Heartbeat and no heartbeat

Patient: I found out I was pregnant at 4 weeks. I went in for an ultrasound at 6 weeks and 1 day. They baby was healthy and the heartbeat was 111. At 8 weeks and 2 days I woke up bleeding so my husband and I went to the ER. They did an ultrasound and there was no heartbeat. How does the baby have a heartbeat one week but not 2 weeks later? Also, The baby came out yesterday and my bleeding has completely stopped. Is that normal?

Doctor: A miscarriage is the natural death of an embryo or fetus in the womb. It takes place in the early stages of prenatal de velopment and is often manifested as sudden onset painless/painful bleeding in the first trimester.What you are experiencing is a complete miscarrriage in which the non-viable (dead) fetus is expelled out completely. It is estimated about half of early miscarriages will be fully expelled naturally without any need for medical intervention. After the expulsion of the fetal tissues, the bleeding completely stops on its own and usually there is no need for any procedures such a dilatation and curettage ( cleaning of the womb done in cases of an incomplete expulsion).I can understand how distressing the incident must have been to you. It is best not to bottle up feelings but to discuss them as fully as possible with husbands or partners, friends, with a doctor or midwife, or with someone who can listen and understand. Once you feel emotionally and physically equipped have an honest discussion with your doctor or midwife regarding the causes and recurrence risks of the miscarriage. Getting the right information will help you heal better and if any correctable risk factors are identified by your doctor, you will benefit in preventing an adverse outcome in your next pregnancy.