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This information relates to a single episode of miscarriage - not assessment of recurrent miscarriage.
- 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
- 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
- pregnancy test
- ultrasound scan
- FBC, Group and Save (cross match if clinical indication)
Last reviewed 04/2019