Call your health care provider if you know or suspect you are pregnant and you are experiencing any of the following:

1. Vaginal bleeding
2. Abdominal pain or cramping, or low back pain
3. Weakness or dizziness
4. Uncontrollable or severe nausea or vomiting
5. Urinary symptoms such as burning, frequency, or pain with urination
   
   

Go immediately to the hospital's emergency department if any of the following are true:

• You know or suspect you are pregnant and have heavy vaginal bleeding (soaking more than one pad every hour) or pain in the back or the abdomen.
• You are passing something that looks like tissue (place what you have passed into a jar or container and take it with you to the hospital).
• You have a history of ectopic (tubal) pregnancy
• You are extremely dizzy or pass out.
• You have a known pregnancy accompanied with passage of clots or other material.
• You have a fever of greater than 100.4°F.
• You are vomiting; nothing stays down
  
  

Self-Care at Home

If you are not sure if you are pregnant, a home pregnancy test will confirm or exclude pregnancy in most cases.

1. If the test is negative, discuss the bleeding and cramping with your health care provider.
2. If the test is positive and you have bleeding or cramping , call your provider. Rest and avoid sexual intercourse.
3. You may also safely take acetaminophen at any time during pregnancy . Do NOT take aspirin, ibuprofen, or naproxen if you are pregnant .
   
   

Follow-up

Your health care provider will monitor you until the pregnancy resumes or if the miscarriage becomes complete. Avoid exerting yourself. You may feel better if you rest, although resting will not prevent the miscarriage from happening. Do not douche or insert anything in your vagina, including tampons. Do not have sex until the symptoms have completely gone away for one week. Return to the emergency department if the following symptoms develop:

1. Worse cramping
2. Worse bleeding (more than one pad per hour)
3. Passage of tissue
4. Fever
5. Anything else that concerns you
   
   

With another blood test, your quantitative beta-HCG level may be checked in 48-72 hours. The rise or fall of this level is helpful in predicting the viability or failure of the pregnancy. If the level is falling, then the pregnancy may have ended.

A follow-up ultrasound may be done at some point.

Prevention

There is no way to predict or prevent a miscarriage. Certain steps can be taken, however, to give your pregnancy every chance to continue to term.

1. Get prenatal care and follow the advice of your health care provider (family doctor, obstetrician, midwife).
2. Avoid alcohol, nicotine, and street drugs , especially cocaine, during pregnancy .
3. Avoid or cut down on caffeine.
4. Control high blood pressure and diabetes.
5. Identify and treat any bacterial and certain viral infections.