What is the first treatment tried for missed miscarriage?

A missed miscarriage means a pregnancy has stopped developing but the body has not yet passed the pregnancy tissue. Medical management uses prescribed medicine to help the uterus empty. Your clinician may first confirm the diagnosis with examination and ultrasound, then discuss your symptoms, health, and preferences.

Some people are offered expectant management, which means allowing the miscarriage to happen without medicine. Surgical management removes the tissue through a procedure and may be considered if medicine is unsuitable, bleeding is heavy, infection is suspected, or a quicker resolution is preferred. The available choice can depend on pregnancy details and your clinical condition.

Ask how and when to take the prescribed medicine, what bleeding and cramping may feel like, and which pain-relief options are suitable for you. Arrange the planned follow-up, which may include a pregnancy test, examination, or ultrasound to check that the uterus has emptied. Use pads while bleeding so you can observe changes, and keep any instructions about contacting the maternity or gynaecology team.

Read about [Medical Management of Miscarriage](/treatments/medical-gynaecology/medical-management-of-miscarriage/) and [Surgical Management of Miscarriage](/treatments/gynaecological-surgery/surgical-management-of-miscarriage/) before deciding with your clinician.

Seek urgent medical help for very heavy bleeding, severe or worsening abdominal pain, fainting, dizziness, fever, chills, or unpleasant-smelling discharge. These symptoms can signal significant blood loss or infection and need prompt assessment. Contact your care team if bleeding continues longer than expected or you are worried about your recovery.

What treatment is safest for my situation? How will I know the medicine has worked? What should I do if bleeding or pain becomes difficult to manage? When will follow-up confirm that the miscarriage is complete?