It appears that most pregnancies are lost during the early (maternal recognition) phase of gestation. Contributive influences in spontaneous abortion can be of maternal and(or) embryonic lineage; common causes include embryonic genetic defects, infection (septic pregnancy) or anatomical anomalies of the genital tract, and endocrinological or immunological disturbances. There is very little that can be done to avert inevitable abortion. Physical problems can sometimes be corrected retrospectively with surgery. Supplementation with progesterone or hCG/hMG is of some value in preventing recurrent abortion as a sequel to a defective luteal phase; bromocryptine can be used if hyperprolactinemia is indicated.
Miscariages that occur within the first six weeks of pregnancy in women
are generally complete. After ten weeks of gestation, uterine evacuation
is usually not total, and placental tissue should be removed because it
often becomes infected and continues to bleed; cervical dilation and suction
curettage are routinely performed in these cases.