Spontaneous abortion

Background

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