Early Pregnancy Loss Questions & Answers

1. Cengiz H, Dagdeviren H, Kanawati A, et al. Ischemia-modified albumin as an oxidative stress biomarker in early pregnancy loss. J Matern Fetal Neonatal Med. 2015 Sep 18. 1-4. [QxMD MEDLINE Link].

2. Barnhart KT, Katz I, Hummel A, Gracia CR. Presumed diagnosis of ectopic pregnancy. Obstet Gynecol. 2002 Sep. 100(3):505-10. [QxMD MEDLINE Link].

3. Condous G, Kirk E, Lu C, et al. There is no role for uterine curettage in the contemporary diagnostic workup of women with a pregnancy of unknown location. Hum Reprod. 2006 Oct. 21(10):2706-10. [QxMD MEDLINE Link].

4. Calleja-Agius J, Jauniaux E, Pizzey AR, Muttukrishna S. Investigation of systemic inflammatory response in first trimester pregnancy failure. Hum Reprod. 2011 Nov 29. [QxMD MEDLINE Link].

5. Nelson DB, Hanlon AL, Wu G, Liu C, Fredricks DN. First trimester levels of BV-associated bacteria and risk of miscarriage among women early in pregnancy. Matern Child Health J. 2015 Dec. 19 (12):2682-7. [QxMD MEDLINE Link].

6. Giakoumelou S, Wheelhouse N, Cuschieri K, Entrican G, Howie SE, Horne AW. The role of infection in miscarriage. Hum Reprod Update. 2015 Sep 19. [QxMD MEDLINE Link].

7. Thangaratinam S, Tan A, Knox E, et al. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ. 2011 May 9. 342:d2616. [QxMD MEDLINE Link]. [Full Text].

8. Arck PC, Rucke M, Rose M, et al. Early risk factors for miscarriage: a prospective cohort study in pregnant women. Reprod Biomed Online. 2008 Jul. 17(1):101-13. [QxMD MEDLINE Link].

9. Maconochie N, Doyle P, Prior S, Simmons R. Risk factors for first trimester miscarriage--results from a UK-population-based case-control study. BJOG. 2007 Feb. 114(2):170-86. [QxMD MEDLINE Link].

10. Gracia CR, Sammel MD, Chittams J, Hummel AC, Shaunik A, Barnhart KT. Risk factors for spontaneous abortion in early symptomatic first-trimester pregnancies. Obstet Gynecol. 2005 Nov. 106(5 Pt 1):993-9. [QxMD MEDLINE Link].

11. Nakhai-Pour HR, Perrine B, Sheehy O, Berard A. Use of nonaspirin nonsteroidal anti-inflammatory drugs during pregnancy and the risk of spontaneous abortion. CMAJ. September 6, 2011. [Full Text].

12. Hahn KA, Hatch EE, Rothman KJ, et al. Body Size and Risk of Spontaneous Abortion among Danish Pregnancy Planners. Paediatr Perinat Epidemiol. 2014 Sep. 28(5):412-23. [QxMD MEDLINE Link].

13. Mølgaard-Nielsen D, Svanström H, Melbye M, Hviid A, Pasternak B. Association Between Use of Oral Fluconazole During Pregnancy and Risk of Spontaneous Abortion and Stillbirth. JAMA. 2016 Jan 5. 315 (1):58-67. [QxMD MEDLINE Link].

14. Osterweil N. Oral Antifungal in Pregnancy Increases Miscarriage Risk. Medscape Medical News. Available at http://www.medscape.com/viewarticle/856792. January 05, 2016; Accessed: October 14, 2016.

15. Hinkle SN, Mumford SL, Grantz KL, Silver RM, Mitchell EM, Sjaarda LA, et al. Association of Nausea and Vomiting During Pregnancy With Pregnancy Loss: A Secondary Analysis of a Randomized Clinical Trial. JAMA Intern Med. 2016 Sep 26. [QxMD MEDLINE Link].

16. Phillips D. Nausea, Vomiting Linked to Reduced Risk for Pregnancy Loss. Medscape Medical News. Available at http://www.medscape.com/viewarticle/869381. September 27, 2016; Accessed: October 14, 2016.

17. Clifford K, Rai R, Regan L. Future pregnancy outcome in unexplained recurrent first trimester miscarriage. Hum Reprod. 1997 Feb. 12(2):387-9. [QxMD MEDLINE Link].

18. Liddell HS, Pattison NS, Zanderigo A. Recurrent miscarriage--outcome after supportive care in early pregnancy. Aust N Z J Obstet Gynaecol. 1991 Nov. 31(4):320-2. [QxMD MEDLINE Link].

19. Stray-Pedersen B, Stray-Pedersen S. Etiologic factors and subsequent reproductive performance in 195 couples with a prior history of habitual abortion. Am J Obstet Gynecol. 1984 Jan 15. 148(2):140-6. [QxMD MEDLINE Link].

20. Chang J, Elam-Evans LD, Berg CJ, et al. Pregnancy-related mortality surveillance--United States, 1991--1999. MMWR Surveill Summ. 2003 Feb 21. 52(2):1-8. [QxMD MEDLINE Link].

21. Farren J, Jalmbrant M, Ameye L, Joash K, Mitchell-Jones N, Tapp S, et al. Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study. BMJ Open. 2016 Nov 2. 6 (11):e011864. [QxMD MEDLINE Link].

22. O’Riordan M. Pregnancy loss associated with a later risk of atherosclerosis. March 29, 2013. Available at http://www.medscape.com/viewarticle/781681.

23. Ranthe MF, Andersen EA, Wohlfarht J, Bundgaard H, Melbye M, Boyd HA. Pregnancy Loss and Later Risk of Atherosclerotic Disease. Circulation. 2013 Mar 27. [QxMD MEDLINE Link].

24. Practice Committee of American Society for Reproductive Medicine. Medical treatment of ectopic pregnancy. Fertil Steril. 2008 Nov. 90(5 Suppl):S206-12. [QxMD MEDLINE Link].

25. Lewis R. First Do No Harm: Guidelines Define a Nonviable Pregnancy. Medscape Medical News. Available at http://www.medscape.com/viewarticle/812346. Accessed: October 15, 2013.

26. Doubilet PM, Benson CB, Bourne T, Blaivas M. Diagnostic Criteria for Nonviable Pregnancy Early in the First Trimester. N Engl J Med. 2013 Oct 10. 369(15):1443-1451. [QxMD MEDLINE Link].

27. Weeks A, Alia G, Blum J, et al. A randomized trial of misoprostol compared with manual vacuum aspiration for incomplete abortion. Obstet Gynecol. 2005 Sep. 106(3):540-7. [QxMD MEDLINE Link].

28. Zhang J, Gilles JM, Barnhart K, Creinin MD, Westhoff C, Frederick MM. A comparison of medical management with misoprostol and surgical management for early pregnancy failure. N Engl J Med. 2005 Aug 25. 353(8):761-9. [QxMD MEDLINE Link].

29. Lee SK, Kim JY, Han AR, et al. Intravenous immunoglobulin G improves pregnancy outcome in women with recurrent pregnancy losses with cellular immune abnormalities. Am J Reprod Immunol. 2015 Oct 29. [QxMD MEDLINE Link].

30. Luna RL, Nunes AK, Oliveira AG, et al. Sildenafil (Viagra) blocks inflammatory injury in LPS-induced mouse abortion: A potential prophylactic treatment against acute pregnancy loss?. Placenta. 2015 Oct. 36 (10):1122-9. [QxMD MEDLINE Link].

31. [Guideline] American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 94: Medical management of ectopic pregnancy. Obstet Gynecol. 2008 Jun. 111(6):1479-85. [QxMD MEDLINE Link]. [Full Text].

32. Wahabi HA, Fayed AA, Esmaeil SA, Al Zeidan RA. Progestogen for treating threatened miscarriage. Cochrane Database Syst Rev. 2011 Dec 7. 12:CD005943. [QxMD MEDLINE Link].

33. Boyle FM, Mutch AJ, Barber EA, Carroll C, Dean JH. Supporting parents following pregnancy loss: a cross-sectional study of telephone peer supporters. BMC Pregnancy Childbirth. 2015 Nov 9. 15:291. [QxMD MEDLINE Link].

34. [Guideline] ACOG practice bulletin. ACOG practice bulletin. Medical management of tubal pregnancy. Number 3, December 1998. Clinical management guidelines for obstetrician-gynecologists. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1999 Apr. 65(1):97-103. [QxMD MEDLINE Link].

35. Chipchase J, James D. Randomised trial of expectant versus surgical management of spontaneous miscarriage. Br J Obstet Gynaecol. 1997 Jul. 104(7):840-1. [QxMD MEDLINE Link].

36. Chung TK, Cheung LP, Sahota DS, Haines CJ, Chang AM. Spontaneous abortion: short-term complications following either conservative or surgical management. Aust N Z J Obstet Gynaecol. 1998 Feb. 38(1):61-4. [QxMD MEDLINE Link].

37. Creinin MD, Schwartz JL, Guido RS, Pymar HC. Early pregnancy failure--current management concepts. Obstet Gynecol Surv. 2001 Feb. 56(2):105-13. [QxMD MEDLINE Link].

38. Geyman JP, Oliver LM, Sullivan SD. Expectant, medical, or surgical treatment of spontaneous abortion in first trimester of pregnancy? A pooled quantitative literature evaluation. J Am Board Fam Pract. 1999 Jan-Feb. 12(1):55-64. [QxMD MEDLINE Link].

39. Hurd WW, Whitfield RR, Randolph JF Jr, Kercher ML. Expectant management versus elective curettage for the treatment of spontaneous abortion. Fertil Steril. 1997 Oct. 68(4):601-6. [QxMD MEDLINE Link].

40. Jurkovic D, Ross JA, Nicolaides KH. Expectant management of missed miscarriage. Br J Obstet Gynaecol. 1998 Jun. 105(6):670-1. [QxMD MEDLINE Link].

41. Kalousek DK. Clinical significance of morphologic and genetic examination of spontaneously aborted embryos. Am J Reprod Immunol. 1998 Feb. 39(2):108-19. [QxMD MEDLINE Link].

42. Katz VL, Lentz G, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia: Mosby Elsevier; 2007.

43. Keith SC, London SN, Weitzman GA, O'Brien TJ, Miller MM. Serial transvaginal ultrasound scans and beta-human chorionic gonadotropin levels in early singleton and multiple pregnancies. Fertil Steril. 1993 May. 59(5):1007-10. [QxMD MEDLINE Link].

44. Nielsen S, Hahlin M. Expectant management of first-trimester spontaneous abortion. Lancet. 1995 Jan 14. 345(8942):84-6. [QxMD MEDLINE Link].

45. Scroggins KM, Smucker WD, Krishen AE. Spontaneous pregnancy loss: evaluation, management, and follow-up counseling. Prim Care. 2000 Mar. 27(1):153-67. [QxMD MEDLINE Link].

46. van Veen TR, Haeri S, Baker AM. Teen pregnancy: are pregnancies following an elective termination associated with increased risk for adverse perinatal outcomes?. J Pediatr Adolesc Gynecol. 2015 Dec. 28 (6):530-2. [QxMD MEDLINE Link].

47. Marko EK, Buery-Joyner SD, Sheridan MJ, Nieves K, Khoury AN, Dalrymple JL. Structured teaching of early pregnancy loss counseling. Obstet Gynecol. 2015 Oct. 126 suppl 4:1S-6S. [QxMD MEDLINE Link].

48. Schreiber CA, Creinin MD, Atrio J, Sonalkar S, Ratcliffe SJ, Barnhart KT. Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss. N Engl J Med. 2018 Jun 7. 378 (23):2161-2170. [QxMD MEDLINE Link].

Elizabeth E Puscheck, MD Professor, Department of Obstetrics and Gynecology, Wayne State University School of Medicine; In Vitro Fertilization Director, Gynecologic Ultrasound Director, Clinical Endocrine Laboratory Consultant, Department of Obstetrics and Gynecology, University Women's Care

Elizabeth E Puscheck, MD is a member of the following medical societies: American Institute of Ultrasound in Medicine, International Society for Clinical Densitometry, Society for Assisted Reproductive Technology, Society of Reproductive Surgeons, Society for Reproductive Endocrinology and Infertility, American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine, Association of Professors of Gynecology and Obstetrics, Endocrine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Richard S Legro, MD Professor, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Pennsylvania State University College of Medicine; Consulting Staff, Milton S Hershey Medical Center

Richard S Legro, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists, Society of Reproductive Surgeons, American Society for Reproductive Medicine, Endocrine Society, Phi Beta Kappa

Disclosure: Received honoraria from Korea National Institute of Health and National Institute of Health (Bethesda, MD) for speaking and teaching; Received honoraria from Greater Toronto Area Reproductive Medicine Society (Toronto, ON, CA) for speaking and teaching; Received honoraria from American College of Obstetrics and Gynecologists (Washington, DC) for speaking and teaching; Received honoraria from National Institute of Child Health and Human Development Pediatric and Adolescent Gynecology Research Thi.

Richard Scott Lucidi, MD, FACOG Associate Professor of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine

Richard Scott Lucidi, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine

Disclosure: Nothing to disclose.

Suzanne R Trupin, MD, FACOG Clinical Professor, Department of Obstetrics and Gynecology, University of Illinois College of Medicine at Urbana-Champaign; CEO and Owner, Women's Health Practice; CEO and Owner, Hada Cosmetic Medicine and Midwest Surgical Center

Suzanne R Trupin, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Institute of Ultrasound in Medicine, International Society for Clinical Densitometry, AAGL, North American Menopause Society, American Medical Association, Association of Reproductive Health Professionals

Disclosure: Nothing to disclose.

The authors and editors of Medscape Drugs & Diseases gratefully acknowledge the contributions of previous author Archana Pradhan, MD, MPH, to the development and writing of this article.

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