Early Pregnancy Loss Follow-up

Updated: Nov 15, 2017
  • Author: Elizabeth E Puscheck, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Follow-up

Further Outpatient Care

With a complete abortion, measure the hCG level weekly until it is less than 5 mIU/mL in situations in which the products of conception were not evaluated by a physician (eg, the products were flushed down the toilet).

If the expelled products of conception are evaluated by a physician and confirmed to be intact and truly products of conception (not a clot), performing any further follow-up tests is not necessary.

Providing reassurance and routine gynecologic care is recommended.

For ectopic pregnancies, the hCG levels should be monitored as noted above, particularly if medical therapy is performed. If surgical therapy is performed and it is a linear salpingostomy, then the hCG levels should be monitored until they are less than 5 mIU/mL. If a complete salpingectomy is performed and the pathology confirms the ectopic pregnancy, then one may forgo the follow-up for hCG levels.

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Deterrence/Prevention

Contraceptive counseling is warranted. Patients should avoid intercourse or use contraception until the hCG levels have become negative. Patients may wish to continue contraception until they are emotionally ready to try again to become pregnant.

Psychological counseling or grief counseling should be offered for those with early pregnancy loss. Support groups can also be helpful. [33]

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