Anembryonic Gestation Research Articles

Quality of Life in Women Undergoing Medical Treatment for Early Pregnancy Failure

To examine predictors of quality of life, depression, and stress in women undergoing medical management of early pregnancy failure with misoprostal and to assess the relationship of quality of life, depression, and stress to treatment acceptability. Descriptive observational study of women undergoing medical management of early pregnancy failure with misoprostol conducted as part of a multicenter pilot study testing the efficacy of saline-moistened versus dry application of vaginal misoprostol. Data were collected prior to treatment through 15 days posttreatment. Four university-based hospitals. Women (n = 80) < or = 1 weeks pregnant diagnosed with anembryonic gestation or fetal demise. Vaginal misoprostol for medical evacuation. Quality of life (physical role functioning, emotional role functioning, social functioning, vitality, and bodily pain), depression, stress, and treatment acceptability. Women who received medical evacuation demonstrated poorer quality of life than same-age published population norms, scoring 0.25 to 0.78 of a standard deviation below the population mean for four of the five subscales. Nurses should assist patients to minimize and manage physical symptoms during treatment for early pregnancy failure. Women with higher external demands and lower social/tangible support may need greater assistance.

Endometrial thickness after misoprostol use for early pregnancy failure

Objectives: To assess if there was any potential relationship between endometrial thickness and final treatment outcome in women successfully treated with misoprostol for a first trimester anembryonic gestation, embryonic demise or fetal demise. Methods: Eighty women were treated with up to two doses of misoprostol 800 μg vaginally for early pregnancy failure. Subjects were scheduled to return 2 (range 1–4), 7 (range 5–9) and 14 (range 12–17) days after treatment. Transvaginal ultrasonography was performed at each follow-up visit. Results: The median endometrial thickness at each of the follow-up visits for women who had expelled the gestational sac was 14 mm, 10 mm, and 7 mm, respectively. The endometrial thickness at the first follow-up visit exceeded 15 mm in 20 subjects (36%) and 30 mm in four subjects (7%). Only three women had a suction aspiration for bleeding after documented expulsion. The endometrial thickness for these women was 11, 13, and 14 mm at the first follow-up visit. Conclusions: There is no obvious relationship between increasing endometrial thickness and the need for surgical intervention in women treated with misoprostol for early pregnancy failure.

Missed abortion: Still appropriate terminology?

The term missed abortion has been in the obstetric literature more than 100 years. With ultrasonographic evaluation of early pregnancy, its textbook definition (death of a fetus without its expulsion for greater than or equal to 8 weeks) is rarely fulfilled. Yet the term missed abortion is still extensively used today with regard to early pregnancy losses. We recommend its abandonment and in its place the use of the following terms: first trimester intrauterine fetal death, second trimester intrauterine fetal death, and anembryonic gestation.