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2698 pages added, reviewed or updated during the last month (last updated: 12/4/2021)


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assessment of miscarriage

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This information relates to a single episode of miscarriage - not assessment of recurrent miscarriage.

History:

  • period of amenorrhoea - last menstrual period; regularity of cycle; any other episodes of vaginal bleeding
  • amount of bleeding - is less or more than a normal period - heavy bleeding is suggestive of an incomplete miscarriage; a minimal brown loss may be the result of a missed miscarriage
  • degree of pain - a threatened miscarriage usually presents with minimal pain
  • onset of pain and bleeding - if the pain started before the bleeding then this is suggestive of an ectopic pregnancy
  • were any products passed? - this question is difficult to answer because organized clot may be mistaken by the patient for passed products
  • shoulder tip pain? suggestive of diaphragmatic irritation and possible ectopic

Examination:

  • cardiovascular status - evidence of shock?
  • abdominal examination - tenderness should not usually be unilateral; rebound tenderness may occur with an ectopic pregnancy
  • examination with speculum and by vaginal examination
    • cervical examination - open or closed; any cervical excitation; any products visible
    • uterine size
    • HVS taken if appropriate

Investigation:

  • pregnancy test
  • ultrasound scan
  • FBC, Group and Save (cross match if clinical indication)

Last reviewed 04/2019

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