Management of complete abortion

1. Between 8 and 14 weeks, curettage is necessary because of the high probability that the abortion was incomplete.

2. D immunoglobulin (RhoGAM) is administered to Rh-negative, unsensitized patients.

3. Beta-HCG levels are obtained weekly until zero. Incomplete abortion is suspected if beta-HCG levels plateau or fail to reach zero within 4 weeks.

V. Missed abortion is diagnosed when products of conception are retained after the fetus has expired. If products are retained, a severe coagulopathy with bleeding often occurs.

A. Missed abortion should be suspected when the pregnant uterus fails to grow as expected or when fetal heart tones disappear.

B. Amenorrhea may persist, or intermittent vaginal bleeding, spotting, or brown discharge may be noted.

C. Ultrasonography confirms the diagnosis.

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