Most women on having missed a period would do a pregnancy test which may be positive. Confirmation of pregnancy is made by clinical features, ultrasound scan and a positive pregnancy test either ain the urine or in blood.

In early pregnancy, many women experience some pain and/or spotting, which generates anxiety. An early scan, usually transvaginal, provides diagnosis and usually reassurance.

However in about 10%, the pregnancy may not be viable. A non-viable pregnancy within the uterine cavity is called ‘miscarriage’, which may be expelled spontaneously with bleeding like a heavy period and crampy pains or may be retained for a long time before expulsion accompanied by bleeding and some pain. Sometimes, the non-viable pregnancy may need surgical intervention to allow for return of normal periods.

Less commonly but more significantly, the non-viable pregnancy may have implanted in a fallopian tube, called ectopic pregnancy where the main symptom is of pain with some bleeding. If not diagnosed and treated in time, the fallopian tube may rupture with bleeding into the abdomen leading to an acute emergency.

It is best to check with an ultrasound if there is any doubt or concerns regarding an early pregnancy.