Aborto espontâneo
Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- sangramento vaginal com ou sem coágulos
Other diagnostic factors
- dor suprapúbica
- lombalgia
- sangramento pós-coito recente
- anormalidade estrutural uterina
- história de trauma
Risk factors
- idade avançada
- malformação uterina
- vaginose bacteriana
- trombofilia
- anomalia cromossômica parental
- deficiência de vitamina D
- aborto espontâneo/induzido prévio
- infertilidade/concepção assistida
- anti-inflamatórios não esteroidais (AINEs)
- cafeína
- bebidas alcoólicas
- tabagismo
- sobrepeso/obesidade
- disfunção tireoidiana
- diabetes mellitus
Diagnostic tests
1st tests to order
- ultrassonografia transvaginal
- títulos de beta-hCG
Tests to consider
- ultrassonografia transabdominal
- progesterona sérica
- teste de gravidez na urina
- Hemograma completo
- tipagem sanguínea para grupo RH
- anticoagulante lúpico/anticorpos anticardiolipina
- ultrassonografia pélvica
- análise citogenética em produtos de concepção
- cariótipo parental
- swab vaginal
Treatment algorithm
ameaça de aborto espontâneo
aborto espontâneo inevitável/incompleto/não identificado
aborto espontâneo completo
abortamento habitual
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
Divulgaciones
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
Divulgaciones
JB declares that he has no competing interests.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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 Resumen
Tunçalp O, Gülmezoglu AM, Souza JP. Surgical procedures for evacuating incomplete miscarriage. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD001993.Texto completo Resumen
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].
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Gravidez ectópica/gravidez heterotópica
- Mola hidatiforme
- Mola hidatiforme parcial
Más DiferencialesGuías de práctica clínica
- Ectopic pregnancy and miscarriage: diagnosis and initial management
- ACR appropriateness criteria: abnormal uterine bleeding
Más Guías de práctica clínicaFolletos para el paciente
Aborto espontâneo
Más Folletos para el pacienteVideos
Aborto espontâneo: experiência de aborto espontâneo
Aborto espontâneo: discussão sobre fatores causais
Más vídeos
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