Abortion
AbortionDefinition of abortion
Interruption of the pregnancy before the fetus can survive outside the womb.
As restrictions are used less than 22 weeks gestation or fetal weight
less than 500 grams.
Cause of abortion
Large part due to chromosomal abnormalities products of conception. Some
Other causes are trauma, content and tools for abnormalities that are not
known.
Clinical Overview of abortion
- The symptoms of pregnancy (missed period, nausea / vomiting in the morning) that
accompanied by vaginal bleeding (spotting started to gather) and / or
lower abdominal pain, leading to a diagnosis of abortion.
- Abortion Imminens (Threat of Miscarriage)
Marked with a little vaginal bleeding, abdominal pain does not exist or
slightly. There are currently no opening of the cervix
- Insipiens abortion (miscarriage is in progress)
Vaginal bleeding a lot (to be lumpy), abdominal pain
great, there is the opening of the cervix. Sometimes it seems the network results
conception in the ostium of the cervix.
- Inkompletus Abortion (Incomplete Miscarriage)
Many vaginal bleeding, severe abdominal pain sedangsampai. History
out most of the conceptus tissue, cervical ostium can still open
or closing.
- Abortion Kompletus (incomplete miscarriage)
Vaginal bleeding begins to decline - stop, without abdominal pain, ostium
the cervix is closed. Out the history of the conceptus tissue intact, entirely.
- Missed Abortion (Miscarriage is retained)
Abortion with retained products of conception for 2 weeks of intra uterine
or more. History of vaginal bleeding a little, without abdominal pain, ostium
cervix is still closed. Enlargement of the uterus is not appropriate (smaller) than the age
gestation should be.
Diagnosis of abortion
- Late menstruation (amenorhea) less than 22 weeks.
- Vaginal bleeding, possibly accompanied by network products of conception.
- Pain in the upper region simpisis.
- The opening of the ostium of the cervix.
Management of abortion
In the non-care centers:
• Abortion Imminens
- Bed rest at least 2-3 hours (preferably hospitalization)
- Abstaining from sexual intercourse
- After 3 days bed rest, re-evaluation of diagnosis, when abortion was still
imminens bed rest on the move
- Gradual mobilization (sitting - standing - walking) began when believed
no vaginal bleeding 24 hours
• Abortion next level
- If possible to do the stabilization of the general state of the liberation of the road
breath, providing oxygenation (O2 2-4 liters per minute), the installation of a liquid
intravenous crystalloid (lactated Ringer / Ringer Acetate / NaCl 0.9%) in accordance
resuscitation guidelines.
- The patient was referred after vital signs within normal limits to health center
Care or hospital
At the health center care
• Abortion Imminens
- As in the non-care health center
• Abortion Insipiens
- Prophylactic antibiotics: Ampicillin iv before curettage action.
- Need immediate expenditure of the POC and discharge cavity
uteri. Abortion can be performed with forceps, spoon curette, and suction curettage
- Uterotonic: Oxytocin 10 IU i.m
• Abortion Inkompletus
Needs to be done emptying the uterus cavity. Can be done
with abortion forceps, spoon curette, and suction curettage
- Immediately tackle emergencies:
A. Oxygenation 2-4 liters / minute
2. Iv crystalloid fluids (0.9% NaCl, Ringer's lactate, Ringer
Acetate)
3. Transfusion when the hemoglobin is less than '
3d 8 g / dl
• Abortion Kompletus
- Evaluation is there any abortion complications (anemia and infection)
- When encountered complications, treatment adjusted
- If no complications, no need for special management.
• Missed Abortion
- Evaluation of routine hematology (hemoglobin, hematocrit, leukocytes, platelets)
and test of hemostasis (fibrinogen, bleeding time, clotting time).
- If there is hemostasis disorders and hipofibrinogenemia physiology, immediately refer
in a hospital that is able to transfuse platelets / Buffy-Coat and
other blood components.
- The conception needs to be evacuated from the uterine cavity. Implemented after the
certainly there is no interference hemostasis physiology.
Share story
