An average pad absorbs approximately 20-30 mL of blood. The abdomen usually is soft and nontender. On pelvic examination, products of conception may be partially present in the uterus, may protrude from the external os, or may be present in the vagina. Bleeding and cramping usually persist. The cervix appears dilated and effaced.
Bimanual examination reveals an enlarged and soft uterus.
Trisomy chromosomes commonly are encountered, with trisomy 16 accounting for approximately a third of chromosomal abnormalities in early pregnancy. M llerian duct lesions usually are found in second-trimester pregnancy loss. Anomalies of the uterine artery with compromised endometrial blood flow are congenital. Hypothyroidism, hypoprolactinemia, poor diabetic control, and polycystic ovarian syndrome are contributive factors in pregnancy loss. Bacterial, viral, parasitic, fungal, and zoonotic infections are associated with recurrent spontaneous abortion.