What a Miscarriage Looks Like

Pregnancy Loss or Heavy Period?

A woman's periods can differ from cycle to cycle for all sorts of reasons, from stress or an illness (like the flu) to a chronic medical condition, a change in diet, extreme weight loss or weight gain, or fluctuations in hormones. Any of these can result in a flow that's heavier or lighter than usual, that lasts longer or for a shorter amount of time, and so forth.

An exceptionally heavy period sometimes can mean a miscarriage. If this happens to you and you've recently tested positive on a pregnancy test, then it's highly probable that the pregnancy wasn't viable, meaning not healthy enough to continue, and Mother Nature is taking its course. Most miscarriages are one-time events that occur because of random chromosome abnormalities in the baby.

But what if you experience a really heavy period without having taken a pregnancy test? Is there any way to tell if the bleeding is actually a miscarriage rather than a regular period?

What a Miscarriage Looks Like

The tissue from an early miscarriage may not be obvious to the naked eye. Many early miscarriages simply look like heavy menstrual periods, with maybe a few tiny blood clots in the discharge. If the miscarriage happens beyond four or five weeks gestational age (which is determined based on the first day of a woman's last menstrual period and therefore includes about two weeks during which she wasn't pregnant), it is possible that there may be a small, transparent gestational sac with the rudimentary beginnings of a placenta on its edge.

In a miscarriage that happens beyond six weeks, the flow may contain an identifiable embryo or fetus in the early stages of development. Depending on the point at which the pregnancy stopped developing, this could range in size from as small as a pea to as big or bigger than an orange. But sometimes in a later first-trimester miscarriage, there may not be recognizable tissue if the pregnancy began to deteriorate before the onset of the miscarriage bleeding.

If You Aren't Sure You Are or Were Pregnant

If you've been using birth control and have a heavy flow, it's unlikely but not impossible that your period is, in fact, a miscarriage. No contraceptive is 100 percent effective, after all.

At the same time, a change in a hormonal therapy, such as a birth control pill, sometimes brings about noticeable changes in menstrual flow. Some women, in fact, have a rare reaction to a new contraceptive and their bodies expel a decidual cast—a piece of tissue that is the shape and size of the uterine cavity. Decidual casts also can occur in women with ectopic pregnancies.

A heavy flow sometimes signals a condition such as fibroids and hypothyroidism.

What to Do If You Think You're Having a Miscarriage

Call your doctor to find out if you might need to be seen or even treated. Even over the phone he should be able to make an educated guess as to the cause of the bleeding. If you're worried and can't get in touch with your doctor, go to the emergency room or urgent care.

You may be asked for a sample of the tissue that was expelled in your menstrual blood. If you have a history of miscarriages, your doctor may be able to test for chromosome abnormalities that might explain what happened.

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