Miscarriage
Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- presence of risk factors
- vaginal bleeding with or without clots
Другие диагностические факторы
- suprapubic pain
- low back pain
- recent post-coital bleed
- uterine structural abnormality
- history of trauma
Факторы риска
- older age
- uterine malformation
- bacterial vaginosis
- thrombophilia
- parental chromosomal anomaly
- vitamin D deficiency
- previous spontaneous/induced miscarriage
- infertility/assisted conception
- non-steroidal anti-inflammatory drugs (NSAIDs)
- caffeine
- alcohol
- smoking
- overweight/obesity
- thyroid dysfunction
- diabetes mellitus
Диагностические исследования
Исследования, которые показаны в первую очередь
- trans-vaginal ultrasound scan
- serum beta hCG titres
Исследования, проведение которых нужно рассмотреть
- transabdominal ultrasound scan
- serum progesterone
- urine pregnancy test
- FBC
- rhesus blood group
- lupus anticoagulant/anticardiolipin antibodies
- pelvic ultrasound
- cytogenetic analysis on products of conception
- parental karyotype
- vaginal swab
Алгоритм лечения
threatened miscarriage
inevitable/incomplete/missed miscarriage
complete miscarriage
recurrent miscarriage
Составители
Авторы
Ida Muslim, MBChB, MRCOG
Consultant Obstetrician & Gynaecologist
The Women’s Centre
Gloucestershire Royal Hospital
Gloucester
UK
Раскрытие информации
IM declares that she has no competing interests.
Jothi Doraiswamy, MBBS, MRCOG
Consultant in Obstetrics and Gynaecology
Gloucestershire Royal Hospital
Gloucester
UK
Раскрытие информации
JD declares that she has no competing interests.
Выражение благодарностей
Dr Ida Muslim and Dr Jothi Doraiswamy would like to gratefully acknowledge Dr Isaac Babarinsa and Professor Tim Draycott, previous contributors to this topic.
Раскрытие информации
IB and TD declare that they have no competing interests.
Рецензенты
Jo Trinder, MD
Consultant Obstetrician and Gynaecologist
St Michael's Maternity Wing
Bristol Royal Infirmary
Bristol
UK
Раскрытие информации
JT is the primary author of one randomised controlled trial cited in this topic. This trial was funded by an NHS Research and Development Grant and a donation from Exelgyn, the manufacturer of misoprostol. JT has accepted honoraria for speaking to groups of midwives and doctors about miscarriage management.
John Bachman, MD
Consultant in Family Medicine
Parker D Sanders and Isabella Sanders Professor of Primary Care
Rochester
MN
Раскрытие информации
JB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
World Health Organization, UNICEF, United Nations Population Fund. Vaginal bleeding in early pregnancy. In: Managing complications in pregnancy and childbirth: a guide for midwives and doctors - 2nd edition. 2017 [internet publication].Полный текст
National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. Nov 2021 [internet publication].Полный текст
American College of Obstetricians and Gynecologists. Practice bulletin: early pregnancy loss. Nov 2018 [internet publication].Полный текст
Kim C, Barnard S, Neilson JP, et al. Medical treatments for incomplete miscarriage. Cochrane Database Syst Rev. 2017 Jan 31;(1):CD007223.Полный текст Аннотация
Tunçalp O, Gülmezoglu AM, Souza JP. Surgical procedures for evacuating incomplete miscarriage. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD001993.Полный текст Аннотация
European Society of Human Reproduction and Embryology. Guideline on the management of recurrent pregnancy loss. Nov 2017 [internet publication].Полный текст
Duckitt K, Qureshi A. Recurrent miscarriage. BMJ Clin Evid. 2015 [internet publication].
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Ectopic pregnancy/heterotopic pregnancy
- Hydatidiform mole
- Partial hydatidiform mole
Больше ОтличияРекомендации
- Ectopic pregnancy and miscarriage: diagnosis and initial management
- ACR appropriateness criteria: abnormal uterine bleeding
Больше РекомендацииЛифлеты для пациента
Miscarriage
Больше Лифлеты для пациентаVideos
Miscarriage: experience of miscarriage
Miscarriage: discussing causal factors
Больше Видео
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