Miscarriage medical therapy: Difference between revisions
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===Medical Therapy=== | ===Medical Therapy=== | ||
Blood loss during early pregnancy is the most common symptom of both miscarriage and of [[ectopic pregnancy]]. Pain does not strongly correlate with miscarriage, but is a common symptom of ectopic pregnancy.<ref name="risk factors" /> In the case of concerning blood loss, pain, or both, [[Obstetric ultrasonography|transvaginal ultrasound]] is performed. If a viable intrauterine pregnancy is not found with ultrasound, serial [[human chorionic gonadotropin|βHCG]] tests should be performed to rule out ectopic pregnancy, which is a life-threatening situation.<ref name="diagnostic">{{cite journal | author = Yip S, Sahota D, Cheung L, Lam P, Haines C, Chung T | title = Accuracy of clinical diagnostic methods of threatened abortion | journal = Gynecol Obstet Invest | volume = 56 | issue = 1 | pages = 38-42 | year = 2003 | id = PMID 12876423}}</ref><ref name="followHCG">{{cite journal | author = Condous G, Okaro E, Khalid A, Bourne T | title = Do we need to follow up complete miscarriages with serum human chorionic gonadotrophin levels? | journal = BJOG | volume = 112 | issue = 6 | pages = 827-9 | year = 2005 | id = PMID 15924545}}</ref> | Blood loss during early pregnancy is the most common symptom of both miscarriage and of [[ectopic pregnancy]]. Pain does not strongly correlate with miscarriage, but is a common symptom of ectopic pregnancy.<ref name="risk factors" /> In the case of concerning blood loss, pain, or both, [[Obstetric ultrasonography|transvaginal ultrasound]] is performed. If a viable intrauterine pregnancy is not found with ultrasound, serial [[human chorionic gonadotropin|βHCG]] tests should be performed to rule out ectopic pregnancy, which is a life-threatening situation.<ref name="diagnostic">{{cite journal | author = Yip S, Sahota D, Cheung L, Lam P, Haines C, Chung T | title = Accuracy of clinical diagnostic methods of threatened abortion | journal = Gynecol Obstet Invest | volume = 56 | issue = 1 | pages = 38-42 | year = 2003 | id = PMID 12876423}}</ref><ref name="followHCG">{{cite journal | author = Condous G, Okaro E, Khalid A, Bourne T | title = Do we need to follow up complete miscarriages with serum human chorionic gonadotrophin levels? | journal = BJOG | volume = 112 | issue = 6 | pages = 827-9 | year = 2005 | id = PMID 15924545}}</ref> | ||
If the bleeding is light, making an appointment to see one's doctor is recommended. If bleeding is heavy, there is considerable pain, or there is a fever, then emergency medical attention should be sought. | If the bleeding is light, making an appointment to see one's doctor is recommended. If bleeding is heavy, there is considerable pain, or there is a fever, then emergency medical attention should be sought. | ||
No treatment is necessary for a diagnosis of complete abortion (as long as ectopic pregnancy is ruled out). In cases of an incomplete abortion, empty sac, or missed abortion there are three treatment options: | No treatment is necessary for a diagnosis of complete abortion (as long as ectopic pregnancy is ruled out). In cases of an incomplete abortion, empty sac, or missed abortion there are three treatment options: | ||
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*Medical management usually consists of using [[misoprostol]] (a [[prostaglandin]], brand name Cytotec) to encourage completion of the miscarriage. About 95% of cases treated with misoprostol will complete within a few days.<ref name="afp" /> | *Medical management usually consists of using [[misoprostol]] (a [[prostaglandin]], brand name Cytotec) to encourage completion of the miscarriage. About 95% of cases treated with misoprostol will complete within a few days.<ref name="afp" /> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WikiDoc Help Menu}} | {{WikiDoc Help Menu}} | ||
{{WikiDoc Sources}} | {{WikiDoc Sources}} | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
Blood loss during early pregnancy is the most common symptom of both miscarriage and of ectopic pregnancy. Pain does not strongly correlate with miscarriage, but is a common symptom of ectopic pregnancy.[1] In the case of concerning blood loss, pain, or both, transvaginal ultrasound is performed. If a viable intrauterine pregnancy is not found with ultrasound, serial βHCG tests should be performed to rule out ectopic pregnancy, which is a life-threatening situation.[2][3]
If the bleeding is light, making an appointment to see one's doctor is recommended. If bleeding is heavy, there is considerable pain, or there is a fever, then emergency medical attention should be sought.
No treatment is necessary for a diagnosis of complete abortion (as long as ectopic pregnancy is ruled out). In cases of an incomplete abortion, empty sac, or missed abortion there are three treatment options:
- With no treatment (watchful waiting), most of these cases (65-80%) will pass naturally within two to six weeks.[4] This path avoids the side effects and complications possible from medications and surgery.[5]
- Medical management usually consists of using misoprostol (a prostaglandin, brand name Cytotec) to encourage completion of the miscarriage. About 95% of cases treated with misoprostol will complete within a few days.[4]
References
- ↑
- ↑ Yip S, Sahota D, Cheung L, Lam P, Haines C, Chung T (2003). "Accuracy of clinical diagnostic methods of threatened abortion". Gynecol Obstet Invest. 56 (1): 38–42. PMID 12876423.
- ↑ Condous G, Okaro E, Khalid A, Bourne T (2005). "Do we need to follow up complete miscarriages with serum human chorionic gonadotrophin levels?". BJOG. 112 (6): 827–9. PMID 15924545.
- ↑ 4.0 4.1 Kripke C (2006). "Expectant management vs. surgical treatment for miscarriage". Am Fam Physician. 74 (7): 1125–6. PMID 17039747. Retrieved 2006-12-31.
- ↑ Tang O, Ho P (2006). "The use of misoprostol for early pregnancy failure". Curr Opin Obstet Gynecol. 18 (6): 581–6. PMID 17099326.