Abortion is the removal or destruction of an embryo or fetus before birth.

It may be spontaneous or
induced.

Types of Abortion:

1. Spontaneous abortion or miscarriages - is a type of abortion that occur without medical or other
intervention.

About 25% of all pregnancies result in miscarriages, women older than 35 or younger than 17 years old
and couples who have difficulty in achieving pregnancy; and women who have had at least two miscarriages
has a higher chance of experiencing miscarriage. About 90% of miscarriages occur during the first trimester
(first three months, or 12 weeks of pregnancy).

Some cases of miscarriages happen even before a woman realizes that she is pregnant, and she even
may not realize that she has aborted.

Symptoms of Miscarriage:

 A typical 10th week miscarriage is characterized by a very heavy menstrual period. A pregnant
woman may experience several days of bleeding and cramps before the contents of the uterus are
removed, followed by a short period of bleeding until the lining of the uterus heals.
 Miscarriage after the 12th week is like a mild version of the labor of during childbirth, with strong
contractions that dilate the cervix and expel the fetus.
 Miscarriages between the 13th and 24th weeks (second trimester) are most often caused by faulty
attachment of the placenta to the walls of the uterus or from a weak cervix that dilates too soon.

Medical names of the various stages of actual or possible miscarriages:

 Threatened abortion is a condition of pregnancy, occurring before the 20th week of gestation, the
patient usually experiences vaginal bleeding with or without some cramps, and the cervix is closed. Bed
rest is usually the only treatment needed. In a few cases the symptoms disappear and the rest of the
pregnancy is normal.
 Inevitable abortion is when the bleeding continues and becomes heavy, it usually means that the
cervix is dilating and the contents of the uterus are being expelled. Pregnant women will experience
lower abdominal cramping and bleeding.
 Complete abortion is when all the contents are expelled. There is no treatment other than rest is
usually needed. All of the tissues that came out should be saved for examination by a doctor to make
sure that the abortion is complete. The laboratory examination of the saved tissue may determine the
cause of abortion.
 Incomplete abortion is a name given to abortion where the uterus retains part or the entire placenta.
Bleeding may occur because part of the placenta may adhere to the uterine wall and the uterus does not
contract to seal the large blood vessels that feed the placenta. The usual treatment is a drug that induces
labor by stimulating uterine contractions, a surgical procedure called curettage can also be done to
remove the remaining material from the uterus, the goal of this treatment is to prevent prolonged
bleeding or infection.
 Missed abortion - is a case in which an intrauterine pregnancy is present but is no longer developing
normally. Before widespread use of ultrasonography, the term missed abortion was applied to
pregnancies with no uterine growth over a prolonged period of time, typically 6 weeks after its (fetus)
death. A missed abortion is usually indicated by the disappearance of the signs of pregnancy except for
the continued absence of menstrual periods. Missed abortions are usually treated by induction of labor
by dilation (or dilatation) and curettage (D & C).
2. Induced abortion - this type of abortion uses drugs or instruments to stop the normal course of
pregnancy.

Different methods for performing abortions:

 Menstrual Extraction (endometrial or vacuum aspiration).

o This method is used for most abortions performed during the first trimester. It is done by
suctioning out the lining of the uterus (endometrium) through a thin opening of the undilated
cervix. It is a method used after a woman has just missed a period, or anytime up to about the
eight week or pregnancy. It can be performed safely in the doctor's office and has a very low rate
of mortality.
 Dilation and Evacuation (D & E) (also called vacuum suction or suction curettage) and
Dilation and Curettage (D & C).
o This method is commonly used for late first trimester or early second trimester abortions. In
this method suction is used to remove the fetus and placenta. The cervix is first dilated under
local anesthesia using a suction tube that is firm, and a stronger suction is used than in
menstrual extraction. Another way of dilating the cervix is the use of a type of dried seaweed,
called laminaria, which expands as it absorbs moisture. Some doctors use a hollow, spoon-
shaped knife, or curette, to ensure that all the placental tissues are removed by scraping the
uterine walls.
o If curettes are used throughout the procedure instead of suction, the method is called dilation
and curettage (D&C). Before the 12th week of pregnancy, D&E is preferred over D&C because it
does not require general anesthesia, causes less discomfort and is less costly. D&C can be used
up to the 12th week of pregnancy. The mortality rate for both D&E and D&C is approximately 3
per 100,000 abortions.
 Prostaglandin or Saline Administration.
o This method is done by injecting prostaglandins or saline solution through the uterine wall and
into the amniotic sac holding the fetus to induce labor and delivery of a nonviable fetus. This
procedure is commonly used for second trimester abortions. Prostaglandins may cause nausea,
elevated temperatures, and vomiting but are safer than the saline solution. Mortality rate for
second trimester abortions performed by this method is approximately 20 per 100,000
abortions.
 Hysterotomy.
o This method is similar to caesarian section, the uterus is opened through a small abdominal
incision and the fetus is removed. Hysterotomy is usually performed only when other methods
have failed repeatedly, it is performed under general anesthesia. It is used between the 12th and
the 24th week of pregnancy. This method has the greatest risk of complications out of all the
abortion procedures, maternal mortality rate is approximately 200 per 100,000 abortions.