My friend says she had no signs before her miscarriage and that the diagnosis caught her off-guard. I'm six weeks pregnant myself and was curious about that. Is it really possible for people to have a miscarriage with no bleeding or other symptoms?
Unfortunately, yes -- it is possible to have a miscarriage with no bleeding or cramping before the diagnosis. In fact, I wouldn't be surprised if this is becoming more common as medical practitioners run earlier routine ultrasounds.
When a miscarriage is diagnosed without bleeding, a situation called "missed miscarriage" or "blighted ovum," the reason usually is that the body hasn't yet recognized that the pregnancy has miscarried. Miscarriages rarely begin the instant the baby has passed away, but rather the hormone levels first have to drop before the mother's body will recognize the pregnancy as no longer viable and begin the process of shedding the uterine lining. This can take a few days or weeks, which is why ultrasounds performed after early pregnancy bleeding will often show that the baby passed one to two weeks before the actual onset of the bleeding. But if an ultrasound is performed for some other reason, such as a routine check for a heartbeat, it is possible for the ultrasound to detect that the baby has miscarried before the mother has begun to have any miscarriage symptoms and she may even still feel pregnant.
In most cases, the miscarriage bleeding would start on its own within two weeks following the diagnosis. But given the uncertainty of the time range and the emotional aspects of carrying a nonviable pregnancy, many moms opt for a D&C or medically induced miscarriage once the diagnosis has been confirmed, preferring to get the physical aspect of the miscarriage over with as quickly as possible.
The possibility of a missed miscarriage is scary to any pregnant woman, and I can't tell you not to worry about it because it does happen (and I know how it is easy to start worrying when you are pregnant). But I think it is important to remember that the majority of pregnancies continue without these complications. Sadly miscarriage is just something that happens sometimes, and there isn't anything anyone can do to affect the outcome, especially in the first trimester. If you are feeling anxious about your own pregnancy, you can ask your doctor about having hCG blood tests or an early ultrasound done to confirm that the baby is growing as expected.
Miscarriage. March of Dimes. Accessed: Aug 11, 2009. http://www.marchofdimes.com/printableArticles/14332_1192.asp