Spontaneous Abortion and Miscarriage: A Comprehensive Guide
Spontaneous abortion, also known as miscarriage, is the loss of a pregnancy before 20 weeks' gestation. While the layperson use of the term “abortion” is often intended to refer to induced termination of a pregnancy, “miscarriage” is preferred for spontaneous loss. Most spontaneous abortions occur within the 1st 12 weeks of gestation and can be caused by several factors such as infection, trauma, and genetic and autoimmune causes. Pregnancy is defined as the status during which female mammals carry their developing young (embryos or fetuses) in utero before birth, beginning from fertilization to birth.
Epidemiology
Spontaneous abortion is a common complication of early pregnancy. It accounts for pregnancy loss in 10%–20% of clinically recognized pregnancies. It occurs in all age groups, but the incidence is higher in women > 35 years of age. There is conflicting data on racial predilection.
Classification and Types of Miscarriage
Spontaneous abortion can be classified into different types. When a woman suffers a pregnancy loss, the body must expel the embryonic tissues. Depending on whether this process occurs naturally or not, there are different types of abortion:
- Complete abortion: yes, the entire uterine content is removed.
- Incomplete abortion: embryonic remains remain in the uterus.
- Retained abortion: after the abortion, the woman does not eliminate the embryonic tissue, which is retained inside the uterus.
- Septic abortion: In the event that embryonic remains remain in the woman, it could lead to a septic abortion due to infection, for which medical intervention is necessary.
Other clinical classifications include threatened, inevitable, and missed abortions.
Diagnosis and Management
Spontaneous abortions are diagnosed based on history, physical examination, and ultrasound findings. Spontaneous abortion is the noninduced loss of pregnancy before 20 weeks’ gestation. Regarding treatment, management options include expectant, medical, or surgical therapy. This may occur naturally, or some type of medical intervention such as a curettage may be necessary.
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