▪ Abortion is the process of

partial or
Complete separation of the
product
Of conception from the uterine
wall
With or without partial or
complete
Expulsion from the uterine
cavity
Before the age of viability.
▪Abortion is the expulsion or extraction of
an embryo or foetus weighing less than
20-22 weeks when it is not capable of
independent survival.
▪ Uterus is a pear –
shaped organ that plays
an important role in
menstruation , fertility ,
and pregnancy. It is a
hollow and muscular
sits between rectum
and bladder in pelvis.
▪ SIZE :-
Length -7.5 cm
Width – 4.5 cm
Thickness- 3.0 cm

WEIGHT :- a typical adult uterus weight

about 60 gm.

REGIONS:-
The fundus
The corpus
The cervix
The cervical canal
▪ LAYERS:- the uterus has three layers
▪ Endometrium
▪ Myometrium
▪ Perimetrium
▪ It provides a suitable environment for embryo
development and attachment. The secretions
produced by the endometrial glands are important
for maintaining preimplantation embryo.
▪ Uterus stretches for the growth of baby during
pregnancy
▪ It can also contract to help push baby out of vagina.
▪ During menstrual cycle the endometrium grows to a
thick, blood vessels rich glandular tissue layer.
It represents an optimal environment for the
implantation of a blastocyst upon its arrival in the
uterus.
▪ 15% of all confirmed
pregnancies are said to result in
miscarriages the majority of
which happen in the 1st trimester.
1-2 % of spontaneous
miscarriages occur after the 13th
week
▪ FETAL FACTORS
▪ MATERNAL
FACTORS
▪ CHROMOSOMAL
ABNORMALITY
▪ Monosomy
▪ Autosomal trisomy
▪ Gross congenital
malformation
▪ A ) INFECTION
▪ Viral infection :- rubella , hepatitis
▪ Parasitic :- malaria

▪ B) MATERNAL HYPOXIA AND SHOCK

▪ Heart failure
▪ Cholera
▪ Severe gastroenteritis

▪ C) CHRONIC ILLNESS
▪ Hypertension
▪ Chronic nephritis
▪ D )ENDOCRINE FACTORS
▪ Hyperthyroidism
▪ Hypothyroidism
▪ Diabetes mellitus

▪ E) TRAUMA
▪ Direct trauma on abdominal wall by direct blow
▪ Psychic:- emotional upset Or change in
environment
▪ F) Toxic
▪ Alcohol
▪ Tobacco
▪ Caffeine
▪ Excessive exposure
in radiation
▪ It is defined as the involuntary loss of the products of conception prior to 20 weeks
of gestation.
▪ IT HAS TWO TYPES
▪ Isolated abortion
▪ Recurrent abortion
▪ ISOLATED ABORTION:- The abortion that occur one time it may result from
certain viruses- rubella , herpes virus
▪ RECURRENT ABORTION :- it is defined as the occurrence of 3 or more
consecutive spontaneous abortion before 20 weeks.
▪ It is a clinical entity where the process of miscarriage has started but
has not progressed to a state from which recovery is not possible.
▪ CLINICAL FEATURES
▪ Painless vaginal bleeding
▪ Abdominal pain
▪ Mild backache
▪ INVESTIGATIONS
▪ Blood test
▪ Urine test
▪ USG
MEDICAL MANAGEMENT
A) For poor sleep and anxiety
▪ Tab.diazepam
▪ Tab. Calampose
▪ Tab.vallium
▪ B) For good bowel activity
▪ Milk of magnesia
▪ Mild laxative
▪ As there is no foetal malformation , assure the
mother that everything would be fine.
▪ Advise the patient to have bed rest .
▪ Vulvual swabbing should be performed at least
twice a day.
▪ Advise the patient to preserve the vulval pads or
anything expelled out per vaginum for inspection.
▪ It is the clinical type of abortion where the changes have
progressed to a state from where continuation of pregnancy is
impossible.
▪ CLINICAL FEATURES
▪ Increased vaginal bleeding
▪ Severe colicky, lower abdominal pain
▪ No tissue is expelled
▪ Assess and record vital signs, bleeding
and cramping of pain.
▪ Measures and record iv fluids and
laboratory test results in instances of
heavy vaginal bleeding.
▪ Recommend iron supplements and
increased dietary iron as indicated to
help prevent anaemia.
▪ It is the type of abortion where the product of conception is
expelled in masses
▪ CLINICAL FEATURES
▪ Abdominal pain
▪ Uterus is smaller than the period of amenorrhea.
▪ NURSING MANAGEMENT
▪ Observe the condition of mother meticulously.
▪ Note the effect of blood loss
▪ If there is doubt about complete expulsion of the products then
uterine curettage should be done.
▪ Transvaginal sonography is useful to prevent unnecessary
surgical procedure.
▪ It is a condition when the entire products of conception are not
expelled instead a part of it is left inside the uterine cavity.
▪ CLINICAL FEATURES
▪ History of expulsion of a fleshy mass per vaginum.
▪ Sharp pain in lower abdomen.
▪ Uterus smaller than the period of amenorrhea.
▪ NURSING MANAGEMENT
Before giving active management resuscitate the patient.
* for early abortion under GA ( dilatation +evacuation) is done.
▪ It is a condition when foetus is dead and retained
inside the uterus for more than 4 weeks.
▪ CLINICAL FEATURES
▪ Persistence vaginal brownish discharge.
▪ Subsidence of pregnancy symptoms.
▪ Non-audibility of Foetal heart sound.
▪ NURSING MANAGEMENT
▪ Before 12 weeks:- vaginal evacuation is done without
delay.
▪ More than 12 weeks:- 10- 20 units oxytocin in 500 ml of
5% dextrose saline is administered in drip with 30
drops.D&E should be done .
▪ Any abortion associated with clinical evidence of
infection of the uterus and its contents is called
septic abortion.
▪ CAUSES
▪ It is caused by microorganisms :-
▪ Tetanus bacilli
▪ E.coli
▪ Incomplete evacuation
▪ Injury to the genital organs and adjacent structures ,
particularly the gut.
▪ The women looks sick and anxious .
▪ Chills and rigors
▪ Hypothermia
▪ Offensive purulent discharge
▪ INVESTIGATIONS
▪ Swab culture
▪ Urine analysis
▪ Blood test
▪ Plain x-ray
▪ USG
▪ Hospitalization is essential for cases
of septic abortion.
▪ Vaginal examination should be
done.
▪ Evacuation of uterus.
▪ Administer analgesics and
antibiotics.
▪ Formulate the line of treatment to
control sepsis , remove source of
infection.
It is defined as the sequence of two or more spontaneous abortion as
documented by sonography before 20 weeks of gestation.
ETIOLOGY
Genetic factors
Endocrine factors
Inherited thrombophilia
Immunological factors
NURSING MANAGEMENT
Ask to the pregnant women’s action before the spotting or bleeding
occurred and identifies
Inquire the duration and intensity of bleeding or pain felt.
▪ Induce abortion is the intentional medical or
surgical termination of pregnancy for any
reason, before the viability of the foetus is called
induction of abortion.
▪ IT HAS 2 TYPES
▪ Legal abortion
▪ Illegal
▪ LEGAL ABORTION
▪ Termination is performed by the medical
practitioners ( assisted in at least 25 MTP & degree in
OBG) by the act.
Illegal abortion is also known as unsafe abortion it is the
termination of pregnancy by people lacking necessary skills
and minimal medical standard it is a life threatening
procedure
It includes:-
Self induced abortion
Abortion in unhygienic conditions
METHODS
Sharp objects
Toxic chemicals like alum , Lysol
Over the counter drugs obtained illegally that are not indicated
for abortion but known to result in miscarriage or uterine
contractions.