- Threatened Abortion. Threatened abortion is characterized by bleeding, a closed cervical os, and no passage of POCs. It is managed expectantly until the patient’s symptoms resolve or there is a progression to an inevitable, incomplete, or complete abortion
- Inevitable abortion: The patient has vaginal bleeding, usually with crampy pelvic pain, and the cervix is dilated (i.e an open os). The products of conception(POC) can usually be seen or felt through the internal cervical os. In other words, for an inevitable abortion, the symptoms cannot be stopped and a miscarriage will happen.
- Incomplete abortion: The patient has vaginal bleeding and/or pain are present, the cervix is dilated (ie. os is open), and POC is found within the cervical canal on examination.
- Missed abortion: Missed abortion defines “a pregnancy in which there is a fetal demise (usually for a number of weeks) but no uterine activity to expel the products of conception”AAFP 2005. The cervical os is closed. “The pregnancy is lost and the products of conception do not leave the body.”
- Complete abortion defines an abortion in which the POC have completely passed out of the uterus and cervix, the cervix is closed, and the uterus is small and well-contracted; vaginal bleeding and pain may be mild or may have resolved.
*”The most common cause of spontaneous abortion in the first 12 weeks of pregnancy is chromosomal anomalies (accounting for about half of abortions). Maternal lupus anticoagulant, incompetent cervix, maternal tobacco abuse, and inadequate progesterone during.”
References / Further Reading
www.uptodate.com/contents/spontaneous-abortion-management
https://www.aafp.org/afp/2005/1001/p1243.html