Spontaneous abortion.

Spontaneous abortion rates vary with maternal age, but the overall incidence is approximately 2% of clinically recognized pregnancies. The incidence of clinically unrecognized loss is approximately 20%. Most early fetal losses are caused by abnormal karyotypes. Other causes include heavy caffeine use, acute alcohol consumption, and smoking. Ultrasonographic examination, which includes yolk sac configuration and crown-rump length determination can help differentiate between normal and abnormal pregnancies. After 8 weeks' gestation, hormonal assays are decreased. Conservative management of spontaneous abortions can be considered if patients have low beta-hCG levels and no residual tissue detected using ultrasonography. Complications of spontaneous abortion include maternal death, bleeding, and infection. Consideration should be given to the psychological health of women and their partners who experience spontaneous abortion, particularly if they exhibit depression, guilt, and grief reactions.