Pregnancy loss

Miscarriage and recurrent loss.

Roughly one pregnancy in four ends in miscarriage, and most are chromosomal events that nothing would have prevented. A single loss does not mean something is wrong with you — and two or more means a workup, not reassurance.

How this is approached here

What happens, and what you choose

  1. 01

    Ultrasound and serial hCG where the diagnosis is not yet certain. We do not call a loss on one scan where a second would settle it.

  2. 02

    Three management options

    And they are genuinely yours to pick: expectant, medical with mifepristone and misoprostol, or surgical management in the office or theatre.

  3. 03

    Rh status checked and anti-D given where indicated

    At every loss.

  4. 04

    Tissue sent for chromosomal analysis after a second loss

    Because an aneuploid result is itself an answer and stops a longer workup.

  5. 05

    A follow-up appointment booked before you leave

    Rather than a note saying to call if you need to.

When a workup is warranted

After two losses, not three

Antiphospholipid antibodies

The one clearly treatable cause, and the reason the workup is worth doing.

Thyroid function and HbA1c

Both common and both treatable.

Uterine cavity assessment by saline sonography

Or hysteroscopy, for a septum, polyps or adhesions.

Parental karyotype where the history or a prior aneuploidy result points at it.

A frank statement of what the workup finds

In roughly half of couples, nothing — and the chance of a subsequent live birth is still good.

Pregnancy loss: common questions

Did I cause this?
Almost certainly not. Exercise, work, stress, sex, lifting and a glass of wine before you knew do not cause miscarriage. The majority of early losses are chromosomal and were determined at conception.
Do I have to have a procedure?
No. Expectant management is safe for most early losses, medical management works for most of the rest, and surgical management is appropriate where there is heavy bleeding, infection, or simply where you want it over with. All three are offered.
How long should we wait before trying again?
Physically, once bleeding has settled and you have had one period there is no evidence that waiting longer improves outcomes. Emotionally is a different question and is yours to answer.
When should I be worried it will happen again?
After one loss the chance of a successful next pregnancy is around 80 per cent. The workup starts after two consecutive losses, and even after three, around 60 to 70 per cent of couples go on to a live birth.

Know before you book.

Vireo opens in 2027. Until then the plan list, panel status and first-available wait for every office are published on this site and kept current. Questions can go to the practice office on (305) 555-0180.

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