Signs of miscarriage before knowing you are pregnant

Some people notice cramping, bleeding or clots; others notice little beyond a period that arrived later than expected.

Bleeding may be lighter or heavier than your usual period and can be accompanied by lower abdominal cramps or passing tissue. Those features can also occur with a period or another gynaecological problem, so they do not prove miscarriage.

A pregnancy test may remain positive for a while after a loss. A clinician can use your symptoms, examination, pregnancy hormone testing and a transvaginal ultrasound to work out whether a pregnancy was present and whether any tissue remains.

If pregnancy is possible, take a home test and contact a healthcare professional, particularly if the bleeding is unusual for you. Note dates, flow, clots, pain, fever and any dizziness. Avoid placing anything in the vagina until you have received advice if you are bleeding or in pain.

Go to urgent care for severe or one-sided pain, shoulder-tip pain, fainting, marked dizziness, fever, or bleeding that is rapidly becoming heavy. These symptoms can occur with ectopic pregnancy or significant blood loss and need prompt assessment, whether or not you knew you were pregnant.

Ask whether you need a pregnancy test, blood tests or a transvaginal ultrasound, and how to recognise an ectopic pregnancy. If a loss is confirmed, ask whether expectant, medical or surgical management is appropriate and when to arrange follow-up.