How to distinguish between natural miscarriage and menstruation?

Patient's question:

I had sexual intercourse with my boyfriend twice before. For the past month, I haven't had my period, and it has been delayed by seven days. This morning, I suddenly noticed a little blood in my underwear. I don't know if it's a natural miscarriage or my period. How can I differentiate between a natural miscarriage and a period?

Doctor's answer:

Hello, have you had sexual activity with your boyfriend and been breastfeeding? Your period is delayed by 7 days. This morning, you noticed a very small amount of blood in your underwear. This could be either the start of your period or signs of a miscarriage. You should buy a pregnancy test kit from a pharmacy to test. If it shows two red lines, it indicates signs of a miscarriage, but it cannot rule out ectopic pregnancy. Further ultrasound examination is needed. If it shows two lines, it means your period has arrived, and you should wait and see for now.

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