Management of spontaneous abortion

Area of Science:

• Reproductive Medicine
• Obstetrics and Gynecology

Background:

• Spontaneous abortion (SA) affects up to 20% of recognized pregnancies.
• SA encompasses various types, including threatened, inevitable, incomplete, missed, septic, complete, and recurrent.
• Diagnosis often involves ultrasonography, with further testing needed to rule out ectopic pregnancy.

Purpose of the Study:

• To review current diagnostic and treatment modalities for spontaneous abortion.
• To highlight the efficacy of expectant and medical management in specific SA types.
• To emphasize the importance of addressing psychological impacts on patients and partners.

Main Methods:

• Review of existing literature on spontaneous abortion diagnosis and management.
• Analysis of treatment outcomes for expectant, medical, and surgical interventions.
• Examination of psychological sequelae following spontaneous abortion.

Main Results:

• Expectant management is successful for incomplete SA within two weeks.
• Medical management with misoprostol shows an 80% success rate for missed SA.
• Patients often prefer expectant management when given a choice.

Conclusions:

• Selected patients can benefit from expectant or medical management for SA.
• Surgical evacuation remains the standard for hemodynamically unstable patients.
• Post-SA psychological support is crucial due to increased risks of depression and anxiety.