Miscarriage Flashcards
Miscarriage who definition
Expulsion of a fetus or embryo weighing 500g or less, and the gestational limit is less than 22 completed weeks of pregnancy
Early miscarriage
Loss before 12 weeks
Late miscarriage
Loss between 12 - 24 weeks
Causes of miscarriage
Chromosomal abnormalities Fetal malformations Placental abnormalities Infection Multiple pregnancy AMA, APA Stress Previous TOP Low pre preg weight Change of partner Previous misc Infertility ART Chronic illness Endocrine disorders RT and CT Uterine malformations/fibroids High mat BMI
Reduced risk of miscarriage
Previous live birth Nausea Vitamin supplementation Well enough to fly or have sex Eating fresh fruits and vegetables daily
Expectant management
First line treatment for 7-14 days
Can have a further 2 weeks if wish
Risk of pleading higher
Higher mental health scores in an RCT
Medical management follow up
Urine preg test in three weeks
Infection rate of miscarriage
3%
Work up prior to procedure
FBC Blood group Consent Administer meds (some use mife, some use miso only) Return advice
Risks with ERPOC
Perforation up to 5:1000 Trauma to cervix Bleeding Repeat ERPOC up to 5:100 Infection 3:100 Laparoscopy
Rh prophylaxis dosing
<20 weeks 250IU
>20 weeks 500IU
Routine anti-D not required below 12 weeks if fetus is viable unless bleeding heavy or associated with abdominal pain
USS intervals
1 week repeat scan if <7mm w/o FHR
GSD 12-24mm, no live embryo
2 week repeat scan if GSD <12mm
