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[Threatened late miscarriage. French guidelines].

X Carcopino1, K Barde2, M Petrovic2

  • 1Service de gynécologie-obstétrique, Aix-Marseille université (AMU), hôpital Nord, assistance publique des hôpitaux de Marseille (APHM), chemin des Bourrely, 13915 Marseille cedex 20, France; Centre de cancérologie de Marseille, Inserm, U1068, Aix-Marseille université (AMU), UM 105, CNRS, UMR7258, 13000 Marseille, France.

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|December 3, 2014
PubMed
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Guidelines for threatened late miscarriage (TLM) management emphasize history, speculum, and ultrasound for diagnosis. Treatment includes vaginal progesterone for short cervix and cerclage for specific high-risk cases.

Area of Science:

  • Maternal-Fetal Medicine
  • Obstetrics
  • Reproductive Health

Background:

  • Threatened late miscarriage (TLM) presents a clinical challenge in managing pregnant women.
  • Effective management strategies are crucial to improve outcomes and reduce complications.

Purpose of the Study:

  • To establish evidence-based guidelines for the clinical management of threatened late miscarriage.
  • To provide clear recommendations for diagnosis and therapeutic interventions in TLM.

Main Methods:

  • A systematic literature review was conducted using PubMed and the Cochrane Library.
  • Guidelines from major international obstetrical societies were also incorporated.

Main Results:

  • Key diagnostic steps include detailed history, speculum examination for membrane prolapse, and ultrasound for cervical length measurement.
Keywords:
AntibiothérapieAntibioticsBacterial vaginosisCerclageCervical lengthFausse couche tardiveLate miscarriageLongueur cervicaleMembrane prolapseProgesterone therapyProgestéroneProtrusion des membranesVaginose bactérienne

Related Experiment Videos

  • Vaginal progesterone is recommended for shortened cervix (<25mm) in mid-pregnancy (Grade A).
  • Cervical cerclage is indicated for women with a history of premature delivery/late miscarriage and a shortened cervix before 24 weeks (Grade A).
  • For TLM with cervical dilation and potential membrane prolapse, cerclage with tocolysis and antibiotics is recommended (Grade C).

    • Conclusions:

    • Comprehensive assessment including history and ultrasound is vital for diagnosing TLM.
    • Specific interventions like vaginal progesterone and cervical cerclage are recommended based on cervical length and patient history.
    • These guidelines aim to standardize and optimize the management of threatened late miscarriage.