miscarriage.

Remember that during pregnancy, vaginal spotting is common especially after sexual activity. This occurs because of increased blood flow and hormone effects on your vagina and cervix.

Vaginal bleeding after a miscarriage can pose a risk to your health if it is heavy or prolonged, because you may become anemic or develop an infection. Also, if you are Rhesus (Rh) negative and the pregnancy is Rh positive, your doctor may recommend an injection of anti-D after miscarriage or heavy bleeding to protect future pregnancies. ACOG+1

Women that are Rhesus negative can become sensitized if fetal blood mixes with theirs and they do not get anti-D injection. This can lead to antibodies that fight and attack the red blood cells of a future Rh-positive baby, causing serious problems like anemia or stillbirth.

What to do?

If you are spotting while pregnant, it may not be due to a miscarriage. It could be due to trauma after sex, or even vaginal infections. Don’t hesitate to see your doctor for evaluation, especially if the bleeding is heavy, painful, associated with dizziness or you have a history of ectopic pregnancy. Mayo Clinic Health System+1

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2. Abdominal cramps and back pain

Another common sign of a miscarriage is back pain and lower abdominal cramps. Cramps may be severe or mild and happen because of uterine contraction to expel your baby.

The truth is, abdominal cramps can occur in your first trimester, and most times, it’s nothing serious. Having said that, if you are bleeding heavily with blood clots or fetal parts coming out, see a doctor or go straight to the emergency room. WebMD

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3. An open cervix during your doctor’s check-up

One quick way your doctor can tell if you are having a miscarriage is through vaginal examination. If you are bleeding from vagina, an open cervix means your baby is likely to be washed out from your womb. Cleveland Clinic

It’s also possible that you may have a closed cervix after spotting. At this point, your doctor will usually check you with ultrasound and blood tests. Strict bed rest has not been proven to prevent a miscarriage, but avoiding heavy lifting and listening to your body is reasonable. ACOG+1

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What causes a miscarriage to occur?

It’s difficult to tell the exact reasons you will have a miscarriage, though genetic abnormality is the most common reason women get a miscarriage in the first 3 months of pregnancy. ACOG+1

Other causes are an advanced age of pregnant women (the highest risk if you are more than 40 years), smoking mothers, excessive alcohol intake, diabetes mellitus (especially if poorly controlled), hypertension, obesity, abnormal shape of uterus, vaginal infections, blood clotting problems and endocrine disorders such as thyroid problems or uncontrolled PCOS. RCOG+2nhsinform.scot+2

Most of the time nothing you did caused the miscarriage. If you have had two or more miscarriages, or one late miscarriage, talk to your doctor or a specialist clinic for further tests and counselling before your next pregnancy. RCOG+1