Medical history (history of illness) is an important component in the diagnosis of miscarriage (abortion). Family history Are there any hereditary diseases in your family? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints). Are you bleeding from the vagina?* … Miscarriage (Abortion): Medical History
Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Appendicitis (inflammation of the appendix). Colitis (inflammation of the colon) Ileitis (inflammation of the small intestine) Neoplasms – tumor diseases (C00-D48) Cervical carcinoma (cervical cancer). Pregnancy, childbirth, and puerperium (O00-O99). Abortive egg (wind egg) – placenta (placenta) develops, but not the embryo (trophoblast/outer cell layer of … Miscarriage (Abortion): Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by miscarriage (abortion): Infectious and parasitic diseases (A00-B99). Septic shock – severe blood poisoning, possibly resulting in death. Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Peritonitis (inflammation of the peritoneum). Psyche – nervous system (F00-F99; G00-G99) Anxiety/anxiety disorder Depressiveness/Depression … Miscarriage (Abortion): Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin and mucous membranes Abdomen (abdomen): Shape of the abdomen? Skin color? Skin texture? Efflorescences (skin changes)? Pulsations? Bowel movements? Visible vessels? Scars? Hernias (fractures)? Gynecological … Miscarriage (Abortion): Examination
Laboratory parameters of the 1st order – obligatory laboratory tests. Beta-HCG (human chorionic gonadotropins) – determination is necessary in case of inconclusive findings or abortus imminens (threatened miscarriage) or suspicion of disturbed early pregnancy (early pregnancy). It is performed as a follow-up at 2-day intervals. In an intact pregnancy, the beta-HCG values double per 48 … Miscarriage (Abortion): Test and Diagnosis
Therapeutic target Prevention of abortion in abortus imminens or promotion of expulsion of the fruit. Therapy recommendations Therapy recommendations depending on the diagnosis: Abortes imminens (threatened abortion): magnesium, progesterone/dehyrosterone (progestins). Missed abortion (restrained abortion): abortion induction (initiation of abortion) using Gemeprost (prostaglandin E1 analogue). Late abortion 15 – 24 SSW post menstruationem: abortion induction in … Miscarriage (Abortion): Drug Therapy
Pathogenesis (development of disease) In miscarriage, a multifactorial event is present. Several factors can be distinguished, such as maternal (maternal), genital, and extragenital factors, as well as immunologic, fetoplacental, or andrologic (male-related) factors. Chromosomal disorders of the embryo or fetus are present in 50-70% of all spontaneous abortions. Another frequent cause of spontaneous abortions is … Miscarriage (Abortion): Causes
General measures In case of abortus imminens (threatened abortion): Bed rest Repeated determination of β-HCG (human chorionic gonadotropin; pregnancy hormone). In abortus febrilis (febrile or septic abortion): Intensive care monitoring Observance of the general hygiene measures! Nicotine restriction (refrain from tobacco use). Alcohol restriction (abstaining from alcohol) Limited caffeine consumption (max. 200 mg caffeine per … Miscarriage (Abortion): Therapy
Obligatory medical device diagnostics. Vaginal sonography (ultrasound examination using an ultrasound probe inserted into the vagina (vagina)). Sonography is performed for accurate diagnosis of abortion or disturbed early pregnancy (early pregnancy), as well as to exclude other intra-abdominal diseases (diseases of the abdominal organs). In addition to an exact determination of the gestational age and … Miscarriage (Abortion): Diagnostic Tests
A symptom of deficiency may indicate that there is an insufficient supply of vital substances (micronutrients). The complaint miscarriage indicates a deficiency of vital substances (micronutrients) for: Folic acid Vitamin B12 Iodine Within the framework of micronutrient medicine (vital substances), the following vital substances (micronutrients) are used for prevention (prevention): Folic acid Vitamin B12 Iodine … Miscarriage (Abortion): Micronutrient Therapy
Surgical therapy – 1st order. For abortus incipiens – incipient abortion, abortus incompletus – incomplete abortion, abortus completus (complete abortion), or missed abortion (restrained abortion). Curettage (scraping of the uterus) – surgical intervention using a blunt curette alternatively as a suction curette (suction curette is the means of choice in the treatment of abortion up … Miscarriage (Abortion): Surgical Therapy
To prevent miscarriage (abortion), attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Micronutrient deficiency (vital substances) – see Prevention with micronutrients. Consumption of stimulants Coffee – Women who consumed 200 mg (equivalent to one cup of coffee) or more of caffeine per day during pregnancy had twice the risk of … Miscarriage (Abortion): Prevention
