Synopsis
Communicate early-pregnancy uncertainty and loss honestly, preserve choice and dignity, and provide practical, psychological, cultural and safety follow-up without euphemism or assumptions.
- Confirm what is known before breaking bad news: uncertain viability, PUL and confirmed pregnancy loss require different words and follow-up.
- Create privacy, sit at eye level, use a professional interpreter, ask whom the patient wants present and obtain consent before involving a partner.
- Give a clear warning shot, state the result in one short sentence, pause, acknowledge the response and check understanding before discussing options.
Key red flags
Syncope, shoulder-tip pain, peritonism, haemodynamic instability or escalating unilateral pain after a presumed early loss.
Investigation priorities
Ensure the conversation rests on a safe and defensible diagnosis rather than an ambiguous scan phrase.
Management branches
Safe diagnostic criteria confirm pregnancy loss and the result must be explained.
- Arrange privacy, minimise interruptions, sit down, confirm identity and preferences, and ask whom the patient wants present before sharing information.
- Give a brief warning such as I am sorry, the scan shows something serious, then state clearly that the pregnancy has stopped developing or that the baby has died using preferred terms.
The patient is physically stable after confirmed loss and can consider next steps.