From the Guidelines
The different types of abortion, now more accurately referred to as Early Pregnancy Loss (EPL), include Concerning for, Diagnostic of, In progress, Incomplete, and Completed EPL, as well as terms like Miscarriage and Spontaneous abortion in progress (SAB). These terms are used to describe various scenarios in early pregnancy loss, with modifiers to differentiate between them, such as Concerning for, indicating a pregnancy that may not progress, and Diagnostic of, indicating a pregnancy that will not progress 1. The term Early Pregnancy Loss (EPL) is a general term endorsed by OB-Gyn communities and societies to describe a pregnancy that may or will not progress, is in the process of expulsion, or has incompletely or completely passed, replacing the term 'failure' 1. Key points to consider in the management of EPL include:
- Concerning for EPL: GS normally located but with findings that it may not progress
- Diagnostic of EPL: GS normally located but with findings that it will not progress
- In progress EPL: GS located in cavity of LUS or endocervical canal in process of expulsion
- Incomplete EPL: Intracavitary tissue, thickened endometrium or persistent GS following EPL
- Completed EPL: No persistent GS or intracavitary tissue following EPL Management of EPL varies depending on the specific scenario, and may involve observation, medical management with medications such as mifepristone and misoprostol, or surgical evacuation 1. It's also important to note that the term "miscarriage" is preferred by patients in one survey, and spontaneous abortion in progress (SAB) can be used synonymously with miscarriage for patient clarity 1. In contrast to older classifications, the new lexicon provides a more nuanced and accurate way to describe and manage early pregnancy loss, prioritizing patient-centered care and clarity 1. The older terms, such as threatened abortion, missed abortion, incomplete abortion, complete abortion, inevitable abortion, and septic abortion, are no longer recommended, as they do not accurately reflect the current understanding of early pregnancy loss 1. Instead, the new lexicon provides a more comprehensive and patient-centered approach to managing early pregnancy loss, focusing on the specific needs and circumstances of each individual patient 1.
From the Research
Types of Abortion
The different types of abortion include:
- Threatened abortion: characterized by bleeding and/or uterine cramping while the cervix is closed 2
- Inevitable abortion: a type of spontaneous abortion where the cervix is open and bleeding is present 3
- Incomplete abortion: a type of spontaneous abortion where some fetal tissue is expelled, but some remains in the uterus 3, 4
- Complete abortion: a type of spontaneous abortion where all fetal tissue is expelled from the uterus 3, 5
- Missed abortion: a type of spontaneous abortion where the fetus has died, but is not expelled from the uterus 3, 4
- Septic abortion: a type of spontaneous abortion where infection is present, often due to unsafe abortion practices 3, 4
Characteristics of Each Type
Each type of abortion has distinct characteristics, including:
- Threatened abortion: may progress to spontaneous incomplete or complete abortion 2
- Incomplete abortion: often requires uterine evacuation to prevent complications 3, 4
- Complete abortion: may be managed conservatively, without the need for curettage 5
- Missed abortion: often requires uterine evacuation to remove the deceased fetus 3, 4
- Septic abortion: requires prompt medical attention to prevent serious complications and death 3, 4