How long does the pregnancy hormone last after miscarriage

If there's no pregnancy tissue left in your womb, no treatment is required.

Table of Contents Show

Expectant management
After a miscarriage
Normal hCG Levels in Pregnancy
Low hCG Levels and Miscarriage
hCG Levels After Miscarriage

However, if there's still some pregnancy tissue in your womb, your options are:

expectant management – wait for the tissue to pass out of your womb naturally
medical management – take medicine that causes the tissue to pass out of your womb
surgical management – have the tissue surgically removed

The risk of complications is very small for all these options. It's important to discuss them all with the doctor in charge of your care.

Expectant management

If you have a miscarriage in your first trimester, you may choose to wait 7 to 14 days after a miscarriage for the tissue to pass out naturally. This is called expectant management.

If the pain and bleeding have lessened or stopped completely during this time, this usually means the miscarriage has finished. You should be advised to take a home pregnancy test after 3 weeks.

If the test shows you're still pregnant, you may need to have further tests.

If the pain and bleeding have not started within 7 to 14 days or are continuing or getting worse, this could mean the miscarriage has not begun or has not finished. In this case, you should be offered another scan.

After this scan, you may decide to either continue waiting for the miscarriage to occur naturally, or have drug treatment or surgery. If you choose to continue to wait, your healthcare professional should check your condition again up to 14 days later.

Contact your hospital immediately if the bleeding becomes particularly heavy, you develop a high temperature (fever) or you experience severe pain.

Medicine

You may choose to have medicine to remove the tissue if you do not want to wait, or if it does not pass out naturally within 2 weeks. This involves taking tablets that cause the cervix to open, allowing the tissue to pass out.

In most cases, you'll be offered tablets called pessaries that are inserted directly into your vagina, where they dissolve.

The tablets usually begin to work within a few hours. You'll experience symptoms similar to a heavy period, such as cramping and heavy vaginal bleeding. You may also experience vaginal bleeding for up to 3 weeks.

In most units, you'll be sent home for the miscarriage to complete. This is safe, but ring your hospital if the bleeding becomes very heavy.

You should be advised to take a home pregnancy test 3 weeks after taking this medicine. If the pregnancy test shows you're still pregnant, you may need to have further tests.

You may be advised to contact your healthcare professional to discuss your options if bleeding has not started within 24 hours of taking the medicine.

Surgery

In some cases, surgery is used to remove any remaining pregnancy tissue. You may be advised to have immediate surgery if:

you experience continuous heavy bleeding
there's evidence the pregnancy tissue has become infected
medicine or waiting for the tissue to pass out naturally has been unsuccessful

Surgery involves removing any remaining tissue in your womb with a suction device. You should be offered a choice of general anaesthetic or local anaesthetic if both are suitable.

After a miscarriage

A miscarriage can be very upsetting, and you and your partner may need counselling or support. You may also have questions about trying for another baby and what happens to the miscarried foetus.

For more information, read what happens after a miscarriage.

Page last reviewed: 09 March 2022
Next review due: 09 March 2025

Human chorionic gonadotropin hormone (hCG) is a hormone produced by the placenta while expecting. If hCG levels fall or plateau early in the first trimester, doctors may suspect a potential pregnancy loss. Here's everything you need to know about the connection between hCG levels and miscarriage.

Normal hCG Levels in Pregnancy

During the first few weeks of pregnancy, hCG levels usually double every 29-53 hours. They peak about 8-10 weeks after implantation, and then they slow down and level off, according to Dr. Brennan Lang, an OB-GYN at Baylor Obstetrics and Gynecology at Texas Children's Pavilion for Women.

There's a wide range of normal hCG levels, so high or low numbers don't usually cause concern. In fact, up to 25% of healthy pregnancies don't have hormone levels that double every two days, says Michele Hakakha, M.D., an obstetrician and co-author of Expecting 411.

Even so, too-low numbers—or numbers that start dwindling or plateauing—may raise concerns. It's possible that the doctor miscalculated your conception date, and your pregnancy isn't as far along as previously thought. But you could also be suffering from a blighted ovum, ectopic pregnancy, or a miscarriage.

Low hCG Levels and Miscarriage

Your doctor may perform a single hCG test at each prenatal appointment to make sure your first trimester is progressing properly. If hCG levels aren't rising like they should—or if you're experiencing symptoms of miscarriage— your OB-GYN may request that you take two hCG tests about 48 hours apart. Comparing the results will let her see trends in your hCG levels.

HCG levels during miscarriage "usually fall, plateau, or rise abnormally slow," says Dr. Lang. He clarifies a "slow" rise as less than 35% over 48 hours. Any of these trends can signal miscarriage, but most of the time, "you have to wait until a pregnancy can be seen on ultrasound around six weeks to confirm things are going normally," says Maureen Baldwin, M.D., MPH, an assistant professor of Obstetrics and Gynecology at Oregon Health & Science University.

Besides falling or plateauing hCG levels, other signs of miscarriage include:

Bleeding or spotting
Cramping
White-pink vaginal mucus
Blood clots or tissue coming from the vagina
Back or abdominal pain

Missed Miscarriage and hVG Levels: Sometimes a miscarriage won't have any symptoms at all. These "missed miscarriages" can be detected through ultrasound and low hCG levels in early pregnancy.

hCG Levels After Miscarriage

After suffering from a miscarriage, your hCG levels will continue to decrease. They should return to normal in about 4-6 weeks, depending on how far along the pregnancy progressed. "After a miscarriage has been completed, there is not typically any need to monitor hCG levels," says Dr. Baldwin. "If a home urine pregnancy test is still positive after a month, or if you still feel pregnant after a week, you should speak with your provider."