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Miscarriage (Early Pregnancy Loss)

Clara M. Keegan, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Miscarriage, also known as early pregnancy loss (EPL), and formerly as spontaneous abortion (SAb), is the failure or loss of a pregnancy before 13 weeks’ gestational age (WGA).

  • Relate...

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, consisten...

TREATMENT

GENERAL MEASURES

  • Discuss contraception plan at the time of diagnosis of EPL, 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

1
Prine LW, MacNaughton H. Office management of early pregnancy loss. Am Fam Physician.  2011;84(1):75–82.
2
Haas DM, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in wom...

ADDITIONAL READING

SEE ALSO

  • Ectopic Pregnancy

  • Algorithm: Recurrent Pregnancy Loss

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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