spontaneous abortion.3

8/13/2019 Spontaneous Abortion.3

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ABORTION

REINA F. VELUZReporter


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Danger Sign of Pregnancy

Swelling of face, finger and foot Hypertension ofpregnancy

Headache; continuous and severe Hypertension ofpregnancy

Abdominal, chest and back pain Ectopic pregnancy,Uterine rupture

Vaginal bleeding Placental problems (previa, abruption)

Vomiting, persistent

Infection Visual changes Hypertension of pregnancy Escape of vaginal fluids Premature rupture of

membrane


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Definition of Terms

Abortion is a fetus that is aborted before it is 500 gramsin weight.

Blighted ovum a small macerated sometimes there is nofetus surrounded by a fluid inside an open sac.

Carneous mole a zygote that is surrounded by clottedblood.

Maceration a dead fetus under going nechrosis.

Lithopedion - a calcifite embryo, the product ofconception becomes becomes a hard as stone. Early abortion the termination of pregnancy before 16

weeks.


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Late abortion abortion that occurs between 16 to 20weeks.

Immature infant an infant having a birth weight betweena 500 to 1000 grams.

Full term an infant born between 28-42 weeks. Occult pregnancy refers to those zygote the where

aborted before pregnancy is diagnose or recognize.


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ABORTIONTermination of pregnancy before the age of viabilityusually before 20 24 weeks.It is the most common bleeding disorder of earlypregnancy.

TYPES OF ABORTIONSPONTANEOUS without medical or mechanical

intervention.

INDUCED

with medical or mechanical intervention.


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INDUCED ABORTION THERAPEUTIC ABORTION the termination agent

because a continuation of pregnancy would be hazardousto the mother.

CRIMINAL ABORTION/ELECTURE/VOLUNTARY donewithout medical justification, maybe performed with littleor no medical training.


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SPONTANEOUS ABORTIONTypes :

Threatened Abortion possible loss of product ofconception.

Inevitable Abortion

the loss of the product of conceptioncannot be prevented.Complete Abortion spontaneous expulsion of product ofconception after the fetus has died in utero.

Incomplete Abortion

explusion of some part andretension og other part after the death of fetus in uterus.Missed Abortion The woman usually is not aware of theloss, specifically when there is no vaginal bleeding orabdominal pain.


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Habitual Abortion Abortion occurring in 3 or moresuccessive pregnancies.

Septic Abortion

Abortion complicated by infection.


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Types ofabortion

Bleeding Abdominalcramps

Cervicaldilation

Tissuepassage

Management

Threatened Slight May ormay notpresent

Closedcervix

None Bed rest,save allpads, nocoitus up to2 weeksafter

bleedingstop.

Inevitable Moderate Moderate Open None Hospitalization, D andC,sympatheticunderstanding andemotionalsupport.


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Complete Small tonegative

Moderate Closed orpartially open

Completeplacentawith fetus

Sympatheticunderstandingand emotionalsupport.

Incomplete Severe Severe Open withtissue in cervix

Fetal orincompleteplacentaltissue

D and C,oxytocin afterDandC,sympqtheticunderstandingand support

emotional.Missed None to

severeNone None None Regarding to

the age ofconceptionhas to be

removed fromthe uterus.

Septic mild tosevere

Severe Closed oropen withor without

tissue

possibly,fouldischarge

s

Treatabortion,antibiotics.


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HabitualMay present signs of any of the above; usually detected in thethreatened phase; cervical closure(Mcdonald surgery and

Shirodkar

barter surgery) may be employed.

*McDonald Surgery temporary closure of the cervix.*Shirodkar Barter Surgery permanent suturing of the cervix.


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Sign of abortionVaginal bleeding or spotting, mild to severeUterine/abdominal crampsPassage of tissue or product of conception

Sign related to blood/shock: pallor, tachycardia,tachypnea, cold clammy skin, restlessness, oliguria, airhunger, and hypotension.


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Causes of Abortion FETAL CAUSE the most common causes of early

spontaneous abortion is abnormal development of zygote,embryo or fetus.

MATERNAL CAUSE there are congenital or acquired

condition of mother and factors that had adverselyaffected pregnancy outcome and had to aborting.MATERNAL FACTORSViral infection

MalnutritionTrauma (physical and mental)Congenital defects of the reproductive tractIncompetent cervix


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HormonalIncreased temperature as in febrile conditions

Systemic disease in the motherEnvironmental hazardsRh incompatibility


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Treatment Surgery : dilatation and curettage

AntibioticsBlood, plasma, fluid replacement

Habitual abortion: Mcdonald surgery and Shirodkar-bartersurgeryBlood test


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