1. Causes? Spontaneous abortion Ectopic pregnancy Trophoblastic disease
Cervical polyps
Friable cervix
Trauma

2. Definitions: spontaneous abortion
Involuntary loss

3. Tests? Quantitative beta-HCG
Correlate with gestational age and ultrasound
2 measurements
2-3 days apart
Should double
Falling or plateauing indicates problem

4. Beta-HCG and Ultrasound
EGA by LMP
Transabdominal U/S
Transvaginal U/S
Serum β-HCG
< 5 weeks
None
Possible gestational sac
1800
5-6 weeks
Gestationa sac
Gestational sac, yolk sac
1800 – 3500
7 weeks
5-10 mm embryo
Same as transabdominal with cardiac activities

5. Progesterone <5 mg/ml – poor outcome
> 25 mg/ml associated with living IUP