If miscarriage is suspected or has occurred, your doctor will do a pelvic examination to check the size of your uterus and determine whether your cervix is open or closed.
Miscarriages are more common than you can realise. A miscarriage can be defined as the loss of a pregnancy during the first 23 weeks.
If you are pregnant and consult your doctor with vaginal bleeding or any symptom suggestive of miscarriage, he or she will take a history, examine you and recommend tests to confirm if you have had a miscarriage.
History and examination
The doctor may ask questions such as how many weeks pregnant are you, when you last menstruated, if you have been pregnant before or many children you, if you have had any miscarriages, ectopic (tubal) pregnancy, or abortions, if you were using any sort of birth control measure before pregnancy and if you have any medical problems or are on any medication?
Pelvic exam
During pelvic exam, the doctor will insert a speculum (a metal or plastic device) in your vagina to open and spread the walls of your vagina so that the cervix (the mouth of your womb) is seen. It may show lot of blood or clots coming from the cervix or the cervix may be open (dilated) or thinned out (effaced).
Tests
The doctor may recommend certain tests to determine whether you have had a miscarriage and the pregnancy has ended. These tests will certainly help and check if some foetal tissue is left in the uterus (an incomplete miscarriage) or all the foetal tissue has been expelled from the uterus (a complete miscarriage).
Hormonal level - Blood tests to measure level of the pregnancy hormone called human chorionic gonadotropin or hCG. If the level is too low it may suggest that the pregnancy is abnormal and a very high number (over 100,000) will indicate a normal living pregnancy. If the test is not conclusive then the doctor may recommend repeat test after a few days to see if everything is developing normally.
Ultrasound scan - The test can identify if there evidence of a pregnancy within the uterus. A transvaginal (through the vagina) ultrasound scan is a painless test (although it is a little uncomfortable) can show a close-up image of your womb and the foetus.
Blood tests - Some other blood tests which may be performed - blood type (pregnant women with an Rh-negative blood type, may need treatment with Rh-immune globulin), complete blood count (CBC) to determine if you have lost significant amount of blood.
In women with recurrent miscarriage (three or more miscarriages in a row) the doctor may recommend other tests to determine the underlying cause. Your doctor can guide you on the tests that may be needed.
Read more articles on Miscarriage.
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