Threatened miscarriage

You may have heard of threatened miscarriage and wondered what it meant. People sometimes informally use ‘threatened miscarriage’ when you have bleeding and/or pain in early pregnancy but you have not miscarried. In some of these situations, you may be able to have treatment to help you avoid miscarriage and increase the chances of having a healthy pregnancy.  

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What is a ‘threatened miscarriage’?

What is the difference between a ‘threatened miscarriage’ and miscarriage?

What are the symptoms and signs of ‘threatened miscarriage’?

What are the causes of ‘threatened miscarriage’?

How is a ‘threatened miscarriage’ diagnosed?

How is a ‘threatened miscarriage’ treated?

How long does a ‘threatened miscarriage’ last?

Is there a way to prevent a ‘threatened miscarriage’ in future? 

What is a ‘threatened miscarriage’?

You may not hear health professionals use the phrase ‘threatened miscarriage’. But if you do hear people use it, they probably mean bleeding or pain in early pregnancy (the first 12 weeks, or the first trimester).

If you have bleeding in early pregnancy, with or without pain, you may be offered an ultrasound scan to check on your baby. This is because bleeding and pain can sometimes be a symptom of miscarriage.  

This can be very worrying but most women and birthing people who have bleeding in early pregnancy go on to have a healthy pregnancy.

If it is too early to find a heartbeat, you may be offered a further scan in 7 or 14 days.

If a heartbeat is found, you will only be offered more scans if you have more bleeding or pain.  

What is the difference between a ‘threatened miscarriage’ and miscarriage?

Threatened miscarriage is an unofficial term to describe miscarriage symptoms.

The chances of your pregnancy surviving a ‘threatened miscarriage’ (bleeding and pain in the first trimester) are good. You are still more likely to have a successful pregnancy after having these symptoms than not.

What are the symptoms and signs of ‘threatened miscarriage’?

Bleeding or pain in pregnancy can be the first sign of miscarriage but they are also common during the early stages of healthy pregnancies.

Read more about bleeding in pregnancy and symptoms of miscarriage.

What are the causes of ‘threatened miscarriage’?

If you have vaginal bleeding and stomach (abdominal) pain but go on to have a healthy pregnancy, you may never find out for sure what caused your symptoms.

These are some of the possible causes of bleeding in early pregnancy:

• A small blood clot called a sub chorionic haematoma. This is the most common cause of bleeding in the first trimester and it can also cause abdominal pain. It’s usually nothing to worry about but can cause complications later in pregnancy. 
• The cells that will make the placenta implanting into the lining of the womb, causing some blood vessels to bleed
• Changes or damage to the cervix. Even slight damage (such as during sex) can cause bleeding because during pregnancy the tissues become softer and have a richer blood supply
• A vaginal infection. Infections may cause bleeding.  In most cases you can take antibiotics which are safe in pregnancy to treat an infection

You can read more about the causes of miscarriage here.

How is a ‘threatened miscarriage’ diagnosed?

A threatened miscarriage is not something you are officially diagnosed with. If you have symptoms of bleeding or pain in early pregnancy, you will be referred for a scan. You may have to wait to have your scan if your pregnancy is earlier than 6 weeks, unless you are in pain.  

If you are very early on in your pregnancy, you may have an internal scan. This is known as a transvaginal scan and it involves having a slim probe gently inserted into your vagina. The scan should not cause pain and you will not need an anaesthetic. The scan will show an image of your baby and can be used to tell if you baby has a heartbeat.

If your baby is too small for a heartbeat to be found, you will have further scans after 7 or 14 days. 

If the pregnancy cannot be seen on the scan but you have a positive pregnancy test, this is called a pregnancy of unknown location (PUL). You will need blood tests and further scans to find out what is happening. 

Find out more about what happens if you’re worried you’re having a miscarriage.

How is a ‘threatened miscarriage’ treated?

If you are bleeding in early pregnancy (the first 16 weeks) and you have had 1 or more previous miscarriages, your EPAU or your GP should offer you progesterone. You will need to have a scan first to make sure your pregnancy is not ectopic.

Progesterone is a hormone that helps maintain a pregnancy in the early stages. It has been shown to help reduce the risk of another miscarriage where there is bleeding in early pregnancy.

You make progesterone naturally yourself, but progesterone supplements will help boost your levels. Read more about taking progesterone in early pregnancy.  

Doctors once advised bed rest for management of pain and bleeding in pregnancy, but there’s no evidence it helps to stop miscarriage. 

Your GP or midwife may recommend taking it easy for a while and not doing intense activity.  

To be on the safe side, avoid sex for however long the bleeding lasts. Only use period pads or pants too. This will help prevent any infection.

How long does a ‘threatened miscarriage’ last?

How long bleeding and pain in pregnancy lasts depends on what is causing your symptoms. It will differ from person to person.

If you have more bleeding, or the bleeding doesn’t stop, speak to your midwife, GP or Early Pregnancy Unit for advice.

Is there a way to prevent a ‘threatened miscarriage’ in future?

There’s no one piece of advice to prevent pain and bleeding again. It depends on the cause of your symptoms, which may not be related to miscarriage. If you’re worried about miscarriage in future pregnancies, there are lifestyle changes you can make that may help. 

Changes like stopping smoking, eating healthily, being a healthy weight, staying active and quitting drinking can help improve your chances of having a healthy pregnancy. Read more about reducing your risk of miscarriage.

You can also talk to a Tommy’s midwife for free. You can call them on 0800 0147 800, 9am-5pm, Monday-Friday. Or you can email them at [email protected].  Our midwives are specialists who can support you with any aspect of pregnancy and pregnancy loss that would be helpful for you.