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Abortion
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What is abortion?

An abortion is the premature exit of the products of conception (the fetus, fetal membranes, and placenta) from the uterus. It is the loss of a pregnancy and does not refer to why that pregnancy was lost.

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Types of Abortion

Spontaneous Abortion Induced Abortion

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Types of spontaneous abortion:

Threatened

abortion Inevitable abortion Complete abortion Incomplete abortion Missed abortion

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Types of induced abortion:

Menstrual Extraction (endometrial or vacuum aspiration) and Evacuation (D & E) (also called vacuum suction or suction curettage)and Dilation and Curettage (D & C).

Dilation

Prostaglandin

or Saline Administration 5/3/12

Etiology

The most frequent cause of miscarriage is abnormal fetal formation, due to either to a teratogenic factor or a chromosomal abberation. maternal nutritional status others, immunologic factors may be .present or rejection of the embryo through an immune response. also involves the implantation 5/3/12 abnormalities.

Poor In

It

It

also occurs if the corpus luteum fails to produce enough progesterone to maintain the decidua basalis. such as rubella, syphilis, poliomyelitis, cytomegalovirus and toxoplasmiosis can also cause abortion. of teratogenic drugs can cause abortion.

Infection

Ingestion

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Clinical Manifestations
Uterine cramping, low back pain. Vaginal bleeding usually begins as dark spotting, then progresses to frank bleeding as the embryo separates from the uterus. -hCG level may be elevated for as long as 2 weeks after loss of the embryo.

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Ultrasonic

evaluation of the gestational sac

or embryo
Visualization

of the cervix; presence of dilatation or tissue evaluated

Diagnostic Evaluation
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Complications
Uterine

infection

Septicemia

Hemorrhage Disseminated

Intravascular Coagulation(DIC) in missed abortion.

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Schematic Diagram of Abortion

Abnormal Fetal Formation

Immunologic Factors

Infection

Crosses placenta Rejection of the embryo through immunologic response Fetus fails to grow Decrease estrogen and progesterone production Endometrial sloughing Release of prostaglandin which causes uterine contractions and 5/3/12 cervical dilatation

Teratogenic Factors (smoking, alcohol, drugs)

Miscarriage

Nursing Diagnoses

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Risk for fluid volume deficit r/t maternal bleeding

Nursing Diagnosis

Report any tachycardia, hypotension, diaphoresis, or pallor, indicating hemorrhage and shock. Draw blood for type and screen for possible blood administration. Establish and maintain an IV with large-bore catheter for possible transfusion and large quantities of fluid replacement.

Nursing Interventions

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Nursing Diagnosis grieving r/t loss of pregnancy, Anticipatory

cause of abortion, future childbearing

Nursing Interventions Assess the reaction of patient and support

person, and provide information regarding current status, as needed. Encourage the patient to discuss feelings about the loss of the baby include effects on relationship with the father. Do not minimize the loss by focusing on future childbearing; rather acknowledge the loss and allow grieving. Providing time alone for the couple to 5/3/12 discuss their feelings.

Risk for infection r/t dilated cervix and open uterine vessels

Nursing Diagnosis

Evaluate temperature q 4H if normal, and every 2H if elevated. Check vaginal drainage for increased amount and odor, which may indicate infection. Instruct on and encourage perineal care after each urination and defecation to prevent contamination.

Nursing Interventions

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Acute pain r/t uterine cramping and possible procedures

Nursing Diagnosis

Instruct patient on the cause of pain to decrease anxiety. Instruct and encourage the use of relaxation techniques to augment analgesics. Administer pain medication as needed and as prescribed.

Nursing Interventions

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Nursing Diagnosis deficit r/t signs and symptoms of Knowledge

possible complications

infection (fever, pelvic pain, change in character and amount of vaginal discharge), and advise to report them to provider immediately. Deal with clients anxiety. Present information out of sequence, if necessary, dealing first with material that is most anxiety producing when the anxiety is interfering with the clients learning process. Teach client of the complications for a mother has reason to be especially worried about her 5/3/12 infants health.

Nursing Interventions to observe for signs of Teach the woman

Thank you!!!

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