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Missed abortion

Authoring team

This is the situation where there is fetal death before 24 weeks gestation but the fetus is not lost from the uterus.

This definition was changed from 28 weeks to 24 weeks on the 1st of October 1992.

Clinical presentation:

  • questionable vaginal bleeding
  • uterus small for dates
  • cervix is closed
  • few obvious symptoms

Diagnosis:

  • pregnancy test is either positive or negative
  • fetal heart, movements and ultrasound evidence of fetal life are all absent

Management:

  • assess clotting status
  • ERPC
  • Rhesus prophylaxis if appropriate
  • effective medical management include:
    • high dose of prostaglandin with longer duration of use
    • priming with antiprogesterone (1)

Bleeding into the chorio-decidual space may result in the formation of an organized, laminated mass called a carneous mole.

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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