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Aborto espontâneo

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Last reviewed: 24 Sep 2025
Last updated: 03 Feb 2023

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • sangramento vaginal com ou sem coágulos
Full details

Other diagnostic factors

  • dor suprapúbica
  • lombalgia
  • sangramento pós-coito recente
  • anormalidade estrutural uterina
  • história de trauma
Full details

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
Full details

Diagnostic tests

1st tests to order

  • ultrassonografia transvaginal
  • títulos de beta-hCG
Full details

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
Full details

Treatment algorithm

INITIAL

ameaça de aborto espontâneo

ACUTE

aborto espontâneo inevitável/incompleto/não identificado

aborto espontâneo completo

ONGOING

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

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

Disclosures

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.

References

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.

Key articles

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].Full text

National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. Nov 2021 [internet publication].Full text

American College of Obstetricians and Gynecologists. Practice bulletin: early pregnancy loss. Nov 2018 [internet publication].Full text

Kim C, Barnard S, Neilson JP, et al. Medical treatments for incomplete miscarriage. Cochrane Database Syst Rev. 2017 Jan 31;(1):CD007223.Full text  Abstract

Tunçalp O, Gülmezoglu AM, Souza JP. Surgical procedures for evacuating incomplete miscarriage. Cochrane Database Syst Rev. 2010 Sep 8;(9):CD001993.Full text  Abstract

European Society of Human Reproduction and Embryology. Guideline on the management of recurrent pregnancy loss. Nov 2017 [internet publication].Full text

Duckitt K, Qureshi A. Recurrent miscarriage. BMJ Clin Evid. 2015 [internet publication].

Reference articles

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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