A miscarriage is a loss of pregnancy that occurs under 20 weeks of pregnancy. Though rare, people can be diagnosed with a false miscarriage. A false miscarriage is when a suspected pregnancy loss has happened—but a person is still pregnant.
The diagnosis can result from inaccurate conception predictions and ultrasound technology issues. Read on to learn more about how someone may be diagnosed with a false miscarriage.
:max_bytes(150000):strip_icc()/Health-GettyImages-1387710368-004e29648f904b509b293bdcf197625f.jpg "False Miscarriage: How It May Be Misdiagnosed While a Person is Still Pregnant (1)")
You may receive a diagnosis of a false miscarriage based on information about your conception date and problems with an ultrasound machine.
Incorrectly Predicting Conception Date
Conception can be much later than an individual and a healthcare provider anticipated. "It's a pretty rare event," Charles Lockwood, MD, executive vice president of the University of South Florida Health and USF Health Dean, USF Health Morsani College of Medicine, told Health, "but we do see it happen. Sperm can remain active and viable in a woman's reproductive tract for up to six days."
Dr. Lockwood said this occurs most often with in vitro fertilization (IVF) or other forms of assisted reproductive technology. For example, there may be a few days between conception and when an embryo has been implanted.
"Even when we think we know with incredible precision when the date of conception is, we can be three or four days off. Delays in ovulation and/or an embryo's implantation can occur. I have seen twins that are both growing at a perfectly normal rate, but one of them has been nearly a week off," explained Dr. Lockwood.
A fertilized egg can take several days to implant and begin growing in a uterus, leading to initial tests and ultrasound results that seem to indicate an embryo that is slow to develop and therefore likely to be miscarried. However, the embryo is simply behind schedule due to its later-than-expected implantation.
Issues With Technology
Sometimes, an ultrasound may show what looks like a blighted ovum when it's not. A blighted ovum is when a fertilized egg implants in the uterus, and the gestational sac begins to grow. However, there is no embryo within the sac.
"This is a new conundrum people face," Paul Blumenthal, MD, the director of family planning services and research at the Stanford University School of Medicine, told Health. "We don't want people to get upset by the [ultrasound] technology because, when we're looking at early pregnancy, we can't be sure which side of the coin we're coming down on—a pregnancy or a missed abortion. That's why we've got to wait a few days and test again."
In the future, it may be possible to measure hCG levels more precisely with at-home urine tests, said Dr. Blumenthal. An individual unsure of their diagnosis might be able to test daily and watch if hCG levels are rising or falling.
Why Bleeding Occurs During Pregnancy
One of the symptoms of a miscarriage is vagin*l bleeding. However, spotting—bleeding in small amounts now and then—is normal early in a pregnancy. Bleeding can also occur for other reasons during pregnancy, such as:
- Cervical trauma from a recent pelvic exam
- Early labor
- Ectopic pregnancy
- Hormonal changes
- Implantation of a fertilized egg
- Infection
- Partial or whole covering of the cervix by the placenta
- Sexual intercourse
There's limited specific research on false miscarriages, but it's suggested that it's a rare diagnosis. What's more apparent is the occurrence of a miscarriage.
"The vast majority of times that we see blood pregnancy hormone (hCG) levels rising slowly, or a sac in the uterus that isn't doubling in size appropriately, it turns out to be a miscarriage," said Dr. Lockwood. "It doesn't end happily."
While there aren't exact numbers, early pregnancy loss occurs in approximately 10% of known pregnancies. Additionally, if a gestational sac was empty at an initial ultrasound and then was empty on a repeat scan at least seven days later, this was associated with losing the pregnancy.
When To Seek Medical Care
Even though bleeding is common and may not have a serious underlying cause, there are more serious bleeding causes. These causes include miscarriages, ectopic pregnancies, molar pregnancies—when an implanted, fertilized egg doesn't come to term—and blood clots. If you have any of the following symptoms, you should see a healthcare provider right away:
- Bleeding with or without pain or cramping
- Dizziness and bleeding
- Heavy bleeding
- Labor pains
- Pain in your stomach or pelvis
Although uncommon, a miscarriage can be misdiagnosed. This can occur if the conception date is earlier than predicted or if there are some difficulties with the ultrasound technology.
It's normal to experience light bleeding in early pregnancy. Spotting can mean that the egg is implanting into the uterus or your hormone levels are fluctuating.
Bleeding can, however, be a sign of a miscarriage. If you are experiencing heavy bleeding, pain, dizziness, or cramping, contact a healthcare provider.
