Miscarriage

Question 1

How can you differentiate between an ectopic pregnancy and an early viable uterine pregnancy when no sac can be seen in the uterus on US?

Answer 1

hCG should increase >66% over 48hrs with a viable intrauterine pregnancy.

In an ectopic hCG commonly drops or stays roughly the same (‘plateaus’)

Question 2

What are the management options of a non-viable intrauterine pregnancy?

Answer 2

Conservative:
- Await bleed

Medical:

• Anti-progesterone = Mifepristone
• Prostaglandin = Misoprostil

Surgical:
- Evacuation of retained products of conception