Spontaneous abortion

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Epidemiology

Occurs in 15% of pregnancies

Differential Diagnosis

Threatened abortion
Incomplete abortion
Inevitable abortion
- Ongoing bleeding, dilated cervix, products of conception being expelled
Missed abortion
Septic abortion

Management

Management depends on etiology
- Threatened abortion
  - Expectant management until symptoms resolve or abortion progresses
- Incomplete, inevitable, and missed abortion
  - If unstable: surgical evacuation
  - If stable: expectant management, prostaglandins, +/- surgical evacuation (suction curettage)
- Septic abortion
  - Blood cultures
  - Endometrial cultures
  - Broad-spectrum antibiotics
  - Surgical evacuation

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Obstetrical medicine