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Patient who comes to the medical office today july 27,2010 with bled vaginal. Date of Last Rule = On April 07, 2010.
The endovaginal ultrasound, shows:
womb of increased size with gestacional sac in the interior, which is of irregular rims. Not solution of continuity. Some fetal remains are visualized in the interior, but not beats cardiac. Gestacional Sac = 32.0 x 15.8 mm, compatible with 8 weeks 1 day of gestation.
Abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus or embryo, resulting in or caused by its death.[2] An abortion can occur spontaneously due to complications during pregnancy or can be induced, in humans and other species. In the context of human pregnancies, an abortion induced to preserve the health of the gravida (pregnant female) is termed a therapeutic abortion, while an abortion induced for any other reason is termed an elective abortion. The term abortion most commonly refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed miscarriages.
Causes and Risks: The cause of most spontaneous abortions is fetal death due to fetal growth abnormalities, not any factor related to the mother. Other possible causes for spontaneous abortion include: infection, physical defects of the mother, hormone (endocrine) factors, immune responses, and serious systemic diseases of the mother (such as diabetes or thyroid problems).
It is estimated that up to 50% of all fertilized eggs die and are lost (aborted) spontaneously, usually before the woman knows she is pregnant. Among known pregnancies, the rate of spontaneous abortion is approximately 10% and usually occurs between the 7th and 12th weeks of pregnancy (gestation).
The risk for spontaneous abortion is increased in women over the age of 35, and in women with systemic disease (such as diabetes or thyroid dysfunction) and those with a history of three or more prior spontaneous abortions.
Spontaneous abortion naturally occurs after fetal death. The dead tissue is discarded from the uterus and the woman resumes her normal menstrual cycle within a few weeks (usually). Note: It is frequently possible to become pregnant immediately after a spontaneous abortion. However, it is recommended that a woman wait for one or two normal menstrual cycles before attempting another pregnancy. On occasion, the uterus does not expel all of the fetal tissue, in which case it is considered an incomplete abortion. Incomplete spontaneous abortions may require surgical removal of the retained tissue.
If there is fetal death that is not accompanied by uterine expulsion of the dead tissue, it is considered a missed abortion. Signs of pregnancy decrease, the uterus begins shrinking to its original size, and a brownish or reddish vaginal discharge is often experienced. If spontaneous abortion does not occur in a reasonable amount of time (about 4 weeks), a D and C or D and E will have to be performed, or labor induced to remove the dead fetus.
When a mother’s body is having difficulty sustaining a pregnancy, signs such as slight vaginal bleeding may occur. This is a threatened abortion, which means there is a possibility of abortion, but it is not inevitable. A pregnant woman who develops any signs or symptoms of threatened miscarriage should contact her prenatal provider immediately.
Retained dead fetal tissue in the uterus is referred to as an incomplete abortion. This may cause infection and the retained uterine tissue must be removed surgically (D and C ).
An infection may occur after either a complete or incomplete abortion.
In a missed abortion, the pregnancy has continued for 4 weeks or longer following the death of the fetus. This usually occurs during the second trimester. Sometimes (if early enough in the pregnancy) a D and C or D and E can be performed to remove all of the dead tissue. Frequently labor must be induced to expel the dead fetus and other uterine tissue if the pregnancy is late in the second trimester.
Dead fetus syndrome is the term used to describe a condition that affects the mother. If the fetus has died but the dead tissue has not been discarded by the uterus, an abnormal activation of blood clotting systems (coagulation and fibrinolytic systems) can develop in response to the release of anti-clotting chemicals from the retained dead fetus (missed abortion).

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