Presentation
A 22-year-old Chinese woman with HWWS whose left uterine pregnancy underwent spontaneous abortion presented with a right perforated obstructed hemivagina and right renal agenesis. [ncbi.nlm.nih.gov]
[…] be made at presentation. [journals.lww.com]
Cardiac activity is present in normal embryos before it can be detected on ultrasound. [sonoworld.com]
Gastrointestinal
- Abdominal Pain
The right vaginal septum was resected and the hematocolpos was drained, thereby relieving lower abdominal pain and preserving future fertility. [ncbi.nlm.nih.gov]
Patients typically present with vaginal bleeding and severe lower abdominal pain. We report a 25 year old female with vaginal bleeding, bilateral abdominal pain, and normal transvaginal US findings on admission. [openaccessjournals.com]
Symptoms of miscarriage may include vaginal spotting or bleeding; abdominal pain or abdominal cramps; low back pain; or fluid, tissue, or clot-like material passing from the vagina. [web.archive.org]
Factors that may contribute to miscarriage include A genetic problem with the fetus Problems with the uterus or cervix Chronic diseases, such as polycystic ovary syndrome Signs of a miscarriage include vaginal spotting, abdominal pain or cramping, and [medlineplus.gov]
- Abdominal Cramps
Symptoms of miscarriage may include vaginal spotting or bleeding; abdominal pain or abdominal cramps; low back pain; or fluid, tissue, or clot-like material passing from the vagina. [web.archive.org]
At this point, minor abdominal cramping and light spotting or bleeding are possible. An ultrasound will show an empty gestational sac. A blighted ovum eventually results in miscarriage. [mayoclinic.org]
If a pregnant woman has any of the symptoms of pregnancy loss, such as abdominal cramps, back pain, light spotting, or bleeding, she should contact her health care provider immediately. [nichd.nih.gov]
- Abdominal Tenderness
Signs and symptoms of this infection include: Fever Chills Lower abdominal tenderness Foul-smelling vaginal discharge Prevention Often, there's nothing you can do to prevent a miscarriage. [mayoclinic.org]
An abdominal exam should evaluate for tenderness and any peritoneal signs, such as rebound or guarding, that may indicate an ectopic pregnancy. [cancertherapyadvisor.com]
Musculoskeletal
- Back Pain
Symptoms of miscarriage may include vaginal spotting or bleeding; abdominal pain or abdominal cramps; low back pain; or fluid, tissue, or clot-like material passing from the vagina. [web.archive.org]
Urogenital
- Vaginal Bleeding
(see “differential diagnosis of vaginal bleeding”). [amboss.com]
bleeding occurring before 20 wk gestation without cervical dilation and indicating that spontaneous abortion may occur Inevitable Vaginal bleeding or rupture of the membranes accompanied by dilation of the cervix Incomplete Expulsion of some products [merckmanuals.com]
A woman at 6-8 weeks' gestation presented with vaginal bleeding and abdominal pain. Although afebrile, the patient was hypotensive, tachycardic, and tachypneic. [ncbi.nlm.nih.gov]
Typically, patients present with vaginal bleeding and a (still) closed uterine orifice. Pregnancy is still intact and infantile heart sounds are still detectable. [lecturio.com]
[…] miscarry Inevitable abortion: Vaginal bleeding, cervical os is open; products of conception (POC) have not been expelled Incomplete abortion: Vaginal bleeding, cervical os is open with partial passage of some POC and some retained POC Complete abortion [emergency.unboundmedicine.com]
- Vaginal Discharge
Signs and symptoms of this infection include: Fever Chills Lower abdominal tenderness Foul-smelling vaginal discharge Prevention Often, there's nothing you can do to prevent a miscarriage. [mayoclinic.org]
Symptoms of an infection include fever, vaginal bleeding that does not stop, cramping, and a foul-smelling vaginal discharge. Infections can be serious and need immediate medical attention. [nlm.nih.gov]
There was no association of the presence of BV with the gynecological complaints, such as vaginal discharge, itching, and pain ( P > 0.05). [jcytol.org]
- Foul Smelling Vaginal Discharge
Signs and symptoms of this infection include: Fever Chills Lower abdominal tenderness Foul-smelling vaginal discharge Prevention Often, there's nothing you can do to prevent a miscarriage. [mayoclinic.org]
Symptoms of an infection include fever, vaginal bleeding that does not stop, cramping, and a foul-smelling vaginal discharge. Infections can be serious and need immediate medical attention. [nlm.nih.gov]
Women who have had an unsafe abortion usually come to the health care facility with the following signs and symptoms: ‐ vaginal bleeding ‐ abdominal pain ‐ fever ‐ purulent or foul smelling vaginal discharge ‐ shock The interventions which the health [doi.org]
- Adnexal Tenderness
tenderness or peritoneal irritation can be consistent with an ectopic pregnancy Bimanual exam to determine the size of the uterus: Size of an orange: 6–8 wk Fundus at the symphysis pubis: 12 wk Fundus at the umbilicus: 16–20 wk Pregnancy test as below [emergency.unboundmedicine.com]
Diagnosis required the presence of two or more of four clinical features — purulent yellow, green, or foul-smelling vaginal discharge; pyrexia (>38.0°C according to ear thermometry); uterine, parametrial, or adnexal tenderness on examination; and a white-cell [doi.org]
Signs and symptoms of ectopic pregnancy include increased hCG, vaginal bleeding (in varying amounts), sudden lower abdominal pain,[4] pelvic pain, a tender cervix, an adnexal mass, or adnexal tenderness.[1] In the absence of ultrasound or hCG assessment [en.wikipedia.org]
Workup
Bourne, There is no role for uterine curettage in the contemporary diagnostic workup of women with a pregnancy of unknown location, Human Reproduction, 21, 10, (2706), (2006). [doi.org]
Although MRIs are not involved in the SA workup, an MRI study was ordered in the ED in the background of otherwise normal findings to asses for a potential appendicitis, which has been commonly reported during pregnancy in the literature [ 11 ]. [openaccessjournals.com]
Procedures When the diagnosis is unclear, the following procedures may be performed: Culdocentesis Diagnostic dilation and curettage See Workup for more detail. [reference.medscape.com]
It is of utmost importance that the laboratory has its interest invested in infertility workups. [fertilitysolution.com]
What type of workup is needed after early pregnancy loss? No workup generally is recommended until after the second consecutive clinical early pregnancy loss (7). [m.acog.org]
Treatment
The positive rate of ACA in failure group before treatment was higher than the data of after treatment, and the difference was statistically significant (p < 0.05). [ncbi.nlm.nih.gov]
The specific treatment used depends on how far along the pregnancy was, the woman's overall health, her age, and other factors. 1 In many cases, pregnancy loss before 20 weeks may not require any special treatment. [nichd.nih.gov]
Prognosis
Miscellaneous Unknown (in some studies, more than half of all stillbirths were of unknown etiology) Environmental (exposure to toxins such as drugs or maternal smoking during pregnancy) References:[2][1][3] Clinical features Type Findings Cervical os Prognosis [amboss.com]
Speert, H. ( 1954 ) Pregnancy prognosis following repeated abortion. Am. J. Obstet. Gynec. 68, 665. Spicer, C.C. & Lipworth, L. ( 1966 ) Regional and Social Factors in Infant Mortality. [cambridge.org]
Liu et al ( 29 ) demonstrated that IGFBP-7 was downregulated in gastric cancer, and that it may be used as an indicator of poor prognosis in patients with gastric cancer. [spandidos-publications.com]
Prognosis Threatened miscarriage is associated with risk of subsequent preterm delivery. Increased risk of further miscarriages. After three miscarriages, consider as recurrent spontaneous miscarriage. [patient.info]
Etiology
Similarly, fetal autopsy should be performed after a stillbirth in order to determine the underlying cause and address any modifiable etiologies. [amboss.com]
Only etiologic studies were considered. Results. Fifteen studies met inclusion criteria. [doi.org]
The data are still incomplete regarding the etiologic role, if any, of cytomegalovirus and the occurrence of spontaneous abortion. [ncbi.nlm.nih.gov]
Epidemiology
Department: Institutionen för medicinsk epidemiologi och biostatistik / Department of Medical Epidemiology and Biostatistics Abstract The overall objectives of this thesis were to increase the understanding of the etiology of spontaneous abortion and [openarchive.ki.se]
Epidemiology 1996;7:250-255 6. Fenster L, Eskenazi B, Windham GC, Swan SH. Caffeine consumption during pregnancy and spontaneous abortion. Epidemiology 1991;2:168-174 7. Fenster L, Hubbard AE, Swan SH, et al. [nejm.org]
Dose-response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiology 1995 ; 6 : 356 –65. 29. Ford JH, MacCormac L, Hiller J. [doi.org]
American Journal of Epidemiology, 128(2), 420-430. [top] Nybo Andersen, A. M., Wohlfahrt, J., Christens, P., Olsen, J., & Melbye, M. (2000). Maternal age and fetal loss: Population based register linkage study. [web.archive.org]
Pathophysiology
All miscarriages are the result of a pathophysiologic reproductive event. It is the current challenge of medicine to find those underlying causes and, in some cases, underlying causes that are common occurrences are often overlooked. [naprotechnology.com]
The pathophysiology of cervical insufficiency is still poorly understood. [doi.org]
"This approach is currently criticized as our insight into the pathophysiology of miscarriage has improved, and it has become clear that there is lack of evidence to support the [efficacy] of bed rest in this condition." [medscape.com]
Most studies do not differentiate separately between the epidemiology and pathophysiology of each entity. [reference.medscape.com]
Prevention
In many cases, a woman can do little to prevent a miscarriage. However, having pre-conception and prenatal care (before becoming pregnant and during pregnancy) is the best prevention available for all complications associated with pregnancy. [web.archive.org]
Is there a way to prevent? BACK TO TOP [nichd.nih.gov]
Therefore, progestogens have been used, beginning in the first trimester of pregnancy, in an attempt to prevent spontaneous miscarriage. To determine the efficacy and safety of progestogens as a preventative therapy against miscarriage. [ncbi.nlm.nih.gov]