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pregnancy Headache; continuous and severe Hypertension of pregnancy 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
Definition of Terms
Abortion is a fetus that is aborted before it is 500 grams
in weight. Blighted ovum a small macerated sometimes there is no fetus surrounded by a fluid inside an open sac. Carneous mole a zygote that is surrounded by clotted blood. Maceration a dead fetus under going nechrosis. Lithopedion - a calcifite embryo, the product of conception becomes becomes a hard as stone. Early abortion the termination of pregnancy before 16 weeks.
weeks. Immature infant an infant having a birth weight between a 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.
ABORTION
Termination of pregnancy before the age of viability
usually before 20 24 weeks. It is the most common bleeding disorder of early pregnancy. TYPES OF ABORTION SPONTANEOUS without medical or mechanical intervention. INDUCED with medical or mechanical intervention.
INDUCED ABORTION
THERAPEUTIC ABORTION the termination agent
because a continuation of pregnancy would be hazardous to the mother. CRIMINAL ABORTION/ELECTURE/VOLUNTARY done without medical justification, maybe performed with little or no medical training.
SPONTANEOUS ABORTION
Types : Threatened Abortion possible loss of product of conception. Inevitable Abortion the loss of the product of conception cannot be prevented. Complete Abortion spontaneous expulsion of product of conception after the fetus has died in utero. Incomplete Abortion explusion of some part and retension og other part after the death of fetus in uterus. Missed Abortion The woman usually is not aware of the loss, specifically when there is no vaginal bleeding or abdominal pain.
Types of abortion
Bleeding
Abdominal cramps
May or may not present
Cervical dilation
Closed cervix
Tissue passage
None
Manageme nt
Bed rest, save all pads, no coitus up to 2 weeks after bleeding stop. Hospitalizati on, D and C, sympathetic understandi ng and emotional support.
Threatened Slight
Inevitable
Moderate
Moderate
Open
None
Complete
Small to negative
Moderate
Incomplete
Severe
Severe
Missed
None to severe
None
None
None
Septic
mild to severe
Severe
Habitual
May present signs of any of the above; usually detected in the threatened 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.
Sign of abortion
Vaginal bleeding or spotting, mild to severe
Uterine/abdominal cramps
Passage of tissue or product of conception Sign related to blood/shock: pallor, tachycardia,
tachypnea, cold clammy skin, restlessness, oliguria, air hunger, and hypotension.
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 adversely affected pregnancy outcome and had to aborting. MATERNAL FACTORS Viral infection Malnutrition Trauma (physical and mental) Congenital defects of the reproductive tract Incompetent cervix
Hormonal
Increased temperature as in febrile conditions Systemic disease in the mother Environmental hazards Rh incompatibility
Treatment
Surgery : dilatation and curettage
Antibiotics
Blood, plasma, fluid replacement Habitual abortion: Mcdonald surgery and Shirodkar-barter