Spontaneous Abortion: Definition, Classification, and Management
Spontaneous abortion, also known as miscarriage, is the loss of a pregnancy before 20 weeks' gestation. According to the medical definition, spontaneous abortion is the noninduced loss of pregnancy before 20 weeks’ gestation. However, the layperson use of the term “abortion” is often intended to refer to induced termination of a pregnancy, whereas “miscarriage” is preferred for spontaneous loss.
Epidemiology and Etiology
As a common complication of early pregnancy, it accounts for pregnancy loss in 10%–20% of clinically recognized pregnancies. While it occurs in all age groups, the incidence is higher in women > 35 years of age. 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.
Classification
There are different types of spontaneous abortions, including threatened, inevitable, incomplete, complete, and missed abortions. These can be categorized as follows:
| Classification Type | Clinical Category |
|---|---|
| 1 | Threatened abortion |
| 2 | Inevitable abortion |
| 3 | Incomplete abortion |
| 4 | Complete abortion |
| 5 | Missed abortion |
Clinical Presentation and Diagnosis
Spontaneous abortions are diagnosed based on history, physical examination, and ultrasound findings. It is important to distinguish between clinical science and physical symptoms during assessment.
Management Options
Current management options include expectant, medical, or surgical therapy to address the noninduced loss of pregnancy.