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About 8 to 20 percent of all pregnancies end in miscarriage before 20 weeks. If you are experiencing the most common symptoms of a miscarriage, abdominal pain and vaginal bleeding, it’s...
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- AMITA Health
- Introduction
- Aetiology
- Clinical Features
- Investigations
- Complications
- References
Miscarriage is the spontaneous loss of an intrauterine pregnancy before 24 weeks gestation. It occurs in approximately 10 – 24% of all clinical pregnancies.1 The major risk factors for miscarriage are increasing maternal age and the number of previous miscarriages.1 Most miscarriages (~80%) are diagnosed under 13 weeks, with the risk of miscarriage...
In the first trimester, the most common cause of miscarriage is a chromosomal abnormality(50-60%). Autosomal trisomy is the most common abnormality (e.g. trisomy 16). The most common single chromosomal anomaly is 45X karyotype. Maternal age is related to aneuploidy risk, with increasing maternal age increasing aneuploidy risk (and therefore increas...
History
Typical symptomsof miscarriage include: 1. Vaginal bleeding 2. Cramping abdominal pain 3. Passage of any fetal tissue or clots Other important areas to coverin the history include: 1. Symptoms of, and risk factors for, ectopic pregnancy 2. Menstrual history: last menstrual period (LMP), cycle length, days bleeding, severity & nature of bleeding 3. Pregnancy history (if known): dating based on LMP/ultrasound results 4. Past obstetric history: outcomes from previous pregnancies and complication...
Clinical examination
All patients with miscarriage should have basic observations (vital signs)recorded using an obstetric or maternal early warning chart. A thorough abdominal examination should be performed to assess for signs of an acute abdomen (e.g. rebound tenderness and guarding), which may be suggestive of an ectopic pregnancy. A speculum examinationshould be performed to assess the cervical os, rule out other sources of bleeding (e.g. cervical/vaginal pathology), quantify the bleeding and assess for visi...
Laboratory investigations
Relevant laboratory investigationsmay include: 1. Full blood count: in patients who have significant blood loss and/or evidence of hypovolaemia 2. Beta-HCG: provides an indication as to whether the pregnancy is progressing (see below) 3. Group and save / cross-match: if significant bleeding 4. Antibody screen: rhesus negative women undergoing a surgical procedure to manage miscarriage will require anti-D rhesus prophylaxis
Imaging
A transvaginal ultrasound should be performed in any patient presenting in early pregnancy with vaginal bleeding and/or abdominal pain. The aim of ultrasound scanning is to assess for an intrauterine pregnancy or evidence of an ectopic pregnancy(adnexal pathology or the presence of free fluid in the abdomen). In addition, the ultrasound can assess fetal viability at that point in time. If the ultrasound scan is inconclusive for an intrauterine pregnancy (i.e. there is a pregnancy of unknown l...
Complications of miscarriage include: 1. Infection 2. Retained products of conception: may require surgical management 3. Asherman’s syndrome (uterine adhesions): a complication of repeated surgical management 4. Psychological impact: depression and/or anxiety
NICE Clinical Knowledge Summary. Miscarriage. Available from: [LINK]BMJ Best Practice. Miscarriage. Available from: [LINK]Miscarriage Association. Support Services. Available from: [LINK]Jun 11, 2024 · Miscarriages early in pregnancy can cause similar symptoms to a period, including bleeding and cramping, so you may wonder how to know if you miscarried. If you have large blood clots, it may be due to a miscarriage.
Feb 3, 2023 · Miscarriage occurs in up to one third of pregnancies. Described as threatened, inevitable, incomplete, complete, missed, or recurrent miscarriage. Presence of pain, hypotension, tachycardia, and/or anaemia warrants exclusion of a life-threatening differential diagnosis such as an ectopic pregnancy. Serial serum beta hCG titres and a trans ...
Caring for women experiencing pregnancy loss: a free e-learning resource. We have developed this free e-learning resource to support you in providing the best care you can to women* experiencing pregnancy loss – that is, miscarriage, ectopic pregnancy or molar pregnancy.
A miscarriage is the loss of a pregnancy during the first 23 weeks. Symptoms of a miscarriage. The main sign of a miscarriage is vaginal bleeding, which may be followed by cramping and pain in your lower abdomen. If you have vaginal bleeding, contact a GP or your midwife.
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Jul 17, 2023 · Common symptoms include heavy spotting and discharge of tissue or other fluid from your vagina. Seek a doctor immediately if you notice any of these signs. A miscarriage,...
