Treatment Guideline Chart

Spontaneous miscarriage is the loss of fetus before 20 weeks of gestation or delivery of a fetus weighing <500 g, in the absence of elective medical or surgical measures to terminate pregnancy.
Early loss is considered if it occurred before menstrual week 12 while late loss refers to those that occurred from menstrual week 12-20.
It is also known as spontaneous abortion, spontaneous pregnancy loss or early pregnancy failure.

Miscarriage - Spontaneous References

  1. Duckitt K, Qureshi A. Recurrent miscarriage. Am Fam Physician. 2008 Oct;78(8):977-978. http://www.aafp.org/afp/2008/1015/. Accessed 04 Feb 2013. PMID: 18953976
  2. Branch DW, Gibson M, Silver RM. Clinical Practice. Recurrent miscarriage. N Engl J Med. 2010 Oct;363(18):1740-1747. doi: 10.1056/NEJMcp1005330. PMID: 20979474
  3. Giorgino FL, Egan CG. Use of isoxsuprine hydrochloride as a tocolytic agent in the treatment of preterm labour: a systematic review of previous literature. Arzneimittelforschung. 2010;60(7):415-420. doi: 10.1055/s-0031-1296305. PMID: 20712130
  4. Ford HB, Schust DJ. Recurrent pregnancy loss: etiology, diagnosis, and therapy. Rev Obstet Gynecol. 2009;2(2):76-83. PMID: 19609401
  5. Griebel AP, Halvorsen J, Golemon TB, Day AA. Management of spontaneous abortion. Am Fam Physician. 2005 Oct;72(7):1243-1250. http://www.aafp.org/afp/2005/1001/p1243.html. Accessed 04 Feb 2013. PMID: 16225027
  6. Wahabi HA, Fayed AA, Esmaeil SA, AL Zeidan RA. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev. 2011 Dec(12):CD0059943. http://www.ncbi.nlm.nih.gov/pubmed. PMID: 22161393
  7. The Practice Committee of the American Society for Reproductive Medicine. Evaluation and treatment of recurrent pregnancy loss: a committee opinion. Jul 24, 2012. Fertil Steril. 2012 Nov;98(5):1103-1111. http://www.asrm.org. Accessed 04 Feb 2013. PMID: 22835448
  8. Siriwachirachai T, Piriyasupong T. Effect of Dydrogesterone on treatment of threatened miscarriage: a systematic review and meta-analyses. Thai J Obstet Gynaecol. 2011 Jul;19:97-104
  9. Dulay AT. Spontaneous Abortion (Miscarriage). Merck Manual; 2010 Feb. http://www.merckmanuals.com. Accessed 21 May 2013.
  10. MedWormhttp://www.medworm.com/rss/index.php/OBGYN/29/http://www.medworm.com/rss/medicalfeeds/specialities/OBGYN.xml
  11. Institute of Obstetricians and Gynecologists, Royal College of Physicians of Ireland and Directorate of Strategy and Clinical Programmes, Health Service Executive. Management of early pregnancy miscarriage. http://www.hse.ie/eng. 2012. Accessed 05 Feb 2013.
  12. National Collaborating Centre for Women's and Children's Health commissioned by the National Institute of Health and Clinical Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. http://www.nice.org.uk. Dec 2012. Accessed 05 Feb 2013.
  13. Women's Hospitals Australasia (WHA). Management of early pregnancy loss. Clinical practice guideline 2008. http://www.midwives.org.au. Accessed 04 Feb 2013.
  14. Royal College of Obstetricians and Gynaecologists. The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. Green-top guideline no. 17. http://www.rcog.org.uk. Apr 2011.
  15. Workshop of Association of Indonesian Fertility Endocrinologists Reproduction-Indonesian Society of Obstetrics and Gynecology. Guidelines for the Management of Recurrent Miscarriage. http://www.rcog.org.uk. Jun 2010.
  16. Gul U, Zafar M, Akhtar A. Efficacy of Dydrogesterone in the management of threatened miscarriage in the first trimester. http://www.pafmj.org. 2012.
  17. Committee on Practice Bulletins-Gynecology. The American College of Obstetricians and Gynecologists practice bulletin no. 150. Early pregnancy loss. Obstet Gynecol. 2015 May;125(5):1258-1267. doi: 10.1097/01.AOG.0000465191.27155.25. Accessed 25 Aug 2016. PMID: 25932865
  18. Costescu D, Guilbert E, Bernardin J, et al. Medical abortion. The Society of Obstetricians and Gynaecologists of Canada. http://www.jogc.com. Apr 2016. Accessed 17 Aug 2016.
  19. BMJ Best Practice. Miscarriage. BMJ Best Practice website. http://bestpractice.bmj.com. 30 Dec 2016.
  20. Tulandi T, Al-Fozan HM. Definition and etiology of recurrent pregnancy loss. UpToDate. https://www.uptodate.com. 11 Jan 2017.
  21. Tulandi T, Al-Fozan HM. Spontaneous abortion: management. UpToDate. https://www.uptodate.com. 11 Apr 2017.
  22. Cosma S, Carosso AR, Cusato J, et al. Coronavirus disease 2019 and first-trimester spontaneous abortion: a case-control study of 225 pregnant patients. Am J Obstet Gynecol. 2021 Apr;224(4):391.e1-391.e7. doi: 10.1016/j.ajog.2020.10.005. PMID: 33039396
  23. ESHRE Early Pregnancy Guideline Development Group. Recurrent pregnancy loss. Version 2. ESHRE. https://www.eshre.eu. 01 Apr 2019. Accessed 08 May 2021.
  24. Li YH, Marren A. Recurrent pregnancy loss: a summary of international evidence-based guidelines and practice. Aust J Gen Pract. 2018 Jul;47(7):432-436. doi: 10.31128/AJGP-01-18-4459. PMID: 30114870
  25. National Institute for Health and Care Excellence (NICE). Ectopic pregnancy and miscarriage: diagnosis and initial management. NICE. http://www.nice.org.uk. 17 Apr 2019. Accessed 08 May 2021.
  26. Prager S, Micks E, Dalton VK. Pregnancy loss (miscarriage): management techniques. UpToDate. https://www.uptodate.com. 30 Oct 2020.
  27. Norwitz ER, Park JS. Overview of the etiology and evaluation of vaginal bleeding in pregnant women. UpToDate. https://www.uptodate.com. 17 Dec 2019.
  28. Prager S, Micks E, Dalton VK. Pregnancy loss (miscarriage): risk factors, etiology, clinical manifestations, and diagnostic evaluation. UpToDate. https://www.uptodate.com. 25 Jan 2021.
  29. Papas RS, Kutteh WH. A new algorithm for the evaluation of recurrent pregnancy loss redefining unexplained miscarriage: review of current guidelines. Curr Opin Obstet Gynecol. 2020 Oct;32(5):371-379. doi: 10.1097/GCO.0000000000000647. PMID: 32590384
  30. Prager S, Micks E, Dalton VK. Pregnancy loss (miscarriage): assessment, counseling, and choice of treatment. UpToDate. https://www.uptodate.com. 09 Feb 2021.
  31. South Australian Perinatal Practice Guidelines. Bleeding & pain in early pregnancy: ectopic pregnancy, miscarriage & PUL. https://www.sahealth.sa.gov.au. 12 Apr 2021.
  32. Tulandi T, Al-Fozan HM. Recurrent pregnancy loss: definition and etiology. UpToDate. https://www.uptodate.com. 19 Feb 2021.
  33. Tulandi T, Al-Fozan HM. Recurrent pregnancy loss: evaluation. UpToDate. https://www.uptodate.com. 21 Oct 2019.
  34. Tulandi T, Al-Fozan HM. Recurrent pregnancy loss: management. UpToDate. https://www.uptodate.com. 07 Apr 2021.
  35. World Health Organization. Medical management of abortion. WHO. https://www.who.int. 2018.
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