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Table of Contents:
1. Spontaneous Abortion
2. Cervical Insufficiency
3. Intrauterine Fetal Demise



Spontaneous Abortion, Incompetent Cervix, & Intrauterine Fetal Demise

1. Spontaneous Abortion
Spontaneous abortion
(miscarriage) is a pregnancy  TABLE 1. TYPES OF MISCARRIAGE
that ends <20 weeks
gestation, before fetal viability. Types Tissue Passage Bleeding
Risk Factors
Threatened: Pregnancy still No Spotting
 #1 risk = fetal
progressing, but symptoms
chromosomal
suggest miscarriage is likely.
abnormalities.
y Maternal health history
y Endocrine imbalance
(hypothyroidism,
uncontrolled diabetes
mellitus)
Missed: Pregnancy ended, No None or
y Obesity
but no tissue passed; tissue spotting
y Advanced maternal
remains in the uterus.
age (>35 years)
y Substance abuse
Assessment
Miscarriage typically causes
bleeding, cramping, cervical Inevitable: Cervix dilates, No Moderate
dilation, and passage of and although tissue remains
pregnancy tissue (embryo, in the uterus, the miscarriage
endometrial lining). Findings is unavoidable.
vary depending on type of
miscarriage (TABLE 1).
Interventions
Care for clients with early
Incomplete: Some tissue Yes, some Heavy
pregnancy bleeding focuses


Maternal & Newborn
passed, but some remains in tissue remains
on:
the uterus. in uterus or
1. Assessing blood loss
cervix
and for pregnancy
viability
2. Removing retained
nonviable pregnancy
tissue
Complete: All tissue passed Yes Transitions
3. Educating clients
from the uterus. from heavy
about infection
to light after
prevention and
passing
recovery




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