Early pregnancy scans after a miscarriage

You will be offered 2 routine ultrasound scans during pregnancy:

• at 10 to 14 weeks (often called the dating scan)
• and between 18 and 21 weeks (called the fetal anomaly scan).

You may be offered more than 2 scans, depending on your health and how your pregnancy is going.

What is a reassurance scan and what are the reasons why some people have them?

Some people would like an extra scan in the early weeks (6 to 10 weeks) to confirm they are pregnant, because they have miscarried before. These are often known as early pregnancy or reassurance scans.

During the scan, the sonographer will check that the pregnancy is growing in the womb (uterus), whether there is a heartbeat and whether the pregnancy is the right size according to date of your last period. 

Confirming these things are all positive signs for your pregnancy. But it’s important to know that a scan will just show how the baby is growing at that time. It can’t predict how your pregnancy will progress.

Sometimes you may need more than one scan if the result is inconclusive (unclear). For example, if there are signs of a pregnancy in the womb (uterus) but it’s not measuring as expected according to your menstrual cycle, or if the heartbeat can’t be seen clearly. 

If this happens, you may be offered another scan in 10-14 days so that any changes or progression in the pregnancy can be seen clearly. Scanning again very soon after one scan may not be helpful as it may be hard to see any changes.

Having to wait for another scan can be very difficult. Some people describe it as being ‘in limbo’ and feel anxious and worried. This is natural and understandable. Your healthcare professional can explain why you need another scan and when this will be. 

You should get medical help in the meantime if you have:

• bleeding
• persistent stomach pain (pain that won’t go away) or cramping, or if the pain comes on suddenly
• a high temperature or vaginal discharge that smells bad or is green, brown or yellow. This may be a sign of infection. 

You can use the Tommy's Miscarriage Support Tool to find out your chance of a successful next pregnancy and get personalised information and support.

Will I get a reassurance scan?

If you’ve experienced an early miscarriage before, you can talk to your GP or Early Pregnancy Unit about having an early pregnancy scan in your next pregnancy, if you want one.

This may not always be possible. This may be because there is no medical reason for you to have one. This can be frustrating, but try to remember that most miscarriages are a one-off event and there is a good chance you will have a successful pregnancy. 

Some people who have an early pregnancy loss before will be offered an extra scan early in their pregnancy. For example, if you’ve had an ectopic pregnancy or molar pregnancy before, you should be offered a scan at 6 to 8 weeks to check that the baby is developing in the right place.  

If you have experienced recurrent miscarriages (3 or more miscarriages in a row), you (and your partner, if you have one) should be seen by a specialist health professional in a specialist clinic to have some tests to try and find out why you are experiencing pregnancy loss. Find out more about getting referred to a miscarriage specialist.

Some units may offer a ultrasound scan and follow-up in the early stages to reassure and support you if you’ve had recurrent miscarriages. 

Are reassurance scans helpful?

This depends on your circumstances. Reassurance scans may give some people peace of mind. Others may find the idea of having an extra early scan increases their worry. 

If there is no medical reason for having an early scan, it may help to think about how you feel about the idea and if it would help you. 

A reassurance scan may be able to detect (find) a pregnancy and a heartbeat, which are positive signs. But they cannot guarantee or predict how your pregnancy will progress.

“I have had 5 losses prior to having my son. After that many losses, reassurance scans were a lifeline. A scan is only a snapshot in time and will not affect outcomes, as any recurrent loss patient is well aware, so they are not ‘reassuring’ in that way, but they can help. I found it helpful  to know I was really pregnant in the early stage and not imagining it. Which is strange, but something I often wondered! 

Claire

When can I have a reassurance scan?

An ultrasound may be able to detect (find) a pregnancy and a heartbeat in a ‘normal’ pregnancy at around 6 weeks. But a scan at this time may show nothing, even in a healthy, developing pregnancy.

The best time to have a scan is from about 7 weeks as it this is when it should be possible to see the heartbeat.

What kind of scan will I need to have?

Some people will have an external ultrasound scan. The sonographer (a healthcare professional who uses ultrasonic imaging devices to perform examinations of the body) will pass a probe over your stomach. An image of your womb will then appear on a monitor.  

You may be offered a transvaginal scan. Transvaginal means ‘through the vagina’. Your healthcare professional will insert a small ultrasound probe with a sterile cover into your vagina and the image are transmitted to a monitor. 

This may be a bit uncomfortable, but the healthcare professional will use a lubricant for ease and take things as slowly as you need. An internal scan should not be painful and shouldn’t take long. 

These scans will not harm you or your unborn baby.

Can I pay for a private scan?

Some people pay to have scans through private healthcare, but this can be expensive. There are also independent baby scanning services that offer ultrasound scans. 

All baby scanning services offering diagnostic procedures that use ultrasound in the UK must be registered with the Care Quality Commission (CQC). If the service is not registered they may be practising illegally and without appropriate insurance. 

Find out more about choosing a baby scanning service. 

If you have any miscarriage symptoms

If you notice any miscarriage symptoms, especially vaginal bleeding or stomach pain, contact your GP or midwife (if you have one yet) straight away. Your GP may refer you to an Early Pregnancy Unit if needed. You can also contact your nearest Early Pregnancy Unit if they offer a self-referral or walk in service.

If it is out of hours, contact you can call the NHS emergency number 111 at any time of day or or visit your local A&E. 

Your healthcare professional will usually do an ultrasound scan to check your baby’s development. If this scan confirms a pregnancy, you should be offered a medication called progesterone. Some people who have had multiple losses may already be taking this treatment. 

Find out more about progesterone. 

How to cope with any stress or anxiety

If you’ve miscarried before and are pregnant again, you’re probably feeling quite emotional. It’s important to be kind to yourself and find ways to manage any anxiety you’re feeling. Don’t forget that your maternity services are there to support you.

Find out more about getting help and support with your mental health.

Find out more about pregnancy after a miscarriage.