Miscarriage

Definition

  • Abortion is the expulsion or extraction from its mother of an embryo or fetus weighing 500 g or less when it is not capable of independent survival (WHO)

  • 500 g of fetal weight = approx. at 22 weeks (154 days) of gestation

  • Abortus = expelled embryo

Incidence

  • 10-20% of all clinical pregnancies end in miscarriage

  • 10% are induced or deliberate

  • about 75% miscarriages occur before 16th weeks and of these about 80% occur before 12th week of pregnancy

Etiology

  1. Genetic - autosomal trisomy, polyploidy, monosomy, chromosomal rearrangement

  2. Endocrine & metabolic - luteal phase defect, progesterone deficiency, hyper/hypothyroid, DM

  3. Anatomic - cervical incompetence, abnormal uterus, fibroid, intrauterine adhesions

  4. Infection - Virus: rubella, cytomegalovirus, HIV; Parasite: toxoplasma, malaria; Bacteria: ureaplasma, chlamydia, brucella

  5. Immunological - antiphospholipid antibody syndrome, immune factors, autoimmune

  6. Thrombophilias

  7. Environmental - cigarette smoking, anesthetic gases, arsenic, formaldehyde

  8. Others - maternal heart disease, hemoglobinopathies, premature rupture of membrane

  9. Unexplained

Types of Miscarriage

  1. Complete miscarriage - os closed, no POC

  2. Incomplete miscarriage - os closed, some remaining POC

  3. Missed miscarriage - os closed, non-viable

  4. Threatened miscarriage - os closed, PV bleeding with a viable fetus

  5. Inevitable miscarriage - os open, non-viable

  6. Septic miscarriage - os may open or closed, there maybe POC with intrauterine infection characterized by uterine tenderness and fever

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Table Of Contents
Miscarriage
Definition
Incidence
Etiology
Types of Miscarriage