Abortion, Spontaneous (Miscarriage)

Clara M. Keegan, MD Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Spontaneous abortion (SAb) (miscarriage) is the failure or loss of a pregnancy before 13 weeks' gestational age (WGA).

  • Related terms

    • ▪ Anembryonic gestation: gestational sac on ultraso...

DIAGNOSIS

HISTORY

  • The possibility of pregnancy should be considered in a reproductive-age woman who presents with nonmenstrual vaginal bleeding.

  • Vaginal bleeding

    • ▪ Characteristics (amount, color, consist...

TREATMENT

GENERAL MEASURES

  • Discuss contraception plan at the time of diagnosis of SAb, as ovulation can occur prior to resumption of normal menses.

  • Expectant management (“watchful waiting”) is 90% effec...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

All patients should be offered follow-up in 2 to 6 weeks to monitor for resolution of bleeding, return of menses, and symptoms related to grief, as well as to rev...

REFERENCES

Prine  LW, MacNaughton  H. Office management of early pregnancy loss. Am Fam Physician.  2011;84(1):75–82. [View Abstract on OvidInsights]
Haas  DM, Ramsey  PS. Progestogen for preven...

ADDITIONAL READING

  • Murphy FA, Lipp A, Powles DL. Follow-up for improving psychological well being for women after a miscarriage. Cochrane Database Syst Rev.  2012;(3):CD008679.

  • Neilson JP, Gyte ...

SEE ALSO

  • Ectopic Pregnancy

  • Algorithm: Abortion, Recurrent

CODES

ICD10

  • O03.9 Complete or unspecified spontaneous abortion without complication

  • O03.4 Incomplete spontaneous abortion without complication

  • O02.1 Missed abortion

  • O20.0 Threatened abortion

  • N96 Recurrent ...

CLINICAL PEARLS

  • Any pregnant woman with abdominal pain and/or vaginal bleeding must be evaluated to rule out ectopic pregnancy, which is potentially life threatening.

  • As all options have similar long-t...

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