Women's Health

Miscarriage

Miscarriage is the spontaneous loss of a pregnancy before 24 weeks; this chapter focuses on early pregnancy loss, where ultrasound, clinical stability and the amount of tissue passed determine diagnosis, urgency and management.

Definition

Miscarriage is the spontaneous loss of a pregnancy before 24 weeks' gestation. NICE NG126 focuses on complications and care in early pregnancy, up to 13 completed weeks.

First principles

Confirm the diagnosis safely before treating

Bleeding and pain do not by themselves prove miscarriage. First establish clinical stability, consider ectopic pregnancy, and use appropriately performed transvaginal ultrasound to assess pregnancy location and viability. A pregnancy of unknown location needs symptoms-led follow-up rather than a premature label of miscarriage.

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