ABORTION

DEFINITION
It is the termination of
pregnancy before reaching
the age of viability (20th to
24th week of AOG and
weighing at least 500 grams).
The cause is frequently
unknown, but 50% of
cases are due to
chromosomal anomalies.
RISK FACTORS
 Abnormal uterine development or structural defect in
the maternal reproductive system.
 Bacterial microorganisms or virus.
 Age older than 35 (15% miscarriage rate).
 Renal diseases or other chronic and systemic maternal
diseases.
 Poor nutritional status.
 Smoking or drug abuse.
 Trauma or other environmental factors
CLASSIFICATIONS
THREATENED ABORTION
 Vaginal bleeding occurring before 20
weeks of gestation without cervical
dilation and indicating that
spontaneous abortion may occur.
INEVITABLE/IMMINENT ABORTION
 Vaginal bleeding or rupture of the
membranes accompanied by cervical
dilation.

COMPLETE ABORTION
 Expulsion of all products of conception
INCOMPLETE ABORTION
 Expulsion of some products of
conception.

THERAPEUTIC ABORTION
 Termination of pregnancy because the
woman’s life or health is endangered or
the fetus is dead or has malformations
incompatible with life.
MISSED ABORTION
 Undetected death of an embryo or a fetus
that is not expelled and that causes no
bleeding. It is also called blighted ovum,
enembryonic pregnancy or intrauterine
embryonic demise.
INDUCED ABORTION
 Termination of pregnancy with medical or
elective reasons.
SEPTIC ABORTION
 Seriousinfection of the uterine contents
during or shortly before or after an
abortion.
SPONTANEOUS ABORTION
 Non-induced abortion
EARLY ABORTION
 Expulsion of the fetus before 12 weeks of
gestation

LATE ABORTION
 Expulsionof the fetus between 12 and 20
weeks of gestation.
DIAGNOSIS
 Ultrasonic evaluation of the
gestational sac or embryo.
 Visualization of the cervix;
presence of dilation or tissue
evaluated.
MANAGEMENT
THREATENED
 Observation for threatened abortion
 No evidence suggest that bed rest decreases
the risk of subsequent completed abortion
 If the cervix is dilated, avoidance of sexual
intercourse is often recommended to
prevent infection; however, intercourse has
not been shown to cause loss.
MANAGEMENT
INEVITABLE, INCOMPLETE & MISSED
 Suction curettage at less than 12
weeks.
 Dilatation and evacuation 12 to 23
weeks, medical induction (for women
without prior uterine surgery) at more
than 16 to 23 weeks.
MANAGEMENT
If Complete Abortion is suspected,
uterine evacuation is done when
bleeding occurs or other signs
indicate that products of
conception may be retained.
MANAGEMENT
 Maintain fluid volume.
 Report tachycardia, hypotension, diaphoresis
or pallor indication hemorrhage or shock
 Inspect all tissue passed for completeness.
 Establishand maintain an intravenous line
with large-bore catheter for possible
transfusion and large quantities of fluid
replacement.
MANAGEMENT
PREVENT INFECTION!
 Evaluate temperature.
 Checkvaginal drainage for increased amount
and odor which may indicate infection.
 Instruct
on and encourage perineal care after
each urination and defecation to prevent
contamination.
 THE END.
Thank you for listening!