8. MANAGEMENT OF EARLY PREGNANCY LOSS

^{Updated June 2016 by Jennifer Amico MD, MPH}

This chapter will assist you in learning skills to support your patients through a common and often emotionally and physically difficult experience – the spontaneous loss of a pregnancy (miscarriage). Management of early pregnancy loss now commonly occurs in the primary care setting, with expectant, medication, or aspiration management. These options are recognized as being both safe and effective, while also providing more choices for patients.

CHAPTER LEARNING OBJECTIVES

Following completion of this chapter, you should be able to:

• Evaluate, diagnose, and counsel patients presenting with signs or symptoms of early pregnancy loss
• Evaluate for ectopic pregnancy vs. early pregnancy loss, including changes in hCG levels
• Answer questions about short and long term implications of early pregnancy loss including emotional effects and implications for fertility
• Present expectant, medication and aspiration management options
• Provide appropriate follow-up, including contraceptive counseling

READINGS / RESOURCES

• Websites:
  • www.earlypregnancylossresources.org
  • http://provideaccess.org/resources-and-initiatives/pregnancy-loss/
  • https://depts.washington.edu/obgyn/education/miscarriagemanagement/welcome.html
• Prine LW, MacNaughton H. Office management of early pregnancy loss. Am Fam Physician. 2011 Jul 1;84(1):75-82.

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