Missed Abortion.

MIssed Abortion

Define Missed abortion : When foetus is dead and retained inside the uterus for a viable period, It is called missed abortion or silent miscarriage or early fetal demise.

We have described in article :

Causes of missed abortion

Diagnosis of missed abortion

Investigations of missed abortion

Complications of missed abortion:

missed abortion

Causes of missed abortion:

1.) Chromosomal abnormality within the foetus: Due to

  • Poor quality sperm or ovum.
  • Abnormal cell division of foetus.

2) Genetic abnormalities of father or mother.

3) Infection:

4) Abnormal uterine anatomy:

  • Unicornuate uterus. 
  • Septate uterus.

5) Abnormal hormonal levels within the mothers: Low progesterone. 

6) Systemic illness:

7) Immune disorders.

8) Substance abuse.

Also read.

Management of missed abortion: 

Diagnosis: The patient presents with features of threatened abortion followed by : 

  1. Persistence of brownish vaginal discharge
  2. Subsidence of pregnancy symptoms. 
  3. Retrogression of breast changes.
  4. Cessation of uterine growth which in fact becomes smaller in size 
  5. Non-audibility of the fetal heart sound even with Doppler cardioscope if it had been audible before.
  6. Cervix feels firm

Investigations of missed abortion:

  1. Immunological test for pregnancy becomes negative.
  2. Real time ultrasonography reveals an empty sac carly in the pregnancy or the absence of foetal motion or foetal heart movement later in the pregnancy.
  3. Bleeding time, clotting time, platelet count, FDP: For treatment planning 
  4. Blood grouping, Rh typing & cross matching.

Treatment of Missed abortion: 

1) Uterus is less than 12 weeks:  Vaginal evacuation by suction evacuation or slowly dilatation cervix by laminara tent followed by D & E of the uterus under G/A.

2) Uterus more than 12 weeks : 

  • First dilation of cervix then evacuation. 
  • Induction is done by following drugs:

           ✓ Oxytocin

           ✓ Prostaglandins.

Complications of missed abortion: 

1) Psychological upset.

2) Infection: Sepsis (by gas forming organisms like Clostridium welchii).

3) Blood coagulation disorder: DIC 

4) During labour : 

  • Uterine inertia 57.
  • Retained placenta.
  • Postpartum haemorrhage.

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  1. April 19, 2023

    […] Missed Abortion. […]

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