Miscarriage, spontaneous abortion (mechanism of disease)

ERRATA:
- The box labeled "Maternal smoking and/or drugs" should be labeled blue, representing "Environmental / toxins"
- The box labeled "Iatrogenic / unknown" should read "Idiopathic / unknown"
This is a flow chart on miscarriages (also called spontaneous abortion), covering the definition, etiologies, and manifestations.
ADDITIONAL TAGS:
Risk factors / SDOH
Cell / tissue damage
Hereditary / genetic
Miscarriage
Medicine / iatrogenic
Infectious / microbial
Biochem / metabolic
Immunology / inflammation
Signs / symptoms
Tests / imaging / labs
Environmental / toxins
Reproductive pathology
Uterus / cervix
Definition
Etiology
Manifestations
Miscarriage, aka spontaneous abortion: loss of pregnancy before 20 weeks' gestation.
Threatened abortion
Inevitable abortion
Missed abortion
Incomplete abortion
Complete abortion
x
x
x
x
or
Uterus
+/- POC:
products of
conception
+/- bleeding
Cervical os
Fetal activity
+ bleeding
+ activity
Reversible
Closed os
Intrauterine POC
+ bleeding
+/- activity
Irreversible
Open os
Visible / palpable POC
+ bleeding
No activity
Irreversible
Open os
Uterus or cervical canal POC
+ bleeding
No activity
Irreversible
Closed os
Extrauterine POC
No bleeding
No activity
Irreversible
Closed os
No expulsion of POC
TVUS: confirms +/- uterine bleeding; +/- fetal cardiac motion; abnormalities of yolk or gestational sac
Pelvic exam: visualize cervix; +/- vaginal bleeding
Downtrending β-hCG
Loss of pregnancy after
20 weeks is called stillbirth
Abnormal maternal reproductive organs:
Septate uterus
Uterine leiomyomas
Uterine adhesions
Cervical incompetence
Maternal systemic diseases:
Diabetes mellitus
Hyper/hypothyroidism
Infections
Hypercoagulation (antiphospholipid synd)
Fetoplacental:
50%: chromosomal abnormalities
Congenital anomalies
Anembryonic pregnancy (sac, no embryo)
Trauma
Maternal smoking and/or drugs
Amniocentesis, chorionic villus sampling
Idiopathic
/ unknown

[@DrA902]

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[@itssomeone4407]

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