Guidance
Update information
August 2023: We have reviewed the evidence and made new and updated recommendations on the medical management of miscarriage. These recommendations are marked [2012, amended 2023] or [2023]. In some cases, minor changes have been made to recommendations to bring the language and style up to date without changing the meaning.
November 2021: We have reviewed the evidence and made new recommendations on the use of progesterone in threatened miscarriage. These recommendations are marked [2021].
We have also made changes without an evidence review:
Recommendation 1.5.1 has been amended to clarify that this applies to women with early pregnancy bleeding but no history of previous miscarriage.
Recommendation 1.5.17 has been amended to advise that women should be provided with a urine pregnancy test.
These recommendations are marked [2012, amended 2021].
April 2019: We have reviewed the evidence and made new recommendations on the diagnosis of tubal ectopic pregnancy using ultrasound and expectant management of ectopic pregnancy. These recommendations are marked [2019].
We have also made some changes without an evidence review:
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Recommendation 1.1.2 has had an additional link added to related NICE guidance on antenatal and postnatal health.
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Recommendation 1.1.3 has been updated to bring the wording on obtaining consent in line with other NICE guidance.
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Recommendation 1.3.10 has been updated with extra information covering a wider range of factors so that potential ectopic pregnancies are not missed.
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The headings of section 1.4 and 1.6 have been updated to clarify it only relates to tubal ectopic pregnancy.
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Recommendation 1.4.16 has been updated to reflect the possibility of a pregnancy of unknown location, and a cross reference to advice on pregnancy of unknown location added.
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Recommendation 1.4.22 has been updated to reflect current ultrasound practice.
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Recommendation 1.6.1 has been updated to include advice on miscarriage in the ectopic pregnancy section.
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Recommendation 1.4.31 has been updated to make it clear the decrease in serum hCG level is less than 50%.
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Recommendation 1.6.7 has been changed to reflect current practice and prescribing guidance on methotrexate.
These recommendations are marked [2012, amended 2019].
Recommendations marked [2012] last had an evidence review in 2012. In some cases minor changes have been made to the wording to bring the language and style up to date, without changing the meaning.
Minor changes since publication
October 2023: We have clarified advice on which healthcare professional recommendation 1.5.18 refers to.
September 2022: We have corrected the references to anti-D immunoglobulin prophylaxis in section 1.7.
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