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Placenta Previa Seen at the 20 Week Ultrasound

One of the most common problems spotted at the 20 week ultrasound is placenta previa. Placenta previa is where the placenta is nearby, or actually covering some or all of the cervix. It’s a potentially dangerous condition because if the placenta covers the cervix, it blocks baby’s way out, requiring a cesarean section to deliver the baby. And more seriously, as the cervix dilates towards the end of pregnancy, the placenta can be torn and bleed, which can be life-threatening to mom and baby.

Complete or partial placenta previa, where the placenta covers at least a quarter, or even all of the cervix, occurs in around 1 in 200 pregnancies, and requires careful monitoring by your doctor.

And more common is a marginal placenta previa, where the placenta is close by, or touching the cervix, but not actually covering it.

At 20 weeks, when the placenta is relatively large compared to the size of the uterus, many women appear to have placenta previa. The ultrasound technician will note the position of the placenta, so your doctor is aware and can discuss it with you. The doctor will probably tell you to avoid intercourse, heavy lifting, and strenuous activity. Your husband will be thrilled that he has to do the vacuuming instead of sex.

Several moms I know, including me, had marginal placenta previa at 20 weeks. At my next obstetrician appointment, the doctor explained what it was. The position of the placenta is largely random, but there are risk factors to placenta previa, including previous cesarean sections, a history of placenta previa, and it’s more common in older moms. Apparently, smoking or using cocaine also increases the risk, my doctor told me, raising one eyebrow. What? I’ve never smoked and the only kind of coke I know comes in a red can with a swirl on it.

The good news is that for most women who have marginal placenta previa at 20 weeks, as your uterus grows, the placenta gets further from the cervix and you’ll likely be given the all-clear to get back to normal activities by 24-28 weeks. Your doctor will schedule another ultrasound to check the position of the placenta at that time. If the placenta is now clear of the cervix, then vaccuming, etcetera are back on.

I had another ultrasound at 25 weeks, and like 90% of moms with marginal placenta previa at 20 weeks, my placenta was in a normal position, and the rest of my pregnancy went smoothly, except for having to think of other excuses to not vacuum.

If you are pregnant, and experience any vaginal bleeding, get checked by a doctor asap. If you have been told you have, or may have placenta previa, it is important to let the doctor who examines you know, as they will need to take extra precautions when they examine you to avoid causing any damage to your placenta.

Introduction to Trying To Conceive (TTC)

Introduction to Trying To Conceive (TTC)Congratulations! You’re entering an important and exciting time in your life as you try to conceive! Are you concerned about getting pregnant? Don’t worry; even if it doesn’t happen right away, the odds are in your favor that you’ll be selecting a layette set and painting the nursery soon enough. Statistics show:

  • 25 percent of all couples become pregnant in their first month of trying
  • 60 percent become pregnant within six months
  • 75 percent become pregnant within nine months
  • 80 percent of all TTC couples will be pregnant within a year

If you’ve been trying for 12 months (or six months if you are over the age of 35), you may want to consult a fertility specialist, just to make sure there is no problem. You can learn more about going to see a fertility doctor in this article.

Since 90 percent of all couples will achieve success within 18 months, odds are in your favor that there is no problem and you just need to be patient and keep trying. While you’re trying to conceive, this section will help you with tips, tricks and information about your health, nutrition, and your cycle, and how to recognize pregnancy when it happens!

Here are some articles that you may find informational:

Before Trying to Conceive

Trying to Conceive

Fertility Issues


See all of the TTC articles here.

Author: Dawn Allcot

Baby Sleep Options: Pack-N-Play vs. a Crib

Pack-n-play’s, also often called travel yards, are becoming very popular with new parents as an option for their baby when it comes to bedtime. This is not only true for newborns, but also as your baby gets older. How do pack-n-plays measure up for long term use and would it be a good idea for your family?

baby-sleep-options-pack-n-play-vs-crib.jpgMost pack-n-plays come with a bassinet option and several come with a changing table, making the pack-n-play a good multi-functional piece of baby gear to go in mom and dad’s room before a baby is moved to his crib in his room that might have a changing table in it. It is nice because at night diapers, wipes and a place to change baby is right there and at hand at 3am. However, the use of pack-n-plays for naps and bedtime doesn’t have to end with your baby outgrowing the bassinet or learning how to sit up.

Many people have chosen to skip over the whole idea of a crib, and use a pack-n-play as their child’s bed for the first year and beyond. This is an idea with many benefits included.

Firm/Small Sleep Area
Pack-n-play’s have a smaller sleeping area than a crib. For some babies who may be over stimulated easily, being more confined may actually be a comfort to them. The pad in a pack-n-play is also very firm and there are no “bumpers” to it that a baby could get pressed up against. There are also no bars that a baby can get their foot, arm or head through, possibly leading to injury like a crib has.

Pack Up and Go
Cribs can not be taken with you when you go to a friends’ for the afternoon or out of town for a weekend. Pack-n-plays however can be easily broken down and put back up, fitting into a small bag that can be put in the trunk or on a plane with no problem. This allows parents to literally take their baby’s bed with them if they are going to be gone for an extended amount of time. This is helpful for some babies who get used to “their space” and may have a hard time falling asleep in strange surroundings. If you have your baby’s bed with you, when he gets over stimulated, needs a nap, or it is bedtime, you can put him in his bed and let him feel safe and comfortable.

Doubles as a Play Pen
Many times while at home or on the road you need a safe place to put your baby for a few minutes while you have to do something that puts you in a position where you can not keep your eyes on him. The pack-n-play can easily double as a play pen for your baby or a time-out area for you. Your baby can’t get out and can easily be entertained for a while with a few of his favorite toys.

If you buy a crib new, including the mattress and bedding you are likely to spend $300-$400 or more on this place for your baby to sleep. You can buy a pack-n-play for as little as $59.00 or up to $170.00. You can find sheets for pack-n-plays for about $11.00 or three packs of sheets at an even better savings of $27.00.

Con: Will Out Grow Faster
One of the main cons in the debate of a pack-n-play vs. a crib is that because of the size of a pack-n-play your baby will probably outgrow the pack-n-play faster than he will his crib, or be able to crawl out of it faster. Some people will leave their babies in a crib till they are three years old, or can climb out of the crib on their own. Depending on the size of your baby and his curiosity you may only get a year or two of use from your pack-n-play when using it as a permanent sleep area for your baby. The plus side of this is when your baby does try to climb out of his crib, he has a shorter distance to fall and less chance to get hurt.

In a situation where there is no right or wrong choice regarding what your baby sleeps in, the choice is really a personal one that you need to make dependent upon what is best for your family. Look at the pros and cons, your budget and all your options before you make a decision that will be with you for the first few years of your new baby’s life.

Potty Training a 2 Year Old

You have heard those stories about the toddlers who are completely potty trained at 18 months old. Their mothers walk around bragging and all smug, while you sit there looking at your 2 1/2 year old, wondering why he isn’t interested at all. Some mothers worry that there is something wrong developmentally with their child if they aren’t potty trained and seem to have no interest in potty training. In reality, this is perfectly normal.

A study put out by the Children’s Hospital of Philadelphia states that the average age for a child to start potty training is 27 months. This being the average age, there are a lot of toddlers that won’t be completely potty trained till after their third birthday.

You can try to encourage your child to potty train, but you shouldn’t push them or get mad as it could only slow the process for them. When your child starts to show interest in YOU going potty, ask them if they want to sit down and try. Many kids might be scared or might just say no. Try to put them on their own potty chair or on the toilet before and after baths, right before bed, or first thing when they wake up in the morning. Some kids will be more comfortable on their own potty chair, others will want to try it like a “big person”.

If you have a child that just doesn’t “get it”, see if you can get them to sit on the toilet or potty chair and try giving him milk, juice or water. Have him sit there till he goes, as the urge might still be involuntary. When he does go applaud and cheer, make a big deal out of it. Chances are he may not know the jist of what he did, but he will know that he pee’d in the potty and you are happy. This praise from parents can often help a child along.

Dr. Phil has his own advice and tips when it comes to teaching your child the art of potty training. Several celebrities have used his methods and believe that they worked in helping them succeed in training their child, including Holly Robinson Peete and Vanessa Marcil. His method includes getting a doll that wets letting the child see this doll going potty and getting praise, so that the child wants the praise as well.

Often times, subsequent children potty train faster than your first. Seeing an older sibling running around is often encouragement for a toddler to hurry up and get there. They want to be like their older sibling. Also, getting a child to not only pee, but poop on the toilet can be a challenge in itself, especially for boys. For some reason boys seem to find it harder than girls to get fully potty trained.

There are no concrete methods that will guarantee your 2 year old will potty train when you are ready for him too, if he is not ready. It is best to remember that you just not push him, get mad, or yell if he isn’t doing it fast enough. Don’t make it seem like a big deal so that your child doesn’t fight the effort to learn. Eventually something in your child’s head will “click” and your child will be ready to potty train. After all, how many kindergarteners do you know who start school still in diapers?

Itching During Pregnancy

Pregnancy itching can range from a slight to severe, can be caused by many different things, and can affect many different areas on a woman’s body.

Itching during pregnancy is quite normal. The most common cause is dry skin, also known as xerosis, which can be caused by not staying well hydrated. Xerosis can be treated by increasing daily water intake and rubbing lotion on the itchy areas.

Other causes of itchy skin include a liver abnormality called intrahepatic (within the liver) cholestasis (pooling of bile salts) of pregnancy, chicken pox, Fifth’s disease, or even a possible reaction to prenatal vitamins or a new medication. If you have a rash that will not go away, or is accompanied by a fever, you should consult your doctor.

Some women may experience some vaginal itching during pregnancy. This itching can be caused by a sexually transmitted disease, or an infection, but is more commonly caused by the change in your vaginal PH level. Yeast infections during pregnancy are also very common and can be the cause of moderate to severe itching.

What Can You Do?
Before trying to treat vaginal itching with over the counter or home remedies, you should consult your doctor or midwife to rule out the possibility of any STDs. If it is determined that your itching is being caused by a change in your PH level, there are several things you can do to try to relieve the itch.

  • Run a bath and add baking soda to it
  • Make a paste of baking soda and water to put on the itchy areas
  • Place a cold compress on the itchy area

Preventing Vaginal Itching
There are many things you can try to do to help prevent the vaginal itching from starting or returning during your pregnancy.

  • Keep yourself clean and dry
  • Always wipe from front to back to keep bacteria away from your vagina
  • Refrain from douching
  • Use scentless detergents
  • Wear loose clothing and cotton panties
  • Take warm baths free of perfumed bubble bath, and use soap for sensitive skin to wash

If you still experience recurrent itching, whether on your belly, arms, legs or vaginal, consult your doctor to discuss other causes of itchy skin and what you can do about it.

The Purpose of Amniotic Fluid and Amniotic Sac

What is amniotic fluid and what is it’s purpose? Also referred to as the “bag of waters”, the most pregnant women generally know about it is that about the time labor begins their amniotic sac will break, or be broken by their midwife or doctor, causing the start of the delivery process. They don’t however know what its purpose is during a pregnancy.

The amniotic fluid is the clear, slightly yellowish fluid within the amniotic sac that surrounds the baby in the uterus. The baby grows in this amniotic sac, surrounded by the amniotic fluid, as he learns to move his limbs, open his eyes and breathe. Amniotic fluid levels generally sit at approximately 800ml through most of the pregnancy, dropping slightly in most cases to about 600ml by the time a woman reaches the 40 week mark.

The amniotic fluid has many purposes. It helps to cushion hard blows and jolts to your belly to protect the baby and it allows your baby the freedom to move while permitting symmetrical musculoskeletal development. It also maintains an even temperature so that your baby does not get too hot or too cold, even if you are extremely hot or cold.

Amniotic fluid also helps your baby develop his lungs. While in the womb your baby practices breathing by breathing in and out the water in the amniotic sac. The baby swallows and inhales the amniotic fluid and replaces the volume in the amniotic sac by urinating and exhaling the liquid.

In some cases, a woman may have too much or too little amniotic fluid. Having too much is called polyhydramnios and having too little is called oligohydramnios. In either case, a woman might be watched more closely by her physician throughout her pregnancy.

Midwives and Doctors

Today’s pregnant woman has many different choices when it comes to her prenatal care. Often, the first choice a woman makes is who to have take care of her during her pregnancy, a midwife or a doctor.

For some the decision is simple. Women who either have medical problems or have had a previous c-section and know that they are going to have another one, choose to see an obstetrician because only they can perform c-sections. However, for most women, the choice isn’t as obvious, and careful research must be undertaken to determine what choice is best for her and her family.

Prior to labor, during office visits, a mother to be might find that a midwives’ office is much more personal, friendly, and quicker than a doctor’s office. The wait isn’t as long, and the midwife is willing to listen and answer all your questions no matter how long it takes. While in labor, either at home or the hospital, a midwife will generally not leave the mothers side until labor is over, remaining with the mother to give constant support.

Midwives are generally believed to be more personable and more willing to listen, and to do exactly what the mother-to-be wants during her pregnancy and birth. Midwives generally support and believe in a more natural, comfortable birth for the mother and baby, as well as using less traditional birthing aids such as birthing balls and water births. A midwife also is knowledgeable about perineal massage to help avoid tears and episiotomies during labor, as well as using oils and teas to help your cervix soften and prepare for labor. Also, if a mother-to-be wants to have a homebirth, a midwife is who she would choose to assist her.

Doctors can offer a lot of benefits as well. Often a doctor can come with a lot of recommendations from friends. Also, if you register with a group of doctors you will have more than one option of who to see. Many times you will actually see all the doctors at different appointments so you’ll get to know each one. You will also be able to get several different opinions regarding any problems you might be having in your pregnancy in one place, rather than having to go elsewhere for a second opinion. Another benefit is that if your doctor is ill, or has to deliver a baby, you probably won’t have to reschedule your appointment because there should be another doctor that you could see in the practice that day.

Often, you will find that the doctor’s office is packed and you have to wait for your appointment. When you finally get in to see your obstetrician, he is rushed and doesn’t want to take the time to answer your questions. These are common complaints from women who have a doctor versus a midwife for their prenatal care.

Obstetricians can also support and believe in a more natural method of childbirth, but they can also be quick to recommend pain medication during labor. They might also be quick to recommend a c-section if labor is not progressing as fast as they want. You also often won’t find the doctor at the hospital or in your room until it is time to actually deliver the baby, instead leaving the labor, early pushing and delivery up to a nurse to take care of.

The choice between an obstetrician and a midwife is purely personal for each mother-to-be. It is a decision to be weighed carefully and not taken before first getting all the facts. In the end, the mother-to-be wants to be happy and 100% comfortable with whoever she chooses, because this is the person she is going to be depending upon to bring a new life into the world safely.

Tossing and Turning

Sleep! That wonderful time where you get to lay down, close your eyes, and enjoy a comfortable, uninterrupted, peaceful night’s sleep at the end of a long day. Unless of course, you are pregnant!

After a woman’s baby is born the advice you will probably most often hear her give is, “Sleep while you can!”, however this is really easier said than done. Most pregnant women are awakened at least once or twice during the night from the beginning of their pregnancies to a bladder that is calling and just can’t wait till morning. If they are lucky, this will slow down during the second trimester as their body adjusts to the pregnancy and the baby grows.

Unfortunately, the second trimester doesn’t last long enough! Once the third trimester comes, so does the yelling of the bladder, as well as other problems making a good nights sleep become something most pregnant women just dream of.

For the women who sleep on their stomachs or backs when not pregnant, they will find that by the third trimester they will have to find a way to get comfortable in a new position. With a big belly, there is now no way to sleep on your tummy and it gets painful to lie on your back, putting all the weight of your belly on your back. This leaves 2 choices for most women, the right side or the left side. Still getting comfortable isn’t as easy and some might think.

As the belly gets bigger, it also gets heavier. You might try to lay on your right or left side, only to discover that the baby is rolled up on that side of your belly and that he doesn’t like this position. The lack of support to your belly and heaviness of the belly might cause you to have to roll over. Then there is another problem you might encounter. While asleep, laying on one side or the other, the baby might decide to start poking and kicking you on that side waking you up, and making the comfort you finally found go away.

Some women have increased back and leg pain while pregnant which doesn’t help with the night time comfort. One solution that works for many women is easy and cheap. Pillows! You will often see pictures of pregnant women at the end of pregnancy surrounded by pillows as they lay in bed, taking up so much room that sometimes their husband looks very crowded. The most popular places for a pillow are between the knees and under the belly. The pillows help support and prop up the belly and legs so that MAYBE comfort can be found. Sometimes women will put on behind their back as well. Some pregnant women will make use of body pillows during the last weeks of their pregnancy to give their whole body extra support.

Tossing and turning is a sure sign that the end of pregnancy is near. Between the frequent bathroom trips, the comfort level (or lack thereof), and the constant thoughts, questions and worries running through a woman’s head, you might as well give up the idea of an uninterrupted, peaceful nights sleep for at least the next several months.

I Have Got To Go Pee!

Once you get pregnant you may feel like you are never getting out of the bathroom. Almost immediately in your first trimester you will have the unmistakable urge to sit on the toilet all day and empty your bladder. Even at night, while you are trying to sleep, you may be woken up several times by your body telling you it is time to visit the bathroom. This can be frustrating and tiresome for pregnant women who are already not getting enough sleep from either excitement or morning sickness.

But why does it happen? Your uterus is not that big to begin with. Once the egg implants in the uterus, the uterus starts to grow and to expand in order to make room for that egg that is going to be multiplying in size rapidly to grow for the next few months. As the uterus grows it pushes down on the bladder causing the frequent urges to pee. This can be made even more frequent if you increase your water and fluid intake once you find out you are pregnant, as is recommended by your provider.

Once you get into the second trimester, the early growth of the baby and uterus slow down some, and your bladder and body readjust to the lack of as much room, the urge to go to the bathroom will probably slow down. You will feel more like your old self. But be prepared, it is only temporary.

By the time the third trimester starts, your baby’s organs and limbs are all formed. All that is left for your baby now is to get stronger and grow bigger so that they can survive outside of the womb. Most of the weight your baby will gain will be gained during the third trimester. Because of this your uterus begins to grow quickly again, putting more pressure on your bladder. The weight of the baby also puts more pressure on your bladder, causing it to scream out to you more often.

Probably one of the most frustrating parts of this is the urge to pee, without being able to go. During the third trimester you may often feel like you have to go NOW, and if you don’t get to a bathroom, that you will not be able to hold it. However, once you get to the toilet you sit there and as hard as you try, nothing comes. When something finally does come, it is just a little trickle, making you wonder why you had to race to the bathroom. After all, it has only been 10 minutes since you went the last time.

You may also find that you are waking up more often during the night again to pee, making an already uncomfortable and broken night of sleep, that much more impossible. Thankfully, pregnancy only lasts 9 months, so there is an end in site. Eventually you will be back to your old self, not visiting the bathrooms as much, and only waking because the baby is crying next to you.

Fundal Height

What exactly is your fundal height, why is it important and how does your doctor or midwife measure it? Many first time moms hear this phrase and wonder what it means, if it is normal, and if their baby is ok.

The fundal height is the measurement from the top of your pubic bone to the top of your fundus. Your doctor or midwife will normally start measuring this during your second trimester, possibly around the 20 week mark, or when you start showing if it is later in pregnancy.

The fundal height is used to assess your baby’s health while in the womb. Your fundal height should be equal to the number of weeks you have progresses in your pregnancy. So if you are 30 weeks pregnant, your fundal height should measure around 30 centimeters. A couple of centimeters in either direction normally isn’t much of a worry. However, if you are measuring quite a bit different it could be a sign of a problem.

If you are measuring bigger than normal, it could be a sign of a baby that is also bigger than normal, or a sign that you are having twins if it was not previously discovered. If you are measuring smaller than normal, it could be a sign that your baby is not growing properly, or has perhaps stopped growing. If either of these is the case your doctor or midwife will most likely order an ultrasound to further check the health and development of your unborn baby.

As you reach the end of your pregnancy, the fundal height can become less accurate. As your baby grows and fills out your uterus, his position can change and the measurement of your fundal height can change as well. If your doctor or midwife shows no concern over your fundal height, it isn’t something that should concern you either.

Chinese Conception Chart

Also known as the Chinese Pregnancy Chart or Pregnancy Calendar, this chart is supposed to predict the sex of your baby based on how old you were in the month that you conceived.

As rumor has it, this chart was found buried in a royal tomb around the year 1000, and is on display at the Beijing Institute of Science in China. No one claims for it to be completely true and accurate so don’t base your attempts at trying to conceive on it, or decorate your nursery by the chart before the doctor tells you the sex of your baby.

It is fun, but how accurate is it really? Some people swear it has been correct for all their children. It was correct for my third son, but wrong on both of my first two children. It is a lot of fun guessing however at the sex of the baby and taking bets with family and friends on if the Chinese Conception Chart is accurate or not.

Month of Conception
Age Of Mother At Conception Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
18 F M F M M M M M M M M M
19 M F M F F M M F M M F F
20 F M F M M M M M M F M M
21 M F F F F F F F F F F F
22 F M M F M F F M F F F F
23 M M M F M M F F F M M F
24 M F F M M F M F M M F M
25 F M F M F M F M F M M M
26 M M M M M F M F F M F F
27 F F M M F M F F M F M M
28 M M M F F M F M F F M F
29 F M F F M F M M F M F F
30 M M F M F M M M M M M M
31 M M M M F F M F M F F F
32 M F F M F M M F M M F M
33 F M M F F M F M F M M F
34 M M F F M F M M F M F F
35 M F M F M F M F M M F M
36 M F M M M F M M F F F F
37 F F M F F F M F F M M M
38 M M F F M F F M F F M F
39 F F M F F F M F M M F M
40 M M M F M F M F M F F M
41 F F M F M M F F M F M F
42 M F F M M M M M F M F M
43 F M F F M M M F F F M M
44 M F F F M F M M F M F M
45 F M F M F F M F M F M F

Signs of Miscarriage

Miscarriage is a painful experience that many women have to go through in their lifetime. Painful physically as well as emotionally. The most common medical term used for miscarriage is spontaneous abortion. The term “abortion”, however has very negative connotations so we prefer to use the term miscarriage, referring to the fact that the woman failed to carry the fetus to full term and results in delivery of a baby too young to be able to survive outside the uterus.

When is a Miscarriage More Likely to Occur?

Miscarriage can happen very early or a bit later during the pregnancy period. Clinical guidelines define miscarriage as loss of a fetus aged 20 weeks to 22 weeks, weighing about 500 g or less. Most miscarriages, however, occur at the first trimester before the 13th week. An estimated 50% of pregnancies result in miscarriages due to a wide range of causes but only about 15% to 20% are detected as such.
Miscarriage is a life-and-death event, yet it is not a simple yes-or-no occurrence. It can manifest in many different forms. It does not happen in a single instant but consists of a series of events that culminate in the loss of the fetus and termination of the pregnancy.

Most miscarriages occur at a very early stage, sometimes even before a woman even realizes she is pregnant, and the embryo hasn’t even had the chance to implant in the uterus aka chemical pregnancy. About 15% of pregnancies result in early miscarriage during week 1 or 2. In such cases, the woman is blissfully unaware of what happened.

What’s an Embryonic Pregnancy?

A blighted ovum aka embryonic pregnancy will inevitably end up in a miscarriage which occurs a bit later, when the woman is usually aware of her condition. What she is not aware of is that although there is a sac in her uterus, there is no embryo inside. The body eventually passes the empty sac, usually before the 8th week of pregnancy.

As the fetus grows older, the chances of miscarriage decrease. However, the emotional pain that comes with miscarriage increases with increasing fetal age.

A threatened miscarriage is actually a potential tragedy thwarted. The most common sign of a threatened miscarriage is vaginal bleeding or commonly known as “spotting”. In such cases, the doctor usually prescribes bed rest as well as medications that can prevent contractions. Many threatened miscarriages have a happy ending, resulting in a healthy baby.

What Are the Signs of Miscarriage?

  • Vaginal bleeding, which may be mild or profuse. The bleeding is due to the passing of the embryonic/fetal and placental tissue out of the body, the so-called conception products. Miscarriage is complete if all products are expelled, characterized by profuse bleeding. Miscarriage is incomplete if the body cannot get rid of all products. In such cases, bleeding may be mild. Take note, however, that vaginal bleeding or spotting does not necessarily mean miscarriage. Some women with viable pregnancy can occasionally have some light spotting.
  • Pain in the lower back, which has been described as a persistent, dull but also sharp pain.
  • Abdominal cramps and pain, which can be mild or severe. Some women describe the sensation as being similar to menstrual cramps. The cramps may actually be real contractions wherein the body is trying to expel the conception products.

The intensity, timing, and duration of the symptoms vary from woman to woman.

In the doctor’s clinic, impending, threatened, or complete miscarriage is confirmed by several tests that include manual examination, pelvic ultrasound, and blood test to check for levels of human chorionic gonadotrophin (HCG) hormone.

Manual examination checks the state of the cervix (dilation is a bad sign) and presence of other structural abnormalities such as tenderness and pain.

An ultrasound can check the status of the fetus, usually in terms of its size and heartbeat. The ultrasound can also detect abnormalities such as ectopic pregnancy.

The levels of HCG in the blood can indicate whether the pregnancy is proceeding normally or not.

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