Spontaneous Abortion

First-trimester miscarriage is a common event. All women with clinically recognized pregnancies have approximately a 15% chance of spontaneous pregnancy loss in the first 3 months of pregnancy (Evans and Beischer, 1970). The risk is lower for younger women and higher for older mothers. Because women can present with symptoms of spontaneous miscarriage even before they are aware of pregnancy, all family physicians should be well versed in its assessment and management.

There are many causes of spontaneous pregnancy loss in the first trimester; sporadic chromosomal aneuploidy accounts for about 60%. The remaining 40% have various etiologies, including chronic maternal illness (e.g., diabetes, connective tissue disorder), uterine structural malformations, certain infections, inadequate progesterone production, and possibly other, less-well-understood causes such as immunologic "rejection" and environmental factors.

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