Miscarriage Care & Treatment

Miscarriage and early pregnancy bleeding are far more common than many people realise. Miscarriage affects around one in four pregnancies, yet each experience is deeply personal. Whether you are worried about bleeding, have received difficult news at a scan, or have experienced loss before, Dr Duncan provides kind, calm, and unhurried care throughout.

As a sub-specialist in Maternal and Fetal Medicine with over 30 years' experience, Dr Duncan personally performs your scans, explains what he sees, and guides you through every option with clarity and kindness. Dr Duncan can normally offer same-week availability or even same-day appointments in some instances, and patients under his care have 24hr access to Dr Duncan's personal mobile, so you are never left waiting for answers at an anxious time.

 

Understanding early pregnancy loss

"Miscarriage" covers several different situations, and understanding which one applies to you is the first step towards the right care:

• Threatened miscarriage - bleeding in early pregnancy where the pregnancy is continuing. Many of these pregnancies settle and then go on completely normally.
• Missed (silent) miscarriage - where the pregnancy has stopped developing but there are no obvious symptoms, often found at a routine scan.
• Incomplete miscarriage - where some pregnancy tissue remains in the womb after miscarriage has begun.
• Complete miscarriage - where the womb has emptied on its own.
• Recurrent miscarriage - three or more consecutive losses, which warrants dedicated investigation.

 

Early pregnancy bleeding - when to seek review

Bleeding or pain in early pregnancy is frightening, but it does not always mean you are losing the pregnancy. Dr Duncan offers prompt, same-week and emergency assessment so you can be seen quickly rather than waiting in uncertainty. You should seek urgent review if you have heavy bleeding, severe or one-sided abdominal pain, shoulder-tip pain, dizziness or feel faint - these can occasionally signal an ectopic pregnancy, which needs urgent attention.

 

Reassurance and viability scanning

A scan is the fastest route to reassurance, or diagnosis. As a Fetal Medicine Specialist, Dr Duncan performs your scan himself and takes the time to talk you through the findings. An early viability or reassurance scan can confirm whether the pregnancy is continuing, locate the pregnancy, and, from 6+ weeks, check the baby's heartbeat, frequently providing the reassurance for which many patients are searching.

 

Your management options

If a miscarriage is confirmed, there is usually no single "right" answer - the best choice depends on your circumstances, your wishes and your safety. Dr Duncan will discuss each option fully:

• Expectant management - allowing the miscarriage to complete naturally, with monitoring and support.
• Medical management - medication to help the process along, avoiding surgery.
• Surgical management - a short procedure to remove pregnancy tissue from the womb.

 

Surgical management of miscarriage (evacuation of retained products)

Where a surgical approach is needed or preferred, Dr Duncan has extensive expertise in performing surgical evacuation of the uterus - sometimes called ERPC (evacuation of retained products of conception) or SMM (surgical management of miscarriage). Drawing on decades of experience, he carries out these procedures with great care, prioritising both your physical safety and your emotional wellbeing.

Dr Duncan will explain exactly what the procedure involves, what to expect on the day, and the recovery afterwards. The procedure is typically carried out under light general anaesthesia as a day case at The Portland Hospital. Being looked after by the same consultant who has cared for you throughout - rather than an unfamiliar team - makes a real difference at a difficult time.

Following the procedure, it is possible to ask our laboratory to do a test to ascertain if there was a genetic reason for the miscarriage. This can sometimes be helpful to know, and Dr Duncan will discuss its relevance. It is always your choice whether you wish to know or not.

 

Recurrent miscarriage - investigation and planning

Experiencing more than one miscarriage can be very distressing, and it is natural to feel lost and confused. Dr Duncan offers a thorough, evidence-based review to look for treatable factors that may have contributed, and to build a personalised plan for a future pregnancy. Where appropriate this includes relevant blood tests, preconception advice, and a clear framework of monitoring and care in your next pregnancy, so that you can feel supported and confident in your body’s ability to see a pregnancy through to a birth.

 

Emotional support and looking ahead

Pregnancy loss is not only a medical event, it is very much also an emotional one. Dr Duncan's approach is unhurried, honest and compassionate. When you feel ready, he will help you to plan for a subsequent pregnancy, and offer early pregnancy reassurance with scanning and close, consultant-led care.

 

Arrange a consultation

If you are worried about early pregnancy bleeding, have had difficult news, or want to talk about care after a loss, please get in touch with Dr Duncan's secretary Colette.