missed abortion

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Related to missed abortion: Blighted ovum


termination of pregnancy before the fetus is viable. In the medical sense, this term and the term miscarriage both refer to the termination of pregnancy before the fetus is capable of survival outside the uterus. The term abortion is more commonly used as a synonym for induced abortion, the deliberate interruption of pregnancy, as opposed to miscarriage, which connotes a spontaneous or natural loss of the fetus. Because of this distinction made by the average layperson, care should be exercised in the use of the word abortion when speaking of a spontaneous loss of the fetus.

The technique chosen to terminate pregnancy depends on the stage of pregnancy and the policies of the institution and patient needs. It is rare for a fetus to survive if it weighs less than 500 g, or if the pregnancy is terminated before 20 weeks of gestation. These factors are, however, difficult to determine with a high degree of accuracy while the fetus is still in utero; survival of the fetus delivered near the end of the second trimester often depends to a great extent on the availability of personnel and equipment capable of supporting life until the infant develops sufficiently.

Viability of the fetus outside the uterus is frequently used as the determining factor in deciding the legality and morality of induced abortion. Whether this is a valid criterion is essentially based on whether one believes that the fetus is human from the moment of conception or that it achieves humanity at some point during physical development. Those who oppose abortion on moral grounds believe that the fetus is human or potentially human and that destruction of the fetal body is tantamount to murder. Many others have equally strong beliefs that abortion is a woman's right.

The liberalization of abortion laws has resulted in a dramatic increase in the number of abortions performed in physicians' offices, clinics, and hospitals. While this has diminished the occurrence of septic abortions performed at the hands of unscrupulous abortionists and has improved the possibility of safe and uneventful physical recovery from an induced abortion, the issue remains controversial and charged with emotion. The health care provider who strongly objects to abortion is legally and morally free to choose not to participate in the procedure and is advised to avoid situations involving responsibility for the care of patients who have chosen abortion as a means of ending an unwanted pregnancy. Women who have made a decision to have an abortion need a safe, non-judgmental environment to recover physically and emotionally from the procedure.

The patient should know that other alternatives are available and that an abortion after 20 weeks is inadvisable for medical and other reasons. Preabortion counseling in the psychological, religious, and legal aspects of abortion should be readily available, with immediate referral to the proper resources. Although delay in carrying out the procedure may increase the risk of complications, no patient should be encouraged to go through with an abortion until she has had time and sufficient counseling to reach a rational decision. During postabortion counseling there should be a discussion of various methods of contraception. The client will need information on the advantages and disadvantages of each method, her responsibilities in preventing future unwanted pregnancies, and available help in initiating and following through on a program of effective contraception. She should be informed that women who have had two or more abortions run a greatly increased risk of miscarriage or spontaneous abortion in the first six months of subsequent pregnancies.
Patient Care. The type of care required and the complications to be avoided in abortion will depend on the stage of pregnancy at the time of termination and whether the abortion is spontaneous, is induced under sterile conditions, or is performed by an unskilled abortionist or the patient herself. Many women who choose to have an abortion are anxious and confused about the physical and psychological outcomes of the procedure. Therefore both pre- and postabortion counseling are recommended.

In cases of spontaneous or habitual abortion, patient care is directed toward emotional support of the patient and acceptance of her feelings of bitterness, grief, guilt, relief, and other emotions associated with the loss of the fetus. The patient should be able to express her feelings in an open, nonjudgmental, and nonthreatening environment.
complete abortion complete expulsion of all the products of conception.
criminal abortion termination of pregnancy by illegal interference, usually undertaken when legal induced abortion is unavailable. The most frequent complications are severe hemorrhage and sepsis, and for those who delay seeking medical attention the mortality rate is high.
early abortion abortion within the first 12 weeks of pregnancy.
elective abortion induced abortion done at the request of the mother for other than therapeutic reasons.
habitual abortion spontaneous abortion in three or more consecutive pregnancies before the 20th week of gestation.
incomplete abortion abortion in which parts of the products of conception are retained in the uterus.
induced abortion abortion brought on intentionally by medication or instrumentation.
inevitable abortion a condition in which vaginal bleeding has been profuse, membranes usually show gross rupturing, the cervix has become dilated, and abortion is almost certain.
infected abortion abortion associated with infection of the genital tract from retained material, with a febrile reaction.
missed abortion retention of dead products of conception in utero for more than 8 weeks.
septic abortion abortion associated with serious infection of the products of conception and endometrial lining of the uterus, leading to generalized infection; it is usually caused by pathogenic organisms of the bowel or vagina.
spontaneous abortion termination of pregnancy before the fetus is sufficiently developed to survive; called miscarriage by laypersons. In the United States this definition is confined to the termination of pregnancy before 20 weeks' gestation (based upon the date of the first day of the last normal menses). Chromosomal abnormalities cause at least half of spontaneous abortions.
therapeutic abortion abortion induced legally by a qualified physician to safeguard the health of the mother.
threatened abortion a condition in which vaginal bleeding is less than in inevitable abortion, the cervix is not dilated, and abortion may or may not occur; this is the presumed diagnosis when any bloody vaginal discharge or vaginal bleeding occurs in the first half of pregnancy.

missed a·bor·tion

abortion in which the fetus dies in utero but the product of conception is retained in utero for 2 months or longer.

missed abortion

Etymology: OE, missan, to be lacking; L, ab, away from, oriri, to be born
a condition in which a dead immature embryo or fetus is not expelled from the uterus for 2 months or more. The uterus diminishes in size, and symptoms of pregnancy abate; maternal infection and blood clotting disorders may follow. The fetus and placenta may become necrotic; less commonly the fetus becomes calcified, and the rest of the products of conception are resorbed.

missed abortion

The retention of a fetus known to be dead for ≥ 4 wks Management Expectant–spontaneous delivery occurs usually by the 6th post-mortem wk. See Abortion.

miss·ed abor·tion

(mist ă-bōr'shŭn)
Abortion in which the fetus dies but is retained in utero for 2 months or longer.

missed abortion

Death of the fetus which remains in the womb (uterus) for weeks or months. The uterus ceases to enlarge and the cervix remains tightly closed. Pregnancy tests may give equivocal results for several weeks after the death of the fetus but ultrasound scans can reveal the condition. The uterus is cleared surgically.


premature expulsion from the uterus of the products of conception; termination of pregnancy before the fetus is viable.

complete abortion
complete expulsion of all the products of conception.
early abortion
abortion within the first third of pregnancy.
epizootic bovine abortion
characterized by serious fetal disease followed by abortion. Endemic in California's coastal range and in the foothill region of the Sierra Nevada, USA. Necropsy findings in the fetus are diagnostic; they include profuse petechiation and severe granulomatous hepatitis. Cause appears to be a novel deltaproteobacterium closely related to members of the order Myxococcales. Transmitted by the tick, Ornithodoros coriaceus. Called also foothill abortion.
habitual abortion
spontaneous abortion occurring in three or more successive pregnancies.
incomplete abortion
abortion in which parts of the products of conception are retained in the uterus.
induced abortion
abortion procured by the veterinarian to eliminate a misalliance, to reduce wastage in animals in a feedlot, to encourage commencement of lactation earlier than would otherwise occur. In cattle manipulation through the rectal wall is a possible way of destroying the viability of the fetus. Induction by the administration of prostaglandins or corticosteroids is more usual. See also pregnancy termination.
infectious abortion
the common causes in the various species are:
Brucella abortus (brucellosis); Campylobacter fetus subsp. venerealis (vibriosis); Campylobacter fetus subsp. fetus; Leptospira pomona, L. hardjo (leptospirosis); Listeria monocytogenes (listeriosis); Arcanobacterium pyogenes; Aspergillus, Absidia and Mucor spp. (fungal abortion); bovine virus diarrhea virus; infectious bovine rhinotracheitis herpesvirus; Chlamydophila abortus; a deltaproteobacterium (epizootic bovine abortion); Coxiella burnetii (Q fever), Neospora caninum.
sheep and goats
Campylobacter fetus subsp. fetus (vibriosis); Campylobacter jejuni; Chlamydophila abortus (enzootic abortion of ewes); Listeria monocytogenes (listeriosis); Salmonella abortus-ovis; Brucella melitensis; Toxoplasma gondii (toxoplasmosis); Brucella ovis (limited occurrence); bluetongue virus; border disease.
Streptococcus equi subsp zooepidemicus; Actinobacillus equuli, A. equisimilis; Rhodococcus equi; leptospirosis, most commonly the pomona serogroup and less frequently serovar grippotyphosa; equine herpesvirus (EHV1); equine viral arteritis (EVA); equine arteritis; Potomac horse fever; and in the USA the mare reproductive loss syndrome associated with ingestion of the Eastern tent caterpillar Malacosoma americanum.
Leptospira pomona, L. grippotyphosa, L. canicola, L. icterohaemorrhagiae (leptospirosis); Erysipelothrix rhusiopathiae (erysipelas); porcine reproductive respiratory syndrome (PRRS) virus; parvovirus; porcine circovirus 2; Aujesky's disease; classical swine fever; and African swine fever.
dog and cat
Brucella canis, feline leukemia virus, feline herpesvirus.
missed abortion
retention of a dead embryo or fetus for more than 1 to 2 weeks.
pine needle abortion
a late-term abortion with retained fetal membranes in cattle caused by ingestion of isocupressic acid in the needles of Pinus spp., commonly P. ponderosa, but also P. jeffryi, P. contorta and Juniperus scopulorum and J. communis. Nutrient deficiency and tree management practices may promote ingestion off the ground as cattle graze through while eating early growing spring grass.
abortion rate
number of abortions as a percentage of the cows in the herd which were diagnosed pregnant in early pregnancy; the target is <2% but="" rates="" commonly="" approach="" 8%="" in="" dairy="" cattle="" and="" 5%="" in="" beef="">
septic abortion
abortion associated with serious infection of the uterus leading to generalized infection.
spontaneous abortion
abortion occurring naturally. See also spontaneous abortion.
abortion storm
a cluster of abortions occurring at about the same time or in rapid sequence within a group of pregnant females. See also equine viral abortion.
therapeutic abortion
abortion induced by a veterinarian for medical or other health reasons.
References in periodicals archive ?
Almost double increase of HLA-DR of missed abortion high risk group patients is likely associated with the increase of the mother and fetus identity under HLA genes what might be a reason for the early termination of pregnancy.
Studies done so far have addressed all cases of missed abortions including those where an embryo is present.
An initial 800-[micro]g dose was five times more likely than a 400-[micro]g dose of misoprostol to be successful in medically managing missed abortion on an outpatient basis, according to Dr.
If pelvic ultrasound showed evidence of incomplete abortion, missed abortion or continuing pregnancy, suction evacuation was done.
Procedure related complications were seen in 20 cases and missed abortion occurred in 6 out of 798 couples, 1% couples had refused to abort b-thalassaemia major affected fetus whereas 97% fetus was aborted as per recommendation.
One case of missed abortion at 14 weeks had parvovirus B19 viral exposure at 9.
PROCHIEVE([R]) 8% is contraindicated in patients with active thrombophlebitis or thromboembolic disorders, or a history of hormone-associated thrombophlebitis or thromboembolic disorders, missed abortion, undiagnosed vaginal bleeding, liver dysfunction or disease, and known or suspected malignancy of the breast or genital organs.
KY Kun has reported a case wherein the patient presented with 16 weeks missed abortion in antenatal clinic.
PROCHIEVE(R) 8% is contraindicated in patients with active thrombophlebitis or thromboembolic disorders, or a history of hormone-associated thrombophlebitis or thromboembolic disorders, missed abortion, undiagnosed vaginal bleeding, liver dysfunction or disease, and known or suspected malignancy of the breast or genital organs.
In case patient had an ongoing pregnancy, missed abortion or an incomplete abortion even on the 14th day after Misoprostol intake or requested for surgical termination of the pregnancy at any point in the study, she was classified as a failure of this study and surgical termination (Either vacuum aspiration or instrumental evacuation) was performed.
A total number of 95 women with sonography diagnosis of gestational trophoblastic disease, missed abortion, incomplete abortion and blighted ovum participated in the study.