5-Minute Emergency Consult
Early Pregnancy Loss
Basics
Description
- Spontaneous termination of a <20-wk intrauterine pregnancy
- Formerly: Spontaneous abortion
- Synonyms: miscarriage, early pregnancy failure
- Most common complication of early pregnancy:
- 9–17% in women aged 20–30
- 20% at age 35
- 40% at age 40
- 80% at age 45
- ∼80% occur in 1st trimester
- Vaginal bleeding in the 1st trimester is seen in about 25% of pregnant patients:
- Early pregnancy loss rate is highest in patients with heavy vaginal bleeding (defined as similar or greater than normal menses), estimated to be 24%
- Definitions:
- No intervention indicated:
- Threatened abortion: Vaginal bleeding, cervical os is closed, viable intrauterine pregnancy confirmed
- Complete abortion: Vaginal bleeding, cervical os closed, complete passage of products of conception (POC)
- Intervention indicated:
- Incomplete abortion: Vaginal bleeding, cervical os is open with partial passage of some POC and some retained POC
- Inevitable abortion: Vaginal bleeding, cervical os is open; POC have not been expelled
- Missed abortion: Fetal demise with no uterine activity to expel
- Septic abortion: Spontaneous abortion complicated by intrauterine infection
- Recurrent spontaneous abortion: 3 or more consecutive pregnancy losses
- No intervention indicated:
Etiology
- Chromosomal abnormalities of the fetus
- Uterine abnormalities (eg, leiomyoma, uterine adhesions, congenital anomalies)
- Risk factors include:
- Increased age of both mother and father
- Increased parity
- Alcohol use
- Cigarette smoking
- Cocaine use
- Conception within 3–6 mo after delivery
- Assisted reproduction
- Chronic maternal disease (eg, HTN, DM, thyroid disease)
- Maternal infections (eg, syphilis, parvovirus B19, Zika virus, CMV, and ascending pelvic infections)
- Medications:
- Misoprostol
- Methotrexate
- NSAIDs
- Previous early pregnancy loss
- Toxins
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Citation
Schaider, Jeffrey J., et al., editors. "Early Pregnancy Loss." 5-Minute Emergency Consult, 7th ed., Wolters Kluwer, 2027. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307234/2.2/Early_Pregnancy_Loss_.
Early Pregnancy Loss. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Wolters Kluwer; 2027. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307234/2.2/Early_Pregnancy_Loss_. Accessed July 18, 2026.
Early Pregnancy Loss. (2027). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (7th ed.). Wolters Kluwer. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307234/2.2/Early_Pregnancy_Loss_
Early Pregnancy Loss [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Wolters Kluwer; 2027. [cited 2026 July 18]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307234/2.2/Early_Pregnancy_Loss_.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Early Pregnancy Loss
ID - 307234
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307234/2.2/Early_Pregnancy_Loss_
PB - Wolters Kluwer
ET - 7
DB - Emergency Central
DP - Unbound Medicine
ER -
