Early Pregnancy Loss (EPL) describes a nonviable intrauterine pregnancy identified prior to 13 weeks gestation, often a consequence of significant fetal chromosome abnormalities incompatible with life. Frequency of EPL increases with maternal age.
Note: Research (RCT) demonstrates the administration of 200 mg mifepristone followed by 800 micrograms misoprostol improves outcomes
Expectant, medical or surgical management to treat miscarriage are considered equivalent. Unless there is a change in clinical status (e.g. hemorrhage or infection), patient preference can guide decision making.
Note: In the case of medical management, the ACOG Guideline states that “Women who are Rh(D) negative and unsensitized should receive Rh(D)-immune globulin within 72 hours of the first misoprostol administration”
ACOG Practice Bulletin 200: Early Pregnancy Loss
Manual vacuum aspiration: an outpatient alternative for surgical management of miscarriages.
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