ABSTRACT
This chapter presents a case study of a 35-year-old woman who is presented to the Emergency Department with dark red vaginal bleeding. There should be a high index of suspicion of threatened miscarriage in this patient. A diagnosis of miscarriage can be made on the basis of a detailed history and examination or on ultrasound. Depending on trust policy, in-hours stable patients can usually be sent straight to the Early Pregnancy Assessment Unit (EPAU) for a scan. Baseline investigations required within the Emergency Department include a urinary pregnancy test, a full blood count and group and screen to assess for anaemia and the patient's rhesus status. Once a diagnosis has been made, it is vital to express sympathy and provide adequate counselling. She must be reassured that miscarriages are common, that they are usually due to sporadic chromosomal abnormalities and that it is not a result of anything that she has done.
