LOZANO, MICHAEL ANFERNEE
BSN2A2-3
Clinical Manifestations
Vaginal Bleeding that occurs in
the first 20weeks of gestation and
sometimes accompanied by
abdominal cramps, persistent
backache or feeling of pelvic
pressure. In such circumstance
Threatened wherein there is threatened
abortion due to various factors
such as hormonal dysregulation or
vaginal infection, miscarriage
eventually turns into inevitable
abortion.
There are both bleeding and lower
abdominal cramping accompanied
by some degree of cervical
dilatation. Bleeding may range
Inevitable from minimal to severe and even
life threatening. Ruptured
membranes (loss of fluid from the
vagina)
Vaginal bleeding, Uterine
cramping, Cervical dilatation and
incomplete passage of the products
Incomplete of conception. The cramping be
rhythmic or labor-like, although
less intense than a full term labor.
Complete Occurs when all of the uterine
Therapeutic Management
 Avoid strenuous activities
 Complete Bed rest,
 Avoid coitus
 Perineal Pad Counting
 Ultrasound
 Administer RHIg if the
mother is Rh negative(-).
 Pyschosocial Support
 Vacuum Curettage
 Dilation and Curettage
 Confirmation that the baby is
no longer alive, physical and
emotional support is needed.
 Blood typing, Screening and
Crossmatching (For
preparation for BT)
 Fluid replacement and Drug
administration
 Dilation and evacuation
followed by vacuum or
surgical curettage
 IV administration of
oxytocin or IM
administration of
methylgernovine
 Dilation and curettage may
not be performed if the
pregnancy has advanced
beyond 14weeks. In this
case, oxytocin or
prostaglandin is administered
to stimulate uterine
contractions until all
products of conception are
expelled.
 No additional intervention is
LOZANO, MICHAEL ANFERNEE
BSN2A2-3
contents of gestation are expelled,
after which cramping and bleeding
subside, the cervix will comes
back to undilated state, and uterus
will begin to involute. Other
symptoms of pregnancy disappear,
including the negative result on
pregnancy test.
It refers to a fetus that died during
first half of pregnancy but is
retained in the uterus. When the
fetus dies all of the symptoms of
pregnancy will gone. Usually the
Missed Uterus will stop growing and will
decrease in size, reflecting the
absorption of amniotic fluid and
maceration of the fetus.A color red
or brownish vaginal bleeding may
or may not occur.
“Habitual Abortion”
Possible causes: Defective
spermatozoa or ova, Endocrine
factors such as lowered levels of
protein-bound iodine(PBI) ,
Recurrent butanol-extractable iodine (BEI) ,
and globulin-bound iodine (GBI);
poor thyroid function; or luteal
phase defect. Deviation of the
uterus such as septate or
bicornuate uterus.
required unless excessive
bleeding or infection
develops.
 Rest and watch out for
further bleeding, pain, or
fever.
 Emotional support is
generally required.
 Ultrasound examination
 For a first-trimester abortion,
D&C can be done.
 During 2nd trimester when
the fetus is larger, D&E may
be done or vaginal
prostaglandin or misoprostol
to induce uterine
contractions that expel the
fetus. D&C may be needed
to remove the placenta ( Left
untreated beyond
approximately 4weeks will
lead serious maternal
infection rarely,
Disseminated Intravascular
Coagulopathy (DIC) in the
mother, which can be fatal.)
 Culture and antimicrobial
therapy if infection occurs.
 Examination of the
reproductive system
 Genetic screening
 Treatment of the underlying
cause or medical condition of
the mother
LOZANO, MICHAEL ANFERNEE
BSN2A2-3