What should you know about twin miscarriage symptoms?

Bleeding and cramps can occur with miscarriage, but they can also happen in an ongoing pregnancy. In a twin pregnancy, one pregnancy may stop developing while the other continues, and the amount of bleeding does not reliably identify what has happened. A transvaginal ultrasound can check development, heart activity when visible, and the number and location of pregnancies. Your clinician may also use pregnancy hormone tests and symptoms to plan follow-up. This is emotionally difficult, and clear information may take more than one appointment.

Contact your maternity or early-pregnancy service for advice about any bleeding or persistent cramps. Note the colour and amount of bleeding, clots or tissue, pain location, dizziness, and any fever. Use pads rather than tampons while bleeding so changes are easier to observe. Do not take medicines or begin strenuous activity without checking what is suitable for your pregnancy. If a loss is confirmed, expectant care, medical management, or surgical management may be discussed according to your symptoms, scan findings, and preferences.

Go to emergency care for heavy or rapidly increasing bleeding, severe abdominal pain, fainting, significant dizziness, fever, chills, or feeling very unwell. One-sided pain or shoulder-tip pain also needs urgent assessment because other pregnancy complications can cause internal bleeding. Seek help promptly even if you are unsure whether the symptoms represent miscarriage.

Ask whether the scan shows one or both pregnancies developing, when reassessment is needed, how to monitor bleeding, and which treatment or emotional-support options are available if a loss is confirmed.