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Tests and diagnosis
By Mayo Clinic staffYour doctor may do a variety of tests:
- Pelvic exam. Your doctor will check to see if your cervix has begun to dilate.
- Ultrasound. This helps your doctor check for a fetal heartbeat and determine if the embryo is developing normally.
- Blood tests. If you've miscarried, measurements of the pregnancy hormone, beta HCG, can be useful in determining if you've completely passed all placental tissue.
- Tissue tests. If you have passed tissue, it can be sent to the laboratory to confirm that a miscarriage has occurred — and that your symptoms aren't related to another cause of pregnancy bleeding.
Possible diagnoses include:
- Threatened miscarriage. If you're bleeding but your cervix hasn't begun to dilate, you're having a threatened miscarriage. Such pregnancies often proceed without any further problems.
- Inevitable miscarriage. If you're bleeding, your uterus is contracting and your cervix is dilated, a miscarriage is inevitable.
- Incomplete miscarriage. If you pass some of the fetal or placental material but some remains in your uterus, it's considered an incomplete miscarriage.
- 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 very severe infection and demands immediate care.
References
- Tulandi T, et al. Spontaneous abortion: Risk factors, etiology, clinical manifestations, and diagnostic evaluation. http://www.uptodate.com/home/index.html. Accessed Aug. 13, 2008.
- Tulandi T. Patient information: Miscarriage. http://www.uptodate.com/home/index.html. Accessed Aug. 13, 2008.
- Miscarriage. March of Dimes. http://www.marchofdimes.com/printableArticles/681_1192.asp?printable=true. Accessed Aug. 13, 2008.
- Early pregnancy loss: Miscarriage and molar pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp090.cfm. Accessed Aug. 14, 2008.
- Blighted ovum. American Pregnancy Association. http://www.americanpregnancy.org/pregnancycomplications/blightedovum.html. Accessed Aug. 14, 2008.
- Puscheck EE, et al. The impact of male factor on recurrent pregnancy loss. Current Opinions in Obstetrics and Gynecology. 2007;19(3):222-228.
- Tulandi T, et al. Spontaneous abortion: Management. http://www.uptodate.com/home/index.html. Accessed Aug. 13, 2008.
- Cytotec (prescribing information). New York, N.Y.: Pfizer; 2006.
- Cunningham, FG. First-trimester abortion. In: Schorge JO, et al. Williams Gynecology. 1st ed. New York, N.Y.: The McGraw Hill Companies; 2008. http://accessmedicine.com/resourceTOC.aspx?resourceID=514. Accessed Aug. 13, 2008.
- Misoprostol: Drugdex DrugPoint Summary. Micromedex Healthcare Series. http://www.micromedex.com/. Accessed Sept. 19, 2008.
- Sifakis S, et al. High-dose misoprostol used in outpatient management of first trimester spontaneous abortion, Archives of Gynecology and Obstetrics. 2005;272(3):183-186.
- Blum J, et al. Treatment of incomplete abortion and miscarriage with misoprostol. International Journal of Gynecology and Obstetrics. 2007;99(2)(suppl):S186-S189.
- Stephenson M, et al. Evaluation and management of recurrent early pregnancy loss. Clinical Obstetrics and Gynecology. 2007;50(1):132-45.
- Patient's fact sheet: Recurrent pregnancy loss. www.asrm.org/Patients/FactSheets/recurrent_preg_loss.pdf. Accessed Sept. 25, 2008.
