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Abortion, Spontaneous, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Spontaneous termination of a <20 wk intrauterine pregnancy

  • Synonyms: Early pregnancy loss, miscarriage

  • Occurs in up to 15–20% of recognized pregnancies (most common complication of ...

Diagnosis

Signs and Symptoms

History

  • Last menstrual period (LMP)

  • Obstetric history:

    • Parity

    • Risk factors for pregnancy loss

    • Prenatal care

  • Abdominal pain, cramping

  • Vaginal bleeding:

    • Duration

    • Amount of bleeding (q...

Treatment

Pre-Hospital

  • IV fluids, oxygen, and cardiac monitor

  • Monitor vital signs and transport

  • Cautions:

    • Patients with spontaneous abortion/vaginal bleeding can have severe hemorrhage and present in shoc...

Follow-Up

Disposition

Admission Criteria

  • Suspected unstable ectopic pregnancy (see “Ectopic Pregnancy”)

  • Hemodynamically unstable patients with hypovolemia or anemia

  • DIC

  • Septic abortions

  • Suspected gestationa...

Pearls and Pitfalls

  • Recognize the possibility of ectopic pregnancy

  • Patients with spontaneous abortion may have clinically significant blood loss

Additional Reading

  • Huancahuari  N. Emergencies in early pregnancy. Emerg Med Clin North Am.  2012;30:837–847.

  • Martonffy  AI, Rindfleisch  K, Lozeau  AM, et al. First trimester complications. Prim ...

Codes

ICD9

  • 634.90 Spontaneous abortion, without mention of complication, unspecified

  • 634.91 Spontaneous abortion, without mention of complication, incomplete

  • 634.92 Spontaneous abortion, without mention ...

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