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Miscarriage

ბოლო მიმოხილვა: 13 Feb 2025
ბოლო განახლება: 03 Feb 2023

შეჯამება

Definição

História e exame físico

Principais fatores diagnósticos

  • vaginal bleeding with or without clots
Detalhes completos

Outros fatores diagnósticos

  • suprapubic pain
  • low back pain
  • recent postcoital bleed
  • uterine structural abnormality
  • history of trauma
Detalhes completos

Fatores de risco

  • older age
  • uterine malformation
  • bacterial vaginosis
  • thrombophilia
  • parental chromosomal anomaly
  • vitamin D deficiency
  • previous spontaneous/induced miscarriage
  • infertility/assisted conception
  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • caffeine
  • alcohol
  • smoking
  • overweight/obesity
  • thyroid dysfunction
  • diabetes mellitus
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • transvaginal ultrasound scan
  • serum beta hCG titers
Detalhes completos

Tests to avoid

  • inherited thrombophilia test
Detalhes completos

Investigações a serem consideradas

  • transabdominal ultrasound scan
  • serum progesterone
  • urine pregnancy test
  • CBC
  • rhesus blood group
  • lupus anticoagulant, anticardiolipin antibodies, and anti-beta 2 glycoprotein I antibodies
  • pelvic ultrasound
  • cytogenetic analysis on products of conception
  • parental karyotype
  • vaginal swab
Detalhes completos

Algoritmo de tratamento

Inicial

threatened miscarriage

AGUDA

inevitable/incomplete/missed miscarriage

complete miscarriage

CONTÍNUA

recurrent miscarriage

Colaboradores

Autores

Ida Muslim, MBChB, MRCOG

Consultant Obstetrician & Gynaecologist

The Women’s Centre

Gloucestershire Royal Hospital

Gloucester

UK

Declarações

IM declares that she has no competing interests.

Jothi Doraiswamy, MBBS, MRCOG

Consultant in Obstetrics and Gynaecology

Gloucestershire Royal Hospital

Gloucester

UK

Declarações

JD declares that she has no competing interests.

Agradecimentos

Dr Ida Muslim and Dr Jothi Doraiswamy would like to gratefully acknowledge Dr Isaac Babarinsa and Professor Tim Draycott, previous contributors to this topic.

Declarações

IB and TD declare that they have no competing interests.

Revisores

Jo Trinder, MD

Consultant Obstetrician and Gynaecologist

St Michael's Maternity Wing

Bristol Royal Infirmary

Bristol

UK

Declarações

JT is the primary author of one randomized 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

Declarações

JB declares that he has no competing interests.

  • Diagnósticos diferenciais

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