First trimester abortion
Background
Clinical Features
Differential Diagnosis
Complete Abortion
- <12 weeks + no IUP
- Distinguish from ectopic based on decreasing hCG, decreased bleeding
- Only need to send hCG if unable to examine POC
Threatened Abortion
- Closed os + IUP + bloody vaginal dischrage or frank bleeding
- If <11wk >90% go to term
- If between 11 and 20wk 50% go to term
Inevitable Abortion
- Open os + contractions/cramps
Incomplete Abortion
- >12 wks + passage of only portion of POC
Missed Abortion
- Fetal death at <20wk w/o passage of any fetal tissue for 4wk after fetal death
Septic abortion
- Evidence of infection during any stage of abortion
- Most commonly caused by retained products of conception