Early pregnancy loss, or loss of an intrauterine pregnancy within the first trimester, is encountered commonly in clinical practice. Obstetricians and gynecologists should understand the use of various diagnostic tools to differentiate between viable and nonviable pregnancies and offer the full range of therapeutic options to patients, including expectant, medical, and surgical management. The purpose of this Practice Bulletin is to review diagnostic approaches and describe options for the management of early pregnancy loss. Most miscarriages happen before the pregnancy is 12 weeks along. In the first several weeks of a pregnancy, a miscarriage sometimes happens because a fertilized egg did not properly form a fetus. In many cases, the activity of the fetal heart stopped days or weeks before the symptoms of miscarriage began.