If you see your GP or midwife because of vaginal bleeding or other symptoms of miscarriage, you may be referred to an early pregnancy unit at a hospital for tests.
Tests
The hospital can do tests to confirm whether your pregnancy has ended and you have had a miscarriage. The tests can also confirm whether:
- There is still some foetal tissue left in your womb (an incomplete miscarriage).
- All the foetal tissue has been passed out of your womb (a complete miscarriage).
The tests include:
- blood tests to measure hormones associated with pregnancy, such as beta-human chorionic gonadotropin (hCG) and progesterone
- a transvaginal (through the vagina) ultrasound scan: a small probe, known as a transducer, is inserted into your vagina to take a close-up image of your womb; the procedure can feel a little uncomfortable but is not painful
- a pelvic examination
Recurrent miscarriages
If you have had three or more miscarriages in a row (recurrent miscarriages), further tests can check if there is an underlying cause. However, in around half of couples no cause is found. These further tests are outlined below. Some of these can only be used if you become pregnant again.
Karyotyping
If you have had recurrent miscarriages, you and your partner can be tested for abnormalities in your chromosomes (blocks of DNA) that could be causing the problem. This is known as karyotyping.
If karyotyping detects problems with your or your partner’s chromosomes, you can be referred to a clinical geneticist (gene expert). They will be able to explain your chances of a successful pregnancy in the future and whether there are any fertility treatments, such as in vitro fertilisation (IVF), that you could try. This type of advice is known as genetic counselling.
Read more about genetic testing and counselling.
Ultrasound scans
A pelvic ultrasound can be used to check the structure of your womb for any abnormalities. The procedure involves using an ultrasound scanner to study your lower abdomen and pelvis.
A transvaginal ultrasound can check if you have a weakened cervix. This test can usually only be carried out if you become pregnant again.
Blood testing
Your blood can be checked for high levels of:
- the hormone prolactin
- the antiphospholipid (aPL) antibody
Prolactin testing can only happen if you become pregnant again.
