[Recent recommendations in the management of early pregnancy failure]

Spontaneous abortion refers to pregnancy loss up to the end of 22 weeks' (21(+7)) gestation. Currently, the terminology suggests early pregnancy loss or early pregnancy failure. Miscarriage occurs in 10-20% of pregnancies, and most of them take place up to 13 weeks'gestation. Management in the case of vaginal bleeding in women with a confirmed pregnancy requires a physical examination (with a speculum), and a biochemical and ultrasound diagnosis. Conservative, pharmacological or surgical management can be offered to patients with an incomplete miscarriage. The pharmacological method of proceeding in miscarriages is recommended by many scientific societies (ACOG, RCOG), and WHO, as well as in manuals for students and for obstetrician-gynecologists developed by leading experts in Poland. The procedure for pharmacological treatment with mizoprostol is: 1. Pregnancy under 9 weeks gestation: 800 mg vaginally, and if there is no effect after 4 h another 400 mg vaginally or orally. 2. Pregnancy over 9 weeks gestation: up to 4 x 400 mg every 3 hours. 3. In the absence of any effect after 36 hours from the start of the treatment, a surgical procedure is recommended. 4. The prevention of chlamydia infection in each patient: 1 g of metronidazole rectally and one dose of 1 g azithromycin, or 2 x 100 mg of doxycycline for 7 days. The legal aspects regarding the administrative proceedings after early pregnancy failure relate to the correct reporting of feat death on proper forms.