When is transvaginal ultrasound recommended for miscarriage?

A transvaginal ultrasound places a covered probe in the vagina to produce detailed images of the uterus and early pregnancy. It can help assess whether a pregnancy is in the uterus, whether a gestational sac or embryo is visible, and whether cardiac activity can be seen at the stage expected. Bleeding and pain do not by themselves confirm miscarriage. If the pregnancy is very early or the images are not conclusive, the team may recommend repeat imaging and blood tests before making a diagnosis.

Tell the clinician about your pregnancy test, the timing and amount of bleeding, cramps, pain on one side, and any previous pregnancy losses or ectopic pregnancy. Ask the sonographer to explain each step and say if you need to pause. Keep the follow-up appointment if the result is uncertain, because change over time can help distinguish a normally developing early pregnancy from a pregnancy that has stopped developing. Emotional support is appropriate while answers are pending.

Seek emergency care for severe abdominal pain, heavy bleeding, fainting, collapse, severe dizziness, shoulder-tip pain, fever, or feeling acutely unwell. These symptoms can need treatment for blood loss, infection, or an ectopic pregnancy. Contact your maternity or gynaecology service promptly if bleeding or pain is increasing, even when a previous scan was reassuring.

Ask whether the scan confirms the pregnancy location and development, what remains uncertain, and whether repeat imaging or blood tests are required. Ask what bleeding or pain is expected, which symptoms require emergency care, and where to obtain emotional support.