• Vaginal bleeding during the first 20 weeks of pregnancy (last menstrual period was less than 20 weeks ago)
• Abdominal cramps may or may not accompany vaginal bleeding

Note: With true miscarriage, low back pain or abdominal pain (dull to sharp, constant to intermittent) typically occurs and tissue or clot-like material may pass from the vagina.

Pelvic examination reveals a cervix that is neither thinned (effaced) nor open (dilated). The presence of effacement and/or dilation is consistent with impending miscarriage.

• A serum HCG may be performed to confirm that a pregnancy exists.
• Beta HCG (quantitative) test may be repeated over a period of days or weeks to confirm either continued pregnancy or fetal death.
• A CBC may be obtained to determine the degree of blood loss.
• A WBC with differential may be obtained to rule out infection.
• A pregnancy ultrasound is used to detect fetal heartbeat.

This disease may also alter the results of the following tests:

• Serum progesterone
• Beta HCG (quantitative)