First trimester abortion: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Visualize any clots or bleeding from external os | |||
*Assess '''internal os''' as open or closed based on ability to pass finger through os | |||
*Pregnancy ≤ 13 weeks | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 07:29, 26 April 2014
Background
- Estimates are up to 15% of pregnancies end in a 1st trimester abortion usually due to fetal chromosomal abnormalities
Clinical Features
- Visualize any clots or bleeding from external os
- Assess internal os as open or closed based on ability to pass finger through os
- Pregnancy ≤ 13 weeks
Differential Diagnosis
Complete Abortion
- <12 weeks + no IUP
- Distinguish from ectopic based on decreasing hCG, decreased bleeding
- Only need to send hCG if unable to examine POC
Threatened Abortion
- Closed os + IUP + bloody vaginal dischrage or frank bleeding
- If <11wk >90% go to term
- If between 11 and 20wk 50% go to term
Inevitable Abortion
- Open os + contractions/cramps
Incomplete Abortion
- >12 wks + passage of only portion of POC
Missed Abortion
- Fetal death at <20wk w/o passage of any fetal tissue for 4wk after fetal death
Septic abortion
- Evidence of infection during any stage of abortion
- Most commonly caused by retained products of conception
Workup
Management
Disposition
See Also
Sources
- Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Association between first-trimester vaginal bleeding and miscarriage. Obstet Gynecol. Oct 2009;114(4):860-7