MISSED ABORTION

 Dead products of conception that have been retained for days or weeks in the Williams
uterus with a closed cervical os. Obstetrics 25th
ed. P. 349
 Vaginal bleeding and perhaps some passage of tissue or products of conception. Williams
 Vital signs usually are within normal limits Obstetrics 25th
 Abdominal exam: may or may not reveal a palpable uterus. If palpable, the ed. P. 349
uterus usually is small for the presumed gestational age.
 The uterus may feel soft and enlarged.
 Pelvic exam: Cervical os closed.
 Cervix: Closed | Bow: - | FHT: - | Uterine size: US<AOG by~6 weeks | Show:
Spotting | Contractions: -
 Fetal heart tones are inaudible or unseen on sonogram.
 TVS: Retained products of conception and there would NOT be a viable fetus.  Williams
 Guidelines for Early Pregnancy Loss: Obstetrics 25th
Sonographic findings ed. P. 350
CRL ≥7mm and NO heartbeat – Non viability
MSD ≥25mm and NO embryo – Dead fetus
An initial US scan shows a gestational sac with yolk sac, and after ≥11 days no
embryo with a heartbeat is seen.
An initial US scan shows a gestational sac without a yolk sac, and after ≥2 weeks
no embryo with a heartbeat is seen.
Yolk sac diameters 6mm in pregnancies <10 weeks AOG – suspicious for
pregnancy failure.
Slower heart beat is unfavorable, especially <85bpm.