Pregnancy Loss: Terms to Know

A note about medical terms: In medical language, “abortion” means the ending of a pregnancy by death and does not indicate the means. It may be difficult to hear that term used regarding a miscarriage, so this site will typically avoid its use and instead use the terms defined below.

 

Pregnancy Dating

Conceptional Age: The length of time since conception.

Gestational Age: The typical term used to date a pregnancy, dating back to the first day of the mother’s last menstrual period, therefore including time (around two weeks) where the baby had not yet been conceived. For example, at six weeks gestation, the baby’s conceptional age is four weeks.

 

Types of Pregnancy Loss

Chemical Pregnancy or Early Pregnancy Loss: a miscarriage that occurs before five or six weeks gestation, when the baby was so small that there would have been no gestational sac seen on an ultrasound.

Blighted Ovum or Empty Sac: Conception occurs, but after implantation, the baby does not grow. The gestational sac develops and is able to be seen on ultrasound, but there is no sign of a baby inside the sac. This will only occur very early in pregnancy. Many times women are scheduled for additional ultrasounds because it is possible that the pregnancy is not as far along as thought and thus the baby is not yet visible on ultrasound. Often women are told that there “was never a baby.” This is not true; conception did occur and for some reason the baby just died early on, similar to a “Chemical Pregnancy” above.

Spontaneous Miscarriage (Spontaneous Abortion): A miscarriage that happens on its own, without medical intervention. This may result in a Complete Miscarriage (Complete Abortion) or an Incomplete Miscarriage (Incomplete Abortion). In the former, everything in the uterus is expelled, including placenta. In the latter the uterus is not fully emptied and usually medical intervention is necessary. Some data suggests that in pregnancies over 12 weeks the placenta is more likely to be retained. It is necessary to completely empty the uterus to avoid hemorrhage and infection. An incomplete miscarriage that results in infection is called a Septic Abortion. There is a risk that this can progress to a life-threatening condition called septicemia (“all over” infection).

Missed Miscarriage (Missed Abortion): The baby has died (or only a sac is seen) but the actual miscarriage has not yet begun. Many miscarriages are actually “missed” at some point, but the miscarriage process begins before this is detected. Waiting for miscarriage to begin on its own is considered a natural miscarriage (to be discussed more below).

Threatened Miscarriage: There are signs that a miscarriage may be in progress or may take place, but it is not certain. Some pregnancies progress normally after this diagnosis and some end in miscarriage. Sometimes (depending on gestation) women are put on bed rest at this point.

Ectopic Pregnancy (Tubal Pregnancy): The baby has implanted outside of the uterus, usually in one of the fallopian tubes. The fallopian tube is very small and not capable of distention past about 8 weeks (though there are always exceptions) with most ectopic pregnancies being detected by 6 weeks. Ectopic pregnancies are considered completely non-viable pregnancies, the continuing of which will endanger the life of the mother. If the tube ruptures, apart from severe pain, the woman may have heavy bleeding to the point of going into shock. More information on ectopic pregnancies, including the Church’s thoughts on their treatment, can be found in the medical and surgical sections below.

Molar Pregnancy: A sperm fertilizes an egg with no genetic material, causing growth of tissue that will create a pregnant-like state in your body. There is no baby present, but the loss of the thought of a baby is still not much different than a “normal” miscarriage. On ultrasound, the tissue often looks like a “cluster of grapes.” You will often be advised to have the tissue removed via vaccuum aspiration (see “Surgical Management: D&C” below). This type of pregnancy can lead to trophoblastic disease, which can inhibit the growth of a new fetus and possibly (but rarely) lead to uterine cancer. Because of this, you are often recommended to avoid getting pregnant again for six months to one year, depending on your doctor. You can also expect to have your blood drawn regularly to be sure that your HCG goes back to normal (zero), which could take several months, much longer than after a non-molar pregnancy.

Partial Molar Pregnancy: Two sperm fertilize one egg. The placenta becomes the molar growth and the baby has severe defects which will typically not allow it to survive past the first trimester. The management of the pregnancy and the subsequent monitoring are the same as for a molar pregnancy, above.

Stillbirth: The delivery of an infant who died either in utero or during the process of birth. In Australia this is defined as 20 weeks gestation and beyond. In the UK, this is defined as 24 weeks and beyond. WHO defines this as 24 weeks and beyond. In the US, there doesn’t seem to be an “official” definition, but it is commonly assumed to be 20 weeks and beyond.