Miscarriage (spontaneous abortion)

  • A natural (spontaneous) loss of a pregnancy (or a fetus) before it has reached a gestation of viability (after which pregnancy loss is classified as “stillbirth”).
    • In Hong Kong, the cut-off gestation for fetal viability is 24 weeks.
    • Some countries use 20 or 22 weeks gestation, or 500g as the cut-off.
  • Miscarriage happens in 10-20% women.
    • Most of them occur before 10 weeks of gestation.
    • With growing gestation past the first trimester, the risk of miscarriage gradually drops.
  • Causes of miscarriage:
    • As early pregnancy loss (<10 weeks) are common, and the majority of them are due to sporadic chromosomal abnormalities, investigations are usually not necessary as the risk of recurrence is very low. 
    • However, further investigation may be indicated for the followings which are covered by other chapters:
      • second trimester miscarriage, especially those initially present with rupture of membranes or painless cervical dilatation suggestive of cervical incompetence
      • fetus with malformations
      • recurrent miscarriage

E2-1 – Miscarriage – POG

E2-2 – Miscarriage – symptom

E2-3 Miscarriage – human chorionic gonadotropin (hCG) level

E2-4 Miscarriage – ultrasonography (USG) examination

E2-5 – Miscarriage – ways of physical examination

E2-6 – Management of miscarriage: suitable for gestation