Miscarriage, Abortion and ectopic pregnancy

Miscarriage

• Spontaneous loss of viability before 24 weeks gestation

Miscarriage• ExtragenitalImmunological

Endocrine

Infection

Environmental

GenitalMalformation

Fibroid

Cervical insufficiency

Miscarriage

• Threatening miscarriageSubchorial haemorrhage, cramps,

bleeding, closed cervix

• Incomplete abortionPassing products of conception, cervix

opened

• Complete abortionSpontenously emptied uterus

Miscarriage

• Evacuation of retained products of conception unless uterus is emptied spontaneously• Rhesus check• Culture & sensitivity +

antibiotics if infectious origin suspected• Special investigations if

recurrent (thrombophilia, LA, immunology, TORCH, karyotyping)

Miscarriage

• Family planning• Preconceptual advice and

support• Periconceptional vitamin

supplementation• Special considerations in

recurrent losses (elimination or suppression of causes) i.e. Aspirin, LMWH

Abortion

• Artificial termination of a pregnancy before 24 weeks gestation

Abortion

Ectopic pregnancy