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Aborto espontáneo

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Última revisão: 21 Aug 2025
Última atualização: 03 Feb 2023

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • presencia de factores de riesgo
  • sangrado vaginal con o sin coágulos
Полная информация

Другие диагностические факторы

  • dolor suprapúbico
  • dolor lumbar
  • sangrado poscoital reciente
  • anomalías estructurales uterinas
  • antecedentes de traumatismo
Полная информация

Факторы риска

  • edad avanzada
  • malformación uterina
  • vaginosis bacteriana
  • trombofilia
  • anomalía cromosómica parental
  • deficiencia de vitamina D
  • aborto espontáneo/inducido previo
  • infertilidad/reproducción asistida
  • antiinflamatorios no esteroideos (AINE)
  • cafeína
  • alcohol
  • tabaquismo
  • sobrepeso/obesidad
  • disfunción tiroidea
  • diabetes mellitus
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • ultrasonido transvaginal
  • títulos de la fracción beta de la gonadotropina coriónica humana (hCG) en suero
Полная информация

Исследования, проведение которых нужно рассмотреть

  • ultrasonido transabdominal
  • progesterona en suero
  • prueba de embarazo en orina
  • hemograma completo (HC)
  • grupo sanguíneo Rh
  • anticoagulante lúpico/anticuerpos anticardiolipina
  • ultrasonido pélvico
  • análisis citogenético en productos de la concepción
  • cariotipo parental
  • frotis vaginal
Полная информация

Алгоритм лечения

Начальные

amenaza de aborto espontáneo

Острый

aborto inevitable/incompleto/retenido

aborto espontáneo completo

ПРОДОЛЖЕНИЕ

aborto espontáneo recurrente

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

Disclosures

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.

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