Managing threatened miscarriage: A compassionate approach

Emeritus Prof William Ledger

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Emeritus Prof William Ledger

Fertility Specialist; City Fertility Sydney, Emeritus Professor of Obstetrics and Gynaecology; School of Medicine, University of New South Wales

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Early pregnancy bleeding occurs in one in four pregnancies. Approximately one third of women who experience early pregnancy bleeding will go on to miscarry whilst two thirds will have a live birth.1

Whether or not the pregnancy eventually continues, early pregnancy bleeding is often a cause of significant stress and anxiety. Miscarriage can often have a profound emotional impact which can affect not only the woman herself but also her partner and family. For many, the psychological effects may persist for years and intensify with recurrent losses.

Despite its frequency and impact, miscarriage remains an area where both clinical management and emotional support can be improved.

Drawing on the 2025 RANZCOG guidelines2 and contemporary research, this article provides evidence-based clinical guidance and practical insights to enhance the support and care provided to individuals and families affected by miscarriage.

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References

  1. Hofmann GE, et al. Fertil Steril. 2000;74(3):609-10.
  2. RANZCOG. C-Gyn 38 Miscarriage, Recurrent Miscarriage and Ectopic Pregnancy Clinical Guideline Melbourne: RANZCOG; 2025 Mar [ Accessed 2025 Dec 11].
  3. Franasiak JM, et al. Fertil Steril. 2014;101(3):656-663.e1.
  4. Kaltsas A, et al. Medicina (Kaunas) 2024; 60(12):1920.
  5. Coomarasamy A, et al. Am J Obstet Gynecol. 2020;223(2):167-176.
  6. Devall AJ, et al. Cochrane Database Syst Rev. 2021;(4):CD013792.

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Emeritus Prof William Ledger

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Emeritus Prof William Ledger

Fertility Specialist; City Fertility Sydney, Emeritus Professor of Obstetrics and Gynaecology; School of Medicine, University of New South Wales

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