Overview
How is early pregnancy loss classified?
What is the pathophysiology of early pregnancy loss?
What is the pathophysiology of threatened miscarriage?
What is the pathophysiology of inevitable miscarriage?
What is the pathophysiology of incomplete miscarriage?
What is the pathophysiology of complete miscarriage?
What causes early pregnancy loss?
What are the risk factors for early pregnancy loss?
What is the role of NSAIDs in the etiology of early pregnancy loss?
What is the prevalence of early pregnancy loss in the US?
What is the global prevalence of early pregnancy loss?
What are the racial predilections of early pregnancy loss?
How does maternal age affect the risk of early pregnancy loss?
What is the likelihood of a successful pregnancy following an early pregnancy loss?
What is the mortality rate associated with early pregnancy loss?
What are the potential complications of early pregnancy loss?
What is included in patient education about early pregnancy loss?
Presentation
Which clinical history findings are characteristic of early pregnancy loss?
What is the focus of the pelvic exam to evaluate a suspected early pregnancy loss?
What are the physical findings of a threatened miscarriage?
What are the physical findings of an incomplete miscarriage?
What are the physical findings of a complete miscarriage?
What are the physical findings of a missed miscarriage?
DDX
How is early pregnancy loss differentiated from an ectopic pregnancy?
What is the role of RhoGAM in the workup of early pregnancy loss?
How is hemorrhage assessed in the evaluation of suspected early pregnancy loss?
How are retained products of conception identified in the workup of suspected early pregnancy loss?
What services should be offered to a patient who has experienced an early pregnancy loss?
What are the differential diagnoses for Early Pregnancy Loss in Emergency Medicine?
Workup
Which lab tests are performed in the workup of early pregnancy loss?
What is the role of ultrasonography in the workup of early pregnancy loss?
Treatment
What is included in prehospital care for early pregnancy loss?
How is early pregnancy loss treated in the emergency department (ED)?
How is inevitable miscarriage treated?
How is incomplete miscarriage treated?
How is complete miscarriage treated in the emergency department (ED)?
How is missed miscarriage treated in the emergency department (ED)?
When is inpatient care indicated for the treatment of early pregnancy loss?
When is patient transfer required for the treatment of early pregnancy loss?
Which specialist consultations are beneficial to patients with early pregnancy loss?
How is recurrent early pregnancy loss prevented?
What is included in the long-term monitoring of threatened miscarriage?
What is included in the long-term monitoring of an incomplete miscarriage?
What is included in the long-term monitoring of a missed miscarriage?
Medications
What is the role of medications in the treatment of early pregnancy loss?
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This image shows an endovaginal longitudinal view of a low-lying gestational sac (GS) within the uterus (Ut), representing an incomplete miscarriage.
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This endovaginal longitudinal view demonstrates fluid within the uterus (Ut). Echogenic debris also is present within the endometrial cavity. This image shows a large pseudogestational sac of an ectopic pregnancy.
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This endovaginal ultrasonographic image demonstrates a subchorionic hemorrhage (SH) less than half the gestational sac size.
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This flowchart details a diagnostic algorithm based on sonographic findings in early pregnancy, using high-frequency endovaginal sonography (HFEVS) of more than 5 megahertz (MHz). The flowchart incorporates clinical presentation (spotting vs clinical bleeding) with sonographic findings to aid in making clinical decisions. The algorithm continues in Media file 5.
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This flowchart outlines a diagnostic algorithm based on the initial endovaginal sonographic finding of an intrauterine embryo. The chart incorporates fetal cardiac activity, crown-rump length (CRL), presence of subchorionic hemorrhage (SCH), and uterine or adnexal masses with clinical presentation (spotting vs bleeding) to aid in making clinical decisions.
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This endovaginal ultrasonogram reveals an irregular gestational sac with an amorphic fetal pole. No fetal cardiac activity was noted. This image represents a missed miscarriage or fetal demise.