PERSONS UNDER 15 YEARS

MUST BE ACCOMPANIED BY A
PARENT OR ADULT GUARDIAN.

MA 15+

IT CONTAINS HIGHLY
DISTURBING GRAPHICAL
Abortion refers to the
termination of pregnancy
before 28 weeks gestation, and
the fetal weight is less than
1000 gram. The gestation
based on the first day of the
last menses.
• An abortion is the termination
of a pregnancy by the removal or
expulsion of an embryo or fetus
from the uterus, resulting in or
caused by its death

• can occur spontaneously due to

complications during pregnancy
or can be induced
SPONTANEOUS ABORTION
also known as miscarriage
is the expulsion of an embryo or fetus due to
accidental trauma or natural causes before the 20th
week of gestation
premature birth - A pregnancy that ends between 20
and 37 weeks of gestation, if it results in a live-born
infant
stillborn - When a fetus dies in utero after about 20
weeks, or during delivery
Premature births and stillbirths are generally not
considered to be miscarriages
Spontaneous abortion can also be caused by accidental
trauma; intentional trauma or stress to cause
miscarriage is considered induced abortion or feticide.
Two types:
Early abortion - occurs in the first 12 weeks of
pregnancy.
Late abortion - occurs between 12 weeks and 28
weeks.
INDUCED ABORTION
 A pregnancy can be intentionally aborted in many ways.

Reasons for procuring induced abortions are typically

characterized as either therapeutic or elective.
Therapeutic when it is performed to:

 save the life of the pregnant woman;

 preserve the woman's physical or mental health;
 terminate pregnancy that would result in a child born with
a congenital disorder that would be fatal or associated
with significant morbidity; or
 selectively reduce the number of fetuses to lessen health
risks associated with multiple pregnancy.
There are four kinds of common type abortion and
three kinds of special type abortion in clinical
classification.

COMMON SPECIAL
Threatened abortion Missed abortion
Inevitable abortion Reccurent Spontaneous
abortion
Incomplete abortion Septic abortion
Complete abortion
THREATENED ABORTION

• vaginal discharge or vaginal bleeding

• lower abdominal pain
• cervix is close,
• without expulsion of products of conception,
• there is possibility of continuation of pregnancy.
INEVITABLE ABORTION
• vaginal bleeding
• abdominal pains
• with or without rupture of membranes
• cervical dilatation
• uterus corresponds to or less than weeks of
pregnancy
• sometimes amniotic sac can be seen from external
os.
INCOMPLETE ABORTION
• expulsion of part products of conception
• the rest is retained in the uterus which interferes
with myometrial contraction
• bleeding ensues sooner or later,often profuse,
occasionally be massive, producing shock.
 COMPLETE ABORTION
• the products of conception have been expelled
completely
• slight vaginal bleeding
• cessation of pain
• close of cervix
• normal uterine size or slight larger
MISSED ABORTION
• embryo or fetus has died but retained in uterus
• the uterine size has not only ceased to enlarge but
also become smaller
• feels no enlargement of abdomen or fetal
movement in the second trimester
• close of cervix
• size of uterus less than weeks of pregnancy
• fetal heart sounds cannot be heard.
 RECURRENT
SPONTANEOUS
It means three or more consecutive spontaneous
ABORTION
abortions. The time of each abortion occurrence may or
may not be the same.
Reasons
in early stage : psychogenesis factor, pituitary
dysfunction, chromosomal abnormalities, and sperm
defect etc.
in late stage : cervical incompetence, uterine deformity,
leiomyomas, and mother-fetus blood incompatibility, etc.
Septic abortion means abortion
associated with signs of infection.
THREATENED ABORTION
The patient should be kept in bed.
 Progesterone 20mg intramuscularly daily.

 Vitamin E 50-100 mg daily.

 If bleeding slight, pregnancy may continue
to term without any harm to fetus, if bleeding
prolonged abortion will become inevitable.
INEVITABLE ABORTION
 Evacuation of uterus should be done early
as possible after diagnosis.
 In early abortion, do curettage.
 In late abortion, given oxytocin.
 If spontaneous evacuation is not
successful, uterus should be evacuated by
suction curettage.
INCOMPLETE ABORTION
Immediately do curettage after diagnosis.

After curettage give appropriate antibiotics

and transfusion of fluid and blood if

necessary.
COMPLETE ABORTION

Not need specific treatment.

Do curettage earlier if existence of

gestational products was suspected.
MISSED ABORTION
Detect coagulation function.
If evidence of a seriously coagulation defect
exists, give fibrinogen intravenously, and
heparin intravenously, fresh blood
transfusion as well.
Estrogen 5-10 mg 3 times daily for 5 days to
improve the sensitivity of uterine muscle to
oxytocine.
 RECURRENT
SPONTANEOUS
ABORTION
• Find the reason first, do etiologic therapy.
• General therapy: Adequate rest and care.
• Sedative, vitamin and progesterone given.
• Uterine deformity should be operated.
• Prophylactic cervical cercalage should be taked in
cervical incompetence
• Curettage usually delayed until infection is
under control by antibiotics unless severe
bleeding occurs.
• Give antibiotics after operation.
• If severe infection of uterus cannot be
controlled by drug, perform hysterectomy
necessarily.
From the 15th week until approximately the 26th,
D&E is used.

a. Dilation and evacuation D&E consists of opening

the cervix of the uterus and emptying it using surgical
instruments and suction.

b. Dilation and curettage (D&C), the second most

common method of abortion, examination of the
uterine lining for possible malignancy, investigation
of abnormal bleeding, and abortion.
Curettage refers to cleaning the walls of the uterus with a
curette.
Prostaglandin for premature delivery this can be
coupled with injecting the amniotic fluid with caustic
solutions containing saline or urea

After the 16th week of gestation

a. Intact dilation and extraction (IDX) (also called

intrauterine cranial decompression), which requires
surgical decompression of the fetus' head before
evacuation. partial-birth abortion
b. Hysterotomy abortion is a procedure similar to a
caesarean section, and is performed under general
anesthesia because it is considered major abdominal
surgery.
“ The greatest destroyer of
peace is abortion because if
a mother can kill her own
child what is left for me to
kill you and you to kill me?
There is nothing between.”

Mother Teresa
Save the Children of Today …

For a Better Tomorrow.