Abortion, spontaneous

Alternative names:

miscarriage

Treatment:

Treatment for threatened abortion varies from restrictions on some forms of exercise to complete bedrest. Abstaining from intercourse is usually recommended until signs have disappeared.

In the event of spontaneous abortion, the tissue passed from the vagina should be examined to determine the source of the tissue (fetal vs. hydatidiform mole) and if any fetal tissue remains in the uterus (incomplete abortion). Missed abortions that do not abort naturally and incomplete spontaneous abortions may require surgical removal of retained tissue (D&C procedure). Any further vaginal bleeding should be carefully monitored.

Expectations (prognosis):

Maternal outcome is good and complications are rare. Waiting a few months before trying to become pregnant again is usually recommended.

Complications:

• Retained dead fetal tissue in the uterus is referred to as an incomplete abortion. This may cause infection and the retained uterine tissue must be removed surgically (D&C (dilation and curettage)).
• An infection may occur after either a complete or incomplete abortion.
• In a missed abortion the pregnancy has continued for 4 weeks or longer following the death of the fetus. This usually occurs during the second trimester. Sometimes (if early enough in the pregnancy) a D&C or D&E can be performed to remove all of the dead tissue. Frequently labor must be induced to expel the dead fetus and other uterine tissue.
• Dead fetus syndrome is the term used to describe a condition which affects the mother. If the fetus has died but the dead tissue has not been discarded by the uterus, an abnormal activation of blood clotting systems (coagulation and fibrinolytic systems) can develop in response to the release of anti-clotting chemicals from the retained dead fetus (missed abortion).

Calling your health care provider:

Call your health care provider if vaginal bleeding with or without cramping occurs during pregnancy.

Call your health care provider if you are pregnant and notice tissue or clot-like material passed vaginally (any such material should be collected and brought in for examination).