Abortion

Abortion is the spontaneous. It may be occur during the first trimester. Spontaneous abortion has various types such as

• Threatened abortion: It may be occur during the first half of pregnancy. Usually 20% of pregnant women have vaginal spotting or actual bleeding early in pregnancy.
• Inevitable abortion: In which, membranes rupture and the cervix dilates.
• Incomplete abortion: In which, uterus retains part or all of the placenta. Before the 10th week of gestation, the fetus and placenta usually are expelled together. Because part of the placenta may adhere to the uterine wall, bleeding continues.
• Complete abortion: Minimal bleeding usually accompanies complete abortion because the uterus contracts and compresses maternal blood vessels that fed the placenta.
• Missed abortion: Uterus retains the products of conception for 2 months or more after the death of the fetus. Uterine growth ceases; uterine size may even seem to de­crease.
• Habitual abortion: In which, if you loss spontaneous three or more consecutive pregnancies then it constitutes habitual abortion.
• Septic abortion: It may be occur with spontaneous abortion but usually results from an illegal abortion. It's related to any remaining fetal or placental tissue in the uterus.

It is a therapeutic expulsion of the products of conception from the uterus before 20 weeks gestation. Mostly up to 15% of all pregnancies and approximately 30% of first pregnancies end in spontaneous abortion and about 85% of miscarriages occur due to the first trimester.

Causes of Abortion

Spontaneous abortion may be occur due to various factors such as fetal, placental, or maternal.

Fetal factors, in which it usually cause such abortions up to 12 week's gestation such as

• Defective embryologic development resulting from abnormal chromosome division
• Faulty implantation of the fertilized ovum
• Failure of the endometrium to accept the fertilized ovum.

Other Placental factors usually cause abortion around the 14th week of gestation. These factors such as

• Premature separation of the normally implanted placenta
• Abnormal placental implantation

Maternal factors mostly cause abortion between the 11th and 19th week of gestation and such as

• Maternal infection
• Endocrine problems
• Trauma
• Antiphospholipid antibody syndrome.
• Blood group incompatibility
• Drug ingestion

Signs and symptoms of Abortion

Abnormal uterine bleeding may be occur due to various symptoms such as:

1. Pink discharge for several days
2. Cramps
3. Increased vaginal bleeding

Treatment of Abortion

• You may have an accurate evaluation of uterine contents, because it is necessary before a treatment plan can be formulated. You can not prevented the progression of spontaneous abortion, except in some cases that may be caused by an incompetent cervix. So for those cases where the progression of spotaneous abortion can't be stopped, then you should be used the treatment such as patient must be hospitalized to control severe hemorrhage. If bleeding is severe, then you should be use transfusion with packed red blood cells or whole blood. In which, the patient receives oxytocin I.V., and it stimulates uterine contractions.
• D&E is also performed in first all second-trimester therapeutic abortions. In second-trimester therapeutic abortions, the insertion of a prosta glandin vaginal suppository induces labor and the expulsion of uterine contents.
• The patient should not have bathroom privileges because she may expel uterine contents without knowing it. So after she uses the bedpan, then inspect the contents carefully for intrauterine material.