From Medicineworld.org: Spontaneous abortion (miscarriage)
Spontaneous abortion (miscarriage)
What are the causes of abortion?
There are three factors responsible for abortion. They are:
Ovo-fetal factors (60%)
Maternal factors (15%)
What is threatened abortion?
Threatened abortion is a clinical entity where the abortion process has started but has not progressed to a stage from which recovery is impossible.
What are the symptoms in the patient?
The patient who is pregnant complaints of:
What must be done in case of threatened abortion?
The physician usually does a pelvic examination gently. Routing blood investigations like hemoglobin, blood grouping are done. Ultrasound of the abdomen is done to find the status of the fetus. Serum progesterone value of 25ng/ml or more generally indicates that the fetus (baby) is alive.
The mother is advised bed rest for a few days until the bleeding stops. Prolonged restriction has got no therapeutic value. For relief of pain mild analgesics are given and patient can be sedated if necessary. Mild laxative for bowel evacuation can be taken if needed. Enema should not be given. The patient is advised to preserve the vulval pads for inspection, if anything expels out.
What are the precautions to be followed after discharge from the hospital?
The patient should limit her activities for at least two weeks and avoid heavy work, strenuous exercise and excitement. Coitus is contraindicated during this period. She should come for checkup after one month.
What is inevitable abortion?
Inevitable abortion is the one in which the changes have progressed to a state from where continuation of pregnancy is impossible. The patient, who was having features of threatened abortion, develops the following problems:
What to do incase of inevitable abortion?
The patient should be immediately admitted in the hospital to improve the general condition and to accelerate the process of abortion. Strict asepsis is to be maintained to prevent infection. Morphine should be give for pain. Excessive bleeding is controlled by giving methergine. Shock should be corrected by intravenous fluid and blood transfusion.
If pregnancy is less than 12 weeks, dilatation and curettage is effective. If more than 12 weeks, uterine contraction is accelerated by oxytocin drip and fetus is expelled.
Did you know?
Abortion is the termination of pregnancy before the period the fetus reaches a viable stage, which is considered to occur at 28th week. However, for international acceptance, the limit of viability is brought down to either 20th week or fetus weighing 500 grams. The term miscarriage, which is mostly used, is synonymous with abortion.
Medicineworld.org: Spontaneous abortion (miscarriage)
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