Understanding Miscarriage: Diagnosis and Treatment

No two miscarriages are alike. Your healthcare provider will talk with you about the treatment that is most suited for you. If you’re in good health and it's early in the pregnancy, your body may expel all the pregnancy tissue on its own. If this doesn't happen, your healthcare provider may advise treatment to remove the tissue. This is done to prevent infection and severe bleeding (hemorrhaging).

What happens during miscarriage

Some miscarriages happen without any signs or symptoms. But most miscarriages start with bleeding and cramping. This may increase over time. The cramps may get very strong. This is normal when a miscarriage is happening. Cramping widens the passage (cervix) at the bottom of your uterus. This is where tissue from the uterus must pass through to leave your body. Your healthcare provider may ask you for a sample of the tissue for lab testing. This is to make sure that the cells being shed from your body are normal.

Diagnosis

To confirm the miscarriage, your healthcare provider will give you a pelvic exam. You may have a blood test to measure the levels of a pregnancy hormone called HCG. You may have an ultrasound test. This is done to find out if all the tissue has passed from the uterus. If a miscarriage happens very early in the pregnancy, an ultrasound is not needed.

Treatment

If any tissue is still in the uterus, your healthcare provider may advise treatment such as:

• Medicine. This is prescribed for you to take at home. The medicine causes the uterus to expel any remaining tissue. Take the medicine exactly as directed.

• Dilation and curettage (D & C). This is a procedure done in your healthcare provider’s office or at the hospital. You are given medicine to prevent pain and allow you to relax or sleep during the procedure. The healthcare provider uses tools to widen the cervix (dilation). Tissue and blood that line the uterus are then removed (curettage).

Talk with your healthcare provider about the risks and benefits of these treatments.

If you have Rh-negative blood

If your blood is Rh-negative, you may need treatment with Rho(D) immune globulin. This is done as an injection. It prevents substances in your blood from attacking the baby’s blood in a future pregnancy. Your healthcare provider can tell you more.

Follow-up care

Keep all follow-up appointments. These are to make sure that you are healing well. During these visits, mention if you’re feeling very sad or depressed. Your healthcare provider can suggest counseling or other resources to help you.

When to get medical care

Contact your healthcare provider if you have any of these:

• Severe pain in your stomach, pelvis, or low back

• Vaginal fluid that has a bad odor

• Bleeding that soaks a new sanitary pad each hour

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider