BACKGROUND In recent years there has been growing international interest in identifying risk factors associated with 'repeat abortion', and developing public health initiatives that might reduce the rate. This article draws on a research study looking at young women's abortion experience in England and Wales. The study was commissioned with a specific focus on women who had undergone more than ...

A case of a 27 year-old patient who presented after medical management of a missed miscarriage with an acute abdomen is described. She was found to have a haemorrhagic angiomyolipoma, which was successfully treated radiologically. This case highlights the need to consider this differential in the presentation of acute abdomen in the context of a recent or concurrent pregnancy. It is the first c...

INTRODUCTION Despite the presence of diagnostic guidelines for the initial evaluation in trauma, the reported incidence of missed injuries is considerable. The aim of this study was to assess the missed injuries in a large cohort of trauma patients originating from two European Level-1 trauma centres. METHODS We analysed the 1124 patients included in the randomised REACT trial. Missed injurie...

OBJECTIVES To determine 1) the frequency of missed vaccine opportunities (VOs) in inner city children </=3 years of age; 2) whether the recommended vaccine(s) were given within 6 months of the missed opportunity (MO); 3) whether these vaccinations were age-appropriate according to the guidelines of the Advisory Committee on Immunization Practices; and 4) variables associated with MOs. DESIGN ...

A series of studies on missed nursing care (i.e., required standard nursing care that is not completed) is summarized. Missed nursing care is substantial and similar levels are found across hospitals. Reasons for missed nursing care are staffing resources, material resources, and communication and these are also similar across hospitals. The higher the staffing levels, the fewer occurrences of ...

OBJECTIVE To compare the efficacy of two different medical treatment regimens: mifepristone 600 mg orally + misoprostol 0.4 mg vaginally (Mf + Ms) or misoprostol 0.4 mg vaginally (Ms) with conventional surgical evacuation (SE) in women with missed abortion. MATERIALS AND METHODS Prospective crossover study with alternating regimens every 4 months. The three university clinics of Obstetrics an...

The nomenclature used to describe clinical events in early pregnancy has been criticized for lack of clarity and promoting confusion. There is no agreed glossary of terms or consensus regarding important gestational milestones. In particular there are old and poorly descriptive terms such as 'missed abortion' and 'blighted ovum', which have persisted since their introduction many years ago (Rob...

A 27-year-old woman evacuated a hydatidiform mole at 11 weeks of gestation. Her serum human chorionic gonadotropin (hCG) levels declined progressively but reached a plateau of 2-3 mIU/ml thereafter. The patient was treated with two courses of methotrexate, which did not affect her hCG levels. She refused further chemotherapy and, for more than one year, she was managed expectantly until a signi...

Missed abortion in the first trimester is characterized by the arrest of embryonic or fetal development. The cervix is closed and there is no or only slight bleeding. Ultrasound examination shows an empty gestational sac or an embryo/fetus without cardiac activity. Based on a review of the published literature a single dose of 800 microg vaginal misoprostol may be offered as an effective, safe,...