Missed abortion

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Description

Foetus die in utero but it is not expelled out

Signs and Symptoms

  • History of amenorrhea
  • Regression of the pregnancy symptoms
  • Uterine size smaller than dates
  • Mild per vaginal bleeding

Investigations

  • Abdominal pelvic ultrasound
  • Clotting profile
  • FBC

Treatment

  • Induce abortion with misoprostol as follows:
  • 1st trimester – 800mcg PV OR 600mcg SL every 3 hours for a maximum of 2 doses. Can be repeated after 24 hours.
  • 13-17 weeks – 200mcg PV every 6 hours for a maximum of 4 doses
  • 18-26 weeks – 100mcg PV every 6 hours for a maximum of 4 doses in 24 hours
  • Evacuate if less than 12 weeks
  • After evacuation give;
  • Amoxicillin (PO) 500mg 8hly for 5 days

PLUS

  • Metronidazole (PO) 400mg 8hly for 5 days
  • Patient education, Counsel and provide appropriate contraception.