🎧 FREE MSRA PODCAST – Miscarriage: Essentials for Exams & Real-World Care

Miscarriage (spontaneous abortion) is one of the most common, and emotionally complex, topics in obstetrics. In this episode, we break down the highest-yield facts from the latest UK notes—covering definitions, causes, diagnosis, management, and the human side. Perfect for rapid revision and clinical recall!

📝 Key Learning Points

📌 Definition & Types
• Miscarriage = loss of pregnancy before 24 weeks’ gestation
• Types: threatened, missed (delayed), inevitable, incomplete, complete, recurrent
• Key sign: cervical os open vs closed guides diagnosis and management

📌 Causes & Risk Factors
• Most common cause: chromosomal abnormalities
• Other causes: maternal anatomical/hormonal issues, infections, autoimmune conditions (e.g. lupus), antiphospholipid syndrome, poorly controlled diabetes/thyroid disease
• Risk increases with maternal age, prior miscarriage, lifestyle factors (smoking, alcohol), certain infections, paternal age >45, low BMI, uterine surgery, and significant stress
• Protective: previous live birth, nausea in pregnancy, healthy diet

📌 Symptoms & Clinical Picture
• Vaginal bleeding (light to heavy), abdominal pain/cramps, passage of tissue
• Loss of pregnancy symptoms (e.g. nausea fading) may suggest missed miscarriage
• Most miscarriages occur in the first trimester: risk is 9.4% at 6 weeks, falling to 0.5–0.7% by 9–10 weeks

📌 Diagnosis & Investigation
• Transvaginal ultrasound: gold standard
• Serial serum hCG: take 2 samples, 48 hours apart
– ↑ by >63%: likely viable pregnancy
– ↓ by >50%: likely failing pregnancy
– In-between: needs urgent review
• Rule out ectopic pregnancy & other causes of bleeding (cervical polyps, infection, molar pregnancy)

📌 Management
• Expectant: watch and wait (7–14 days)
• Medical: vaginal misoprostol (NOT oral mifepristone, per UK guidelines)
• Surgical: manual vacuum aspiration (MVA) or theatre procedure
• Anti-D prophylaxis: only for rhesus-negative women undergoing surgical management
• Emotional support and counselling are essential

📌 Complications
• Haemorrhage (esp. incomplete miscarriage)
• Infection (retained tissue → endometritis/PID)
• Psychological distress – must not be overlooked
• Recurrent miscarriage: 3 or more consecutive losses need further workup

📌 Prognosis
• Most women go on to have successful pregnancies
• Threatened miscarriage → increased risk of preterm birth
• Maternal death is rare in the UK

📎 More Miscarriage Revision Resources:
📝 Revision Notes: https://www.passthemsra.com/topic/miscarriage-revision-notes/
🧠 Flashcards: https://www.passthemsra.com/topic/miscarriage-flashcards/
💬 Accordion Q&A: https://www.passthemsra.com/topic/miscarriage-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/miscarriage-rapid-quiz/
🧪 Quiz Bank: https://www.passthemsra.com/quizzes/miscarriage/
🎓 Full Course: https://www.passthemsra.com/courses/obstetrics-and-gynaecology-for-the-msra/

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