You may be referred for an early scan because of vaginal bleeding or spotting, or possibly because you have had problems in a previous pregnancy.
We have not been able to tell from scan today whether you will have a viable pregnancy with a heart beat. We would therefore like to rescan you again in one or two weeks time. We understand that this can be a difficult and anxious time for you to wait.
Sometimes, it can take several scans before you know for sure what is happening. It can be very stressful dealing with this uncertainty. We understand that this can be a difficult and anxious time for you to wait. We advise a watchful wait period for a reason and can answer any questions you may have concerning waiting and what you may or may not do during this time.
Why can’t you tell if there is a viable pregnancy?
You may have been scanned too early to see a viable pregnancy, so all we can see is an early gestational (pregnancy) sac. If we rescan you in two weeks we would hope to see a small intrauterine pregnancy with a heart beat. You may have a missed miscarriage. This is where we can see a pregnancy sac with nothing inside it. This may be because the baby has not developed or that it stopped developing at an early stage and has been reabsorbed back into the surrounding tissue. However we may need to perform a repeat scan in order to confirm this.
You may have a pregnancy sac with a small foetus, which does not have a heartbeat; again this is probably because it might be too early to see. If we rescan you in one or two weeks we would hope to see a heart beat.
You may have what we call a PUL which is a pregnancy of unknown location. Again this could just be a very early pregnancy, an ectopic pregnancy or you may have already had a miscarriage but still have a positive pregnancy test. (If we suspect an ectopic pregnancy then we will take bloods from you).
What happens next?
In all of the above cases we will ask you to return to the unit for a rescan within 7 to14 days. You may also need a blood test to help us with your diagnosis. We obviously hope that the reason we cannot see the baby on scan is because it is too early. However, there may be other outcomes. If your pregnancy is failing you may start to get heavier bleeding and abdominal cramps before your next appointment with us.
Sadly having scans sooner and / or later does not stop a pregnancy from failing. Women are often advised to rest when a miscarriage is suspected, but this will not prevent a miscarriage and the normal activities of daily living should not interfere with an on-going pregnancy. If you do get any bleeding, it may be like a very heavy period, possibly with clots, sometimes quite large ones. You may see the pregnancy sac, which can be greyish in colour. You are likely to experience abdominal cramps this pain can be like very strong period cramp, especially as the pregnancy tissue is being passed. The pain is usually controlled with over the counter pain killers. The doctor / nurse will discuss pain relief with you. We advise you to use sanitary towels rather than tampons to reduce the risk of infection.
If you do experience very heavy bleeding and feel very unwell, dizzy or faint then please seek medical advice, from your GP, or, or in an emergency from A&E. Alternatively, you can always phone The Early Pregnancy Unit (EPU) for advice, or the ward nurses.
If the bleeding has been very heavy and you have passed lots of clots, then please phone EPU to discuss what to do next.
Royal Sussex County Hospital
Main telephone 01273 696955
EPU Ext. 664402
Monday to Friday 8:00 am to 4:00 pm
Level 11 Ext. 64013
Princess Royal Hospital
Main telephone 01444 441881
EPU Ext. 68370
Horsted Keynes Ext. 65685 / 65686
If you have bleeding and /or pain you can get medical help and advice from:
- Your GP or midwife who may advise you to go to hospital
- Your nearest EPU
- Referral into the Early pregnancy unit is based on assessment by a health professional
NHS Choices 111 when you need medical help fast but it’s not a 999 emergency. The service is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones.
The Miscarriage Association
17 Wentworth Terrace
This is an organisation through which you may find information and support that you need to help you through if you have been affected by miscarriage.
Telephone 01924 200799
Email [email protected]
- BSUH NHS Trust (2011) GP001 Early Pregnancy Unit Clinical Guidelines.
- Patient UK Information leaflets Women’s Health Category
- Royal College of Obstetricians and Gynaecologists
- National institute for Heath and Clinical Excellence: Clinical Guidelines: Nice Pathways
This leaflet is intended for patients receiving care in Brighton & Hove or Haywards Heath.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.