Incomplete Miscarriage?

  How can you tell if a miscarriage was complete?  
  After having the flu, I started having gastrointestinal pains and after my period was a week late, started spotting.
  I went to the doctor and was advised that I was appx. 5 weeks pregnant and threatening to miscarry or possibly ectopic.  After this initial examination, I was sent for blood tests every to check the pregnancy levels.  The levels dropped and the 3rd test was negative.  
  In the meantime, I continued to cramp and lightly spot for almost 10 days.  
  I normally have a heavy period.  The spotting I experienced was very slight and I did not pass clots.  I advised the nurse of this but was not advised to return for a checkup or D&C.
  A week after the spotting stopped, I developed a severe case of hives and there has been no cause for these found to date (no previous known allergies, no use of new products or medications, etc.).  Since infection can be a cause, I am concerned that this may have something to do with the miscarriage.  
  Is it possible to tell that a miscarriage was completed just with blood test results?
  Is it standard to have a follow up exam after a miscarriage?
  What should I do now?   Please advise, thanks.

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A complete miscarriage means that all the pregnancy tissue is passed. This is documented by following the hCG level: when it becomes undetectable, there is no longer any living trophoblast (early pregnancy tissue).
It may still take time for all the non-viable tissue to be passed. It is still possible that one may require a D&C. Thus, one follows patients and uses clinical clues such as persisting bleeding/spotting or cramping as indicators to consider further tests (for example, ultrasound) or treatment (for example D&C).
Following a miscarriage, a follow up visit is optional: if patients are not having any problems and their menstrual cycles return without issue, and they have no questions/emotional concerns, then a follow up visit has no purpose. You are concerned and having symptoms: follow up with your physician.
Keywords: complete abortion
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please ask your physician.