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==Signs and symptoms== Signs of a miscarriage include [[vaginal spotting]], [[abdominal pain]], [[cramps|cramping]], [[amniotic fluid|fluid]], [[blood clots]], and [[Tissue (biology)|tissue]] passing from the [[vagina]].<ref>{{cite web|url=https://www.nichd.nih.gov/health/topics/pregnancyloss/conditioninfo/Pages/diagnosed.aspx|title=How do health care providers diagnose pregnancy loss or miscarriage?|website=www.nichd.nih.gov|date=September 2017 |access-date=2017-11-07}}</ref>{{sfn|Hoffman|page=176}}<ref name=":4">{{cite journal | vauthors = Li L, Dou L, Leung PC, Wang CC | title = Chinese herbal medicines for threatened miscarriage | journal = The Cochrane Database of Systematic Reviews | issue = 5 | pages = CD008510 | date = May 2012 | pmid = 22592730 | doi = 10.1002/14651858.cd008510.pub2 | pmc = 11366073 }}</ref> [[Bleeding]] can be a symptom of miscarriage, but many women also have bleeding in early pregnancy and do not miscarry.<ref name="auto">{{cite news|url=https://medlineplus.gov/miscarriage.html|title=Miscarriage {{!}} Miscarriage Symptoms {{!}} MedlinePlus|access-date=2017-09-09|url-status=live|archive-url=https://web.archive.org/web/20170728020027/https://medlineplus.gov/miscarriage.html|archive-date=July 28, 2017|df=mdy-all}}{{PD-notice}}</ref> Bleeding during the first half of pregnancy may be referred to as a threatened miscarriage.<ref name=Relationship>{{cite journal | vauthors = Lee HJ, Norwitz E, Lee B | title = Relationship between threatened miscarriage and gestational diabetes mellitus | journal = BMC Pregnancy and Childbirth | volume = 18 | issue = 1 | pages = 318 | date = August 2018 | pmid = 30081861 | pmc = 6080503 | doi = 10.1186/s12884-018-1955-2 | doi-access = free }}</ref> Of those who seek treatment for bleeding during pregnancy, about half will miscarry.<ref name="bmj1997">{{cite journal | vauthors = Everett C | title = Incidence and outcome of bleeding before the 20th week of pregnancy: prospective study from general practice | journal = BMJ | volume = 315 | issue = 7099 | pages = 32β4 | date = July 1997 | pmid = 9233324 | pmc = 2127042 | doi = 10.1136/bmj.315.7099.32 }}</ref> Miscarriage may be detected during an ultrasound exam or through serial [[human chorionic gonadotropin]] (HCG) testing.
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