miscarriage

Question 1

types

Answer 1

1. threatened
2. missed/delayed
3. inevitable
4. incomplete

Question 2

what is threatened miscarriage?

Answer 2

painless vaginal bleeding occurring before 24 weeks, but typically occurs at 6 - 9 weeks

the bleeding is often less than menstruation

cervical os is closed

complicates up to 25% of all pregnancies

Question 3

what is a missed or delayed miscarriage?

Answer 3

a gestational sac which contains a dead fetus before 20 weeks without the symptoms of expulsion

mother may have light vaginal bleeding / discharge and the symptoms of pregnancy which disappear.

Pain is not usually a feature

cervical os is closed

when the gestational sac is > 25 mm and no embryonic/fetal part can be seen it is sometimes described as a ‘blighted ovum’ or ‘anembryonic pregnancy’

Question 4

what is an inevitable miscarriage

Answer 4

heavy bleeding with clots and pain

cervical os is open

Question 4

what is an inevitable miscarriage

Answer 4

heavy bleeding with clots and pain

cervical os is open

Question 5

what is an incomplete miscarriage

Answer 5

not all products of conception have been expelled

pain and vaginal bleeding

cervical os is open

Question 6

Mx

Answer 6

1. expectant - waiting for 7-14 days
2. medical vaginal misoprostol - prostaglandin analogue +/- addition of oral mifepristone

• bleeding should start with in 24h
• also give natiemtics and pain relief

3. surgical