Journal Article: Signs and symptoms associated with early pregnancy loss: findings from a population-based preconception cohort

Reasoning:

• Educate patient about signs and symptoms of early pregnancy loss, which was a concern of hers
• Patient had previous history of abortions, which puts her at an increased risk of developing ectopic pregnancy
• Patient education is important, especially with ectopic pregnancy, which could have complications

Purpose:

• To determine the relationship between s/sx of early pregnancy and pregnancy loss of less than 20 weeks gestation

Methods:

• Population based prospective cohort of 347 women were followed daily from 2 to 7 weeks post-conception
• Women recorded signs and symptoms daily in the same time frame, including:
  • Vaginal bleeding: none, spotting, light, moderate, heavy
  • Lower abdominal cramping
  • Nausea
  • Vomiting

Key Points:

• Women experienced lower abdominal cramping, nausea, vomiting, and vaginal bleeding during early pregnancy, most commonly nausea/vomiting
• Cramping pain also common, occurred in 85% of participants and is not associated with pregnancy loss, rather vaginal bleeding is associated with higher loss rates
• 28% of women experienced loss of pregnancy
• Incidence of pregnancy loss was increased in women with vaginal bleeding and lower abdominal cramping
• Incidence of pregnancy loss was decreased in women with vomiting
• If a woman had vaginal bleeding with lower abdominal cramping, vomiting reduced the incidence of pregnancy loss

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