Diagnosis

Your health care provider might do a variety of tests:

  • Pelvic exam. Your health care provider might check to see if your cervix has begun to dilate.
  • Ultrasound. During an ultrasound, your health care provider will check for a fetal heartbeat and determine if the embryo is developing normally. If a diagnosis can't be made, you might need to have another ultrasound in about a week.
  • Blood tests. Your health care provider might check the level of the pregnancy hormone, human chorionic gonadotropin (HCG), in your blood and compare it to previous measurements. If the pattern of changes in your HCG level is abnormal, it could indicate a problem. Your health care provider might check to see if you're anemic — which could happen if you've experienced significant bleeding — and may also check your blood type.
  • Tissue tests. If you have passed tissue, it can be sent to a lab to confirm that a miscarriage has occurred — and that your symptoms aren't related to another cause.
  • Chromosomal tests. If you've had two or more previous miscarriages, your health care provider may order blood tests for both you and your partner to determine if your chromosomes are a factor.

Possible diagnoses include:

  • Threatened miscarriage. If you're bleeding but your cervix hasn't begun to dilate, there is a threat of miscarriage. Such pregnancies often proceed without any further problems.
  • Inevitable miscarriage. If you're bleeding, cramping and your cervix is dilated, a miscarriage is considered inevitable.
  • Incomplete miscarriage. If you pass fetal or placental material but some remains in your uterus, it's considered an incomplete miscarriage.
  • Missed miscarriage. In a missed miscarriage, the placental and embryonic tissues remain in the uterus, but the embryo has died or was never formed.
  • Complete miscarriage. If you have passed all the pregnancy tissues, it's considered a complete miscarriage. This is common for miscarriages occurring before 12 weeks.
  • Septic miscarriage. If you develop an infection in your uterus, it's known as a septic miscarriage. This can be a severe infection and demands immediate care.
July 20, 2016
References
  1. Tulandi T, et al. Spontaneous abortion: Risk factors, etiology, clinical manifestations, and diagnostic evaluation. http://www.uptodate.com/home. Accessed May 15, 2016.
  2. Strand EA. Increasing the management options for early pregnancy loss: The economics of miscarriage. American Journal of Obstetrics and Gynecology. 2015;212:125.
  3. Robinson GA. Pregnancy loss. Best Practice & Research: Clinical Obstetrics & Gynaecology, 2014;28:169.
  4. Ferri FF. Spontaneous miscarriage. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. http://www.clinicalkey.com. Accessed May 15, 2016.
  5. Rink BD, et al. Recurrent pregnancy loss. In: Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed May 15, 2016.
  6. Ectopic pregnancy and miscarriage. National Institute for Health and Care Excellence (NICE). https://www.clinicalkey.com/#!/content/nice_guidelines/65-s2.0-QS69. Accessed May 15, 2016.
  7. Marx JA, et al., eds. Acute complications of pregnancy. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed May 15, 2016.
  8. Tulandi T, et al. Definition and etiology of recurrent pregnancy loss. http://www.uptodate.com/home. Accessed May 15, 2016.
  9. Tulandi T, et al. Evaluation of couples with recurrent pregnancy loss. http://www.uptodate.com/home. Accessed May 15, 2016.
  10. Septic abortion. Merck Manual Professional Version. http://www.merckmanuals.com/professional/gynecology-and-obstetrics/abnormalities-of-pregnancy/septic-abortion. Accessed May 15, 2016.
  11. Tulandi T, et al. Spontaneous abortion: Management. http://www.uptodate.com/home. Accessed May 15, 2016.
  12. Pregnancy loss. American Family Physician. 2012;85:905.
  13. What is recurrent pregnancy loss (RPL)? American Society for Reproductive Medicine. https://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/recurrent_preg_loss.pdf. Accessed May 15, 2016.
  14. Huffman CS, et al. Couples and miscarriage: The influence of gender and reproductive factors on the impact of miscarriage. Women's Health Issues, 2015;25:570.
  15. Para A, et al. Exercise and pregnancy loss. American Family Physician. 2015;91:437. https://www.clinicalkey.com. Accessed May 15, 2016.
  16. Moscrop A. Can sex during pregnancy cause a miscarriage? A concise history of not knowing. British Journal of General Practice. 2012;62:e308. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310038/. Accessed May 15, 2016.
  17. Risk factors for miscarriage from a prevention perspective: A nationwide follow-up study. BJOG: An international journal of obstetrics and gynaecology. 2014;121:1375. https://www.clinicalkey.com/#!/content/medline/2-s2.0-24548778. Accessed May 15, 2016.
  18. Louis GMB, et al. Lifestyle and pregnancy loss in a cohort of women recruited before conception: The LIFE study. Fertility and Sterility. In press. Accessed May 15, 2016.
  19. Early pregnancy loss. American College of Obstetricians and Gynecologists. http://www.acog.org/-/media/For-Patients/faq090.pdf. Accessed May 15, 2016.
  20. ACOG Practice Bulletin Number 150: Early pregnancy loss. May 2015. American College of Obstetricians and Gynecologists. Obstetetrics and Gynecology. 2015;125:1258.
  21. Wick, MJ (expert opinion). Mayo Clinic, Rochester, Minn. June 5, 2016.