Miscarriage

Question 1

Initial Assessment

Answer 1

History and Examination
BP, pulse, temperature
Haemoglobin, group and save (or crossmatch if severe haemodynamic compromise)

Question 2

Risk factor

Answer 2

Maternal age (independent risk factor)

Question 3

Causes

Answer 3

Chromosomal abnormalities
Medical/endocrine disorders
Uterine abnormalities
Infections
Drugs/chemicals

Question 4

Threatened Miscarriage

Answer 4

Present with PV bleeding and pain
Speculum - cervical os closed
US - intrauterine pregnancy

Question 5

Inevitable Miscarriage

Answer 5

Present with PV bleeding and pain
Speculum - cervical os open
US - intrauterine pregnancy

Question 6

Incomplete Miscarriage

Answer 6

Present with PV bleeding and pain
Speculum - cervical os open, production of conception located in cervical os
US - retained products of conception

Question 7

Complete Miscarriage

Answer 7

Present with pain and bleeding that has resolved
Speculum - cervical os closed
US - no retained products of conception

Question 8

Missed Miscarriage

Answer 8

May present with or without pain and bleeding
US - fetal pole present, but no fetal heartbeat is identified. Gestational sac is present, but no fetal pole is identified.

Question 9

Definition

Answer 9

Loss of fetus from week 20