Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- sangrado vaginal con o sin coágulos
Other diagnostic factors
- dolor suprapúbico
- dolor lumbar
- sangrado poscoital reciente
- anomalías estructurales uterinas
- antecedentes de traumatismo
Risk factors
- 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
Diagnostic tests
1st tests to order
- ultrasonido transvaginal
- títulos de la fracción beta de la gonadotropina coriónica humana (hCG) en suero
Tests to consider
- 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
Treatment algorithm
amenaza de aborto espontáneo
aborto inevitable/incompleto/retenido
aborto espontáneo completo
aborto espontáneo recurrente
Contributors
Authors
Ida Muslim, MBChB, MRCOG
Consultant Obstetrician & Gynaecologist
The Women’s Centre
Gloucestershire Royal Hospital
Gloucester
UK
Disclosures
IM declares that she has no competing interests.
Jothi Doraiswamy, MBBS, MRCOG
Consultant in Obstetrics and Gynaecology
Gloucestershire Royal Hospital
Gloucester
UK
Disclosures
JD declares that she has no competing interests.
Acknowledgements
Dr Ida Muslim and Dr Jothi Doraiswamy would like to gratefully acknowledge Dr Isaac Babarinsa and Professor Tim Draycott, previous contributors to this topic.
Disclosures
IB and TD declare that they have no competing interests.
Peer reviewers
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
Declarações
JB declares that he has no competing interests.
Créditos aos pareceristas
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Declarações
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Referências
Principais artigos
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].Texto completo
National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. Nov 2021 [internet publication].Texto completo
American College of Obstetricians and Gynecologists. Practice bulletin: early pregnancy loss. Nov 2018 [internet publication].Texto completo
Kim C, Barnard S, Neilson JP, et al. Medical treatments for incomplete miscarriage. Cochrane Database Syst Rev. 2017 Jan 31;(1):CD007223.Texto completo Resumo
Tunçalp O, Gülmezoglu AM, Souza JP. Surgical procedures for evacuating incomplete miscarriage. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD001993.Texto completo Resumo
European Society of Human Reproduction and Embryology. Guideline on the management of recurrent pregnancy loss. Nov 2017 [internet publication].Texto completo
Duckitt K, Qureshi A. Recurrent miscarriage. BMJ Clin Evid. 2015 [internet publication].
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Differentials
- Embarazo ectópico/embarazo heterotópico
- Mola hidatiforme
- Mola hidatiforme parcial
Mais Diagnósticos diferenciaisGuidelines
- Ectopic pregnancy and miscarriage: diagnosis and initial management
- ACR appropriateness criteria: abnormal uterine bleeding
Mais GuidelinesPatient information
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