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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 ...
- Summary
Miscarriage occurs in up to one third of pregnancies....
- Approach
Approach - Miscarriage - Symptoms, diagnosis and treatment |...
- Investigations
Investigations - Miscarriage - Symptoms, diagnosis and...
- Guidelines
Guidelines - Miscarriage - Symptoms, diagnosis and treatment...
- Complications
Complications - Miscarriage - Symptoms, diagnosis and...
- Prognosis
Prognosis - Miscarriage - Symptoms, diagnosis and treatment...
- Differentials
Differentials - Miscarriage - Symptoms, diagnosis and...
- Aetiology
Aetiology - Miscarriage - Symptoms, diagnosis and treatment...
- Summary
- 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 · The most common sign of miscarriage is bleeding. Some bleeding during pregnancy is common, but not normal. This type of bleeding is usually light. If your bleeding is equal to or heavier than a period, you may be having a miscarriage.
Nov 16, 2017 · Miscarriage warning signs include cramping, spotting, brown or bright red bleeding, passing clots of tissue, and contractions that happen every 5-20 minutes. But when you talk to people...
Symptoms. The most common sign of miscarriage is vaginal bleeding. This can vary from light spotting or brownish discharge to heavy bleeding and bright-red blood or clots. The bleeding may come and go over several days.
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. The resource is based on the real experiences of health professionals and patients, and uses films and interactive activities to enhance your learning.
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Jul 17, 2023 · Symptoms: Severe or worsening back or abdominal pain as well as passing fluids and large clots could indicate a miscarriage. Time: A miscarriage very early in pregnancy can be mistaken for a...
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