Common signs of a missed miscarriage

Some people continue to feel pregnant because hormone levels do not fall immediately. Others notice breast tenderness or nausea easing, brown discharge, light bleeding or mild cramps. These changes can also occur in an ongoing pregnancy, so symptoms alone cannot establish that a miscarriage has happened.

The term missed miscarriage means that development has stopped but pregnancy tissue remains in the womb. Because the tissue has not begun to pass, the bleeding and stronger cramps associated with other miscarriages may not occur. The finding is sometimes made during a routine scan rather than after a noticeable physical change.

A clinician interprets ultrasound in the context of pregnancy dates and earlier results. If dates are uncertain or the scan is very early, a repeat scan may be needed before a firm diagnosis is made. A change in nausea, tiredness or breast tenderness is not diagnostic on its own.

Contact your maternity team or clinician if pregnancy symptoms change and you are worried, or if you develop spotting, bleeding or cramps. Describe the amount and colour of any bleeding, where pain is felt, and whether symptoms are worsening. If a missed miscarriage is confirmed, the team can explain expectant care, medicine and a procedure, including what recovery and follow-up may involve.

Seek emergency assessment for very heavy bleeding, severe or one-sided abdominal pain, shoulder-tip pain, fainting, marked dizziness, collapse or difficulty breathing. Fever, chills, worsening pelvic pain or foul-smelling discharge also need prompt medical review because they may signal infection. These red flags determine urgency regardless of the cause.

You might ask what the ultrasound showed, whether the dates could explain the findings, and whether confirmation requires another scan. If the diagnosis is certain, ask about each management choice, expected bleeding and pain, suitable pain relief, signs of infection and the plan for confirming that care is complete.