Spontaneous Abortion

1 Definition and Clinical Presentation.- Spontaneous Abortion.- Threatened Abortion.- Inevitable Abortion.- Missed Abortion.- Anembryonic Pregnancy.- Spontaneous Abortion of a Live Fetus.- Trophoblastic Tumours.- Septic Abortion.- Recurrent Abortion.- Induced Abortion.- Ectopic Pregnancy.- Summary.- References.- 2 Spontaneous Abortions: Epidemiology.- Problems of Definition and Ascertainment.- Current Estimates of Early Reproductive Loss.- The Role of Chromosomal Anomalies.- The Role of Malformations Other Than Those Caused by.- Chromosomal Anomaly.- Sex Ratio.- Multiple Pregnancies.- Maternal Age and Parity.- Outcome of Other Pregnancies in Sibships with Spontaneous.- Abortions.- Maternal Health.- Maternal Smoking.- Alcohol Consumption.- Oral Contraceptives, Spermicides and Intrauterine Devices.- Other Environmental Hazards.- Conclusion.- References.- 3 Aetiology of Pregnancy Failure.- Numerical Chromosomal Abnormalities (Aneuploidy and Polyploidy).- Preclinical Losses.- First Trimester.- Second and Third Trimester.- Pathological Findings in First Trimester Abortuses.- Fetal Conditions.- Maternal Conditions.- Maternal Health.- References.- 4 Pathology of Spontaneous Abortion.- Anatomo-pathological Classification of Material from Abortions.- Histological Classification of Material from Abortions.- Specific Pathological Abnormalities in Abortion.- Infection.- Placental Ischaemia and Inadequate Placentation.- Immunological Factors.- Anti-phospholipid Antibodies.- Congenital Uterine Abnormalities.- Conclusions.- References.- 5 Ultrasound Diagnosis of Spontaneous Miscarriage.- Am I Pregnant?.- Is My Pregnancy Normal?.- When Is My Baby Due?.- Will I Miscarry?.- Intrauterine Haematomata.- Double Gestational Sacs.- Low Lying Placenta.- Low Ratio of Amniotic Sac to Embryo.- Uterine Abnormalities.- Embryonic Growth Delay.- Early Bradycardia.- Is My Baby Normal?.- Specific Complications of Early Pregnancy.- Early Embryonic Demise.- Anembryonic Pregnancy.- Complete and Incomplete Abortion.- Doppler Ultrasound in the Diagnosis of Pregnancy Failure.- References.- 6 Assessment of Early Pregnancy: Measurement of Fetoplacental Hormones and Proteins.- Diagnosis of Pregnancy.- Normal Pregnancy.- Control of Synthesis and Secretion.- Early Pregnancy Failure.- Threatened and Spontaneous Miscarriage.- Anembryonic Pregnancy.- Ectopic Pregnancy.- Trophoblastic Disease.- Prenatal Diagnosis: Chorionic Villus Sampling.- Conclusions.- References.- 7 The Aetiology and Management of Recurrent Miscarriage.- Incidence.- The Risk of Recurrence.- Aetiology of Recurrent Miscarriage.- Genetic Causes.- Anatomical Causes.- Infective Causes.- Chronic Maternal Disorders, Drugs and Environmental Pollutants.- Endocrine Causes.- Immunological Causes.- Investigation and Management.- Summary and Conclusions.- References.- 8 Septic Abortion.- Felicity Ashworth.- Relevance of Septic Abortion to Maternal Mortality Statistics.- Risk Factors.- Clinical Features.- Microbiology.- Complications of Septic Abortion.- Septicaemia.- Endotoxic Shock.- Acute Tubular Necrosis.- Management of Septic Abortion.- Prevention.- Antibiotic Therapy.- Curettage.- Surgery.- Management of Septic Shock.- Conclusion.- References.- 9 Miscarriage Following Assisted Conception.- Miscarriage in the Infertile Couple.- Pregnancy Diagnosis.- The Influence on Miscarriage of the Drugs used in Assisted Conception.- Anti-oestrogens.- Ovulation Induction with Gonadotrophins.- Miscarriage after IVF and Related Procedures.- Summary.- References.- 10 Abortion Following Invasive Diagnostic Procedures in the First Trimester.- Safety.- Evaluating Safety of Invasive Prenatal Diagnostic Tests.- Transabdominal versus Transcervical CVS.- CVS versus Midtrimester Amniocentesis.- Early Amniocentesis.- Accuracy.- Single Gene Defects.- Chromosomal Abnormalities.- Cost Considerations.- References.- 11 Diagnosis and Management of Ectopic Pregnancy Isabel Stabile.- Incidence of Ectopic Pregnancy.- Aetiology of Ectopic Pregnancy.- Clinical Features of Ectopic Pregnancy.- Diagnostic Tests.- Biochemical Tests.- Sonographic Tests.- Combination of Ultrasound and Biochemical Tests.- Management of Ectopic Pregnancy.- Conclusion.- References.- 12 Surgical Treatment of Spontaneous Abortion.- Cervical Cerclage in the Management of Cervical Incompetence.- Operative Procedures for Cervical Incompetence.- Choice of Patients.- Value of the Procedure.- Randomised Controlled Trials.- Management of Spontaneous Abortion.- Dilatation and Curettage.- Complications of Dilatation and Curettage.- References.- 13 Endocrine Treatment in the Prevention and Management of Spontaneous Abortion.- Prevention.- Systemic Disorders.- Reproductive System Disorders.- Empirical Treatment.- Timing of Treatment.- Endocrine Treatment of Incomplete or Missed Abortion.- Conclusion.- References.- 14 Immunotherapy of Recurrent Spontaneous Miscarriage.- Introduction: Maternal Immunity in Normal Pregnancy.- Rationale for Immunotherapy in Pregnancy Loss.- Definition of Recurrent Pregnancy Loss.- Methods of Treatment.- Leucocyte Immunisation.- Trophoblast Membrane Infusion.- Seminal Plasma.- Intravenous Immunoglobulin (IVIG).- Assessment of Outcome of Treatment: Difficulties of Interpretation.- Potential Hazards of Immunotherapy.- Future Requirements.- Conclusions.- References.